8 Ways Occupational Therapists Work with Children with Autism


Occupational therapy (OT) is often recommended for children on the autism spectrum. Children with autism spectrum disorder (ASD) commonly struggle with developmental skills that pediatric occupational therapists address. But what occupational therapy interventions for autism spectrum disorder intervention strategies do OTs use when they are working with children with autism?

Occupational therapy interventions for autism spectrum disorder: text overlay: 8 Ways Occupational Therapists Work with Children with Autism

As an occupational therapist who works with autistic children and other developmental disabilities, I have had the privilege of supporting many clients as they grow their abilities. Occupational therapy is an evidence-based practice that uses activities to improve function in daily life. Pediatric occupational therapists use autism occupational therapy activities and interventions to improve the child's ability to function at home and in school.

Children with autism have may have many developmental delays that OT can help increase a child's ability to grow and live life to the fullest.

8 Occupational Therapy Interventions for Autism Spectrum Disorder

In this article, we will discuss 8 strategies OTs use when working with children with autism to develop autism occupational therapy activities they use in their sessions.

Sensory Integration Therapy for Children with ASD

Sensory integration or sensory therapy is an intervention used to help the child learn to manage sensory input and may be recommended for children with autism spectrum disorders (ASD). Sensory therapy may be helpful for children who experience sensory informationoverload and for those who have an underdeveloped sensory system. These children are referred to as having sensory processing disorder. Children can have SPD with or without autism. Sensory interventions may include creating a sensory diet.

SI Therapy is commonly used to help children who:

  • Have trouble concentrating, staying on task, or finishing work
  • Are easily distracted, turn their attention quickly from one thing to another, or have trouble focusing
  • Are sensitive to certain sounds, loud noises, feel uncomfortable about certain textures or smells, or are bothered by specific types of touch
  • Have difficulty controlling impulsive behaviors, such as hitting, biting, or throwing things
  • Are easily overwhelmed by sensory challenges
  • Struggle with social skills, such as interacting with peers or participating in groups

Sensory integration problems may be present from infancy yet often aren't identified until a child reaches school age.

Social Stories

Social stories are a type of structured narrative that uses a child's interests to teach language and social interaction concepts that may be difficult for him to understand because of his developmental delays or special needs. They are often used to help children with autism learn new things, engage in social interactions, and develop self-awareness. This systematic approach involves three steps: (1) identifying the child's current level of understanding; (2) using the child's interests to develop a social story; and (3) reinforcing the social story through repeated reading, role-playing, and visual reminders.

Social stories can be written by the practitioner, the teacher, or the parents and can be for many different situations, such as meeting new people, going to the doctor, or taking a trip on an airplane. The use of social stories has been found to improve children's communication skills, self-awareness, and social interactions.

I used social stories with my children often. To explain how to behave in preschool circle time, going on a cruise or vacation, and many more daily activities.

Visual Schedules

I love using visual schedules both in the classroom, therapy sessions, and in the home! Visual schedules are visual representations of what a child's day will look like. They often depict the child's daily routine and provide a visual cue of what is coming up so they can prepare.

For example, a child with autism may need a visual schedule to help him prepare for a transition, such as taking a walk with his family or going to the grocery store with his parents. Visual schedules may be helpful for children who:

  • Have difficulty communicating their needs or feelings
  • Are easily frustrated by change or new situations
  • Have difficulty transitioning from one activity to another
  • Are easily distracted or have trouble concentrating
  • Have difficulty staying on task

Visual schedules should be used consistently, and whenever possible, within the context of the child's environment. Using them at school, home, or in other environments, where the child regularly spends time can help him feel more prepared and less stressed.

Activities to improve fine motor and gross motor coordination in children with autism

Motor activities are therapeutic activities that promote the development of gross motor and fine motor skills. For example, they can be used to help children with autism improve balance and coordination. Examples of gross motor activities include obstacle courses, swings, using a balance board, and the use of therapy balls.

Fine motor abilities can be worked on with activities such as games with small pieces, coins, small toys such as tongs or craft projects.

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Behavior Techniques

Behavior techniques are strategies and techniques used to increase skills and positive behaviors or to reduce challenging behaviors. There are various techniques that can be used, such as positive and negative reinforcement and fading. Many OTs have shied away from using behavior strategies with the increase of ABA services but they still have a place in OT sessions as part of the overall approach.

Positive reinforcement: Positive reinforcement means encouraging or rewarding behavior you'd like to see more of. For example, giving a child with autism a sticker every time he goes to the bathroom alone will encourage him to go to the bathroom alone.

Fading: Fading means gradually reducing the amount of attention or support given to a child. For example, if a child is learning to tie their shows but they are hesitant to try themselves, the support and encouragement are gradually lessened until they are independent with the skill.


DIR/Floortime is a type of therapy that uses a child's interests and curiosity to promote learning and development. DIR/Floortime is one type of occupational therapy treatment plan that focuses on promoting a child's interest in order to help them learn and socialize. DIR stands for a developmental individualized relationship, and

Floortime refers to engaging with the child in an interactive, “on the floor” way. DIR/Floortime therapy is used with children of all ages and may be helpful for children who:

  • Have trouble interacting with others
  • Are easily frustrated when trying to learn new things
  • Have trouble expressing their needs or feelings
  • Have difficulty controlling impulsive or aggressive behaviors

DIR/Floortime therapy is not a quick fix and often takes months to years to show real results. However, it has been shown to improve language skills, social skills, attention span, and adaptive skills. Floortime is a great way to build rapport.

Joint Attention Activities

Joint attention activities are also used in autism occupational therapy activities that promote sharing attention and interest between the child with autism and their caregivers. Joint attention is a type of communication in which two people focus their attention on the same thing or object. It's often used to help non-verbal or non-communicative children learn to communicate.

Joint attention activities are helpful for children who are not yet able to communicate with others. They may show interest in something but not be able to communicate what it is. For example, a child may like the sound of a gum wrapper but not be able to tell his parents that he wants it. Once a child can communicate well, joint attention activities can be used to help the child pay attention and stay focused on a specific activity. They can also be used to help the child learn new concepts and skills.

Joint attention activities can be used with children at any age and at any level of communication. We recommend the use of joint attention activities in conjunction with other types of interventions for autism. This is because joint attention activities alone cannot be used for the purpose of developmental progress. They must be used along with other interventions in order to produce results.

Occupational Therapy Feeding Therapy with Children with Autism

There are very specific difficulties that can affect a child's ability to eat. OTs will evaluate what is causing the difficulty and work on it. Each of these difficulties will be addressed differently, with different therapy techniques and activities.

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While most OTs can address basic feeding difficulties, if the difficulties may be causing difficulties with swallowing a swallow study will be requested prior to therapy for safety concerns. If swallowing is deemed the issue or the feeding needs are too complicated, the child may be referred to a specialized feeding clinic.

Autism is a complex diagnosis that affects every person and family differently. While there are many challenges, it is also important to realize that there are many effective and evidence-based treatments available to help people with autism. Although there is no known cure, early diagnosis and an early intervention program can help children with autism reach their full potential.

Occupational therapy activities can help kids with autism improve their skills in daily living, social interactions, and academic success. OTs often use sensory integration therapy, visual schedules, motor activities, behavior techniques, DIR/Floortime, joint attention activities, feeding therapy, and other interventions when working with children with autism.


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