The diagnosis of children with autism is on the rise. In 2020, approximately 1 out of every 54 children in the United States is diagnosed with an autism spectrum disorder, according to the CDC. A great number (31%) of those with ASD have an intellectual disability, about 40% are nonverbal, and many children with autism lack the social, motor, and physical skills needed to perform everyday tasks and have typical interactions with others.
When a child is diagnosed with autism, the interventions must treat the whole person, not simply a few hand-picked symptoms of the disorder. Because autism is such a multifaceted disorder to work with, various professionals are needed to create interventions for the child. This is why occupational therapy (OT), physical therapy (PT), and speech therapy (ST) are common services that children with autism receive.
The licensed professionals who provide these services to children with autism focus on their area of expertise, yet all experts communicate and collaborate together to treat the symptoms of autism and help the child be successful in all areas of their life.
When young children go to their pediatrician, there is general screening that is done for signs of developmental delays and autism. If there are deficits or signs, they will conduct further testing as well as refer the parent to other professionals for more specific evaluations.
Screening and evaluating is the first step to take to diagnose a child with autism and to determine which type of services they need in their treatment plan.
Those options often include:
- occupational therapy
- physical therapy
- speech therapy
Screening and Evaluating
When a child is diagnosed with autism, screening and evaluation take place to determine the severity of the disorder. The information obtained from these evaluations also shows areas of need that parents, doctors, teachers, and other professionals can focus on. Ideally, screening for autism should take place at an early age, sometimes even before a child is a year old. At around one to three years is when professionals pay close attention to behavioral and developmental milestones and are also when signs of ASD begin showing up. When an evaluation identifies an area of concern, it is recommended that a formal developmental evaluation take place, which will provide even more necessary information to move forward with interventions.
If a red flag comes up in the general screening and evaluation, then an OT, PT, or ST may be hired to conduct specialized evaluations to get a more clear picture of what is going on.
Selected examples of screening and diagnosis tools for general development and ASD are:
- Ages and Stages Questionnaire
- Communication and Symbolic Behavior Scales
- Parents’ Evaluation of Developmental Status
- Modified Checklist for Autism in Toddlers
- Screening Tool for Autism in Toddlers and Young Children
- Autism Diagnosis Interview
- Autism Diagnosis Observation Schedule
- Childhood Autism Rating Scale
- Gilliam Autism Rating Scale
There are various tools used to assess and diagnose children who may have autism, and no single tool alone is appropriate.
The American Academy of Pediatrics has a more comprehensive list of developmental screening tools used on young children to determine if they have autism.
Occupational Therapy (OT)
Occupational therapists work with children with autism in school, at home, and out in the community. They conduct observations and evaluations to determine the strengths and needs of each child they work with and then create a treatment plan.
WebMD offers a simple definition of what an OT is:
Occupational therapists study human growth and development and a person’s interaction with the environment through daily activities. They are experts in the social, emotional, and physiological effects of illness and injury. This knowledge helps them promote skills for independent living in people with autism and other developmental disorders.
Occupational therapists can work in many areas of practice; their schedules can be flexible and they can work for themselves, which means they can go to schools, in homes, and out in the community with children with autism. These are the areas they can work in:
- Pediatric – schools, community, hospitals, outpatient clinics.
- Acute care hospitals
- Inpatient rehabilitation
- Rehabilitation centers – treating stroke (CVA), spinal cord injuries, head injuries
- Skilled nursing facilities
- Home health
- Outpatient clinics
- Specialist assessment centers
- Assisted living facilities
- Productive aging
- Mental health
OTs create individualized treatment plans for the children they work with. They can have one or more goals to work on at a time.
A few examples of OT interventions for children with autism include:
- Physical activities to promote gross and fine motor skills
- Developmental activities such as brushing teeth, making the bed, or getting dressed
- Play-time activities where collaboration, communication, and social skills are involved
- Adaptive tasks like practicing transitions between activities or places and working on self-regulation
- Introducing sensory-based strategies
The benefits of working with an occupational therapist, whether it be at home or in a school setting are wonderful. Children with autism who are provided OT services can increase their communication skills, socialize better with peers and in group settings, express emotions more appropriately, show more independence and confidence, and develop and maintain relationships.
If a parent is wondering whether or not their children will benefit from OT services, they can contact a therapist who specializes in ASD and start the evaluation process.
Physical Therapy (PT)
Physical therapists also work with children with autism on a regular basis because many people on the spectrum have motor deficits. PTs evaluate children to identify their functional motor limitations and restrictions and to determine a plan of action to address those.
PTs work with children on fine and gross motor skills and go above and beyond what an occupational therapist might do. They assess and evaluate a child’s posture, mobility, body awareness, transitions, play skills, daily routines, and how they physically interact with others.
Physical therapists work with your child, the family, and your child’s school to help them:
- Engage and improve in daily routines at home and school.
- Acquire new movement skills.
- Develop better coordination and a more stable posture.
- Improve play skills, such as throwing and catching a ball with another person.
- Develop motor imitation skills (learn by copying anothers’ actions).
- Increase fitness and stamina.
There are great benefits of hiring a physical therapist for a child with autism. Working with a PT can help in the following areas:
- Encourage large-quality movements during therapeutic play
- Improve balance, coordination, and gross motor skills
- Increase confidence in social situations
- Support better behavior and mood
- Provide education and support to parents
Some of these examples may seem similar to what an occupational therapist does.
How are OT and PT different?
The most basic difference between physical therapy and occupational therapy is that a PT focuses on improving the patient’s ability to move their body whereas an OT focuses on improving the patient’s ability to perform activities of daily living, (MCPHS).
Children with autism can work with both an occupational and physical therapist, as they focus on different aspects of the autism disorder.
Speech Therapy (ST)
Lastly, speech-language therapy (ST) is a common service that children with autism have. This service can be provided in the home, in a clinical setting, or at school.
Speech therapy addresses the deficits and challenges that an individual with autism may have such as social communication, proper grammar, functional communication, nonverbal communication, holding a conversation, modulating the tone of voice, verbally interacting back and forth, and understanding facial expressions, as well as working on their own while communicating.
Many children with autism are nonverbal and communicate more effectively using pictures or technology, which is known as Alternative Augmentative Communication (AAC). This type of communication can be done via sign language, iPads, speech output devices, and a picture exchange communication system. Speech therapists will explicitly teach the children they work with to use alternative communication methods.
Specific goals of speech therapy include helping the individual with autism:
- Articulate words well
- Communicate both verbally and nonverbally
- Comprehend verbal and nonverbal communication, understanding others’ intentions in a range of settings
- Initiate communication without prompting from others
- Know the appropriate time and place to communicate something
- Develop conversational skills
- Exchange ideas
- Communicate in ways to develop relationships
- Enjoy communicating, playing, and interacting with peers
- Learn self-regulation
Speech therapy is appropriate for most individuals with autism and can greatly benefit those who struggle with communication and language, especially when interventions are in place early on in the child’s life.
Conclusion to the Benefits of Therapy for Children with Autism
When working with a child with autism, the best way is to take a whole-child, holistic route that includes various forms of treatment. Occupational therapy, physical therapy, and speech therapy are all examples of service-related treatments that children with autism can have in the home or in the classroom. The benefits of obtaining these services at a young age are wonderful. Those who believe their child with autism might need OT, PT, and ST services can contact their physician for recommendations as well as search online for licensed and reputable individuals. It is never too late to start intervening.
Master of Education (M.Ed.) | Northeastern State University
Behavior and Learning Disorders | Georgia State University