What can an OT help with for an autistic child?

We lean on our therapists in unusual ways sometimes. Our Occupational Therapist supports us in all sorts of ways and gives us skills to navigate life. With our OT, we have worked on our child’s emotional regulation, sensory processing, social interactions, thinking, interoception, gross motor skills and fine motor skills. Here’s 7 interesting things our OT has helped with our autistic child.

7 things our OT has helped with:

OT and autism mama and baby capybara

1. Toileting and interoception

We have had lots of trouble with toilet training and incontinence. Our OT developed social stories and used social story videos to explain the steps in toileting. She also has spent much time discussing what it feels like inside the body when you need to go to the toilet. Sometimes we draw pictures of what it feels like inside our bodies when we need to toilet. Other times we practice meditation-style exercises that include paying attention to senses inside our bodies. This has led to greater interoception and more success around toileting.

2. Sensory diet and how to regulate with our bodies

Every session starts with sensory regulation, from rolling around on a big fit ball, to jumping on a trampoline. Sensory input might also come from swinging or jumping onto a big foam cushioned mat.

Regulating through a sensory diet (often involving physical activities) is an important first step. Then our child is calm and attentive enough to engage in the rest of the session. This is one thing our OT helped with. Before attempting an activity that involves concentration or calm, we make sure we give sensory input through whole body activities or exercises.

3. Coordination and hand-eye skills

The autistic profile of our child is that they have low coordination, and low muscle tone. They also have poor gross motor skills compared to the development of age-similar peers. Coordination and hand-eye skills is something we’ve worked on through exercises. We have built up coordination through exercises that

  • use different sized balls,
  • explicitly teach skills (look here, put your arm like this, next step…)
  • are fun practice (like using a target on the floor or wall).

Now our child can throw and catch a tennis ball with some confidence. This makes it easier for him to fit in and be included with sports and PE at school.

4. Social Thinking and understanding what other people are thinking

We work with our speech pathologist on social thinking, but our OT also helped with this. We like it when our therapists work together using similar approaches to reinforce skills. Each therapy session our OT helps with social thinking and understanding what other people are thinking. We read and study pages from Social Thinking books. We talk about what the characters are thinking, doing, hidden rules, what they are feeling. This helps to navigate tricky social situations.

5. Hand writing and forming letters with fluency

One problem with low muscle tone is that hand writing is tiresome. Forming letters, being neat in writing, and gripping a pen is difficult. We spent lots of time practicing hand writing and forming letters slowly. Using special lined paper, we built fluency in letter formation. Over time, when there is more automaticity in forming letters, it becomes faster to write. Once hand writing was established, our OT then helped with the next item.

6. Getting ideas from inside our head and onto the page

At school we noticed that our child took ages to start work, especially written work. It was such as slow, non-starting process. There was lots of procrastination and frequent upsets when we sat down and tried to encourage starting.

Our OT helped with executive functioning skills in:

  • planning out writing using paragraph structures (OREO, TEEL) and story boards
  • structuring creative writing through who, what, where, how prompts
  • using dot points then creating sentences
  • talking through each sentence before putting it on paper

7. Time management and executive functioning

Time management, or the lack of time management, is frustrating at home and at school. At home, there may only be one hour of gaming/computer time. Our child will have something he wants to achieve in the game (like meeting a certain checkpoint or quest). But as soon as he gets into the game he gets distracted by other things and inevitably doesn’t meet his goals. Then the time runs out and he gets frustrated by his own distractions and lack of time management. At school, he might have a task during lesson. He won’t finish it because he’ll get distracted chatting to others or sorting out his pencil case. Then it won’t be done and it will have to be finished for homework.

Our OT has helped with executive functioning and time management through

  • breaking down big tasks into smaller steps (chunking)
  • using checklists to manage the steps and current attention
  • timers to direct attention to the current checklist item for dedicated short-time focus
  • estimating time skill building through estimating, predicting and comparing time to complete tasks
  • use of visual schedules and first…then cards (first complete this… then you get a 5min break on..)
  • Get it Done cards
First-Then cards might read:

First – complete 10 maths problems
Then – use your ipad for 5 mins

Get it Done cards include prompts for:
  • Do it (do I have a problem getting started or getting done? if yes, seek help)
  • Options (what options do I have to get this done? first-then, chunking, checklist, highlighter)
  • Needs (what options meet my needs to get it done?)
  • Evaluate (How did I do? Did I get started and get it done?)

Lots of these executive functioning skills are around project management and breaking down tasks to avoid procrastination. And heading into upper primary and middle school, executive functioning skills are also essential to enjoy and succeed at school.

Conclusion: what our OT has helped with

Our OT has helped with many facets of life skills. From our child’s emotional regulation, sensory processing, and interoception. Through to social interactions, social thinking, and navigating social conflict. And including gross motor skills and fine motor skills.

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