Occupational Therapy (OT)
Occupational Therapy is usually delivered by a trained OT or physical therapist who the trains both the family and the individual as well as other caregivers in a collaborative effort to improve a range of life skills and abilities depending on the needs. OT is beneficial for increasing independence and ensuring the best quality of life possible for people with ASD conditions. OT teaches:
- self help and coping skills such as dressing, toilet training, grooming
- fine motor skills such as learning to hold a pen or utensils
- gross motor skills such as learning to walk properly or use an assistive device
- physical exercise to improve motor skills
- visual and perceptual skills needed for reading and writing
- appropriate play skills
- functional social skills
- sensory integration
Using OT methods, individuals can be assisted with daily living tasks at home, at school or in other programs.
Sensory Integration is how the human brain organizes and interprets stimuli from the environment such as touch, smell, sight, sound and movement. Many people with autism have sensory problems, such as hypersensitivity or hyposensitivity to these stimuli. They may also have difficulty being able to integrate senses. This is called Sensory Integration Dysfunction (SID).
These problems can be mild or severe and may result in repetitive motion symptoms such as rocking, spinning, jumping and flapping as well as over or under sensitivity to one or more senses. Sensory integration therapies are usually provided by a trained occupational or physical therapist and are frequently integrated into other autism programs.
Sensory integration uses exercises which focus on the vestibular sense (e.g., ear problems can cause problems with balance and motion), the tactile sense (e.g., sensitivities to touch such as the feel of clothing; sensitivity or insensitivity to temperature or pain), and on proprioception (e.g. joints, ligaments). Techniques usually focus on stimulating these senses in order to make them less or more sensitive and to help a child to recognize and integrate sensory information.
Sensory integration therapy is usually given by specially trained occupational, physical or speech therapists who observe the child carefully to gain a clear understanding of her/his particular sensitivities. The goal is partly to improve attention and reduce impulsive behaviours that get in the way of concentration and learning. Some people have found that when the sensory needs of autism are met, learning is more focused, progress is better and people are better able to cope with day to day situations. Addressing sensory issues may be a very long process.
Other sensory-based methods:
- Berard Auditory Integration Training (called Berard AIT or AIT) involves listening to high and low frequencies in processed music for a total of 10 hours (two half-hour sessions per day, over a period of 10 to 12 days). AIT is believed to improve auditory processing, decrease or eliminate sound sensitivity and reduce behavioural problems in some autistic children.
- The Tomatis program uses vocal exercises to help children with autism make and hear their own sounds in order to develop self-listening which improves communication and sense of self.
- Computer-based auditory interventions include Earobics and Fast ForWord. These programs may be helpful for children who have delays in language and have difficulty discriminating speech sounds.
- Irlen Lenses: wearing ambient (prism) lenses. People who benefit from these lenses are often hypersensitive to certain types of lighting, such as fluorescent lights and bright sunlight; hypersensitive to certain colours or colour contrasts; and/or have difficulty reading printed text. Irlen lenses may reduce sensitivity to these lighting and colour problems as well as improve reading skills and increase attention span.
- Oculomotor exercises: performing eye movement exercises to reorganize and normalize the visual system.
- Swinging a child on a swing to help normalize the vestibular sense.
- Deep Pressure: Dr. Temple Grandin developed a hug machine which provides deep pressure to help in tolerating touch and which appears to have a calming effect.
- The Wilbarger Protocol: Some children have a tendency to respond to certain harmless sensations as if they were dangerous or painful. This is called sensory defensiveness (SD). The child with SD may misperceive the world as dangerous, alarming or at the very least irritating. The protocol uses frequent application of firm/deep pressure touch input to various parts of the body. This is followed by gentle joint compression.
- Weighted Vests or Blankets: The concept of the weighted vest or blanket is based on the technique of deep pressure. Deep pressure is used to assist the child to self-calm and relax so that sensory stimulus can be processed. The use of a weighted vest or blanket is thought to provide the child with unconscious information from the muscles and joints. Children who are easily distracted, hyperactive and lacking in concentration are said to respond positively to the additional weight. Due to the fact that weighted blankets can cover more of the body there have been some safety concerns associated with the use of weighted blankets for children.
College of Optometrists in Vision Development: Information on vision training.
Computer Software – Laureate: Software designed specifically for children with developmental disabilities.
The Listening Centre: Private clinic offering a method of sound stimulation called the Tomatis Method.
The Masgutova Neurosensorimotor Reflex Integration - MNRI ® Method. Svetlana Masgutova Educational Institute®.
Helping Your Child Cope with his Sensory Needs, Lauren Lowry, Hanen Certified Speech-Language Pathologist; and accompanying checklist [PDF] taken from More Than Words®: A Parent's Guide to Building Interaction and Language Skills for Children with Autism Spectrum Disorder or Social Communication Difficulties (Sussman, 2012).