Occupational Therapy: Advice for Adults with Aspergers

Adults with Aspergers (high functioning autism) often face challenges with social interaction, impaired motor skills, sensory processing issues, repetitive patterns of behavior, and intensely focused interests – all of which might interfere with their ability to complete activities of daily living in a manner similar to their peers.

Increased awareness and knowledge about Aspergers has opened many avenues to help adults with Aspergers adjust to life’s demands. One such avenue is Occupational Therapy (OT), which attempts to address the following:

• Age-appropriate interactions

• Behavior modification

• Communication and social skills

• Coping

• Family education

• Imitation skills

• Independent living skills

• Motor skills

• Repetitive behaviors

• Self-care

• Sensory skills

• Social skills

OT is a discipline that utilizes purposeful activity to obtain, regain and/or maintain one’s highest level of daily functioning, work, play and leisure activities:

• Daily functioning skills (e.g., dressing, bathing, grooming, eating, writing, home and money management, etc.) are necessary for all to maintain a healthy lifestyle.
• Work skills are necessary to be a contributing member of society and to earn an income.
• Play for children contribute to a healthy self-esteem and a fulfilling life.
• Leisure activities for adults contribute to overall mental health.

At times, situations or impairments interfere with an Aspergers person’s ability to independently complete or participate in daily functioning skills. These impairments may consist of physical, cognitive and emotional components, or a combination of all three. Once the components have been identified, the type of treatment approach can be determined.

The goal of treatment may be to increase performance levels, to restore functioning to a prior level (or close to it), or to maintain current skills – or prevent regression. For example, restorative therapy can include (a) strengthening of physical skills (e.g., coordination, strength, endurance), (b) improvement of cognitive skills (e.g., memory, following directions, attending to details), and (c) improvement of psychological skills (e.g., self-esteem, self-expression and confidence).

The Occupational Therapist must (a) evaluate which components - physical, cognitive, or emotional - are impairing the individual’s functioning, (b) begin appropriate remediation, and (c) initiate compensation. Here are some examples:

• An example of a physical deficit is difficulty with performing manual tasks. One man had difficulty writing legibly. An evaluation (which included an assessment of abilities, strengths and weaknesses in daily functioning, work, leisure and play) determined that he had decreased hand strength and impaired fine motor control (physical components). The treatment plan was to strengthen his hands, to improve coordination (restore function) and to adapt the pen grip (compensation).

• An example of a cognitive deficit is difficulty with following directions due to decreased attention. The treatment plan might include changing the environment to decrease visual and auditory distractions, or providing compensation techniques (e.g., timers, breaks, guidelines, outlines for assignments, etc.).

• An example of an emotional deficit is difficulty with environmental stimuli. One young woman with Aspergers disliked shopping. She said it was too noisy and busy. An evaluation (which included an assessment of abilities, strengths and weaknesses in performing tasks) determined she had difficulty processing sensory information (i.e., the noises and sights at the store were overwhelming to her). The Occupational Therapist designed a sensory program and compensation techniques that would allow her to successfully complete her shopping trip. The program consisted of exercises that helped her improve her ability to process sensory input from the environment. Compensation techniques included shopping at a smaller store during times that were not as busy/noisy and to practice a “social script.” The social script was a way for her to role-play and practice interaction before it actually occurs. This “rehearsal” helped her to increase her confidence and skills.

The ultimate goal of OT is to help clients have independent, productive, and satisfying lives. Furthermore, Occupational Therapists are becoming increasingly involved in addressing the impact of social, political and environmental factors that contribute to exclusion and occupational deprivation.

OT services typically include:

• a comprehensive evaluation of the client’s home and other environments (e.g., workplace, school)
• an “outcomes evaluation” to ensure that the goals are being met and/or make changes to the intervention plan
• customized intervention to improve the person’s ability to perform daily activities
• environmental adaptation including provision of equipment or designing adaptations to remove obstacles or make them manageable
• guidance and education for family members and caregivers
• how to break down activities into achievable components (e.g., sequencing a complex task like cooking a complex meal)
• performance skills assessments and treatment
• teaching new ways of approaching tasks
• the use of creative media as therapeutic activity

If you are having difficulty with social skills among friends or within the community, an Occupational Therapist can help identify the underlying reason of the difficulty. Once a likely cause or causes have been defined, treatment can begin.

There is a simple way to determine if you, or someone you know, might benefit from OT. Ask yourself the following:

• Has there been difficulty with social interactions at home, work or school?
• Has there been a change in ability to perform any activity of daily living?
• Is there something that is more challenging for you to do than it is for other people to do?

If you answered yes to one or more of these questions, OT might help you become more independent - or regain your independence.

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