OT Finds Strength in Serving Individuals with Autism

Individuals with Autism have a myriad of strengths. They frequently attend to details that others miss, have excellent memory skills, think linearly and logically, communicate honestly, and are experts on preferred subjects. Occupational therapists, as strength-based practitioners, harness and enhance an individual’s abilities in order to remove barriers to participation in life’s occupations.

Occupational therapists focus on an individual’s participation in:

• Activities of daily living (dressing, bathing, grooming, feeding)
• Instrumental activities of daily living (independent life skills)
• Play and leisure
• Education
• Social Participation
• Sleep
• Work

Whereas OTs utilize occupations (see above list) as their main therapeutic tool to promote skill development within occupations, they are experts in analyzing and targeting the small task components that contribute to participation, success, accuracy, and independence. For individuals with Autism, or other neurodiverse populations, occupational therapists address a huge variety of task components.

• Motor skills: Because neurodiverse individuals frequently communicate and learn differently than same-aged peers, motor skill development may be delayed. Occupational therapists support motor skill acquisition (fine motor, visual motor, and gross motor) through analyzing a person’s strengths and areas of need, such as strength, coordination, dexterity, and dominance, and providing therapeutic activities that strengthen the areas of need.

• Strength: An OT’s understanding of human anatomy and kinesiology allows them to evaluate and provide strengthening intervention. Individuals with Autism and other neurodevelopmental disorders frequently require focused core strengthening to develop a strong base of support for participation in activities that require use of their arms and legs.

• Balance and coordination: Individuals with Autism are noted to have more difficulty with motor coordination tasks, tasks that require skilled movements from both sides of the body. This deficit is likely due to differences in brain connectivity and communication between hemispheres. Occupational therapists work to develop hand dominance, midline crossing, and bilateral coordination for improved participation in life’s occupations.

• Motor planning: Every action requires motor planning. You have an idea for a movement, decide how to accomplish it, execute it, and then receive the feedback so that you can execute it differently next time, if need be. By focusing on an individual’s strengths and areas of interests, occupational therapists address motor planning in an individualistic manner. We do not expect perfect cookie cutter repetition of a task but teach individuals how to create, execute, and adjust their plan so that a task can be completed as independently as possible, in the best way for that individual.

• Sensory processing: Sensory processing challenges are so common for individuals with Autism that it is now included as a diagnostic criteria in the DSM-5 (2013). Under-responsivity or over-responsivity to certain sensory inputs means that a person may be less aware, or more bothered by sensory inputs than a neuro-typical individual. For individuals with Autism, this may look like high or low energy levels, hyper-focused fixation on certain movements or objects, and adverse reactions to specific sounds or textures. Some children may have difficulty tolerating certain clothing textures, sounds, or even movements such as swinging or laying back in the tub. Occupational therapy addresses sensory processing abilities in multiple ways to allow a person to better participate in their occupations, independently or with lower levels of stress. Occupational therapists provide Sensory Integration therapy, to improve the brain’s ability to receive, filter, and respond to sensory input as well as a variety of strategies and life accommodations to better cope with sensory processing differences.

• Executive function skills: Executive function skills are cognitive skills that we use constantly- planning, attention, working memory, sequencing, inhibition, problem solving, reasoning, and flexibility. Use of these skills is crucial for safety and independence in daily living activities. These skills are also important with play and social interactions. Occupational therapists address executive function abilities within play by teaching sharing, turn taking, play flexibility, and other skills for peer interaction. Individuals with Autism may have strengths in some areas of executive function and need support in others. Occupational therapists analyze an individual’s abilities and offer activities that can directly support growth of executive functioning skills.

Occupational therapists create learning opportunities based on an individual’s interests, motivators, and strengths in order to promote skill acquisition for improved performance, success, independence, and quality of life across a variety of life’s occupations. Whereas OTs use a variety of treatment frameworks to address an individual’s needs, they frequently use the challenging occupation itself. OTs address skill development or compensation in the small task components that are making the overall task challenging.

Blog authored by Carey Bradley, OTR/L, OTD, CORA Daleville Pediatrics