Saturday, 25 June 2011

Occupational therapy and autism: the archetypal all-rounder

I will readily admit that I have always been a little bit confused when it comes to occupational therapy (OT). Confused because the name 'occupational therapy' does not really provide the most satisfying answer as to what occupational therapy involves and in what ways occupational therapists can help. There are various definitions on the web about OT; probably the most satisfying that I have found is this one from NHS careers, although I tip my hat to the Wikipedia entry also.

Basically OT is all about enabling people who otherwise might be described as disabled. OT covers a lot of ground in terms of who therapists work with (people with physical and mental health problems, older people, etc), but generally their role includes: (a) looking at everyday tasks and seeing how they are carried out and might be done differently to either make life easier or fit in with a persons strengths and weaknesses, (b) providing advice and help in making referrals to other support agencies, (c) providing advice on speciality equipment, adaptations or training which might improve a person's quality of life. I was quite surprised when I read this job description because in my ignorance, I had always assumed that solving problems with mobility and movement was the mainstay of the profession. I admit I was wrong and apologise to occupational therapists everywhere.

Given the job description for an occupational therapist, one could perhaps see how the profession might be of some use to people diagnosed with an autism spectrum condition for various reasons. Lisa Jo Rudy at About.com provided a good overview a few years back of some of the ways that OT might help, coupled with quite a few 'glowing' reports on the use of OT available on the web. The American Occupational Therapy Association also have a good overview of OT and autism. When it comes to the research-side of things, there are quite a few studies that have utilised facets of OT and produced some quite surprising data. Various areas of interest have been reported on including:

  • Sensory issues (see here and here)
  • Motor and movement abilities (see here)
  • The use of animal-assisted therapies (see here and here)
  • Employment issues (see here)
  • Relationships and social interactive behaviours

I get the impression that OT is the hidden 'all-rounder' for many different conditions including autism. An all-rounder because OT seems to be the group which are supposed to provide the 'overview' of what might be best practice to bring out the best of an individual, day-to-day. Making day-to-day living easier is the goal of many interventions related to autism, for early behavioural and speech and language therapy, through to things like dietary intervention, although often any benefits are more generalised. OT is perhaps at the coal-face because of its emphasis on practical daily living skills and tangible benefits from things like a person learning to dress themselves or using assistive technologies to communicate. Another issue that strikes me from looking at the various information on OT is that whilst having being evaluated for effectiveness, many of the strategies used are quite individualised, hence quite difficult to empirically test under normal experimental conditions (n=1 perhaps?). This combines with the fact that OT normally works alongside other professions such as speech and language therapy; deciphering what is having an 'effect' is perhaps secondary to the cumulative effect from such combined efforts.

I end this post therefore with a salute to occupational therapy; the archetypal all-rounder.