Article Date: 15 Apr 2009
“Occupational therapy helps people develop the life skills needed for living independent and satisfying lives, and it’s also helpful for children diagnosed with ASD,” said Dr. Skip Freedman, Executive Medical Director at AllMed Healthcare Management, a leading independent review organization (IRO). “Occupational therapists who treat children with ASD seek to help them develop suitable responses to stimuli in their environment.”
“Four clusters of behavior characterize autism: disturbances in social interaction, deficits in communication, behavioral abnormalities, and disturbances of sensory and perceptual processing.
Of these, the inability to communicate is key. Children with ASD learn to talk later, don’t learn to talk at all or sometimes lose the ability to talk. Others may learn to talk, but find using language effectively in social interactions difficult.
“Children with ASD can be both under- and over-responsive to sensory stimuli. Disturbances in the children’s perception of auditory stimulation are common.
“Based on analysis of the interactions of an ASD child’s skills, challenges and occupations, occupational therapists can intervene to help the child select alternative behaviors and tailor the intervention for the child’s specific needs and personality. This increases the child’s gaining new skills.
Sensory-based Integration
“Traditionally, occupational therapists focused on the child’s fine and gross motor skills, motor planning, and acquiring self-help skills. For example, they would work with ASD children to develop skills for buttoning their shirts, tying their shoes or work on their handwriting.
” Now, occupational therapists who specialize in ASD work with children on integrating the information coming in through their senses. Sensory integration and sensory-based interventions help children improve their self-regulation and develop acceptable behavioral responses. This integration effort improves the child’s sensory information processing and helps the child sort out acceptable from unacceptable behaviors. Additionally, the occupational therapist also may work with the child on his social and play skills.
Other Interventions
“Occupational therapists find relationship-based intervention treatments help a child with ASD grow both socially and emotionally. Often they use adult imitation involving many positive responses, prompts and cues to facilitate interaction between the children and their peers. This helps to show the positive effects of social engagement. Also, they engage the children in structured-play activities that include cueing, promoting and positive reinforcement to improve social interactions and taking turns.
Occupational therapists find that modeling and practice can have positive effects on activities such as turn-taking, joint attention, eye contact, nonverbal communication and language. Often they use social stories during therapy sessions to involve ASD children actively and to improve their targeted behaviors.
The philosophy and goals of occupational therapists align well with intervention for children with ASD, making them an integral part of the treatment team.
“Pediatricians can help parents identify early intervention programs available through a state’s department of social services or department of health,” said Freedman. “Often, parent’s health-insurance plan can fund occupational therapy.”
To cover occupational therapy for ASD, most health insurers may request documentation that includes integration and praxis tests (SIPT) results, short- and long-term treatment goals and require a therapist to have sensory integration credentials.
Source: AllMed Healthcare Management
