When parents seek out support for their child with autism, sometimes occupational therapy is included in the therapeutic plan. But what is occupational therapy (OT) and how can it help the child with autism?
Any parent who has broken a bone or sprained an ankle has likely experienced physical therapy designed to help restore strength and range of motion for the affected body part. But the goals for occupational therapy are entirely different from those for typical physical therapy, says Shay Michel, MS, OTR/L, Lead Occupational Therapist with Spot On Therapies in Naperville, a division of a.c.e. Therapies.
“The word ‘occupation’ makes people think about a job, but occupational therapy focuses on helping individuals perform activities that are most important to their daily lives,” Michel says. “That might be dressing, brushing teeth or feeding themselves independently.” OT can be helpful for those who have experienced stroke, a traumatic brain injury, epilepsy or a variety of other conditions.
For the child with autism, OT can help build many skills including: self-care skills, play skills, and learning strategies that all children need to master developmentally. Additionally, OT addresses sensory processing difficulties that many children with autism display difficulty with so they can participate in and access their natural environments with greater ease, says Michel.
“These challenges vary from child to child, so we always gather information from the child’s parents through an assessment called a sensory profile. Additionally, clinical observations are gathered from the child exploring and playing in the sensory gym. This allows us as therapists to really break it down and see what areas need to be addressed,” she adds.
OT for sensory processing and more
Some kids with autism seek sensory input through movement to answer their body’s needs — meaning they need to jump or move because their muscles or joints are not registering the amount of force or movement efficiently. “As a result, they seek out extra movement,” Michel explains. “But oftentimes, in the classroom, this may be seen as a behavior issue. They’re just moving and moving, when actually they are experiencing sensory processing difficulties. Their bodies are telling them to seek out movement in order to regulate and calm down.”
To help kids access what their bodies need, OTs engage kids in what they call proprioceptive activities or anything with weight or resistance. Some activities include pushing or pulling heavy items, wheelbarrow walking or weight bearing in a prone position on a therapy ball while playing a game. “These activities help with attention or focus, body awareness and self-regulation,” she says.
Some children with autism may struggle with loud noises, so Michel says an OT can help introduce children to intense or unexpected noises that encourage a startle response, or that fright we have when the jack-in-a-box jumps up.
“We might play a game where the child will never know when the pirate will jump out or the shark will appear,” she explains. OTs work individually with a child to help them become accustomed to random noises they’ll encounter out in the community. Depending on the child and the severity of the auditory sensitivity, OTs may also recommend noise cancelling headphones which will allow the child to participate in community outings.
Highly trained to understand how the body is interconnected, OTs work with children to correct overall physical weaknesses that can negatively affect skills needed for school and future life.
“We help children learn how to hold a pencil the correct way, which can involve hand strengthening, but also strengthening of the shoulder girdle,” Michel says. “Our bodies need to develop those larger gross motor muscles before we can have efficient fine motor skills. We work on core strength and coordination using obstacle courses and balancing activities.”
And, while it may seem that speech and articulation fall into the realm of a Speech Language Therapist, an OT can work with a child to help make speech therapy more effective — and it all relates back to proprioceptive activities.
“If we consider a pyramid of skills which support language at the very top, we understand how everything needs to be in place for communication, and there’s a lot of information to integrate into that communication piece. If we are overstimulated or understimulated, communication skills break down,” Michel explains.
Through vestibular input on a swing followed by proprioceptive input in an obstacle course and ending with tactile activities of playing in a bin of beans, a child with autism can achieve the calm physical state needed to access their language. “After engaging in all of these activities, it’s just amazing that a child will start babbling, even if they don’t have language skills,” she says.
In the therapeutic setting, OTs also work with families to understand what goals parents have for their child and family lifestyle. This might include learning how to hold utensils effectively in order to decrease spills, how to use a toothbrush independently or complete other activities of daily living. Parents are encouraged to engage their children at home to advance their child’s outcome.
“We always provide a home program after we get to know a child. The initial evaluation is often overwhelming for parents because we are focusing on deficits and areas of difficulty. But in the third or fourth week, I invite parents to come in toward the end of a session and learn more about exercises we are working on,” Michel says. Then, she offers families a home program of fun activities and lots of knowledge about the work their child is doing.
“The sensory system is complex and some of the concepts are hard to understand,” she says. “It really just looks like play, like we are helping kids get their energy out, but when we explain what we are doing and the reasons behind it, it can begin to make sense.”
a.c.e. Therapies has convenient locations in Naperville, Palos Heights, Merrionette Park and Lockport. Learn more about ABA therapy, occupational therapy, speech-language therapy and other therapeutic services offered at a.c.e. Therapies. Visit ace-therapies.com.