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Autism and
Occupational Therapy –
Optimizing Function
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Occupational Therapy
Enhancing function inactivities of daily living: – dressing, bathing, toileting,
eating
Promoting participation in playand social activities.
Optimizing sensory processingand motor development.
Facilitating self-regulation. Ensuring safety.
La !, "##$
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Environments
%ome: increasingindependence throughstructuring tas&s.
'aycare and preschool:self-regulation fortransitions( pre-literacys&ill building.
)chool: payingattention for learning,printing.
*linic: improve sensory
and motor
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Self Care: Activities ofDaily Living
'ressing: seuencing,overunder dressing,ta&ing clothes o/.
0athing: hygiene,refusal, fear of ater.
1oileting: boel orbladder incontinence.
Eating: cho&ing,sensory sensitivities,2ne motor s&ills.
*o3 '4 5"#"6
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Productivity: Play and School
%ome: getting readyfor preschool, cleaningup toys.
'aycarePreschool:folloing instructions,participating inactivities.
)chool: starting,maintaining, andcompleting tas&s,
paying attention.
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Leisure: Fun Fitness andFriends
+euires creativity andimagination
Play is a critical factorin development. Play teaches children
physical, social and
language s&ills, as ellas an understanding ofothers emotions.
+osenbaum, P 5"#7, "#"6 Potvin, !*
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!otor Development$#-8$9 of children ith utism e3perience substantial motorcoordination de2cits across a ide range of behaviours.
Fournier et al. "##, 4. utism 'ev. 'isorders
1reatment of identi2ed sensory-motor delays assessed by O1;s
or P1;s.*o3 '4, "#"
)peci2c motor s&ill research includes delays in both 2ne and
gross motor s&ills: –
*lumsiness –
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"ross !otor Control
• 0alance: active and standing
• 0all s&ills: catch, thro, aim,bounce, hit
• Postural stability: pelvic andshoulder girdle
• imberley "##
• Developmentally, grossmotor developmentprecedes 2ne motor control
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Fine !otor Control
1he ability to controlthe trun&, arms,hands, mouth,
2ngers and eyes toaccomplish a tas&:
dress, eat, build,
paint, dra, cutprinting legibility and
output speed, reading
computer
&eyboarding
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Social
1al& and listen.
ppropriate topics.
?nitiatecommunication orplay ith otherchildren.
lloing turn ta&ing.
Participating in groupplay.
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Self #egulation
Being in control of energy states
)oothes self hen upset
Aaits turn
1ransitions from tas& to tas&
Listens
ccepts challenges Pays attention and learns
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Sensory Processing
$ncidence % Autism BC.C9 of adults ith )' reported e3treme levels of sensoryprocessing on at least one sensory uadrant of thedultdolescent )ensory Pro2le, *rane et al "##B.
@B9 of children ith utism demonstrated sensory symptoms
on the )ensory E3periences Duestionnaire, 0arane& et al "##@, 4. *hild Psychology and Psychiatry.
B$9 of children ith utism demonstrated some degree ofsensory processing dysfunction on the )hort )ensory Pro2le 1otal )core, ith the greatest di/erences reported on the
nderresponsive)ee&s )ensation, uditory Filtering and 1actile)ensitivity sections, 1omche& 'unn, "##8.
Ge research supports decades of clinical and anecdotalevidence that individuals ith )' process sensory informationsuch as sound, touch and vision di/erently than typically
developing children, +usso et al "##.
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Sensory $ntegration$ntervention
•
O1-)? is one model ofpractice O1;s use in thetreatment of )'s.
• O1-)? is a Hspecialist
intervention; reuiringpost-graduate training.5)*, *erti2cation Program in )?6
• O1-)? 1heory andprinciples I developed by
4ean yres 5B8", B8B6
• 1o classify as O1-)?, theintervention must meetthe 2delity reuirements.
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Sensory $ntegration$ntervention
• *hild lead play.• )upervised by a trained )?
professional.
• ses euipment that is
enticing, invites creativityand is safe.
• Promotes therapist-childrelationship.
• Provides the H=ust rightchallenge;.
• Promotes adaptiveresponses, self-organization,e3ploration and pleasure.
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Sensory $ntegration $S &OT:
• applying deep pressure to a child.
• earing a eighted vest hile seated in class.
• using a therapy cushion during circle time meda, "#".
• earing headphones to bloc& ambient noise.
• sitting in a uiet corner to recover after a meltdon.
• cheing gum to calm and improve focus.
• ta&ing a al& in the hallay.
These are sensory strategies based on SI theory to supportimproved self-regulation. Research on eectiveness ofsensory strategies is mixed and should be considered on acase by case basis by the T.
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Evidence 'ased #esearch
• O1-)? e/ectivenessuestioned from both insideand outside the profession.
)ha "##", Pollac& "##8
• Fidelity study: Parham "##8 54O16• O1-)? +esearch started
afresh in "##8 and beganto focus on )'s as ell as
other diagnoses.• Ge research studies since
"##8, hich meet 2delityreuirements for O1-)?,
sho promise. Pollac& "##8
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Current OT%S$ #esearch
• +esearch lags behindclinical evidence.
• )tarts ith casereports, group studiesthen retrospectivestudies.
• !iller, L4 5"##86
• !ay-0enson et al 5"##6
• Pfei/er,0. et al 5"#6
• )chaaf, +* et al 5"#"6
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