Occupational Therapy Activities in Autism

Occupational Therapy Activities in Autism

Occupational Therapist observes the child to plan interventional activities. This is a systematic approach in a controlled environment. Occupational Therapy activities in Autism either help to calm or to excite a particular sensory system.

Presentation of a child with Autism:

According to DSM V, Autism symptoms vary from one end of the spectrum to another.  Thus a child can look withdrawn or on the go.

Also, sensory processing difficulties contribute to the stereotypical behaviors displayed by the child.

A child prefers the sameness of routine and gets upset when routines are disturbed. A child can exhibit restricted or fixated interests that vary in intensity.

Also, a child with Autism may be hypo or hypersensitive to sensory inputs. Clinical observations help a therapist to plan activities in Autism.

Let us look at how sensory systems appear in Autism:

Proprioceptive Sense:

Proprioceptive Seeking:

A child who appears to seek Proprioceptive inputs appears to intentionally fall or push other children. He/She prefers tight clothes and appears to be fidgety or unable to sit still.

• Selected activities include proprioceptive inputs in form of pressure or deep touch.
• Weight-bearing activities like wheelbarrow walk and using a weighted jacket are suggested. So are bar hanging, wall climbing, crawling activities under a tunnel, animal walks. All these activities provide excellent proprioceptive inputs.
• Resistive games of clay, rubber bands, provide inputs to small muscles of the hands.

Proprioceptive difficulties:

Some children present with poor standing or sitting posture. They appear weaker than other children their age. Some children also appear to have low tone. Proprioceptive difficulties interfere with the ability to gauge the speed and direction of the ball. It affects prompt body movements needed to catch the ball.

They also contribute to an inability to gauging pressure while writing. Children may write with too much or too little pressure. Proprioceptive difficulties also contribute to moving cautiously in space.

There is certain clumsiness in the handling of objects.

Again, proprioceptive inputs are given through:

• Pressure on shoulders and knees.
• Using weighted jackets or backpacks during sit-down activities to calm the child.
• Steamrollers help provide necessary inputs.
• Mazes or games that help children move through space and provide different heights and surfaces.

Vestibular Sense:

Vestibular Seeking Behaviour:

This is a child who enjoys a variety of movements. He/she can spin or rotate for prolonged durations. This child shows an inability to sit still. He/she can assume various body positions, and enjoy inversions.

For vestibular seeking, calming activities help. The selection of activity includes a proprioceptive element, in form of weight-bearing. These include:

• Wheelbarrow walking and animal walks.
• Vestibular inputs like linear swinging to calm an overstimulated vestibular system.
• Hanging also provides great proprioceptive input, thus trapeze swinging helps.
• Wall climbing is another calming activity that provides ample proprioceptive inputs. A Rope Ladder works similarly.

Hyperresponsive to Vestibular Stimulus:

A child who is hyperresponsive to vestibular stimulus avoids vestibular inputs derived through movements. Fast spinning movements or fast swinging and amusement rides are largely off-limits. This child benefits from the following activities:

• Gentle rocking on a therapy ball.
• Slow bouncing, Jumping on a trampoline,
• Linear swinging with a weighted vest on and also swinging with a large base of support.
• Playing in a lycra swing will also calm the child.
• Adding on a target game on a swing also helps. Thus, a hi -5 to the therapist or beans throw on a mat helps.

Tactile Hypersensitivity:

This child is uncomfortable with a variety of tactile inputs. Clothe labels, elastic binds around arms or legs affects the child.  The roughness of cloth texture or the stitches also bothers a child by causing discomfort. This reduces attention and focuses on the activity at hand.

For increasing tolerance to a variety of tactile stimuli, the therapist selects:

• Object search games in a ball pool.
• Experiencing textures like soft, rough, wet, dry, grainy, or smooth. Textures are selected gradually without overwhelming the child.
• Art and craft activities also help.
• Proprioceptive inputs-based games are continued as calming strategies.

Visual Perceptual Activities:

• Spotting activities and word searches.
• Completing the picture or finding the other half of the picture.
• Tracing and colouring.
• Identifying the shape various forms, like the round of sun and round of orange is still a round shape.
• Design copying.
• Large letter formations in air or wall or on a board are advised before notebook writing.
• Sorting and arranging shapes also help with visual skills like scanning, visual focus.

Pointers for Occupational Therapy Activities in Autism:

Say a child attends an art-based activity and seeks movement. He is allowed to sit on a wobbly chair or a therapy ball at the table. This provides ample movement thus increasing focus on performance.

An overstimulated child is overwhelmed, giggly, cranky, or yawning.

Flapping or stimming may be signs of calming an overstimulated system.

The therapist modifies activity in Autism Intervention:

The therapist adds to the activity when the child achieves a level of ease. Standalone swinging gets a target element. Crawling changes to crawling with rings to put in a stand. Climbing and jumping on crash pillows and moving from different suspension elements. It is essential to follow all safety protocols when a child engages in them.

Occupational Therapy Activities in Autism also discusses Sensory Breaks:

Activity breaks enhance a child’s performance. These form the sensory breaks and they are an integral part of a child’s schedule.

Sensory breaks include jumping in the corner for a certain count. Singing a song, or playing a musical instrument for some time is another example. Water break, toilet break, bursting a bubble wrap also contribute to sensory breaks.

This is how the therapist selects Online Occupational Therapy activities in Autism intervention.

 

Other Useful resources:

Spectrum of Hope – Aariv

Books about autism

The Out-of-synch child by Carol Kranowitz and Lucy Jane Miller

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