Occupational Therapy

Autism is a developmental disorder—typically diagnosed around age 3 years— that affects brain functions, specifically those areas that control social behaviors and communication skills. The National Institute of Child Health & Human Development uses the term autism spectrum disorders (ASDs) to refer to a group of disorders that includes autistic disorder (also known as “classic autism”), Asperger syndrome, and pervasive developmental disorders not otherwise specified (also called “atypical autism”). However, the term autism is frequently used in the literature to describe all of the disorders in the ASD spectrum.

What Is the Focus of Occupational Therapy With Individuals With Autism?

Occupational therapy services focus on enhancing participation in the performance of activities of daily living (e.g., feeding, dressing), instrumental activities of daily living (e.g., community mobility, safety procedures), education, work, leisure, play, and social participation. For an individual with an ASD, occupational therapy services are defined according to the person’s needs and desired goals and priorities for participation.

Occupational therapy services for individuals with an ASD include evaluation, intervention, and measurement of outcomes. Throughout the process, collaboration with the child or adult with autism, family, caregivers, teachers, and other supporters is essential to understanding the daily life experiences of the individual and those with whom he or she interacts. Occupational therapy services can focus on personal development, quality of life, and the needs of the family.

The occupational therapy evaluation process is designed to gain an understanding of the individual’s skills—his or her strengths and challenges while engaging in daily activities (occupations). The occupational therapy intervention process is based on the results of the evaluation and is individualized to include a variety of strategies and techniques that help clients maximize their ability to participate in daily activities at home, school (if relevant), work, and in the community environment. Progress or a successful outcome is noted through improved performance (or adaptation), enhanced participation in necessary or meaningful daily activities, personal satisfaction, improved health and wellness, and successful transitions to new situations and roles. These measures can help the individual, family, and team appreciate success and refocus and change priorities of the intervention plan as needed.

Occupational therapy practitioners help people with autism adjust tasks and conditions to match their needs and abilities. Such help may include adapting the environment to minimize external distractions, finding specially designed computer software that facilitates communication, or identifying skills they need to accomplish tasks.

Where Do Occupational Therapists and Occupational Therapy Assistants Work With Individuals With Autism?

Occupational therapy practitioners provide interventions to clients in the settings where they typically engage in daily activities, such as a child care center or preschool, school, home, worksite, adult day care, residential setting, and so forth. The role of the occupational therapy practitioner may be as a provider of direct services; as a job coach; or as a consultant to family members, educators, employers, or team members.

Where Are Occupational Therapy Services Offered?

Pediatricians can help parents identify early intervention programs available through a state’s Department of Social Services or Department of Health. These programs can refer young children and their families to occupational therapy and other needed services. Preschool and school-age children and youth (to age 21) may be eligible for occupational therapy services under the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act. Services may also be available through local health centers, hospitals, private clinics, and home health agencies. Adults with an ASD who need occupational therapy services may find referrals through developmental disability programs, social services agencies, or state occupational therapy associations. Adults with an ASD may receive occupational therapy services at work, home, in community-based programs, and through medical care facilities.

Who Pays for Occupational Therapy Services?

Occupational therapy is a skilled health, rehabilitation, and educational service covered by private insurance, Medicare, Medicaid, workers’ compensation, vocational programs, behavioral health programs, early intervention, and school programs. Services also may be covered through Social Security, state mental health agencies or those serving individuals with intellectual impairment, health and human services agencies, private foundations, and grants. Many providers accept private payments.