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Words from an OT- Neuroaffirming Occupational Therapy for Neurodivergent Youth

What is Occupational Therapy (OT)? How can OT help neurodivergent children and teens (like autistic youth, kids and adolescents with ADHD, Learning Disabilities etc)? What can neuroaffirming OT look like? How do I find a pediatric OT that can support me or my child/teen?

Occupational Therapy (OT) as a practice takes a perspective that includes the whole person, their environment and the activities the person finds meaningful. As OTs we are trained to use this “wide-lens” in order to find creative ways for our clients to successfully access their life, accomplish goals and participate in meaningful activities. Neurodivergent clients should be understood within the context of their daily lives, including family, home, school, relationships, participation and potential barriers to inclusion in all aspects of their lives.

Boy drawing on paper with pencil crayons for occupational therapy

This includes consideration of:

  • Goals (short and long term)

  • Functional Capacity: Skills, strengths and abilities

  • Personality and preferences

  • Sensory needs and processing capabilities

  • Regulation 

  • Motor skills

In my practice, I take a positive, strengths-based approach where therapeutic goals use the individual’s already existing skills and abilities to expand to new or adapted skills and behaviours. Goals are highly client and family-centered. It is not my intention to provide therapy to some idealized goal where a child fits into the mold of what is considered “normal” or “neurotypical” or "allistic" by someone else’s standards, but rather together we collaborate family, client and therapist to build a vision of the future where the client can fully participate in activities they find meaningful and goals that they are motivated to achieve

As an OT, I act as a guide and rely on clinical experience to assist the client with problem solving ways to break down barriers in your life. Sometimes this means building skills:

  • Social skills: Again this would not be to make a person “fit-in” or appear more “typical”, however but to break-down barriers of social exclusion, conflict or misunderstandings. Often clients have the social skill goal to better understand what the social rules are and how as a neurodivergent person they can be themselves while making friends and forming social relationships.

  • Regulation: This is a person’s ability to regulate their emotions, and behavior to a particular situation. Emotions are a normal, expected part of every human’s functioning. Experiencing intense or distressing emotions and/or behaviors is problematic when one is unable to transition to another state. Dysregulation is commonly displayed as challenges with transitions and changes in routine. In fact, sometimes good regulation is demonstrated when a child cries, gets upset, yet is able to calm and recover to rejoin class/social activities. The problem is not that a person gets upset, but that they get stuck there and take a longtime, intervention or support to adjust their emotions and behavior. 

  • Behaviour: The OT role in behavior is a partnership between the client, and family to uncover the underlying reason for behaviour. Often behaviour is a result of unmet needs (Sensory, regulation, physical) or a skill mis-match with environmental demands (e.g. client’s fine motor skills are a barrier for producing legible written work so the client refuses to complete writing tasks in school). OTs work to uncover the underlying reasons for unwanted behaviour and then break down the barriers, meet the underlying needs or teach skills and compensatory techniques to overcome the lacking skills. Frequently environmental accommodations such as sensory strategies and tools are used to meet the person’s regulation needs. 

  • Sensory Processing: Every individual has a sensory processing style and needs, we are all on a spectrum of sensory processing. Some people need tons of input to perceive or feel the sensation (hyposensitive/high threshold); while others need minute amounts of input to feel and a normal level of sensory input is perceived as intense or even painful (hypersensitivity/low threshold). Sensory processing is all based in neurology and the processes, connections and communications within the brain and between the brain and body. Sometimes these messages take longer to process or sometimes get “tripped up” along the way. When this happens, a person has challenges with regulation, or adjusting their emotions, body and behavior to the situation or task. This is called a sensory-modulation dysfunction. OTs are experts at assessing individual sensory needs and processing challenges, and creating strategies and tools to support a person’s optimal sensory processing which leads to improved regulation, behavior and learning.

  • Executive Functioning: These are cognitive skills such as planning, organizing, sense of time, motivation, sequencing and perspective (thinking about self and others). These skills are often highly challenging in neurodivergence. OTs support skills and strategies to learn executive functioning skills as well as environmental and personal adaptations to compensate (e.g. apps, technology for writing/planning/scheduling).

  • Motor Skills: In some autistic individuals, there can be challenges with motor skills such as writing, drawing or learning new sports or gross motor activities. Trunk-strength and joint hypermobility is also common. OTs can teach strategies to support motor skill development and/or compensatory techniques. 

  • Social Communication: Here OTs take a more functional approach. Our role is to foster participation in social communication across a person’s various life contacts: home, school, leisure, social and play activities. OTs support the implementation of social communication strategies. OTs also support alternative and augmentative communication (AAC). AAC includes both high and low-tech such as visuals, Core-Boards, as well as high tech devices and apps. In this role, OTs facilitate the motor, visual and regulation skills involved in accessing AAC. We also support finding functional phrases to use in social contexts (“Social Scripts”) as well as utilizing training tools such as Video modeling and Social stories in order to demonstrate and practice social communication.

OTs can also support with life transitions such as the transition to school, adulthood, or accommodations in the workplace. Also, OTs often contribute valuable assessment information in the process of diagnosing Autism. 

Want to understand more about how OT can help you? Our OT services are virtual, which means they are open to anyone in Ontario, Canada.

Click below to book an appointment with the post author, Kim Hanson (Ontario residents only) 

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