Occupational therapy is a type of treatment intervention aimed at improving the lives of people who are recovering from an injury or illness, or who live with a disability, such as autism. Interventions are designed to meet the needs of people of all ages.
A common application of occupational therapy is for the treatment of autism. It is routinely incorporated into the treatment plan of children and adults with autism to build cognitive, physical, social, and motor skills.
People with autism frequently struggle with sensory processing issues. They can become overwhelmed by environmental stimuli and not have the skills necessary to filter out what is not important.
Through occupational therapy activities, students learn to manage sensory input better and navigate everyday situations with less stress and anxiety.
What Is Occupational Therapy?
Occupational therapy (OT) helps people in all stages of life accomplish things that they want and need to do in order get through the day. Through the therapeutic use of daily activities, or occupations, OT promotes health and enables people to live better with injury, illness, or disability.
Occupational therapy also helps children with disabilities to participate more fully in school and social situations.
A typical occupational therapy program includes:
- An initial evaluation where the client, their family, and the OT therapist identify the client’s goals.
- A customized intervention plan to address the client’s needs and improve their ability to complete daily activities and reach their goals.
- Ongoing evaluations to make sure the interventions are effective and goals are being achieved. Changes are made to the treatment plan, as needed.
OT is an evidenced-based practice that takes a holistic approach to treatment. The focus of the therapy is to adapt the individual’s environment to work better for them. OT services include evaluating the client’s home, work, or school setting and making recommendations for how to make these settings more accessible to the individual.
Occupational therapists provide training for how to use adaptive tools, such as equipment and activities, as well as education for family and caregivers on how to best assist the individual in need. These skills are addressed through OT:
Through its focus on improving the above skills, occupational therapy helps individuals lead more independent and full lives. This therapy is appropriate for people from all demographics who need specific interventions to help them access their daily lives more completely.
Occupational Therapy & Autism
Occupational therapy is a common intervention for children with autism due to the high rates of sensory processing issues. Approximately 60% to 70% of children with ASD also have some form of sensory processing disorder.
Both autistic children and adults often struggle to integrate the information that comes in through their senses, which makes them take longer to process information. Children with autism can become overwhelmed by the amount of sensory information they take in, not knowing what information is irrelevant.
As a result of this overload, autistic children may exhibit meltdowns or challenging behavior. They may withdraw or completely shut down. Through the use of occupational therapy activities, autistic students learn how to better filter out unnecessary input. Specific interventions are used to target each sensory system.
With time and practice, the child’s nervous system becomes more organized or regulated. As the nervous system becomes more regulated, the child’s performance at daily tasks improves.
Occupational therapists are master’s level therapists who have passed a national certification exam . They are formally educated and trained in the evaluation of a person’s current skill level, identifying their goals and creating a treatment plan to best achieve those goals. After passing the national certification exam, occupational therapists must apply for state licensure.
Occupational therapists work with autistic students, as well as their parents, siblings, and teachers. They observe the student and gather information through parent and teacher interviews. Once enough data has been collected about the child’s relationships, eating, self-care, and daily living skills, the therapist works with families to set goals and create an intervention plan .
The role of the occupational therapist includes:
- Providing direct services.
- Conducting OT evaluations.
- Consulting and collaborating with others in the client’s life, including other treatment team members.
- Making recommendations for additional evaluations and services.
- Advocating for modifications and accommodations.
By fulfilling the above tasks, occupational therapists support community inclusion of individuals with autism.
Through OT evaluations, occupational therapists are often involved in the early detection of autism as well. When an early diagnosis is made, occupational therapists have the opportunity to make recommendations that will support positive development and outcomes. Autism research continually shows that early intervention results in more successful treatment outcomes . Occupational therapists perform the above services in a variety of settings that include:
- State early intervention programs.
- Schools and afterschool programs.
- Private practice.
- Behavioral health programs.
- Vocational programs.
- Day programs.
How Occupational Therapy Sessions Work
An OT session is typically 30 to 60 minutes. Sessions are scheduled regularly, though the number of sessions per week will depend on the needs and goals of the individual. During a session, the therapist works one on one with the client to perform specific tasks designed to develop the previously identified goals.
An occupational therapist will encourage the practice of skills outside of the therapy session as well. The goal of OT is to be able to translate learned skills across a variety of settings the individual encounters in everyday life.
Parents and caregivers can receive OT consultation to learn how to implement appropriate interventions at home. This level of family participation is important as repetition helps to solidify these skills.
Sample OT Interventions
Occupational therapists are equipped with a large toolkit of interventions. When working with children, activities must be creative in order to keep kids interested and engaged while addressing their underlying conditions. For children with autism or sensory processing issues, example OT interventions that can be very helpful include:
- Sensory bins. Make a sensory bin that is full of common household items of varying shapes and textures. Exploring the bin develops visual perception, language, and fine motor skills.
- Swings. Using a platform or similar type of swing, have the child lie on their stomach and toss balls or bean bags into containers you have placed around as they swing. Body awareness, visual perception skills, coordination, and muscle strength are promoted through this type of activity.
