Brain functions that control the social behavior and communication skills of individuals with autism are affected throughout their lives. Occupational therapy has an important role in the acquisition of the skills necessary to manage all this situation and process and in making people’s lives easier by gaining maximum independence. Occupational therapy is a very important health discipline that teaches how to live with autism.
Sensory problems are prominent among the symptoms observed in individuals with autism. Sensory problems reduce the individual’s adaptation to the environment and prevent them from performing appropriate behaviors. It decreases the individual’s adaptation to life, prevents them from showing daily life skills, makes it difficult to provide an academic education, and causes problems in self-care.
With the integrative approach of occupational therapy, improvement is noted in the individual’s behavior and can help to establish and control the self-ego. It provides treatment support to minimize the specified problems.
Sensory integration-based occupational therapy sessions are planned according to the individual needs of children with autism, nourished by the child’s interests and led by the child. These sessions often include supporting self-calming, body awareness, motor planning, or the development of gross and fine motor skills.
Symbolic games or pretend games are often used to facilitate the child’s transition into difficult activities in daily life. The therapist can organize children’s activities so that the activity is at the most appropriate level for the child. The most appropriate level means the level that is not difficult enough to prevent the child’s participation and at the same time not so simple that it does not cause him/her to lose interest easily because he/she can do it easily.
The game established between the child and the therapist during occupational therapy sessions is the product of bonding. This game may also seem indistinguishable from the typical development of the child in terms of child development. But in fact, the therapist is working very hard with organized activities to support the child’s sensory problems and skill development. For this reason, it should be kept in mind that all activities set up for your child are aimed at a goal.
The therapy will initially focus on the improvement of sensory functioning and the development of basic skills such as posture, attention, and calming, but later on, more skill-based activities will be introduced. The ultimate goal will, of course, be to achieve independence in the affected daily life and play activities of the child on the autism spectrum.
What is Occupational Therapy?
Occupational therapy is a person-centered health profession that improves health and well-being with meaningful and purposeful activities. The main purpose of occupational therapy is to enable people to participate in daily life activities. Occupational therapists achieve this goal by developing the skills of individuals and communities to do the activities they want, need, or are expected of them, or by organizing the activity or the environment in a way that enables people to participate better.
Occupational therapists have extensive training in medical, social-behavioral, psychological, psychosocial, and occupational therapy science, equipped with the knowledge, skills, and behaviors necessary to work in collaboration with individuals, groups, or communities.
Occupational therapists work with all people who have impaired body structure and functions due to any health problem or who are excluded from society or restricted from society due to their social or cultural minority group. Individuals with autism are also included in this group and occupational therapy is a therapy method that is very helpful for them and makes their lives easier.
Occupational therapists believe that participation is supported or constrained by the physical, emotional, or cognitive abilities of the person, the characteristics of the activity, or the physical, cultural, social, behavioral, and legal environment. For this reason, occupational therapy focuses on increasing the competence of individuals by organizing the person, activity, environment, or some or all of these in order to increase social participation.
Occupational therapy has a wide range of applications including public institutions such as home, school, workplace, factory, health center, nursing home, rehabilitation center, hospital, and judicial institution, and private or voluntary organizations.
People actively participate in the occupational therapy process. Results are person-centered and varied, measuring improvement in activity performance or satisfaction from activity participation.
The Effect of Occupational Therapy on Individuals with Autism
Occupational therapists use clinical knowledge of emotional and behavioral regulation, sensory processing, fine/gross/verbal motor development, cognitive skills, and task execution to support participation and learning. Occupational therapists, who have sufficient equipment and experience in evaluating and intervening, both manage treatment and provide counseling to families, other caregivers, and educators in this process, to protect the balance of social and emotional health in every environment where the individual is present. They will bring a specific perspective.
The occupational therapist develops the therapy program for the child after gathering all the necessary information. The therapist, who sets out various strategies in this process, can help the child respond better to his environment. These strategies are;
- Sensory integration therapy
- Physical/ mental / social activities
- Play therapy
- Daily life activities
- Communication activities
Occupational therapists know that involvement as a participant in self-care / daily living activities, productive engagement/productivity (education for children), social and communication-oriented participation, leisure and recreational / play activities affects the development and live performance of every person with an autism spectrum disorder in all aspects. It will differ in the individual. Occupational therapy science, which aims to increase the quality of life and functional independence of individuals, provides therapy services in structured environments according to requests and needs.
Sensory World of the Individual with Autism
Many people with autism spectrum disorder may experience some sensory difficulties and may be particularly sensitive to certain stimuli. These difficulties can cause parents and educators to be confused as they try to understand them.
