Occupational therapists are tertiary educated health professionals who have completed a minimum four year undergraduate degree or two year graduate-entry masters degree. Their training includes knowledge about health conditions and child development. Occupational therapists can assist children to engage in school, play, and self-care occupations and to participate in their life roles with their families at home, school, and in the community. It is important to seek a practitioner who has the skills and expertise to provide assessment and treatment for children with ASD. The OT Australia website provides a list of members who have a special interest in working with children who have developmental disorders such as ASD.
The role of occupational therapists
Occupational therapists (OTs) are child- and family-focused. They assist children to manage the sensory sensitivities, as well as the behavioural and coordination difficulties, that often accompany ASD. OTs also help children to overcome challenges they may have with daily activities. OTs use children’s everyday activities as the focus of intervention and are expert at modifying activities and environments to better suit a child’s needs.
When should a child see an occupational therapist?
Referral to an OT is appropriate if a child has difficulties with play, managing transitions, self-care, or school-work tasks such as concentrating and writing, or has sensory and coordination difficulties.
OTs specialise in enhancing children’s development and skill acquisition and, when necessary, designing support programs that allow children to use their skills and strengths optimally.
What does an assessment involve?
The OT will talk with the parents or carers, the child (if appropriate), and other professionals about a child’s strengths, weaknesses, likes, dislikes, and behaviour. OTs use their knowledge of children’s activities, and their sensorimotor, cognitive, language and social-emotional development as the basis for understanding the challenges a child faces, and the abilities he or she possesses. An OT will use both formal and informal assessments to identify the nature of the child’s difficulties. Occupational therapy assessment may identify problems in one or more of the activities that the child undertakes at home, at school, in the playground, or in the community.
Formal assessment may include use of:
• developmental assessments such as the Bayley Scales, the Batelle Developmental Inventory, the Carolina Curriculum, and the Hawaii Early Learning Profile (HELP);
• motor assessments such as the Peabody Developmental Motor Scales;
• sensory measures such as the Sensory Profile; or
• measures for evaluating performance of everyday activities, such as the Canadian Occupational Performance Measure.
What kind of treatments do occupational therapists provide?
The aim of an occupational therapy session is to improve a child’s ability to perform a wide range of play, self-care, social, and school-related activities to maximise the child’s skills for living. The OT will consider the physical, social, and cultural circumstances of each child before developing a treatment plan that is tailored to the child’s development and needs.
The OT will work collaboratively with the child and parents to identify goals for intervention and develop a plan of action with short-term objectives that they can work on together. As part of this process the OT might provide more structure for, or modify, the activities that the child finds difficult — for instance, dressing, playing with other children, or coping with change. Over time, the OT will also work with the child and family to assist the child to learn new ways of doing things and developing new skills.
Occupational therapy sessions for a young child might involve:
• developing play skills that include social interaction, sharing, and taking turns;
• modelling and support for parents who are learning to interact and play with their child;
• teaching self-care activities like toileting, bathing, and feeding;
• engaging in activities to improve the child’s fine and gross motor skills;
• behaviour management such as learning to sit and wait; and
• strategies and interventions that address sensory difficulties.
For a school-aged child, an occupational therapy session might involve additional activities such as active movement, role-plays, stress reduction techniques, handwriting practice, or participation in a social skills group with other children. As the child gets older, these activities might expand to include organising and managing friendships, interests, and responsibilities.
OTs make use of visual strategies such as visual timetables, social stories, and visual cue-cards. They may teach the child self-management or self-regulation strategies to cope with challenges such as personal organisation, social skills, or sensory sensitivity. For instance, the OT may work with the child and the teacher to modify classroom expectations to allow new ways for a child to demonstrate knowledge despite such things as poor handwriting and difficulties with personal organisation.
In summary, OTs are skilled in a variety of types of intervention:
• promoting and maximising a child’s occupation performance, health, well-being, and participation;
• assisting a child to develop new skills;
• ensuring new skills are maintained and built upon;
• modifying the environment or activity to ensure a child can participate in meaningful ways; and
• implementing steps to prevent the development of behaviours or performance that would diminish a child’s strengths or abilities in the long term.