How Occupational Therapy Helps People with Autism Thrive

Occupational Therapy

Occupational therapy (OT) is a science-driven, evidence-based profession that helps people across their lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). The main goal of OT for autism is to enable children on the spectrum to function at the highest possible level of independence by developing skills needed for daily living.

Autism can affect sensory processing, motor planning and coordination, social interaction, play skills, self-care, and behavioral regulation. An occupational therapist addresses these difficulties through various interventions tailored to the child’s unique needs.

Key areas that an OT program focuses on for a child with autism include:

  • Improving sensory processing – Many autistic children have trouble interpreting sensory information, leading to either hyper- or hypo-sensitivity. An OT helps them better modulate and respond appropriately to different stimuli.
  • Building motor skills – Activities to strengthen fine motor skills (using the small muscles, like for writing) and gross motor skills (using large muscle groups, like for running and jumping) help improve coordination and motor planning.
  • Enhancing social interaction – Working on social communication, emotional regulation, and interpersonal skills allows a child to better connect with peers and teachers.
  • Mastering daily living activities – Learning personal hygiene, dressing, feeding, and household tasks helps a child gain independence with self-care and practical life skills.

OT involves guiding the child through playful activities to systematically develop all these areas. The therapist collaborates closely with family members to ensure consistency across environments. Research shows OT can significantly improve functional abilities and quality of life for autistic individuals.


Sensory Differences

Many people with autism have differences in sensory processing. Their brains interpret stimuli differently than neurotypical individuals. Some common sensory issues seen in autism include:

  • Hypersensitivity – Having an intense reaction to certain stimuli like sounds, textures, tastes, or smells that most people tune out. For example, a child may find the hum of a refrigerator extremely disturbing or be unable to tolerate the feeling of clothing tags.
  • Hyposensitivity – Being under-reactive to stimuli. A child may have a high pain tolerance or seek out intense sensory input. They may enjoy textures like slime or not react to loud noises.
  • Sensory seeking – Actively seeking sensory input through actions like humming, flapping hands, rocking, spinning, or chewing on objects. This provides stimulating input.
  • Sensory avoiding – Actively avoiding sensory stimuli to limit overwhelming input. A child may cover their ears or refuse to touch certain textures.

These sensory differences can make daily activities challenging. A child may struggle to tolerate playground noise, classroom lights, or cafeteria smells. They may have trouble focusing if there is too much sensory input. Or they may seek input in disruptive ways during class.

Occupational therapy helps assess sensory needs and provides accommodations and coping strategies. This improves the child’s ability to function and participate. With support, sensory issues can be managed so the child can enjoy daily life.


Improving Motor Skills

Many children with autism spectrum disorder (ASD) have challenges with motor skills like coordination, balance, and motor planning. Developing these gross and fine motor skills is very important for children with autism, as it allows them to perform daily tasks independently and engage in play and social activities.

Occupational therapists can work with children on improving a variety of motor skills through purposeful movements and activities. Some common interventions include:

  • Working on coordination by having the child perform self-care activities like buttoning, zipping, or tying shoelaces. Activities like catching balls of different sizes or throwing at targets also improve hand-eye coordination.
  • Improving balance through exercises like walking on a balance beam or beam, hopping, or stepping over obstacles. Weighted vests and therapy balls can also help improve core strength and balance.
  • Motor planning skills are targeted through sequencing activities, obstacle courses, or following multi-step directions. Having the child dress in sequence or perform a craft project with multiple steps trains motor planning.
  • Bilateral coordination is developed through playing clapping games, drumming, tearing paper, or other activities requiring the use of both hands together.
  • Developing fine motor skills through arts and crafts projects like coloring, cutting, gluing, molding clay, stringing beads, pouring water, or using tweezers to pick up small objects.

Targeted interventions through occupational therapy can significantly improve motor skills in children with autism. Mastering these skills allows kids to participate actively in school, social situations, self-care, and recreational activities.


Building Social Skills

Children with autism often struggle with social interactions and communication. Some common social challenges include:

  • Difficulty understanding nonverbal cues like gestures, facial expressions, and tone of voice. They may have trouble recognizing emotions in others.
  • Problems with back-and-forth conversation. They may go off-topic, dominate the discussion, or fail to respond when spoken to.
  • Trouble making and maintaining friendships. Their play may seem repetitive or restricted. They tend to prefer solitary activities.

Occupational therapists can help kids with autism build their social skills through various techniques:

  • Functional Communication Training: This involves reinforcing and shaping communication attempts to replace challenging behaviors with more appropriate ones. For example, if a child screams when they want a toy, the therapist may start by praising any sounds or words they make. Over time, the child learns to ask for the toy verbally instead of screaming.
  • Social Skills Groups: Small group settings allow kids to practice social interactions in a safe environment. The therapist provides coaching and models appropriate behavior. Groups build skills like starting conversations, compromising, turn-taking, and handling peer conflict.
  • Social Stories: Custom short stories depicting social situations help children understand unwritten rules. They describe the proper behavior for a specific setting using concrete language and visuals. Kids learn to apply this knowledge when interacting with others.
  • Video Modeling: Watching videos of proper social exchanges and then role-playing the behaviors trains kids to replicate appropriate interaction skills. The therapist gives feedback and praise during the reenactments.

With support from an occupational therapist, children with autism can gain the social and communication abilities needed to cultivate meaningful relationships and succeed in social settings.


Mastering Daily Living Skills

Many children with autism spectrum disorder (ASD) struggle with activities of daily living (ADLs) like getting dressed, bathing, brushing teeth, toileting, and eating.

