by Dr. Rachel Timmons, OTD, OTR/L
Children with autism often present with similar delays and deficits that can lead to an occupational therapy evaluation. Some of those delays are in fine motor skills, gross motor skills, sensory processing abilities, balance and coordination, weakened core, poor postural control, and delays in self-care tasks as well as school-related tasks, all of which can be addressed during an occupational therapy session. Most children at Cornerstone receive direct occupational therapy one time a week for 45 minutes each session to work on the skills listed above. In conjunction to this direct service, programs are in place for the child’s ABA therapists to work on skills daily, leading to an increase of OT goals met in a shorter amount of time. Below are some activities and resources that you could do at home to help facilitate the skills listed above for an increase in performance throughout your child’s daily routine.
Fine Motor Skills The focus of activities to promote increased fine motor skills should be to strengthen the tiny muscles throughout the digits and palm. Some activities to do this include:
- Tweezer or chopstick play (I like to incorporate sensory into it and have them use the tweezers to grasp cotton balls, or small objects out of a bucket of beans or rice).
- Squeezing putty or play dough, and making various shapes with the putty
- Playing with Legos, small figurines, or games with small game pieces to facilitate increased grasping and grip strengthening. Focus on having your child use their thumb and index finger only (neat pincer grasp) when grasping a small item.
Gross Motor Skills The focus of gross motor activities should be to include the whole body in the activity, the more muscle groups involved the better. Some good activities to try:
- Any sort of ball play--catching, kicking, rolling, throwing (over and under hand) and vary the size of the ball you use.
- Playing games in which various crawls or walks are incorporated, like crab walk, army crawl, bear walk, etc.
- Any activity which promotoes increased jumping, running, skipping, climbing.
Sensory Processing and Modulation Like most areas- children with autism will show a variety of deficits and delays. Sensory processing is something that is very child specific. The activities below may be very stimulating for one child while it may be extremely aversive to another child. Feel free to contact me to discuss how your child responds to various types of sensory input. Texture play- playing with a variety of textures; rice, beans, putty, play dough, shaving cream, cooked noodles, sand, and the list goes on.
- Vestibular stimulation- using swings in play and varying the type of motion (linear- back and forth or side to side, and rotary- spinning). Also riding bikes, being pulled in a wagon and car rides are all examples of slow linear vestibular stimulation.
- Proprioceptive input and heavy work--playing games where the child is forced to use muscles; gross motor games, crawling, jumping, running, crashing, climbing, pushing or pulling something heavy.
- Deep pressure--these are activities where the input is placed upon the child (child is a passive recipient to the input), muscle massages, joint compressions, laying in a hammock or ball pit, and being smashed by pillows or cushions.
The key component to sensory modulation is to vary the input throughout the day. The more input they receive from the categories listed above, the better their bodies will be at processing the added input.
Postural Control and Core Strengthening Weak or low muscle tone is a common factor in children with autism and without good core control, it makes fine and gross motor skills difficulty because they do not have a stable base of support to work from. Below are some activities to help strengthening the core for increased postural stability;
- Sitting and bouncing on a therapy ball
- Laying prone (on stomach) when completing an activity- this will force them to engage their trunk muscles to keep their head upright during the activity
- Scooter board or bike riding activities
- Games incorporating balance (either standing or sitting)
Self-Care and School Tasks Many times, when the above skills are worked on, the result is improved independence and performance in self-care and school related tasks. But working on these skills can help better facilitate that independence.
- Encouraging all dressing age-appropriate tasks to be independent--at least allow them to attempt the activity, then provide help when needed.
- School tasks- such as cutting, coloring, possibly handwriting. All take practice, which is typically not desireable for most children, but the key is trying to make it fun and motivating for the child. Maybe working on a therapy ball while coloring, practicing cutting skills with play dough or putty instead of just paper, or getting window markers and work on handwriting on a window, mirror or in the bath tub.
The key component to occupational therapy is keeping the sessions and activities “child-directed.” This means I allow the child to pick what we do but I manipulate it into being therapeutic and to work on the goals I have set for the child. This way, it is always motivating, and they child does not realize that they are doing “work.” When working at home, I encourage you to be playful and imaginative with the activities, this will yield the best results. Below are some websites that may be useful resources for activities to do at home.