Why Would (Some) Autistic People Need Occupational Therapy?

Why might someone on the autism spectrum benefit from occupational therapy — and how? Before we can look at that, we'll first have to take a look at what occupational therapy actually is and what kinds of things occupational therapists can do for people. 

What is occupational therapy, and who can benefit from it?

The American Occupational Therapy Association describes occupational therapy as a discipline that helps "people of all ages to live life to its fullest by helping them promote health, and prevent — or live better with — injury, illness, or disability". Its statement that "adapting the environment or task to fit the person" is a prime focus suggests that occupational therapy looks at people's limitations through a "social model of disability" lens.

Some of the goals of occupational therapy can include:

• Evaluating a person's needs, together with them and by looking at their environment. 
• Helping a person improve their ability and competence to do the things they need and want to do, through tailored interventions. 
• Continuing to assess whether interventions already put in place or being worked on are actually helpful, and what could still be improved. 

The very broad range of people who may benefit from occupational therapy include those who have suffered a stroke, burn victims, people with arthritis, those who have sustained a serious fracture, amputees, and people with sensory processing difficulties and neurodevelopmental conditions. 

How might occupational therapy benefit someone on the autism spectrum?

Autism spectrum disorder is, as you know, primarily defined by differences in two major domains.

The first is social communication and interaction. That may mean, for instance, that an autistic person struggles to understand the social chit-chat that is so important to neurotypical people, has lower social motivation, struggles to grasp unwritten social rules, and has a quite clearly different communication style. 

The second is, as the diagnostic and statistical manual of mental disorders (DSM-5) says, "restricted, repetitive patterns of behavior". This would include being really interested in, well, the things an autistic person finds interesting, often to the exclusion of much else, depending on routines to function well and finding it hard to cope with change, and also sensory processing differences. An autistic person may be really sensitive to sounds or lights, for instance, but under-sensitive to pain. This portion fo the diagnostic criteria also covers stimming or repetitive behaviors that help autistic people cope with intense experiences. 

That is part of the reason why both children and adults on the autism spectrum may benefit from physical therapy. While physical therapy focuses on helping a person improve their physical condition and capabilities (such as strength, gait, physical fitness, motor coordination, and so on), occupational therapy has a slightly different angle. It's there to help people be as functional and independent as possible — to enable them to do the things they need and want to. 

Occupational therapists can, among other things:

• Foster independent living skills by helping people become more competent at daily tasks. 
• Help reduce sensory overload in autistic people by altering the environment and teaching coping strategies. 
• Help with diet, which is also, for many autistic people, fraught with sensory challenges. 
• Help improve motor skills.
• Putting visual supports in place. 
• Also, the American Occupational Therapy Association says, play a role in very varied domains related to social skills, from participating in recreational activities to mental coping strategies, social skills therapy that includes cognitive-behavioral approaches, and self-advocacy skills. Occupational therapists may also help an autistic person get ready for the workplace by helping them refine work-related skills. 

Occupational therapists will frequently found in early intervention programs, preschools, schools, vocational programs, and private clinics. Their approaches vary widely and can even include animal-based therapy. 

What else do you need to know about occupational therapy for autistic people?

Some of the "treatments" autistic people have and continue to be subjected to are, without a doubt, dehumanizing, soul-destroying, and even traumatizing to the point of post-traumatic stress disorder. While many people are certainly big fans of Applied Behavior Analysis (ABA) for instance, it is based on the (quite obviously insidious, yes?) idea that people with neurological differences need to "earn" their human dignity.

Research has deemed ABA to be "compatible" with occupational therapy — but one study also noted that many occupational therapists shun its principles because they don't believe ABA has a "client-centered" approach. That is something you'll probably want to know if you're thinking occupational therapy may meet some of your needs, or your child's needs, but you want nothing to do with ABA. Occupational therapists see their profession as a holistic, "whole-person" one, and each occupational therapist will operate slightly differently, but you may well be able to find an occupational therapist who is compatible with your ideas about human dignity.