We need our senses to grasp and adapt to the world we live in. The senses enable individuals to have unique experiences and interact with other people. Our senses help us understand what is happening around us and develop appropriate responses to them. Our senses determine how we react in which situation.
Imagine if one or all of your senses are stimulated at the same time, or none of your senses are present. This type of problem is commonly referred to as sensory integration disorder and is observed in many people with an autism spectrum disorder.
Although there are many definitions of autism, very few of them refer to what an individual with autism feels. We can only gain this kind of perspective on autism in line with the personal experiences of individuals with autism who can convey their difficult feelings and experiences to us.
The everyday experiences of people without autism can turn into an extremely painful and negative experience for people with autism. The unusual behaviors that individuals with autism exhibit are usually a reaction to their sensory experiences.
In this way, we can better understand why individuals with autism exhibit unique behaviors and initiate self-stimulating behaviors (such as turning around, clapping, and waving) because these behaviors cause them to take control of their own world and feel more secure.
“When I am exposed to too many sensory stimuli, I completely shut myself down… It’s like being interrupted… It’s strange, it’s like I’m watching 40 TV channels at the same time.”
Dr. Jean Ayres defines sensory integration as “organizing the information acquired through the senses in order to be processed and ready for use”. Sensory integration is a process that involves the transformation of the senses into perception. The central nervous system (brain) processes, organizes, prioritizes, and understands the sensory information sent from the various sensory systems of the body. Thoughts, emotions, motor responses (behaviors), or all of these may be required at the same time to develop a behavior towards any situation.
There are receptive nerves in our bodies that receive sensory impulses. Our hands and feet contain most of these receptors. Often the sensory information processing is done automatically. We can divide the sensory systems into six parts. We can divide each of these areas into hypo (less sensitive) and hyper (very sensitive) in order to show the sensitivity level.
Examples of sensory integration activities that children will love:
- Tumble over soft surfaces with a small pilates ball
- Swing in the sheet
- Jumping on the bed
- Turning around themselves and you
- Playing while standing like a cat with a softball under their stomach
- Playing with vibrating toys
- Massage with olive oil or baby oil by applying gentle pressure to the whole body
- Touching different surfaces with hands and feet (e.g.: warm water, cold water, cotton, hard objects, grass, and sand)
- Games to find the object hidden inside your clothes
- Opposing ball throwing and playing, throwing the object in their hands to the target
- Jumping from a high floor (over the bed) to a soft floor (cushion, duvet, pillow, etc.)
- Pushing and pulling objects.
- Hitting the floating balloon with their feet while lying on their back
- For young children to lift heavy but soft toys that are large enough to grasp and encourage them to play with them
- Making a pillow fight
- Sandwich between pillows and duvets
- Getting used to playing with shaving foam, play dough, finger paint
- Painting hard and soft surfaces (smooth, serrated, etc.)
- Trying to move the balloon to the other end of the room with a stick that isn’t too long
- Creeping, turning, and lying (carpet, plush, etc.) on hairy and different floors.
- Touching animals
- Imitating the walking patterns of animals (crawling without using hands like a snake, going in the opposite direction like a crab, etc.)
Balance (Vestibular) System
It is located in the inner ear. In connection with gravity, it allows us to perceive where our body is in the field, its speed, direction, and movement, and it gives us information about it. This system is essential for keeping our body in balance and maintaining our body’s posture. The difficulties that individuals with autism spectrum disorder may experience may include:
– Hypo (Less sensitive): Need to swing and turn around
– Hyper (very sensitive): Difficulty doing activities that require movement (such as sports), stopping suddenly or ending an ongoing activity
Body Awareness (Proprioception) System
It is located in the muscles and joints and tells where our body is. It also gives information about where the body parts are and how they move. The difficulties that individuals with autistic spectrum disorder may experience may include:
Hypo (Less sensitive)
- Physical distance – being too close to others
- Not being aware of the space covered by their body
- Difficulty finding direction and avoiding obstacles
- Hitting people around them
Hyper (Very sensitive)
- Difficulty in activities that require using fine motor skills and having difficulty using small objects (button-up, lacing, etc.)
- Do not turn with their whole body while looking at anything
It gives information about the odors in our immediate environment through the processing of chemical receptors in the nose. Smelling is a sensation that we often forget and neglect. However, it is our first sense that we believe in reliability. Individuals with autism spectrum disorder may have the following difficulties with the olfactory system:
Hypo (Less sensitive)
- Not getting any smell or even noticing a very intense smell
- Licking objects
Hyper (Very sensitive)
- Smells are intense and disturbing
- Difficulty going to the toilet
- Dislike of people who use dominant scented shampoo or perfume
“I can’t tolerate the smell of cats, dogs, deodorants, and aftershave, and the smell of perfume drives me crazy.”
