Navigating Therapies After an Autism Diagnosis: Understanding the Roles of Occupational and Physical Therapy
Receiving an autism diagnosis for your child can be a life-altering experience for parents. Whilst it may provide a sense of relief and understanding, it can also open up a world of new challenges and decisions. One of the most significant difficulties parents face is navigating the complex landscape of therapies and interventions recommended for autistic children. Many parents find themselves overwhelmed by the sheer number of options and the pressure to make the “right” choices for their child’s development.
It’s crucial to recognise that these challenges are not inherent to autism itself, but rather a result of societal barriers and a lack of understanding and acceptance of neurodiversity. The social model of disability posits that it is not an individual’s way of being that disables them, but rather the physical, social, and attitudinal barriers in society that limit their full participation and inclusion. In the context of autism, this means that the focus should be on creating inclusive environments and providing appropriate support, rather than trying to “fix” or “cure” autistic individuals.
Furthermore, the Power Threat Meaning Framework (PTMF) offers a valuable perspective on understanding autism and the experiences of autistic individuals and their families. The PTMF suggests that behaviours and experiences that are often pathologised, such as those associated with autism, can be better understood as responses to various forms of power, threat, and the search for meaning in one’s life. This framework emphasises the importance of considering the social, cultural, and political context in which autistic individuals live and the impact of these factors on their well-being and development.
In light of these perspectives, it becomes clear that understanding the various therapies and their roles is not just a matter of making informed decisions about a child’s care, but also a critical step in advocating for their rights and inclusion in society. By gaining a deeper understanding of the different interventions available, parents can better collaborate with professionals to create individualized support plans that promote their child’s strengths, autonomy, and overall well-being. This knowledge also empowers parents to challenge practices or recommendations that may be rooted in ableism or a narrow view of what constitutes “normal” development.
In the following sections, we will explore two commonly recommended therapies for autistic children: occupational therapy and physical therapy. We will examine their roles, the specific skills and challenges they can address, and how they can be used to support autistic children in a way that respects their unique needs and experiences. By providing this information, I hope to empower parents to make informed decisions and advocate for their child’s rights in a society that often fails to fully understand and accept neurodiversity.
The Difference Between Occupational Therapy and Physical Therapy
When considering therapies for autistic children, two commonly recommended interventions are occupational therapy (OT) and physical therapy (PT). Whilst both therapies aim to support an individual’s development and participation in daily life, they focus on different areas of functioning and employ distinct approaches.
Occupational therapy is a holistic intervention that focuses on helping autistic individuals develop the skills necessary for everyday activities, including self-care, play, and learning. OT recognises that many autistic children may experience challenges with fine motor skills, sensory processing, and self-regulation, which can impact their ability to fully participate in home, school, and community life. However, from a social model perspective, it is essential to acknowledge that these challenges are not inherent deficits, but rather a result of environments that are not designed to accommodate neurodiversity.
Occupational therapists work to identify and address the specific barriers that autistic people may face in their daily lives. They may focus on developing fine motor skills, such as handwriting or using utensils, which can be essential for academic success and self-care. OT also addresses sensory processing differences, helping autistic people develop strategies to regulate their sensory experiences and manage potential overwhelm in various environments. By providing tools and adaptations that enable autistic people to engage in meaningful activities, OT can promote a sense of autonomy, competence, and self-determination.
On the other hand, physical therapy primarily focuses on gross motor skills, mobility, and overall physical function. PT recognises that some autistic people may experience challenges with balance, coordination, strength, and motor planning, which can impact their ability to navigate their environment and participate in physical activities. However, it is crucial to view these challenges through the lens of the social model, acknowledging that societal barriers and lack of accommodations can exacerbate these difficulties.
Physical therapists work to identify and address the specific motor challenges that autistic people may face, whilst also considering the social and environmental factors that may limit their participation. They may focus on developing gross motor skills, such as walking, running, and climbing, which are essential for navigating the physical environment and engaging in play and recreational activities. PT also addresses issues related to posture, gait, and mobility, which can impact an autistic person’s ability to fully participate in a variety of settings.
