Occupational Therapy and Autism Spectrum Disorder

18th April 2022

Written by Justin Goddard

Positive Practice

The healthcare industry has many parts to play in the modern world. When we think about healthcare or medicine more generally, we tend to think of doctors offices, surgery, diseases and the like. Most people’s only contact with the medical world comes through these sources, as life throws them a curveball that only someone with hospital resources and a degree in medicine can help them with.

But the healthcare industry must deal with many more cases than those that occur suddenly out of the machinations of the universe. Equally important, but perhaps more nuanced and subtle, is the world of chronic care, in which patients deal with a condition for a lifetime and their healthcare needs are mandated by it.

This is the aspect of healthcare in which Occupational Therapy (OT) resides. OT is an individualised approach that aims to help people who are unable to perform the tasks associated with daily life to do so. This is done by assessing a person on an individual basis and developing a treatment plan within the framework of OT that is right for them. This means there is no one size fits all therapeutic intervention, and is the reason it is used in the treatment of many remarkably distinct conditions, including autism, which is the focus of our article here.

Understanding the Occupational Therapy approach makes it clear why the method is so advantageous in treating Autism Spectrum Disorder (ASD). Autism is a highly complex condition, with certain common symptoms but a wide array of manifestations and severities. The inherently individualistic approach of OT makes it very useful in creating a tailored plan of care that works specifically for the individual.


Introducing a person to OT

All children are inherently play orientated creatures  – that’s how they learn – and almost universally perform better when being asked to engage in an activity they find rewarding and fun. This is no different for kids on the autism spectrum, which is why Occupational Therapy, delivered through a play-based lens, is such an important part of our approach at Brain Train. The versatility of OT allows us to formulate a plan that can seem more like a game than a task. Finding ways to make things fun can be even more important for children on the spectrum as ASD can make it difficult to connect with others. This is often crucial for engagement and hence effective treatment.

To better understand how OT can be implemented into a young person’s life, let’s take a look at a hypothetical situation. Aiden is 6 years old and has just been diagnosed with ASD. Advised about the importance of early intervention, his parents contact an Occupational Therapist. Here’s how Aiden’s introduction to OT might go.

First comes a one on one consultation with Andy to determine his individual needs. This will take into account what sort of developmental milestones he is falling behind in and which tasks he struggles with the most in order to get the best idea of how autism is manifesting in his case. The Occupational Therapist will observe several aspects of Aiden’s behaviour such as how he plays, how he engages with learning materials and his capacity for independent care.

Once the OT has a good idea of who Aiden is as a person and where his development lies, they will begin to mark out goals that would be beneficial for him to reach, and the strategies to help him do so. This is where the therapy truly begins as an approach is developed. Aiden may attend up to a couple of therapy sessions a week, but the regimen is designed in a way that makes it possible for him and his family to practice in daily life as well.

As Aiden’s treatment progresses, his OT will monitor how each activity is or is not helping him to perform the task it was designed to, and modify the regimen accordingly. Hopefully, as weeks, months, and years go by, this Occupational Therapy will help Aiden develop the skills he’s missing to lead as independent and rewarding a life as possible.


Occupational Therapy and Neuroplasticity

The human brain is a highly malleable piece of machinery, but we haven’t known that was the case until quite recently. For a long time, people assumed that after a certain amount of development the brain became ‘fixed’ and a person was who they were, with little room for change. However in recent years this has been shown to be untrue, with the brain showing a remarkable ability to rewire its pathways throughout a person’s lifespan. This is known as neuroplasticity, and is the process by which neural pathways can grow and reorganise. Typically, this is caused when a person’s habits or routine is changed. Initially the change is unfamiliar, and because the brain is not wired towards it, difficult. As the behaviour is repeated, the neural networks change and the behaviour becomes familiar and easier. This is how habits are formed, good and bad.

The process is similar to developing muscles through exercise and is essentially a matter of practice. “Be careful what you practise” is good advice as our brains will automatically wire themselves to how our day to day life unfolds. Being lazy is not simply a matter of being lazy, it’s a matter of practising being lazy, making laziness a default behaviour. By the same token, forcing ourselves to practise what our subconscious would rather not will help that same subconscious complain less loudly the next time we try.

Through a properly structured OT plan, the inherently plastic nature of the brain can be taken advantage of, as important skills for self-help and independence and desirable actions are slowly rewired into new skills and habits. In that sense, the task of an Occupational Therapist is to employ the science of neuroplasticity in a structured and planned environment in which positive and deliberate practice takes place, which is properly geared towards the skillset of an individual with ASD. It may be helpful to think of OT as a framework to guide the individual into skills and behaviours that will be most helpful in developing independence and improving quality of life.

OT is just one of many approaches we use at Brain Train to best help our clients. When done correctly in a way that is consistent with a person’s current abilities and future goals, OT has enormous and well researched potential to help a person with ASD to reach their potential.