It is located in the retina of the eye and is activated by light. Our sense of vision helps us to recognize objects, people, colors, contrasts, and spatial boundaries. The difficulties a person with autism may experience may include:
Hypo (Less sensitive)
- Seeing objects darker than they are, not recognizing lines and distinctive features
- Focusing on the surrounding image due to the blurring of the center image or perceiving the object larger than it is and seeing the surroundings blurry
- Poor depth perception – difficulty holding and catching clumsiness
Hyper (Very sensitive)
- Image distortion
- Small objects and bright lights passing in front of the eye
- Seeing fragmentary due to excessive stimulation
- Focusing on part of the object rather than looking at any object as a whole
It is located in the inner ear and informs us about the sounds around us. It is the most obvious noticeable sensory disorder. Difficulties that people with autism may experience may include:
Hypo (Less sensitive)
- Hearing function in one ear and partial or no hearing in the other ear
- Inability to identify some sounds
- Enjoying crowded and noisy environments, door slams, or sounds made by objects
Hyper (Very sensitive)
- Perceiving the noise louder than it is and the inability to perceive the surrounding sounds clearly
- Inability to ignore certain voices, difficulty concentrating
- The threshold of hearing is very low and therefore very sensitive to auditory stimuli (For example, being able to hear even a very distant speech)
- Hearing impairment directly affects a person’s communication skills and body balance.
It is found in the skin and is the body’s largest organ. Tactile is related to the level of pressure and pain and thus helps us distinguish between heats (hot and cold). It is an important part of social development. It helps us measure and evaluate the environment we are in and allows us to develop responses accordingly.
Hypo (Less sensitive)
- Hold on to others
- Resistant to pain and heat
- Enjoying putting heavy objects on them
Hyper (Very sensitive)
- Touch itself can be painful and uncomfortable. Individuals on the autism spectrum are usually withdrawn, hesitant to touch. This situation negatively affects their relationships with other people.
- Not like to have something on their hands and feet (watch, socks, etc.)
- Difficulty combing and washing hair
- Like to wear only certain fabrics
“Every time they touch me it hurts and I feel like my skin is on fire”
It is processed by chemical receptors in the tongue. It allows us to perceive different tastes such as sweet, sour, bitter, and salty. Individuals with very sensitive taste buds may only prefer certain types of foods. The difficulties that people with autism may experience may include:
Hypo (Less sensitive)
- Not liking sharp flavors (spicy, hot, sour food)
- Eating anything (e.g. soil, grass, etc.)
Hyper (Very sensitive)
- Finding certain flavors sharper and more irritating than they are
- Being uncomfortable with foods of a certain texture (For example, some children may prefer to eat only smooth foods such as mashed potatoes.)
Occupational therapy centers are of great importance for children in need. Sensory integration therapy, behavior development, social skills development, basic language skills, and fine-gross motor development are aimed under the title of personalized occupational therapy.
Noting that autism means a developmental disability, occupational therapists claim that they apply personalized occupational therapy in autism. Physical therapy empowers the patient, and occupational therapy enables the use of power in daily life. Different therapy methods are used for children in occupational treatment.
Sensory Integration and Behavior Development: By activating the senses such as sight, touch, and feeling in the child’s body, it is ensured that these senses work in harmony and bring them into a balance. Thus, it is aimed to increase learning abilities by making preliminary preparation for brain development. For example, a child who is sensitive to touch can overreact when he steps on the carpet. With the treatment performed here, brain coordination therapy such as touch, feeling, and recognition is applied. At this point, toys and specially prepared application devices are used entirely.
Social Skills Development and Basic Language Skills: Studies are carried out to ensure that children play, learn, socialize with their friends, and perform self-care skills in a unified manner. Performing therapy and education sessions with play support children to maximize their life skills and to be independent in the transition from childhood to adulthood. Speech therapies are performed.
Fine and Gross Motor Development: In this section, a study is done on physically balanced movements. For example, activities that improve hand and foot movements such as climbing stairs, walking, using the elbow and hand, hugging is performed. Body reflex and movement control are taught.
Attention Disorder: The physical development of children with autism ensures mental balance. Therapy is carried out with toys and special games. With the reward system, children are educated with small games.