When viewed through the PTMF, both OT and PT can be understood as interventions that aim to support autistic people in developing the skills and strategies necessary to navigate a world that often fails to accommodate their unique needs and experiences. By focusing on enhancing an individual’s abilities and reducing environmental barriers, these therapies can help autistic people assert their autonomy, build resilience, and find meaning in their daily lives.
It is important to recognise that OT and PT are not mutually exclusive and can often complement each other in supporting an autistic person’s development. For example, an occupational therapist may work on fine motor skills and sensory regulation strategies that enable a child to engage in physical activities more successfully, whilst a physical therapist may address gross motor challenges that impact a child’s ability to participate in self-care routines or classroom activities. By collaborating and taking a holistic approach, OT and PT can help create a more inclusive and supportive environment that celebrates neurodiversity and promotes the well-being of autistic individuals.
When Occupational Therapy May Be Recommended
Occupational therapy may be recommended for autistic children when they experience challenges with specific skills that impact their ability to fully participate in daily life activities. These challenges are not inherent to autism but are often a result of environments that are not designed to accommodate neurodiversity. By addressing these skills and advocating for inclusive environments, OT can help autistic children thrive in various settings.
One area where OT can be particularly beneficial is in the development of fine motor skills. Many autistic children may experience difficulties with tasks such as handwriting, cutting with scissors, or manipulating small objects. These challenges can impact their ability to engage in educational activities, complete self-care routines, and participate in play and leisure pursuits. Occupational therapists can work with autistic children to develop these skills through targeted interventions, such as hand-strengthening exercises, visual-motor coordination activities, and the use of adaptive tools and techniques.
Another key area where OT can provide support is in sensory regulation. Autistic individuals often experience sensory processing differences, which means they may be over- or under-sensitive to various sensory stimuli, such as sound, light, touch, or movement. These differences can lead to challenges in regulating emotions, focusing attention, and engaging in daily activities. Occupational therapists can help autistic children develop personalised sensory regulation strategies, such as using weighted blankets, noise-canceling headphones, or sensory breaks, to manage their sensory needs and promote optimal functioning.
OT can also play a crucial role in supporting autistic children’s self-care skills, such as dressing, feeding, and hygiene. These skills are essential for promoting independence, self-esteem, and overall well-being. Occupational therapists can work with autistic children to break down these tasks into manageable steps, provide visual supports and prompts, and identify any necessary adaptations or modifications to the environment or tools used.
In the classroom setting, OT can be invaluable in supporting autistic children’s success and inclusion. Occupational therapists can collaborate with teachers to identify and address any barriers to participation, such as sensory overload, difficulty with fine motor tasks, or challenges with organisation and planning. They can provide recommendations for classroom accommodations, such as flexible seating options, alternative writing tools, or sensory-friendly lighting, to create a more inclusive and supportive learning environment. OT can also work directly with autistic children to develop self-advocacy skills, enabling them to communicate their needs and preferences effectively.
When viewed through the lens of the PTMF, OT can be understood as an intervention that helps autistic children develop the skills and strategies necessary to assert their autonomy and find meaning in their daily lives, despite the challenges posed by environments that are not always accommodating to neurodiversity. By focusing on enhancing an individual’s abilities and reducing environmental barriers, OT can promote a sense of competence, self-determination, and resilience in autistic children.
It is important to recognise that the decision to pursue OT should be based on the individual needs and preferences of each autistic person and their family. For example, not every autistic child will require OT, and some may benefit more from other interventions or accommodations. By taking a person-centred approach and considering the unique strengths, challenges, and goals of each individual, families and professionals can work together to create a comprehensive support plan that promotes the well-being and inclusion of autistic children in all aspects of life.
