Occupational therapy is a crucial support for autistic people. It’s defined as therapy which supports people in developing and maintaining ‘meaningful activities.’ Activities are usually defined as skills necessary to daily living and working (in school or professionally.) An Occupational Therapist works with people of all ages who are experiencing difficulty managing every day activities as a result of an underlying health condition, illness, or injury. This support focuses on the ‘occupation’ or activity that needs to be built up, and works backwards from this while considering the person’s access needs. In other words, it is about empowering someone to do something rather than targeting their condition as a problem to be ‘fixed.‘ This mean’s that it can be considered part of a person-centered approach. For more information on Occupational Therapy, how to find an Occupational Therapist and what they usually work on, check our pages below.
Occupational therapy is concerned with people’s participation in everyday occupations or the things that you do on a day-to-day basis. An Occupational Therapist works with people of all ages who are experiencing difficulty managing every day activities as a result of an underlying health condition, illness, or injury. Occupational therapy aims to support individuals to be as autonomous as possible with the day to day occupations that are important to them, making it particularly relevant in the area of autism supports. Occupational therapists categorize every day occupations into three areas – self- care, productivity and leisure. Self- care includes activities such as washing, dressing, brushing teeth and hair. Productivity describes activities relating to work, school or domestic tasks at home. Leisure includes examining an individual’s participation in their hobbies and interests.
Medical models of healthcare and therapy focus on illness and injury and how therapy or medicine can “treat” or “cure” an illness. Occupational Therapy however, focuses on how an individual’s condition affects their ability to participate in the every day activities that are important to them within the context of their family, community and society. Occupational Therapy therefore, doesn’t necessarily focus on the issues related to a diagnosis such as Autism. Instead it explores how this diagnoses impacts the individual’s life and the goals that the person wants to achieve. This is with the goal to improve their own quality of life in their own unique set of circumstances
There are two main routes by which you can access an Occupational Therapist, through the public healthcare system or privately. Access to an occupational therapist is not based on diagnosis or diagnostic criteria instead it is a needs based service. This means the Occupational Therapist will want to know which every day activities you/your child is having difficulty with. Both public and private routes to Occupational Therapy will provide you with an equal standard of care, however, unfortunately much like with autism diagnosis there can be long wait times for public services. In order to access occupational therapy through the public healthcare system a great place to start is visiting your GP. Explain your needs to the GP and they can provide you with information available services. If you are already working with a primary care therapist, early intervention team or disability network team there should be an occupational therapist working as part of that team/service. If you are looking for a private occupational therapist, the Association of Occupational Therapists of Ireland is a useful starting point. Their website includes a list of state
As Occupational Therapy is not a medical model of therapy or treatment, an occupational therapist will not focus on an individual’s diagnosis. Instead, the occupational therapist will focus on the individual and the occupations that they may struggle with. However, given many autistic people view autism as part of their identity rather than a condition to be studied, it is important that providers of occupational therapy have a thorough understanding of autism and the needs of autistic individuals. It can be useful to identify your areas of concern before choosing an occupational therapist and trying to make your choice based on a therapist’s experience in these areas. Occupational therapists may have undergone additional training in sensory processing or restricted eating for example.
Occupational Therapists work with autistic people in a number of areas. However, one of the most common reasons an autistic individual may require the support of an Occupational therapist would be when sensory processing difficulties are impacting their participation in every day activities. Occupational therapists can support with a number of other experiences of daily living (e.g., sleep, sexuality, puberty, play, handwriting, friendship, money management, advocacy).
For children, the autism assessment is typically multi-disciplinary in its approach. Members of a multi-disciplinary team may include an occupational therapist, speech and language therapist and a psychologist who each assess the child and collaborate to examine needs and ultimately come to a conclusion of the child’s diagnosis. The role of an occupational therapist in the assessment of need is to focus on function (participation in every day activities). For young children who may be pre-verbal, the assessment will be an observational assessment in which an occupational therapist may observe motor skills, play and sensory processing. They also may interview parents based on how their child manages everyday activities based on their age and typical development such as brushing teeth, toilet training and getting dressed for example. For older children or teenagers or even adults, the occupational therapist may speak directly with the individual being assessed about their everyday occupations, sensory challenges and general functioning.
It is important to note that an occupational therapist will not always work directly with the individual alone. Recent evidence suggests the occupational therapist should be focused on working at a universal level (e.g., within the child’s school), or at a targeted level (e.g, with the child’s class). By the occupational therapist working with the people and environments around the child, there should be less need for individual input. Again, the focus should not be on changing the child, it should on changing the environment around them. The number of sessions an required with an occupational therapist depends on someone’s level of need and personal goals. If your child requires the support of an occupational therapist, your first session will typically involve discussing your child’s strengths and needs in the 3 core areas; personal care, self care and leisure. The course of the sessions will depend on these goals that have been set. OTs consider someone’s needs within the context of the demands of the activity and the environments. As a result, support can vary significantly from person to person. For example, if a child has difficulty with toothbrushing the child may be given ideas to desensitise the mouth (support the person), use a flavourless toothpaste(change the activity) or try toothbrushing away from the noisy bathroom fan (change the environment). Typically, you will visit your occupational therapist more frequently at the beginning e.g. once a week. This will be while you complete the assessment and decide on goals together. The phases between your sessions will likely increase as you are working on your goals. For example, you might move to once a fortnight or monthly. Eventually, once the occupational therapist sees you are implementing these skills at home, they may discharge you. Your occupational therapist may also suggest that you attend group sessions or workshops. This would involve attending a sessions alongside people with similar difficulties or challenges to you. For example, an occupational therapist may hold a workshop about various sensory strategies to support you in school. If you are a parent who is visiting the occupational therapist with your child, they’ll probably mix parent education with one-on-one work with your child. It is helpful for you to learn the various skills that the occupational therapist is teaching your child so that you can help to support them in their learning and development at home and maintain the progress over time. Finally, the occupational therapist may also help parents or individuals communicate their sensory difficulties to schools or workplaces. This can be helpful in order to make the school or work environment a more comfortable place for the individual.