Occupational Therapy for Autism

Occupational therapy can benefit individuals with autism, both at home and at school. Autism is a complex neurodevelopmental disorder,thought to occur in at least 1% of children.

Autism is diagnosed behaviourally through identification of differences with social impairments, communication impairments combined with rigid, repetitive behaviours, often associated with sensory sensitivities and stereotyped mannerisms (triad of impairments).

Proposed changes to diagnostic classification systems DSM-5 and ICD11 are due to be implemented in 2013. Subgroups of ASD will be removed including Aspergers and Rett syndrome. There will no longer be considered “a triad”; sensory issues will feature more predominantly. The co-existence with other diagnoses will be allowed.

A person who has autism often has trouble communicating and interacting with other people. The person’s interests, activities, and play / independence skills may be very limited. Occupational therapy plays an important part in the identification of an individual’s strengths, skills, impairments and needs that can be used to create a needs based management plan, taking into account the family and educational context.

How do occupational therapists assess individuals with autism?

The therapist observes children to see if they can do tasks they are expected to do at their ages. These might relate to certain self-help skills, such as getting dressed, preparing a snack or school related tasks (fine and gross motor skills). Sometimes, it helps to video a child during the normal course of the day. This will help the occupational therapist better assess what is needed for care. With the recording, the therapist might learn about the individual’s reactions to the environment (identifying sensory hypo and/or hyper sensitivities). For example the occupational therapist might note any of the following:

attention span and stamina
transition to new activities
play skills
need for personal space
responses to touch or other types of stimuli
motor skills such as posture, balance, or manipulation of small objects
aggression or other types of behaviours
interactions between the child and caregivers

How does occupational therapy help a person with autism?

Once information has been gathered, OT can develop a programme for your child / young person. There is no single ideal treatment programme. But early, structured, individualised care has been shown to work best.

Occupational therapy may combine a variety of strategies. These can help your child respond better to his or her environment. These OT strategies include:

 physical activities, to help a child develop coordination and body awareness

 play activities to help with interaction and communication

 developmental activities, such as cleaning teeth and brushing hair

 adaptive strategies, including coping with transitions

What are the benefits of occupational therapy for autism?

The overall goal of occupational therapy is to help the person with autism improve his or her quality of life. This includes life at home and at school. The Occupational Therapist helps introduce, maintain, and improve skills. That way, people with autism can be as independent as possible, to maximise their potential.

Occupational therapy supports individuals with autism to develop the following:

learn how to self-regulate
peer and adult relationships
learn how to focus on tasks
express feelings in more appropriate ways
engage in play with peers

National Institute for Health and Clinical Excellence NICE guidance :

Autism in children and young people: Recognition, referral and diagnosis of Autism. http://guidance.nice.org.uk/CG128

Signs and symptoms tables http://guidance.nice.org.uk/CG128/SignsAndSymptoms

Autism in adults: https://www.nice.org.uk/guidance/cg142/evidence/cg142-autism-in-adults-full-guideline2

Autism in children: The management and support of children and young people on the autism spectrum: http://www.nice.org.uk/guidance/cg170

NHS Evidence website www.evidence.nhs.uk

NHS Evidence is for everyone in health and social care who makes decisions about treatments, interventions or the use of resources. NHS Evidence is a service that enables access to authoritative clinical and non-clinical evidence and best practice. NHS Evidence is designed primarily for professionals and practitioners, patients and the wider public are also able to search most of the content.

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