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An Overview

Autism is a spectrum disorder characterized by Impairments in social interaction, Impairments in communication & Presence of restricted, repetitive behaviors (RRBs) according to DSM IV criteria. The umbrella term is Pervasive Developmental Disorders (PDD). How ever, the latest DSM V criteria diagnoses Autism as a spectrum disorder characterized by Impairments in social interaction & Presence of restricted, repetitive behaviors (RRBs).

  • No/poor eye contact
  • No/poor response to name
  • No/poor imitation skills
  • Repetitive movements with objects
  • Abnormal posturing of body, arms, hands or fingers
  • Echolalic speech (Repetitive Speech)
  • No social smile by 6 months
  • No imitation of sounds/ smiles/facial expressions by 9 months
  • No babbling by 12 months
  • No imitation of gestures (pointing/waving/reaching) by 12 months
  • No words by 16 months
  1. Autistic Spectrum Disorder - Impairment in social interaction and stereotypical, repititive behaviour
  2. Asperger’s Disorder (with Language) - Autism with monotonous language
  3. PDD-NOS (Not Otherwise Specified)
  4. Rhett’s Disorder -affects mostly girls. Symptoms include partial or complete loss of hand skills, partial or complete loss of spoken language, abnormalities of gait/posture and stereotypic repetitive hand movements
  5. Childhood Disintegrative Disorder -Apparently normal development for at least the first 2 years after birth in all areas followed by regression
  • Psychiatric – Anxiety / Depression / OCD / Oppositional defiant disorder
  • Behavioural – Disruptive / Irritable / Aggressive / Self injurious
  • Sensory disturbances – Tactile / Visual / Auditory sensitivity
  • Oro-motor problems
  • Intellectual Disability
  • Neurological – Epilepsy / Tics
  • Gastrointestinal – GERD / Constipation
  • Sleep disturbances

Occupational therapists work in two main ways: Evaluation and Therapy.

 

EVALUATION

The therapist observes children to see if they can do tasks expected to be done at their ages -- getting dressed or playing a game, for example. The therapist might note any of the following:

  • Attention span and stamina
  • Transition/shifting to new activities
  • Playing skills
  • Need for personal space
  • Response to touch or other types of stimuli
  • Motor skills such as posture, balance, or manipulation of small objects
  • Aggression or any other types of behaviors
  • Interactions between the child and parents

Once an occupational therapist has gathered information, they can develop a program for your child. Early, structured and individualized plans have shown to work best.

 

Occupational therapy may combine a variety of strategies that can help your child respond better to his/her environment. These OT strategies include:

  • Physical activities, such as stringing beads or doing puzzles, to help a child develop coordination and body awareness
  • Play activities to help with interaction and communication
  • Developmental activities, such as brushing teeth and combing hair
  • Adaptive strategies, including coping with transitions/changes

The overall goal of occupational therapy is to help the person with autism improve his/her quality of life at home, in school and in the society. The therapist helps children with autism to be as independent as possible.
These are some of the skills occupational therapy may work on:

  • Daily living skills, such as toilet training, dressing, brushing teeth, and other grooming skills
  • Fine motor skills for holding objects, writing or cutting with scissors
  • Gross motor skills used for walking, climbing stairs, or riding a bicycle
  • Sitting, posture, or perceptual skills, such as differenciating between colors, shapes, and sizes
  • Body awareness and its relation to others
  • Visual skills for reading and writing
  • Play, turn taking, coping, self-help, problem solving, communication, and social skills

 

By working on these skills during occupational therapy, a child with autism may be able to:

  • Develop peer and adult relationships
  • Learn how to focus on tasks
  • Learn how to delay gratification
  • Express feelings in more appropriate ways
  • Engage in play with peers
  • Learn how to self-regulate

 

SENSORY INTEGRATION THERAPY

Researchers estimate that eight out of 10 children with autism have problems processing sensory inputs. For example, they can’t filter out background noise. Other signs of processing issues include:

  • Problems with balance
  • Problems with body position in space
  • Oversensitivity to touch and the feel of certain types of clothing

With autism these problems can be partly a result of these sensory challenges.
OT can help with sensory integration and some of the related behavioral problems.
Examples of sensory integration therapy include:

  • Being brushed or deeply touched and massaged
  • Compressing elbows and knees
  • Swinging
  • Spinning
  • Wearing a weighted vest