Career Pathways & Education

Occupational Therapy & Autism

Tracy Capili, OTD, OTR
December 1, 2023
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Occupational therapy for autism involves specialized strategies and activities to enhance daily living for individuals with ASD.  Autism spectrum disorder (ASD), when diagnosed in early childhood, impacts one in thirty-six children, and the statistics have reflected rising numbers over the past few years.1 Occupational therapy practitioners (occupational therapists and occupational therapy assistants) who work with people with ASD across the lifespan enjoy supporting a highly diverse population with unique strengths and challenges. The emotional rewards of helping people with ASD and their families and caregivers live their best lives are high, and therapy is unlikely ever to be boring. 

Defining Autism

Autism, also known as autism spectrum disorder (ASD), is a highly diverse group of conditions characterized by difficulty with social interactions and communication. Common characteristics include atypical activity patterns, repetitive behaviors, difficulty with transitions (from one activity to another), and intense focus on details, routines, and sequencing.

People with ASD may resist changes in their daily practices, schedules, expectations, and surroundings. A small change in routine can result in very uncomfortable feelings and significant reactions for a person with ASD. People with ASD often have difficulty with abstract ideas, and they make sense of the world through predictability, structure, and rigid adherence to schedules. They can have trouble reading people's facial expressions and understanding others' emotions.    

​​Autism is a spectrum disorder, which means no two people with ASD are exactly alike. Each individual has their unique strengths and challenges. The way that people with ASD think, learn, problem-solve, and interact with the world can range from high-functioning and skilled to severely challenged and in need of maximum support. Some individuals with ASD require a high level of support to function in daily life, sometimes throughout their lifespan, and some need only minimal help or live independently.3

There isn't one known cause of ASD. Several factors, including both environmental and genetic factors, are thought to contribute to the development of ASD. Factors that often accompany ASD include sensory sensitivities (sensitivity to sound, sight, smell, hearing, taste, and touch), gastrointestinal (GI) disorders, and anxiety, depression, and attention issues.3

What is Occupational Therapy for Autism? 

Occupational therapy (OT) is a unique and holistic profession that uses everyday life activities (occupations) to promote health, well-being, and a person's ability to participate in essential activities in their life. OT supports people in doing what they want to do. Occupational therapy services include an evaluation and intervention plan with individualized goals and ongoing assessment of progress toward meeting those goals.

Occupational therapy aims to improve everyday cognitive, physical, social, and motor skills, allowing people to be as independent as possible and participate in various experiences. For people with ASD, occupational therapy typically focuses on everyday life skills such as self-care, learning strategies, and managing sensory issues.5

Some of the life daily life skills addressed by OT include:

  • Eating
  • Dressing
  • Bathing and Personal Hygiene
  • Using the Bathroom
  • Fine Motor Skills (using pencils and markers, grasping, typing, writing, utensils, opening containers, managing buttons and zippers, and scissors)

Occupational Therapy Goals for Children with Autism

Sensory Issues

People with ASD can be susceptible to noises and sounds. These sounds can include those found in an everyday environment, such as chatter in a store or classroom, unexpected noises, such as a fire engine siren, toilet flushing, and the sound of the hand dryer in a public restroom. 

Sometimes, sounds that are unnoticeable to others, such as the buzz from overhead fluorescent lights, can be overwhelming and highly distracting to people with ASD. People with ASD can also be sensitive to touch, such as from clothing textures or water, and visual stimulation, such as sensitivity to too much light or multiple colors of light and strong smells.

OT helps people with sensory sensitivities develop adaptive strategies to function better at home and in their communities. Some examples of adaptive sensory strategies include:

  • Wearing noise-reducing or noise-canceling headphones 
  • Wearing "sensory friendly clothing" such as socks without seams 
  • Using more gentle sounds for notifications and alarm clocks
  • Minimizing visual clutter at home and school
  • Applying breathing and mindfulness techniques to regulate emotions and responses to overstimulation
  • Use unscented products such as laundry soap and self-care essentials

Eating and Feeding Challenges

Eating and feeding challenges can be related to various factors, including oral motor functioning, gastrointestinal dysfunction, and oral sensory issues. People with ASD are more likely to experience eating and feeding challenges related to sensory responses about food's sight, smell, taste, temperature, or texture. Sensory hypersensitivities can result in problem eating, such as picky eating, limited food choices, weight issues, mealtime stress, and meltdowns. Occupational therapists help by providing gentle, child-driven intervention to gradually introduce nutritious foods and variety into a child's diet for healthy nutrition and development. 

Fine and Visual Motor Delays 

Kids with ASD can struggle with letter formation, writing in a straight line, grasping a pencil, and using scissors to cut paper. OT practitioners help by providing fun and functional activities to practice fine and visual motor skills.


Rigid thinking and resistance to routine changes can lead to self-regulation issues. Being unable to be still, having meltdowns, and causing disruptions are all signs of dysregulation. Occupational therapy practitioners help by teaching kids simple and "easy to do anywhere" strategies to recognize and manage their emotions and reactions.  Examples include deep breathing, counting, and taking a break in a calm space.

Practical Occupational Therapy Activities for People with Autism

Occupational therapy practitioners working with people with autism use the person's "occupations" as the basis for treatment interventions. For children, that means lots of play and learning-based interventions. For adults, that means many functional activities to practice life and employment skills. People with autism benefit significantly from tailored occupational therapy activities.

Toddlers and Preschoolers

  • Container Play: grasp, hand manipulation skills, and following simple directions.
  • Cause and Effect Toys: pushing buttons, pulling knobs and handles, and pointing.
  • Sensory Bins: feeling and touching different textures.

Elementary Schoolers

  • Board Games: following directions, taking turns, active waiting (self-regulation skills), and fine motor skills to pick up and move game pieces. 
  • Writing: handwriting, typing, keyboarding.
  • Arts and Crafts: fine and visual motor skills, using scissors and markers, sequencing steps.

Middle and High-Schoolers

  • Complex Games (such as cards or chess): fine and visual motor planning skills, following complicated directions.
  • Graphic Organizers: writing composition (planning a story or paragraph).
  • Calendars and Daily Agendas: planning home, school, and community-based routines and managing a schedule. 


  • Engage in activities to learn employment-related skills, such as establishing a workday schedule, communicating effectively with co-workers, and interviewing skills.
  • Practice using public transportation or planning the route to work.
  • Improve self-advocacy and self-help skills by reviewing common scenarios, such as attending a health care appointment or shopping for groceries.

Embark on a Rewarding OT Journey with Autism Therapy

In summary, occupational therapy for autism provides essential support, helping people with ASD to reach their highest potential in daily activities. The role of an occupational therapy practitioner in this field is not just professionally fulfilling but also deeply rewarding and engaging. As practitioners, OTs working with kids with ASD are at the forefront of creative and adaptive learning, tailoring their approaches to meet the dynamic needs of children and their families. 

If you're inspired to be part of this transformative field, we encourage you to explore opportunities in the OT profession. Sign up for a profile with Trusted Health today, and take the first step towards a career that makes a real difference in the lives of people with autism and their families.


  1. Data & Statistics on Autism Spectrum Disorder | CDC
  2. Autism
  3. What Is Autism?
  4. What is occupational therapy? | AOTA
  5. Occupational Therapy (OT) | Autism Speaks
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