Parent’s Guide to Occupational Therapy for Autism

It’s a quiet weekday morning for our occupational therapy appointment at Reid Health Pediatric Therapy and my autistic toddler is terrified. “We’re just going to look at it today,” his occupational therapist reassures. Stephanie Van Slyke, OTD, OTR/L, is referring to an innocuous swing. But Big A sees something big and unknown.

Over the coming weeks, we get closer to the swing. Eventually, hesitantly, Big A touches it. Soon, he places toys on it. Then, swinging the toys. Finally, Big A sways through the air, a blissful expression on his face. This process took months. At every step, Stephanie modeled and accommodated, encouraged, and instructed; coaching my husband and me how to do the same.

Getting Big A into the swing, in and of itself, doesn’t sound like much. And, honestly, week-to-week, inching closer to that swing, it didn’t look like much. To measure the benefits of occupational therapy with autism, you can’t think in weeks. You have to think in months. It’s only in hindsight that I understand how getting into that swing helped Big A master other day-to-day skills.

occupational therapy for autism
Big A and Stephanie, celebrating the swing

What Is Occupational Therapy?

Occupational therapy (OT) is physical, developmental, coping, social, adaptive, and communication activities that introduce, maintain, and improve skills needed for independent living. Whew. Or, as Stephanie says, “We empower people to do what they love.”

Occupational therapy activities are extremely dynamic. It’s hard to group the activities and the skills they teach into neat categories, as each activity addresses so many different skills simultaneously. “Just like typical play, we challenge kids to use multiple areas of the brain at the same time,” Van Slyke discloses. This is a distinct challenge for autistic children.

At frequent occupational therapy sessions, Big A worked on pulling himself, seated, on a scooter. This simple activity honed Big A’s motor planning skills, grip strength, cognitive processing, and dual task attention. These skills help Big A walk though a busy environment, hold a spoon, do puzzles, and pay attention in school.

autistic boy riding bike at occupational therapy

What’s the Difference between Physical Therapy and Occupational Therapy?

Physical therapy focuses more on the physical body, “strictly motor, neuro, musculoskeletal,” Van Slyke explains. Occupational therapy takes a more holistic approach, extending to cognition, functional speech, social skills, sensory issues, and much more.

Let’s say you suffered a stroke. A physical therapist would work with you to re-learn to walk and navigate your environment. An occupational therapist would “address your new issues with vision, executive functioning, and emotional coping, all while focusing on how to restore your independence with daily meaningful tasks.”

Physical Therapy

  • Decreases pain
  • Increases strength, endurance, joint range of motion, etc
  • Increases gross motor skills

Occupational Therapy

  • Helps with sensory processing problems
  • Improves executive functioning
  • Increases fine motor skills, visual-perception skills, cognitive skills, etc
autistic toddler building gross motor skills in occupational therapy
Being brave with the hammock swing

How Does Occupational Therapy Help with Autism?

Every person experiences autism differently. As said in the autism community, “If you know one person with autism, you know one person with autism.” Occupational therapy helps all people function at their best. Occupational therapy can help kids with autism in two specialized areas: motor learning and sensory processing.

Motor Learning

Motor learning is the complex skills and habits that we perform unconsciously. Take getting something off a shelf, for example. This act requires many muscles to perform harmoniously. Yet, we’re rarely thinking “reach up with right arm, grab box of cookies with hand, lean forward,” etc. That’s because multiple areas of our brains work together with ease. With autism, that’s not always the case.

It takes 10,000 repetitions of a task for the neurons in our brains to make the best connections to complete that task. It takes even longer for someone with autism. A neurotypical brain also engages in more “pruning.” This is when the brain gets rid of neurons and connections that are no longer valuable. A neuroatypical brain does not “prune” as efficiently, and thus is left with a mess of unnecessary information which slows cognitive processing.

Occupational therapy takes an adaptive approach to teaching motor learning to autistic children. Sessions may look as if they’re filled with basic, mundane, and repetitive tasks, but Stephanie is literally shaping Big A’s brain. She is teaching Big A to use his small muscle groups, over and over, creating neural pathways.

Sensory Processing

Many autistic children experience sensory processing problems, meaning that certain sounds, smells, etc, cause distress. Van Slyke doesn’t think these problems can be separated from learning experiences. Have you ever been asked to do a puzzle or complete an obstacle course while you were in extreme distress? Think you could do it? Probably not.

Therefore, Stephanie doesn’t expect Big A to learn and complete tasks when he can’t think clearly. “When our sensory system is disorganized, it’s all we can focus on. Our body is constantly in fight or flight.”

Stephanie works on satisfying Big A’s basic sensory needs. Most importantly, she teaches Big A how to meet his own needs. And she teaches Josh and me how to step in when necessary. When Big A is organized, it’s much easier to work on specific, skill-building tasks.

child with occupational therapist
Scooter work

The Benefits of Occupational Therapy for Autistic Children

The best thing about occupational therapy is its holistic approach. The positive effects of occupational therapy spill over to other life areas. Occupational therapy improves emotional, cognitive, and coping skills. These skills greatly improve a child’s school, family, and social life.

Addressing Big A’s sensory processing problems has been a game changer. When Big A has a meltdown, it’s much easier to find the culprit of distress and provide a soothing sensory experience. A calm child is a teachable child, and Big A is no exception.

autism using scooter at occupational therapy

Pediatric Therapy at Reid Health

If you’re in the Wayne County area and seeking occupational therapy for your autistic child, I recommend Reid Health Pediatric Therapy.

Reid hosts an innovative Occupational Therapy Program, implementing the newest training and treatment techniques. They’re also willing to bring in whatever their population needs, replacing 1,500 square feet with a sensory playground and life skills kitchen in 2019.

Reid offers other incredible pediatric therapy services like custom foot and brace fittings, aquatic therapy, swallowing evaluation and treatment, and functional electrical stimulation.

How Do I Get My Sign My Child up for OT?

If you’re interested in occupational therapy for your child, tell your primary care doctor. Ask for a referral to Reid Health Pediatric Therapy for occupational therapy.

The referral will be sent to the office and Reid Health Pediatric Therapy will contact you to schedule an evaluation.

occupational therapy for autism


Megan writes everything on Ish Mom. She possesses a bachelor's degree in psychology, a flair for theatrics, and a whole lotta nerve. She lives in the Midwest (and loves it) with her wonderful husband and three young boys.

One Response

  1. My sister would like to have her son try occupational therapy because the latter has selective autism. I agree with you that this type of therapy will help the child with his grip. Thank you for sharing here as well that this may help address any vision matters too.

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