Occupational Therapy for Children with ASD

The job of the pediatric occupational therapist (OT) is to help children do the work of childhood better. That means helping children play, take care of themselves, and participate in their school program as fully as possible. The occupations or "jobs" of children can be broken down into three areas: play, self-care, and learning/school. The OT will first assess the child to determine his or her developmental level and to determine whether or how the child's issues are getting in the way of "learning" the jobs of childhood.

Occupational Therapy Areas of Intervention

• Play: building, coloring, games, puzzles, exploring, social interaction
• Self Care: dressing, bathing, self-feeding, grooming, toileting, family routines
• Learning/School: handwriting, drawing, cutting, typing, organization, attention/self regulation

Occupational therapy interventions are child-centered and are designed to help the child build on areas of strength and improve skills in areas of weakness. Often a session with an OT looks like a fascinating and elaborate play scheme. The following is a non-exhaustive list of some common intervention areas:

• Fine Motor Skills (development of small muscles needed for fingers to pick up small items, such as Cheerios®)
• Visual Motor Integration (hand eye coordination, such as picking up small pieces of food from the plate and getting it to the mouth)
• Gross Motor Coordination/ Postural stability (walking, standing, running, gross play skills)
• Cognition and perception (thinking and problem solving, such as trying to figure out how to get a toy out of a box)
• Sensory Processing (integrating information coming in from the different senses, such as adjusting your walk from the boardwalk to the sand and into the water on a summer day at the beach)
• Environmental modifications/adaptive equipment/ technology (modifying the environment so a child can "do" the "work," such as sliding a special pencil grip onto the pencil so it can be held securely for writing)

Who implements treatment?

A licensed OT or certified occupational therapy assistant (COTA) supervised by an OT may implement treatment for your child. Occupational Therapists (OTs) have specialized degrees in occupational therapy. Licensed therapists are regulated by the states in which they practice and must pass a national certification examination. Those who qualify are awarded the title of "Occupational Therapist Registered (OTR)."

Where does treatment occur?

Occupational therapy services are provided at home, in the community, at school, and/or in an outpatient therapy clinic setting. Services can also be accessed if the person is an inpatient in a hospital (in an inpatient behavior program or hospitalized for acute medical needs). During the early intervention years (birth to 3 years) most children receive therapy at home or wherever they are during the day (at day care or at grandma's home, for example). As children grow older, therapy will often take place in school or in an outpatient clinic setting.

What does a treatment session look like?

Typically, treatment includes a mixture of table-top and floor-based play activities, as well as self-help activities. For many children on the autism spectrum, treatment may have a sensory component. It is important to remember that treatment can look very different from one child to another depending on the individual's needs and the location of the therapy. In the case of children receiving occupational therapy in school, treatment will focus on helping each child participate in the education program and school-based activities. In an outpatient setting, treatment will be focused on helping the child function at home and in the community.

Recommended Link

• CAR Resource Directory (Search within the Physical Therapy/Occupational Therapy category)

Additional Resources

• American Occupational Therapy Association