Occupational Therapy Essay

Occupational therapy (OT) helps people function in environments, such as home, work, school, or within his or her community, by addressing the physical, psychological, and cognitive needs of his or her well-being through engagement in everyday activities. In short, occupational therapy helps those live life to its fullest no matter their health or disabilities. Occupational therapists typically provide interventions to clients in the settings where they will likely engage in daily activities the most. Services are provided to all different age groups, including children with disabilities to help them participate fully in school or social situations, those recovering from injury to regain skills, or providing support for older adults who are
experiencing physical and cognitive changes. One group of people who significantly benefit from occupational therapy are those diagnosed with Autism Spectrum Disorder. Occupational therapy services for autistic children aim to increase their personal development and quality of life as well as address specific needs of the family. (aota) Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impairment in brain functioning, specifically to those areas that play a role in social behaviors and communication skills. In addition to diminished social skills, individuals with ASD also present with restricted interests, repetitive and stereotypical behaviors, difficulty processing and integrating sensory information, and delayed language skills. These underlying deficits often impair their ability to develop social relationships, learn social etiquette, and function in everyday activities. In the past 10 years, the number of children diagnosed with autism has increased dramatically. With the increase in diagnoses, the need for services has also increased, particularly for occupational therapy interventions with the highest degree of effectiveness. (smith) Those diagnosed with ASD range in severity and possess varying amount of social skills.
As a result, occupational therapy services are catered to each individuals specific needs, their desired goals, and their priorities for participation in normal everyday activities. For some, services may only focus on developing skills needed for simple activities of daily living, such as feeding or dressing. Others, work on more complex activities of daily living needed to be successful in educational or social settings. (aota) The specific interventions also depend on the age of the person diagnosed. At younger ages, therapists tend to focus on the sensory-processing, sensorimotor, social, and behavioral aspects of autism. In adolescence, the focus shifts to mainly social-behavioral aspects, transitioning to work, and gaining independence within the
community. After an evaluation takes place to determine a child’s developmental delays, an intervention plan is created. The interventions chosen is determined by the empirical data, the child’s strengths and limitations, setting where services are being provided, resources available, family preferences, and the expertise of the occupational therapist in charge. (smith) The approaches to helping children diagnosed with ASD achieve their goals can be broken down into six categories: sensory-based interventions, relationship-based interventions, developmental skill-based programs, social cognitive skill training, parent-directed or-mediated approaches, and intensive behavioral intervention. Together, these interventions all attempt to the child’s sensory, physical, or social environments so that he or she can achieve normalcy. (Swinth) Children with ASD benefit the most from structured activities where the child can copy therapists models and adapt their method of interacting to incorporate communication into their everyday life. To increase an autistic child’s ability to be successful in social environments, research has shown that prearranged environments where the child encounters a social dilemma, such as a toy being out of reach, and needs to respond has shown the greatest positive results. The professional working with the child then waits for the child to respond to the situation, imitates the social response, and then provides positive social reinforcement. An occupational therapist can use this technique in their sessions by creating scenarios that promote social interactions, such as sharing or cooperating, supporting the child as he or she works through social dilemmas on his or her own, or imitating the child and waiting for their response. This differs from behavioral approaches where the occupational therapists creates natural play scenarios while giving directions and rewards and have the child imitate the interaction. Other studies have shown children can typically learn to initiate social interactions with other children with ASD given minimal encouragement. Peer modelling increases the social participation among ASD children. Both social, peer-based, and behavioral approaches have been proven effective in increase social interactions. However, one may be more appropriate for a particular child given his or her circumstances. (smith) For behavioral problems, effective interventions are those that establish environments that consistently prevent said behaviors, eliminate the triggers of the behaviors and the consequences that reinforce them, and develop appropriate behaviors through instruction, modelling and guidance.
Occupational therapists can take this approach and take apply it to their sessions by modifying the environments to facilitate the correct amount of stimulation for the child. This can include using weighted vests, beanbag chairs, or spandex to meet the child’s sensory needs and help the child feel calm, quiet, and secure. In addition to this, occupational therapists can use their sessions to incorporate classroom rules to help the child pick up on social cues and safety procedures.
(smith) Studies have found the access to these services to be one of the most challenging parts of obtaining services for ASD children. “Service challenges were a major source of stress for many families, who found gaining access to services to be daunting, disruptive, and financially straining”(Swinth 4). This sentiment mainly stems from the overall diagnostic process and the diagnostic criteria needed to receive services. The process is quite lengthy and confusing, so parents are often left in the dark until a diagnosis is finally made. Upon receiving a diagnosis of ASD, the services that that diagnosis warrants are often still unclear. Multiple professionals are involved in the assessing the child and coming up with an intervention plan. Communications between all professionals involved are key to creating the most effective intervention plan and to reduce the amount of stress on the family. Occupational therapists must be aware of how the system works so that he or she can navigate it and avoid any obstacles that may delay the process as well as incorporate any specific strategies or evaluations into their intervention plan. (swinth) Family-centered care intervention plans revolves around reframing the family dynamic around the autistic child and stresses the importance of communication between the family and all those involved in his or her treatment plan. Establishing this relationship allows the families to make effective decisions in accommodating the needs of their child with ASD. Occupational therapists partner with the families to provide instruction and guidance. They teach families not to try to “fix” their child, but to accept them for who they are embracing all of their quirks. This creates a better atmosphere where the child feels comfortable and is able to learn. From there, occupational therapists are able to provide strategies that meet the child’s specific developmental goals and needs in order to reframe the family in such a way that the child is better equipped to handle social situations, life roles, routines and transitions from one environment to another. This allows the family to function better as a whole and the child to acclimate better with his or her peers. (Swinth). The sensory integration–based approach for occupational therapy has also been proved effective in addressing ASD children’s needs. This complex approach is designed to foster the maximum amount of engagement within the children.