When Physical Therapy May Be Recommended
Physical therapy may be recommended for autistic children when they experience challenges with gross motor skills, mobility, or overall physical function that impact their ability to fully participate in daily life activities. These challenges are not inherent to autism but are often exacerbated by environments that are not designed to accommodate diverse motor abilities. By addressing these skills and advocating for inclusive environments, PT can help autistic children engage more successfully in physical activities and promote their overall motor development.
One specific area where PT can be beneficial is in addressing challenges with balance and coordination. Some autistic children may experience difficulties with maintaining balance whilst walking, running, or engaging in other physical activities. They may also struggle with coordinating their movements, leading to challenges with tasks such as climbing stairs, riding a bicycle, or participating in sports. Physical therapists can work with autistic children to develop these skills through targeted interventions, such as balance training, obstacle courses, and activities that promote body awareness and motor planning.
Another area where PT can provide support is in building strength and endurance. Some autistic children may have low muscle tone or experience fatigue more quickly than their peers, which can impact their ability to engage in physical activities for extended periods. Physical therapists can work with autistic children to develop individualised exercise programs that focus on building core strength, improving cardiovascular endurance, and promoting overall physical fitness. These interventions can help autistic children build the stamina and resilience necessary to participate more fully in recreational and educational activities.
PT can also play a crucial role in addressing any mobility challenges that autistic children may face. Some autistic individuals may have differences in their gait, posture, or ability to navigate uneven surfaces, which can impact their safety and independence in various environments. Physical therapists can work with autistic children to develop strategies for safe and efficient mobility, such as using assistive devices, practicing safe transfers, or learning proper body mechanics. By promoting mobility and reducing the risk of falls or injuries, PT can help autistic children engage more confidently in their daily routines and activities.
In the context of physical activities and overall motor development, PT can be invaluable in supporting autistic children’s participation and progress. Physical therapists can collaborate with families, educators, and coaches to identify and address any barriers to participation, such as sensory challenges, difficulty with motor planning, or lack of accessible equipment or facilities. They can provide recommendations for adaptations or modifications to activities or environments, such as using visual supports, breaking down tasks into smaller steps, or providing alternative equipment, to create a more inclusive and supportive setting for physical engagement. PT can also work directly with autistic children to develop specific motor skills, such as throwing, catching, or kicking a ball, that are necessary for participation in various sports and games.
When viewed through the lens of the PTMF, PT can be understood as an intervention that helps autistic children develop the physical skills and strategies necessary to assert their autonomy and find meaning in their daily lives, despite the challenges posed by environments that are not always accommodating to diverse motor abilities. By focusing on enhancing an individual’s abilities and reducing environmental barriers, PT can promote a sense of competence, self-determination, and resilience in autistic people.
It is important to recognise that the decision to pursue PT should be based on the individual needs and preferences of each autistic person (and their family). Not every autistic person will require PT, and some may benefit more from other interventions or accommodations. By taking a person-centered approach and considering the unique strengths, challenges, and goals of each individual, families and professionals can work together to create a comprehensive support plan that promotes the well-being and inclusion of autistic people in all aspects of life, including physical activities and overall motor development.
The Importance of Individualized Assessment and Goal Setting
When considering occupational therapy or physical therapy for autistic people, it is crucial to recognise the importance of individualised assessment and goal setting. Each autistic person is unique, with their own strengths, challenges, and experiences, and a one-size-fits-all approach to therapy is unlikely to be effective. By conducting thorough evaluations, collaborating with therapists to set meaningful goals, and regularly reviewing progress, one can ensure that therapy plans are tailored to the specific needs and aspirations of each individual.
The role of evaluations in determining an autistic person’s specific needs and appropriate therapies cannot be overstated. Evaluations should be comprehensive, considering not only the person's motor skills, sensory processing, and self-care abilities but also their interests, preferences, and the environmental factors that may impact their functioning. From a social model perspective, it is essential to recognise that the challenges an autistic person faces are not solely a result of their individual characteristics but are also influenced by the accessibility and inclusivity of the environments in which they live, learn, play, work, etc. Evaluations should consider these environmental factors and identify potential barriers to participation that may need to be addressed through accommodations or modifications.
