How Occupational Therapy Can Support Autistic Children: A Neuro-affirming Approach

Occupational therapy plays an important role in supporting autistic children to participate meaningfully in everyday life. Instead of focusing on “fixing” a child, therapy nowadays increasingly embraces neuro-affirming care. This post briefly discusses how occupational therapy can help autistic children, the benefits of neuro-affirming care, and practical ways this concept can be integrated.

How Occupational Therapy Helps Autistic Children

Occupational therapy focuses on enabling meaningful participation in daily activities (or referred to as occupations). For autistic children, these occupations may include self-care (e.g., feeding, dressing), learning at school (e.g., handwriting, scissoring), and leisure activities (e.g., puzzles, crafts).

Occupational therapists (OT) may help address different areas, such as:

Sensory processing and regulation

Some autistic children may experience sensory differences, such as heightened sensitivity to sound and touch, or seek more sensory input. That can be challenging for some autistic children, causing frustration, anxiety, or meltdowns. OTs help children and their family develop strategies for their sensory and emotion regulation so that they can meaningfully participate in daily activities gradually.

Daily living skills

OTs support children in developing independence in daily activities like eating (e.g., holding a spoon and chopsticks), and dressing (e.g., use of zippers and buttons), while respecting each child’s unique pace and preferences.

School participation

OTs can support classroom participation by addressing person-environment fit (e.g., height of the table and chair), sensory demands (e.g., the brightness of light and the noise level), fine motor and handwriting issues (e.g., improving pencil grip for better endurance in handwriting).

Emotional regulation and coping

OTs can help children identify emotions, recognize signs of stress, and develop emotional regulation and coping strategies that align with their sensory and communication preferences.

What Is Neuro-affirming Care?

Neuro-affirming care is grounded in the understanding that neurological differences are part of normal human variation instead of using a deficit-based mindset. When it applies to autism, neuro-affirming care respects autistic identity and lived experience, avoids suppressing or masking autistic traits, prioritises well-being and autonomy, and values collaboration with the autistic person and their family.

Benefits of Neuro-affirming Occupational Therapy

Benefits of Neuro-affirming Occupational Therapy

Supports Well-Being and Autonomy

When the therapy validates children’s experiences and respects their preferences, they are more likely to feel safe and develop a better sense of autonomy. This can reduce their anxiety and support their overall well-being.

Reduces Harmful Masking

Encouraging autistic children to constantly suppress natural behaviors (such as forcing eye contact when they are not ready) or setting goals that encourage harmful masking may lead to mental health challenges. Neuro-affirming OT recognizes some behaviors as meaningful self-regulation strategies rather than symptoms that should be eliminated.

Meaningful Outcomes

Since the goals of neuro-affirming care are grounded in the child’s and family’s values, they are more likely to be important and relevant to their meaningful participation in daily activities, rather than focused on meeting societal “norms”.

Integrating Neuro-affirming Care into Occupational Therapy Practice

Neuro-affirming occupational therapy is a way of thinking and practicing. Here are some examples of how neuro-affirming care can be integrated into occupational therapy practice:

1. Strengths-Based Goal Setting

OTs focus on identifying children’s strengths and preferences. Goals are created together with the child and family and reflect what matters to them. For example, if the autistic child has a strong interest in cars, the OT may collaborate with the child and family to create some visual car-themed schedules to support daily routine and learning.

2. Respecting Sensory Needs

Instead of trying to solely desensitize children to uncomfortable sensory input, neuro-affirming OTs explore different strategies, such as the use of noise-reducing headphones, movement breaks, and alternative clothing with different textures to support participation in daily activities.

3. Environmental and Task Modifications

Instead of forcing the child to adapt to rigid environments, neuro-affirming OTs also consider modifying the expectation, the task, and/or the environment to improve accessibility. For example, if a child finds sitting still and writing in a noisy classroom overwhelming, the OT may recommend flexible seating and noise-reducing headphones.

Child Neuropsychology Assessment Ontario

Conclusion

Occupational therapy can help autistic children in different aspects. By respecting individual differences and focusing on meaningful participation, occupational therapy, which aligns with neuro-affirming care, can help support autonomy, reduce the chances of harmful masking, and facilitate meaningful outcomes where autistic children can flourish with authentic and fulfilling lives.