- Video clips. Select video clips from the student’s favorite cartoon that demonstrate certain social skills. After watching the clip, you can discuss what the characters were doing, how they felt, and what they may have been thinking. This activity promotes perspective taking (the ability to see the perspective of others) and an understanding of social skills.
- Playdough. Make playdough with your child or student. By working through the process together, the child practices following directions, exploring new textures, and regulating emotions, such as frustration.
- Straw races. For children with oral motor challenges, this activity is a great oral exercise. Fill a large container with water, give each person a straw and an empty paper cup, and race to see who can blow their cup across the water the fastest. If competition is not appropriate for the child, the activity can be done without making it a race. Vision and coordination skills are also addressed.
- Simon Says. This classic game can be used to address a range of skills. Lead the game and have your child practice motions that encourage body awareness, coordination, creativity, and social skills. When they are ready, the child can take a turn leading the game to encourage perspective taking.
- Making a person. With a selection of art supplies, work with your child to make a person. The child gets to select what the person looks like. Additionally, you can have a conversation about what the person is feeling. This activity promotes body awareness, orientation, vision skills, fine motor skills, and discussion of emotions.
The Effectiveness of Occupational Therapy
Occupational therapy is highly effective at developing sensory-integration skills and interventions to improve quality of life for children and adults with autism. Studies have found that an array of OT interventions are effective for promoting positive outcomes in students with autism.
OT benefits a variety of areas of life, and various interventions can be used, including:
- Sensory-integration and sensory-based interventions.
- Relationship-based and interactive interventions.
- Developmental skill-based interventions.
- Social-cognitive skill training interventions.
- Parent-directed or parent-mediated interventions.
- Intensive behavioral interventions.
Through a review of occupational therapy studies and interventions, researchers identified that OT is well aligned with the principles of ASD intervention. OT interventions have a history and demonstrated effectiveness of improving symptoms of ASD.
Research supports the use of comprehensive individualized assessments of the individual’s current performance in order to develop effective intervention strategies. Likewise, family-centered, interdisciplinary approaches that include play and are activity-based are highly effective.
Costs of Occupational Therapy
OT can be an expensive out-of-pocket service, but there are a few ways to get the costs covered for you or your child. Autism Speaks explains three different ways that the costs of occupational therapy services for autistic children are frequently covered. Depending on your situation, the costs of OT can be covered by:
- Insurance. OT is usually a service that is covered by health insurance. Depending on your insurance provider, you may need a doctor to say it is medically necessary in order to get the therapy sessions covered. Contact your provider directly to confirm the specifics of your plan.
- An individualized education program (IEP). If your child has an IEP at school and occupational therapy services are written into the IEP, the costs of the services will be covered by the school.
- An early intervention program. If your child is under the age of 3 and receives OT as part of their early intervention services through the state, the cost of OT will be greatly reduced or free, depending on your family’s income level.
How Occupational Therapy Can Help Autism
Occupational therapy is a valuable tool for helping children and adults with autism perform better at home, work, and school. Social and behavioral skills are developed through targeted OT interventions. Ultimately, occupational therapy helps to provide a foundation for people with autism to develop their skills.
People of all ages across the autism spectrum can benefit from OT services. Occupational therapy can improve overall well-being for people with autism by equipping them with the skills needed to live more independent and meaningful lives.
Most often, occupational therapy is given as part of a comprehensive treatment plan to address autism. Applied behavior analysis therapy and speech therapy are also commonly included in autism treatment plans. While autism spectrum disorder can’t be cured, symptoms can be reduced substantially, allowing individuals to live balanced, successful lives.
- Certification Eligibility Requirements. National Board for Certification in Occupational Therapy.
- Evidenced-Based Review of Interventions for Autism Used in or of Relevance to Occupational Therapy . (April 2020). American Journal of Occupational Therapy.
- Occupational Therapy. Autism Speaks.
- Early Intervention for Toddlers With Autism Highly Effective, Study Finds . (November 2009). Autism Speaks.
- Occupational Therapy’s Role With Autism. American Occupational Therapy Association.
- 6 At-Home Occupational Therapy Techniques That Really Make a Difference . (February 2020). ADDitute Magazine.
- Supporting Parents of Children With Autism: The Role of Occupational Therapy. American Occupational Therapy Association.
- What Is Occupational Therapy? American Occupational Therapy Association.
- Why Is Occupational Therapy Important for Autistic Children? (June 2018). National Autistic Society UK.
- Speech Therapy. Autism Speaks.
- Occupational Therapy and Sensory Integration for Children With Autism: A Feasibility, Safety, Acceptability and Fidelity Study. (May 2012). Thomas Jefferson University.
- Evidence-Based Review of Interventions for Autism Used in or of Relevance to Occupational Therapy. (July/August 2008). American Journal of Occupational Therapy.
- Community-Based Screening and Referrals for Autism. (May 2019). Journal of Occupational Therapy, Schools & Early Intervention.