Neuro occupational therapy: supporting autistic people.
As a UK study of autistic people is paused for an ethics probe, we look at the role of neuro OTs in supporting the autism community.
The most extensive genetic study of autism spectrum disorder (ASD) in the UK has been put on hold amid concerns it failed to consult autistic people about its aims adequately.
The £3m Spectrum 10K study was launched at the end of August by Simon Baron-Cohen, director of the Autism Research Centre (ARC) at the University of Cambridge.
But just ten days later, it was paused after fears were raised that other researchers may misuse the genetic data being collected.
According to a Nature report, [1], the Spectrum 10K team voluntarily paused the study, apologised for causing upset and pledged further consultation with participants.
However, protestors, Boycott Spectrum 10K, ‘a group of Autistic academics, activists, and advocates [2]’, will be gathering outside the ARC on October 29 to highlight their concerns.
What is ASD?
According to the UK’s National Autistic Society [3],there are around 700,000 autistic adults and children in the UK, with one in 100 people on the autism spectrum.
For many, symptoms improve with age, and with treatments and therapies, they can live independently with some support.
The cause of autism is not yet known, but scientists have identified some genes linked to it and regional differences in early brain development.[4]
Environmental factors are also suspected of playing a part, though there is no evidence of this.
However, what is known is that autism is a spectrum condition and, as such, can present different challenges from one person to the next.
Broadly, however, these challenges fall into the following areas:
Communication and interaction
Some autistic people may need support with:
- Recognising or understanding other people’s feelings and aims
- Expressing emotion
- Interpreting language, tone of voice or gestures
- Processing information
- Understanding abstract ideas
- Speaking
Sensory needs
Some autistic people are over-or under-sensitive to stimuli such as pain, temperature, touch, taste, smell, sounds, light and colour.
Some find specific sensory experiences so ever-whelming, it causes them physical pain.
Support may be needed to reduce sensory overload in their surroundings.
Emotions
Some autistic people experience high anxiety levels and may have problems controlling their emotions.
Support may be needed to understand the causes of mood changes and find ways of managing them.
When overwhelmed, an autistic person may go into:
- Meltdown – a temporary loss of behavioural control
- Shutdown – going quiet and appearing to switch off
Repetitive/restrictive behaviour
Some autistic people like routine in their activities of daily living (ADLs), such as the clothes they wear, the food they eat or the routes they travel.
Understanding their routines is essential as changes can cause upset and anxiety.
High focus
Some autistic people become intensely involved in personal interests and may like to share their expertise with others.
They may need support, however, in ensuring they manage other areas of their life too.
OT and ASD
A third of autistic people also have a learning disability but to different degrees. Some can live independently, while others will need specialist support for life.
Neuro occupational therapists (OTs) provide holistic support for autistic people to maximise their ability to function independently.
This could include assessing:
- Home, educational or work environments
- Sensory processing skills
- Social interaction
- Communication skills
- ADL abilities
- Executive function
A neuro OT may also carry out a risk assessment to ensure home, educational or work environments are safe.
They may identify necessary adaptations or suggest the use of aids and equipment to help in daily life.
And other strategies may be recommended to assist with self-care or managing emotions or behaviour.
For autistic people diagnosed with sensory difficulties, a neuro OT may suggest sensory integration therapy to help control sensory stimulation and the brain/body response.
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Further Reading
Executive skills and brain injury: dealing with the unexpected
Brain injury and social skills
Self-awareness after an acquired brain injury