When setting goals for therapy, it is essential to collaborate closely with the autistic person (when possible), their family (if appropriate), and the therapists involved in their care. Goals should be meaningful, achievable, and relevant to the person's daily life and aspirations. The PTMF emphasises the importance of considering the individual’s unique life experiences, the power dynamics at play in their environment, and the ways in which they make meaning of their experiences. By taking a PTMF-informed approach to goal setting, everyone can ensure that therapy plans are not only focused on skill development but also on promoting the individual’s sense of agency, autonomy, and resilience in the face of challenges.
The PTMF also highlights the crucial role that place plays in shaping an individual's experiences and well-being. When planning therapy interventions, it is essential to consider the various environments in which the person lives, learns, and plays, and how these environments may impact their functioning and participation. For example, an autistic child may have different sensory needs or motor challenges in a crowded, noisy classroom compared to a quiet, sensory-friendly home environment. By considering the role of place in therapy planning, families and therapists can develop strategies and accommodations that are specific to each environment, promoting the child's success and inclusion across all aspects of their life.
Regular progress monitoring and plan adjustments are also key components of individualized therapy. As autistic people develop new skills, encounter new challenges, or experience changes in their environments, their therapy needs may shift over time. By regularly reviewing progress and making necessary adjustments to therapy plans, families, and therapists can ensure that interventions remain relevant, effective, and responsive to the individual’s evolving needs and goals. This ongoing collaboration and flexibility are essential for promoting the long-term well-being and success of autistic folks.
Ultimately, individualized assessment and goal setting, informed by the social model of disability and the PTMF, are essential for providing effective and meaningful occupational therapy and physical therapy for autistic people of all ages. By taking a holistic, person-centered approach that considers the unique strengths, challenges, and environmental factors impacting each person, care givers and therapists can work together to promote the inclusion, autonomy, and resilience of autistic individuals in all aspects of their lives.
Final thoughts …
Throughout this article, we have explored the distinct roles of occupational therapy and physical therapy in supporting autistic people. While both therapies aim to promote an individual’s participation and well-being, they focus on different areas of development and employ unique strategies. Occupational therapy primarily addresses fine motor skills, sensory processing, and self-care, while physical therapy focuses on gross motor skills, mobility, and overall physical function. However, it is essential to recognise that these therapies often complement each other, working together to create a comprehensive support plan that meets the individual needs of each autistic child.
As parents navigate the complex landscape of therapies and interventions, it is crucial to remember that they are their child’s most important advocates. Asking questions, seeking support, and actively participating in the decision-making process are essential for ensuring that their child receives the most appropriate and effective care. Parents should feel empowered to collaborate with professionals, share their insights and concerns, and advocate for their child's unique needs and goals.
Informed decision-making is at the heart of selecting appropriate therapies for autistic people. By understanding the key differences between occupational therapy and physical therapy, as well as the importance of individualised assessment and goal setting, folks can make choices that align with their specific strengths, challenges, and aspirations. This process should be guided by a commitment to the social model of disability, which recognises that the challenges autistic people face are not inherent deficits but are often a result of environments that are not designed to accommodate neurodiversity.
Moreover, the Power Threat Meaning Framework reminds us that an individual’s experiences and well-being are shaped by the complex interplay of power dynamics, threats, and the search for meaning in their lives. By considering these factors when selecting and planning therapies, parents and professionals can ensure that interventions not only focus on skill development but also promote the autistic person’s sense of agency, autonomy, and resilience.
To conclude, occupational therapy and physical therapy can play vital roles in supporting the development, participation, and well-being of autistic people of all ages. By understanding the unique contributions of each therapy, advocating for their needs, and making informed decisions based on individualised assessments and goals, folks can help create a supportive and inclusive environment that celebrates neurodiversity and promotes long-term success. Remember, every autistic person is unique, and the most effective approach to therapy will be one that is tailored to their individual needs, strengths, and aspirations.