These self-care tasks require fine motor skills, coordination, and the ability to follow multi-step directions – skills that are often challenging for kids with ASD. Occupational therapists can help children with autism gain independence in daily living. Some strategies include:

  • Visual schedules and checklists: Post-step-by-step pictures that guide a child through each task like handwashing or toothbrushing. Checklists allow them to self-monitor progress.
  • Adaptations: Things, like adapted utensils, plates or cups, or toilet seats, can make eating and bathroom tasks easier. Weighted utensils improve grip.
  • Reward systems: Providing rewards when steps are completed can motivate kids to keep trying. Use their special interests.
  • Hand-over-hand guidance: Physically guiding a child through the steps and gradually fading support teaches the sequence.
  • Video modeling: Watching others complete ADLs teaches children how they’re done. Videos can pause at each step.
  • Social stories: Reading stories about activities like using the bathroom helps kids understand expectations.
  • Consistency and routine: Keeping ADLs in the same environment at consistent times creates habit.

Building independence in self-care allows children with autism to feel accomplished, boosts confidence, and reduces daily frustration. Occupational therapists partner with families to make ADLs easier.


Additional Benefits of Occupational Therapy For Autism

Occupational therapy can provide many additional benefits for children with autism beyond the core treatment areas. Improved sensory processing is a major advantage, as occupational therapists help children regulate responses to various sensory stimuli.

This enables children to function more comfortably in school, social situations, and daily activities. Occupational therapy also promotes increased participation in recreational, social, and self-care activities. As children gain skills and can better manage sensory challenges, they often become more motivated and confident to engage in preferred hobbies and interact with peers. This boosts the overall quality of life.

With support in building cognitive, motor, social, and adaptive skills, children on the spectrum can gain greater independence in childhood roles and activities. They may also transition more smoothly into adolescent and adult roles in the future. Occupational therapy facilitates this lifelong process of gaining skills for participation, independence, and well-being.


Finding an Occupational Therapist

When seeking an occupational therapist to work with your child who has autism, it’s important to find one who has specialized training and experience in this area. Here are some tips on finding a qualified occupational therapist:

  • Look for an OT who is licensed and has credentials such as OTR (Occupational Therapist Registered) or OTD (Doctor of Occupational Therapy). This ensures they have met educational and licensing requirements.
  • Find an OT who has experience working specifically with children on the autism spectrum. Ask about how many children with ASD they have worked with. Experience matters.
  • Inquire about additional certifications or training in areas like sensory integration, the DIR/Floortime model, relationship development intervention (RDI), and applied behavior analysis (ABA). These indicate deeper knowledge.
  • Ask the OT about their therapeutic approach. Look for one who incorporates sensory and play-based strategies tailored to your child’s needs. Avoid overly rigid or one-size-fits-all approaches.
  • Schedule a meet and greet to get a feel for the OT’s demeanor and see if they seem to connect well with your child. Ensuring a good match is crucial.
  • Be sure to check reviews from other parents of children with ASD. Their experiences can reveal a lot about an OT’s competence and family focus.
  • Trust your instincts. You know your child best. Seek an OT who wants to understand your child, not just apply standard techniques. Finding the right fit will empower your child’s progress.

With the right occupational therapist who has the proper credentials, training, and experience with autism, you can feel confident your child will receive therapeutic support that caters to their unique needs.


What to Expect in Therapy

Occupational therapy for autism is a highly individualized treatment approach, so the specific interventions will vary based on each child’s needs. However, there are some common elements to expect when starting occupational therapy:

Evaluation Process

  • The occupational therapist will conduct a comprehensive evaluation, observing the child in various environments and assessing their sensory processing, motor skills, cognition, behavior, self-care abilities, and more.
  • Standardized tests may be used to identify strengths, challenges, and appropriate treatment goals. Interviews with parents and teachers also provide key insights.
  • The evaluation results help guide the creation of an individualized treatment plan tailored to the child’s unique needs.

Individualized Treatment Plans

  • The occupational therapist develops a customized treatment plan outlining specific goals based on the evaluation findings. Goals often relate to improving sensory processing, motor skills, social participation, play skills, self-regulation, and daily living skills.
  • The plan specifies therapeutic interventions and activities to target each goal, as well as the frequency/duration of treatment sessions. Plans are updated continually based on the child’s progress.

Common Interventions and Activities

  • Sensory integration activities like swings, trampolines, or tactile bins help modulate sensory input.
  • Fine motor tasks like cutting, tracing, and manipulating small objects to build coordination.
  • Gross motor exercises to improve balance, strength, and body awareness.
  • Social skills training to build abilities like eye contact, turn-taking, imitation, and reading social cues.
  • Cognitive exercises to work on sequencing, planning, and problem-solving.
  • Simulated tasks to practice real-world skills like getting dressed, brushing teeth, or feeding oneself.
  • Parent/teacher education on therapeutic strategies to foster generalization of skills.

The specific activities are tailored to each child’s unique challenges and goals to help them gain skills for participation in all areas of life. The occupational therapist will monitor progress continually and update the treatment approach accordingly.



Occupational therapy can provide significant benefits for autistic children and adults by addressing some of the core challenges of ASD. By helping autistic individuals process sensory information, improve motor skills, build social skills, and master daily tasks, occupational therapy facilitates greater independence and quality of life. While occupational therapy alone is not sufficient as a comprehensive treatment plan for autism, when combined with other evidence-based interventions like behavioral therapy, speech therapy, and social skills training, it can maximize progress.

The customized sensory diets and tailored skill-building activities employed in occupational therapy complement these other therapeutic approaches. Together, these interventions can help autistic people develop to their full potential, participating meaningfully in school, employment, relationships, and community. The sensory regulation, motor coordination, social aptitude, and practical life skills gained through occupational therapy empower autistics to live richer, more engaged lives.

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