Occupational Therapy Toys You Can Find on Amazon
Skoolzy Preschool Lacing Beads for Kids – 30 Stringing Beads with 2 Strings Toddler Crafts with Travel Tote – Montessori Toys for Toddlers Occupational Therapy Fine Motor Skills Toys Autism OT
It is a shelf-ready Montessori toy which is very helpful for occupational therapy. It is a perfect toy in order to develop fine motor skills. It teaches colors, shapes, and numbers as well. It is an highşy recommended toy. https://www.amazon.com/Skoolzy-Preschool-Large-Lacing-Beads/dp/B00WL539DM/ref=sr_1_5?dchild=1&keywords=occupational+therapy+toys&qid=1601450781&sr=8-5
LISKTO Busy Board Dress Learning Toys for Fine Motor Skills & Learn to Dress, Basic Life Skills Sensory Board, Learn to Zip, Snap, Tie Shoe Laces and Buckle
It is a helpful toy in order to develop the basic life skills of children on the autism spectrum. It teaches children to tie and zip. Thus, it develops fine motor movements. It is a lightweight toy. So, it can be carried easily. It is suitable for children to use. https://www.amazon.com/Learning-Skills-Sensory-Buckle-Orange/dp/B07V214J5Y/ref=sr_1_7?dchild=1&keywords=occupational+therapy+toys&qid=1601450781&sr=8-7
Learning Resources Spike The Fine Motor Hedgehog, Sensory, Fine Motor Toy, Toys for Toddlers, Ages 18 months+
It is a great toy for occupational therapy sessions. It helps to build fine motor development, color recognition, and counting. It is easy to grasp, easy to play, easy to carry, and easy to store. https://www.amazon.com/Learning-Resources-Spike-Hedgehog-Sensory/dp/B078WM314M/ref=sxin_9_ac_d_rm?ac_md=2-2-ZmluZSBtb3RvciBza2lsbHMgdG95cw%3D%3D-ac_d_rm&cv_ct_cx=occupational+therapy+toys&dchild=1&keywords=occupational+therapy+toys&pd_rd_i=B078WM314M&pd_rd_r=2e94141c-9544-481c-ba6e-2eff26ada684&pd_rd_w=dRPUM&pd_rd_wg=UDDQt&pf_rd_p=3d1a8341-be16-45b1-ae3d-ba8c533ec9f0&pf_rd_r=4K5G0PCWBGM2CRCPXG10&psc=1&qid=1601450781&sr=1-3-12d4272d-8adb-4121-8624-135149aa9081
Wooden Apple Lacing Toy with 2 Worms, WOOD CITY Fine Motor Skills Toys, Airplane Travel Toys, Apple Threading Game Early Learning Montessori Toys
It is a great Montessori toy for occupational therapy exercises. It helps to boost hand-eye coordination. The child becomes a master to solve problems by himself/herself. It is easy to play, easy to carry, and easy to store. It is very helpful for children on the autism spectrum. https://www.amazon.com/WOOD-CITY-Threading-Learning-Toddlers/dp/B07V9GJJXG/ref=sxin_9_ac_d_rm?ac_md=3-3-b2NjdXBhdGlvbmFsIHRoZXJhcHkgdG95cyBmb3IgdG9kZGw%3D-ac_d_rm&cv_ct_cx=occupational+therapy+toys&dchild=1&keywords=occupational+therapy+toys&pd_rd_i=B07V9GJJXG&pd_rd_r=2e94141c-9544-481c-ba6e-2eff26ada684&pd_rd_w=dRPUM&pd_rd_wg=UDDQt&pf_rd_p=3d1a8341-be16-45b1-ae3d-ba8c533ec9f0&pf_rd_r=4K5G0PCWBGM2CRCPXG10&psc=1&qid=1601450781&sr=1-4-12d4272d-8adb-4121-8624-135149aa9081
ZaxiDeel Fidget Pop Tube Toys for Kids and Adults 6 Pack, Pipe Sensory Tools for Stress and Anxiety Relief, Cool Bendable Multi-Color Stimming Toys Great as Gift and Prizes for Fidgeters
It is a very helpful toy for occupational therapy exercises in case of its texture and colors. They are helpful for tactile stimuli, visual stimuli, and fine motor development. Your child on the autism spectrum will get the benefit of these tubes for sure. https://www.amazon.com/Sensory-Bendable-Multi-Color-Stimming-Fidgeters/dp/B07QMQ8QP6/ref=sxin_9_ac_d_rm?ac_md=0-0-b2NjdXBhdGlvbmFsIHRoZXJhcHkgdG95cw%3D%3D-ac_d_rm&cv_ct_cx=occupational+therapy+toys&dchild=1&keywords=occupational+therapy+toys&pd_rd_i=B07QMQ8QP6&pd_rd_r=2e94141c-9544-481c-ba6e-2eff26ada684&pd_rd_w=dRPUM&pd_rd_wg=UDDQt&pf_rd_p=3d1a8341-be16-45b1-ae3d-ba8c533ec9f0&pf_rd_r=4K5G0PCWBGM2CRCPXG10&psc=1&qid=1601450781&sr=1-1-12d4272d-8adb-4121-8624-135149aa9081