Autism Spectrum Disorder (ASD) is an array of developmental disorders that impact an individual’s social interaction and communication skills. Individuals with ASD also present with stereotyped, repetitive behaviours as well as sensory processing differences. These disorders often present between the ages of 1 and 3.
Symptoms
Physical
- Increased visual stimulation
- Decreased auditory stimulation
- Decrease in motor skills
- Repetitive behaviours
- Stereotyped behaviours
- Gastrointestinal issues
- Sensory processing differences
- Communication difficulties
Cognitive
- Changes in joint attention
- Decreased attention and memory
- Fixed interests and routines
- Changes in ability to learn adaptive behaviours due to difficulties with communication and social interaction
- Decreased or absent Theory of Mind
Affective
- Increased frequency of emotional outbursts due to difficulty communicating needs
Assessments
Physical
- Peabody Developmental Motor Scales (PDMS)
- Sensory Profile 2
- Sensory Processing Measure
Cognitive
Affective
- Antecedent – Behaviour – Consequence (ABC) Chart
Functional
Common Occupational Performance Issues (OPIs)
Self-Care
- Difficulty learning self-care skills (i.e. toileting, dressing, grooming, bathing) due to difficulty with communication and social interaction
- Difficulties performing self-care ADLs due to sensory processing differences as well as rigid routines, fixed interests, and rigid routines
- Difficulty eating due to sensory processing difficulties and difficulty communicating needs
- Difficulty communicating needs may lead to frustration and self-harming behaviours
Productivity
- Difficulty coping with transitions in the school environment due to rigid routines
- Difficulty interacting with peers, developing relationships, and working in groups due to difficulty with communication, social interaction, and decreased Theory of Mind
- Difficulty focusing in the classroom environment due to overstimulation in the classroom
Leisure
- Repetitive play
- Absent or reduced engagement in group play with same age peers
- Fixed interests in toys and leisure activities
Frames of Reference
- Developmental
- Behavioural
- Environmental
- Sensory Integration
- Compensatory
Interventions
Self-Care
Communication: First-Then boards, Picture Exchange Communication System (PECS), assistive technology
Toileting: Social stories, routines and schedules, foot stool, seat reducer, forward / backward chaining, distractors in the washroom, cueing
Dressing: seamless clothing, forward / backward chaining, shaping, accessible clothing fasteners, social stories
Eating: Social stories, texture progressions, food chaining, appropriate seating, foot stool
Bathing: Social stories, distractors in the bath, adjusted water temperature, adjusted rinsing technique, forward / backward chaining
Productivity
School Engagement: Sensory breaks, modified classroom environment, recommendations for differentiated instruction, assistance with the creation of an individualized education plan (IEP), fine and gross motor skill program, assistive devices and technology (i.e. raised line paper, pencil grips, mind-mapping software)
Behaviour: Social stories, social skills training, ABC chart, First-Then boards, PECS, assistive technology for communication, routines and schedules, advanced warnings for transitions, education about how to approach children with ASD
Leisure
Play Exploration: creating a play space with diverse sensory stimuli, educate parents on how to play with their children to facilitate different forms of play
Play Participation: introduce to group play environments to facilitate interaction with same age peers, scaffold fixed interests to incorporate other play interests and play partners