Demystifying Autism Occupational Therapy – Autism Parenting Magazine

Two occupational therapists bust some common myths around occupational therapy and explain how it can benefit children with autism.

What is occupational therapy? If your child with autism was referred to occupational therapy, you might be wondering what exactly they do, or you may have heard some myths about what they do. Occupational therapists can work with people from birth until old age, and in a variety of settings.

This is why it can be difficult to understand exactly what an occupational therapist does. We hope to help you better understand what an occupational therapist can do to support your child with autism.

Myth #1: Occupational Therapy is ONLY for older kids who need help finding a job

False! A pediatric occupational therapist can work with children from birth to young adult. As described by the American Occupational Therapy Association (AOTA, n.d.): “A child’s life is made up of ‘occupations,’ or daily activities. These occupations include playing, learning, and socializing. Occupational therapy practitioners work with children and their families to help them succeed in these activities throughout the day.”

Children on the autism spectrum often work with an occupational therapist for many different reasons, such as:

• feeding difficulty due to food sensitivity
• sensory seeking or avoiding differences that interfere with daily activities
• learning social skills to make or keep friends
• fine motor skills impacting handwriting, crafts, and self-care routines

Myth #2: Occupational therapists in schools only address handwriting

False! It is common for a school-based occupational therapist to focus on handwriting. However, therapists can help with many tasks in a variety of settings while at school. A student with autism has many occupations.

For example, in the classroom, a student might benefit from added practice with scissor skills. At lunch, they may need help feeding themselves. During recess, an occupational therapist can address motor coordination and play skills.

A school-based occupational therapist may work directly with the child individually or in a small group, while also helping to modify and adapt the environment to increase independence.

Occupational therapists may address the needs of an entire class by collaborating with the classroom teacher on a calming sensory area or helping students get the wiggles out with a variety of seating options. School-based occupational therapy services are best provided with a team approach (teacher, support staff, parents) to embed supportive strategies throughout the day.

Myth #3: The best occupational therapists have expensive and fancy equipment

False! Though specialized equipment is sometimes needed, therapy is often best when familiar objects and places are used for children with autism. Occupational therapists value and utilize a child’s unique strengths and interests by:

• Incorporating special items or themes into a therapy session that are motivating often improves a child’s participation
• Addressing goal areas in familiar settings such as a child’s classroom or home can help them feel more comfortable and reduce distractions
• Looking for ways to support therapy goals within everyday routines, to support consistency in a way that makes sense, and will reduce the barrier to generalizing new skills.

Telehealth can be a helpful tool to allow a therapist to provide therapy in a child’s home instead of an artificial, simulated therapy space. For example, work on dressing skills with the child’s own clothing, or ask your occupational therapist at school to address play or social skills during the child’s lunch or recess. Telehealth use can also easily involve the family in therapy activities.

Myth #4: The occupational therapist doesn’t need or want my help when working with my child with autism

False! Parents know their child best and are valuable therapy resources. Collaboration between parents, teachers (when appropriate), and occupational therapists helps with consistency when learning and practicing new skills. Parents should always be informed about the goal areas being addressed, the approach that is being used in therapy, and how a parent can support progress at home.

Communication between occupational therapists at schools and parents tends to be a challenge, since the therapists are not often routinely seen. Don’t hesitate to get a conversation started with your child’s occupational therapist through email or next time you see them. You will both be glad you did!

Myth #5: My child with autism will always need occupational therapy—the more therapy time, the better!

False! The amount and frequency of services depend on the child and their needs. The occupational therapist working with your child should have an open and honest discussion about a plan of therapy for your child.

Whether your child is seen monthly, weekly, or five times a week, the amount of time spent on therapy is only one aspect. Parents should also consider how well your therapy goals, the therapy model of the site, and the therapist working with your child match.

Some therapy providers value short, intensive therapy programs over a couple of months, while others have less therapy time over more months. A therapy site may require parents to be present and participate during all therapy visits, while others allow parents to drop children off and discuss the session’s highlights at the end.

A good therapy relationship is important; an open dialogue about therapy expectations and your child’s preferences will maximize time spent in therapy. A child with autism may also make gains toward family goals by taking a break from therapy to practice skills at home or by engaging in community-based youth activities.