Many children with autism can benefit from occupational therapy. Occupational therapy (commonly referred to as “OT”) is comprised of exercises designed to help develop fine motor skills and improve life skills such as feeding and dressing. An occupational therapist will also help your child develop social skills, learn adaptive behaviors that will help him adjust to changes in routine and environment, and react more positively to sensory stimuli. The ultimate goal of occupational therapy is to allow your child the highest quality of life possible. OT offers a chance for the autistic child to be as independent as possible, and to live more fully in the world.
Fine Motor Skills
Fine motor delays are common in children with autism. While your child may be able to hold a pencil and write, or feed himself with utensils, the results may be sloppy, and the process frustrating for your child. Accomplishing milestones like being able to tie his own shoes can be a huge confidence boost for your child, and this in turn will help foster social skills. An occupational therapist is trained to help develop these skills. Through practice in a quiet, controlled environment with plenty of positive reinforcement, fine motor skills can be improved. How can I help at home? Provide plenty of age-appropriate toys that will encourage fine motor development. Legos and blocks are wonderful tools, as are Wikki-stix. These brightly-colored wax-coated strands of yarn can be used to form letters and numbers, make pictures, or simply be manipulated, twisted and pressed together, so that those little finger muscles get a good workout. Colorforms and felt-boards are great for developing pincer grasp (using thumb and forefinger to pick up small objects) and have the added social benefit of allowing the child to create scenes in which people interact with the world. Give your child (toddler or older, with no feeding issues that may cause him to choke) dry ring-shaped cereal or other small foods to help develop that tough pincer grasp skill.
Fine motor delays can obviously impact your child’s ability to care for himself, so these two skills go hand-in-hand. An occupational therapist will allow your child opportunities to practice skills such as dressing, feeding, and hygiene such as tooth-brushing. Some of these skills can be impacted by sensory difficulties, and we’ll address that a little more in a moment. Life skills therapy is much the same as the fine motor skills work, but there are a few specific things that you can do to help further your child’s success. At home: Dolls are wonderful tools, for boys and girls alike. No, playing with a doll won’t cause your little man to become “girly”; it may in fact save him the embarrassment of having to get help buttoning his pants long after the other kids in his class have learned to do so. There are soft dolls dressed in clothing with buttons, snaps, zippers and laces, that can allow your child to practice his emerging skills. Playing dress-up also offers opportunities for the child to exercise his fine motor/self-care skills, while encouraging imaginative play. Give your child a spoon and allow him to practice his grip while he “feeds” the doll. By the way, autistic kids often have very focused interests, so I use the term “doll” loosely here. It can be an action figure, a stuffed animal, or a potato with fabric laced up around it and a face painted on; the goal is to keep your child focused and engaged while he practices his new skills.
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Simply visiting an occupational therapist will help develop your child’s social skills; it provides interaction, and that is crucial to this development. During therapy, they may work on conversational skills and recognizing non-verbal cues such as body language or facial expressions. The therapist may show your child pictures of different faces and help her recognize the emotions conveyed in the faces. She may encourage your child to work side-by-side with another child, and gradually increase the time they spend together. At home: Practice the same things with your child that the therapist does. Cut out pictures from magazines that show people being happy, sad, angry, etc. Ask your child to identify the emotion in one of the pictures, and then talk about a time you felt that way. Encourage her to think of a time that she felt that way, and draw a picture of it. Practice sharing, taking turns, and listening quietly. Talk to your child about times you feel empathy or sympathy.
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A trademark of autism is difficulty in transitions. Most children have some difficulty during major transitions, such as having a new sibling, moving to a new house, or starting a new school. But autistic kids can find even the most minor transitions challenging. Children with autism can be very focused (a trait envied by many adults!) and it can be heartbreaking and traumatic to have to switch to a new activity. They also find great comfort in things being the same all the time, and this can make transitions terrifying for these children. An occupational therapist can help by creating transitive situations within the controlled environment of the therapy room, and walking your child through them. The therapist can make minor changes to their routine on a regular basis, allowing the child to conquer these small transitions and feel more confident in facing others. At home: Realistically, there is no way to schedule every minute of your child’s life, and even if you could, it wouldn’t be helpful to him, and might cost you your sanity in the end. However, you can let your child know of any planned changes in his routine by keeping a calendar for him. A dry-erase board works very well; it allows you to replace one activity with another rather than just marking one out, so visibly, the first activity no longer exists. It’s not a matter of “out of sight, out of mind” but a visible reinforcement, a reminder that the new activity is the one and only option. Talk to your child about any changes in routine well in advance, if possible. Allow him to bring a favorite object from home, if appropriate. If there are calming techniques that work with your child (we’ll address those in the next paragraph), be prepared to use those.
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Sensory defensiveness is a common trait of children with autism. Simply put, this means that their brains scramble signals they get from the outside world and cause them to react differently than one would expect. Autistic kids are often especially sensitive to sound and textures. An occupational therapist will employ proven techniques such as brushing to increase tolerance to disturbing sensory input. At home: Your child’s occupational therapist can teach you how to do the calming measures like brushing, and you can use these when your child gets overwhelmed by sensory stimuli. Be sensitive to her needs; these children aren’t trying to be difficult. Something that is only mildly uncomfortable to most people may be agonizing to a child with sensory defensiveness, and forcing her to tolerate such things at length can hinder her emotional growth.
Note: Some of these home suggestions are based on your child being somewhat verbal. Not all children with autism speak, and occupational therapists will work with parents to develop ways to best guide children at home. Even if your child does not respond verbally, don’t assume he isn’t listening. Continue to talk to him and lead by example.
References: www.autismspeaks.org | www.autism-pdd.net | www.autism.ca
Occupational Therapy and the Treatment of Autism ~ by: April Fox
Published: April 2010 © Carolina Pediatric Therapy