Guest Blog: Meg Proctor from Learn, Play, Thrive: How OT Can Help Kids with Autism

You may have heard: the CDC just raised the autism rates to 1 in 59.

There are lots of parents out there looking for ways to help their kids with autism thrive in their daily life. If you’re one of those parents, you may wonder if or how occupational therapy can help your child. Most kids with autism need some help with their daily activities (in OT we call them “occupations”). This is because people with autism think and learn differently than those of us without autism. An OT can help a child with autism participate more successfully in the daily activities that are impacted by the symptoms of autism. 

Social Communication Challenges

Difficulty with social communication is the first issue that must be present to diagnose autism.  This means that a child with autism may struggle with relationships and things like body language and eye contact. Some kids may have difficulty communicating their needs and wants and understanding things that are said to them. A good OT does the detective work to figure out how the child learns, and then teaches them some of these skills in a way they can use. Here are two examples:

Rylan is a fifth-grade boy with autism who is always getting in trouble in class. The teacher says he just won’t stay in his seat for independent work. After observing Rylan and noticing that the teacher gives lots of verbal instructions for independent work time, the occupational therapist wonders if Rylan has trouble with independent work because of his difficulty making sense of spoken language. Rylan seems to have no idea what he is supposed to be doing. Since Rylan is a strong reader, the OT works with Rylan to learn to look for highlighted instructions on his paper at the beginning of every independent work session. When the teacher sees how much more successful he is with written instructions, she agrees to start writing down his instructions on his paper and highlighting them for him at the beginning of independent work. Rylan needs occasional reminders to look for his instructions, but seems more focused now that he knows what to do.

Ella is a two-year-old girl with autism who prefers to play alone. Her parents aren’t sure how to help her, and usually give up on trying to play with her after a few minutes because it never really works. Their early intervention OT watches them try to play for a bit, and then shows Ella’s parents a new way to play. She joins in with Ella’s play and imitates Ella rolling the car until the child notices her OT and looks over at her. Ella is intrigued that the OT is imitating her. After a few minutes of this, when Ella looks up, the OT does something new by making the car crash with a sound effect, “boom!” To her parents’ surprise, Ella briefly imitates her before going back to rolling the car. The OT teaches Ella’s parents a new way to play, and over time Ella is doing more playing together with her parents, complete with imitation and social smiles.

Restricted & Repetitive Behavior

The other main criteria used to diagnose autism is that a child has fewer interests than a child without autism, and their interests or behaviors can also be repetitive. This has so many ripple effects, which might include only playing with a few certain items, not wanting to transition from a preferred activity to something else like a chore or hygiene routine, or having behaviors that are inappropriate or disruptive. An occupational therapist can help teach the child new skills to help them become interested and successful at a wider range of activities.  Here are three examples of what this can look like:

Jasmine is a ten-year-old girl with autism who loves Minnie Mouse.  She badly wants to have play dates, but the other girls play board games and sports, and Jasmine is not interested in these activities. The OT uses Jasmine’s interest in Minnie Mouse to help expand her play skills. They play Minnie Mouse bingo, Minnie Mouse trivia, and eventually expand out into the games that her friends are playing. The OT shows Jasmine’s family how they can practice playing these games with her every weekend. Jasmine discovers over time that she likes playing games and is now pretty good at them.  The OT helps Jasmine’s mom arrange a play date with another little girl, and they structure the play date with a fun activity schedule showing that first they will play Jenga, and then a card game with Jasmine’s Minnie Mouse cards.

Max is a fifteen-year-old boy who likes things that spin. He enjoys watching fans and spinning his fidget spinner. When it’s time to brush his teeth, do his homework, or even go to the bathroom he yells and gets angry because he doesn’t want to transition away from watching his spinning things. The OT problem-solves with his parents and they discover that Max doesn’t know when these transitions are coming or understand the flow of his daily routines. The OT shows Max’s parents how to use an object schedule and a visual timer to help him see what he will be doing and when. They start by showing him a visual timer (a timer where you can see the passage of time in an image) to tell him when spinning time will be over, and then handing him a toothbrush in the evening to start his evening routine.  One evening, after two weeks of practicing this, when timer goes off Max grabs his toothbrush and walks to the bathroom without protest. 

Jayden is a four-year-old boy who loves to move. He is always on the go and can barely seem to sit still. He goes to an OT clinic where the therapist tries different types of movement to discover what helps Jayden calm down and focus. They learn that doing pushing activities and swinging help him the most. After pushing a small table across the room into place, he is able to sit down at it and color for several minutes. Similarly, after swinging for 10 minutes, he is more focused on playing with toys together with his parents. The OT and Jayden’s parents discuss how they can incorporate these types of movement into his daily routines to help with his focus. 

If you have a child with autism who struggles in his daily activities, an OT who understands autism learning styles may be the key to helping your child develop new skills and routines.


Meg Proctor is an autism specialist and occupational therapist, and the founder of

Learn Play Thrive, L.L.C. She offers free ebooks and video tutorials for parents of kids with autism, and

provides online occupational therapy for families in North Carolina and Mississippi.

Visit her website at