Occupational therapy for children with autism

Within the past decade, the number of children diagnosed with autism has risen steadily. In its most recent survey, conducted in 2016, the Centers for Disease Control and Prevention (CDC) estimated that one in 68 children in the United States have been diagnosed with an autism spectrum disorder (ASD).

This increase in diagnoses has resulted in an increase in awareness, too. A new crop of books and blogs are helping pediatricians, therapists and teachers educate parents about the early signs of autism, and support groups for children and families with autism are available in many communities.

And yet, despite all these efforts, the CDC’s findings also show that few children who are eventually diagnosed with autism are not receiving a diagnosis as early as they should be. In their 2016 survey, the CDC found that less than half of children on the autism spectrum receive a developmental evaluation by age three.

“Despite the best efforts of parents or caregivers, it’s not always easy to recognize autism. The signs of autism can vary so widely, which is one of the reasons why many children aren’t diagnosed until they’re two or three years old,” says Talia Theriault, pediatric and NICU occupational therapist for Bryn Mawr Rehab, part of Main Line Health.

Below, Theriault offers some advice for parents and caregivers on recognizing autism, seeking an evaluation for your child and how occupational therapy can help them overcome difficulties at home and in school.

Recognizing autism

“’There is a saying that if you’ve met one child with autism, then you’ve met one child with autism. That phrase is such an accurate representation of autism and the many forms that it comes in. Every child with autism is different,” says Theriault.

This is true for the signs of autism, too. While children may show varying signs or degrees of autism, some of the most commonly reported ‘red flags’ include:

• A lack of eye contact
• Language delays (speech, babbling or social skills)
• Self-stimulatory behaviors (repetitive movements or sounds)
  • i.e., waving fingers in front of the face or spinning the wheels of a car
• Verbal repetition
  • Verbal pattern ‘dic-a-dic-a-dic-a-dic-a’ or other phrase
• Impulsive or inappropriate behavior with peers or classmates

While some parents may recognize these signs in a young child, Theriault says it can take a few years to realize that a child may be exhibiting these behaviors.

“Sometimes, a child isn’t struggling at first. But when their skill level jumps and they graduate to the next grade or turn a year older, they start to fall further behind. That’s when parents and teachers begin to take notice,” she explains.

If you notice your child is exhibiting symptoms like the ones listed above, or that they’re beginning to struggle in school or at home, what can you do?

First, talk to your pediatrician, who can offer a preliminary physical assessment and—if necessary—a prescription for occupational therapy. While the signs described above could be signs of autism, Theriault reminds parents that they could also be a delay in motor or language skills. An occupational therapy evaluation will determine the cause.

“An evaluation with an occupational therapist will observe how a child functions at home and at school, as well as their language and their fine and gross motor skills,” she says. “Based on these, we can make the appropriate diagnosis and set therapy goals.”

Therapy goals for children with autism

While occupational therapy for adults is often focused on helping patients recover from an injury or surgery, Theriault says the goal of occupational therapy for children with autism is to teach children how to function and maintain the skills they need to be successful at home and school, as well as within their community.

And, for each child, these skills will vary. During a preliminary occupational therapy session, therapists work with children and parents to define a set of short-term and long-term goals based on each child’s needs.

“As each goal is met, it’s modified. If a child is struggling with handwriting, for example, a short-term goal may have been to learn upper-case letters. Once they do, we may modify to have them now learn lower-case letters, too,” says Theriault.

In addition to handwriting, occupational therapists work with children on a variety of other skills, including fine motor skills, feeding skills and sensory skills. Speech therapists are often brought in to help children who may be struggling with their social skills, or who may need further help developing their expressive or receptive language and understanding their vocabulary.

Another key focus for occupational therapists is helping children with autism better regulate themselves during transitions, which can often trigger emotional moments.

“Transitional moments, like moving from dinner time to bath time or lunch time to the classroom, can be difficult for some children. During therapy, we offer techniques to make these transitions easier and other daily habits, too, like combing their hair or brushing their teeth.”

While every child’s needs during occupational therapy will differ, Theriault recommends that parents who suspect that their child may be exhibiting signs of autism talk to their pediatrician about their concerns.

“The earlier children begin individualized therapy, the more they can benefit. Regardless of whether a child is diagnosed with autism or has a developmental delay, our goal is to give children the tools and the information they need to function the best way that they can.”