Introduction

As a pediatric occupational therapist, you play a critical role in the lives of children and youth, helping them to improve their health and quality of life. Your role extends into schools, where you support students in their engagement and participation in meaningful activities, ranging from recess to academics. Working with students on the autism spectrum can be both challenging and highly rewarding, provided you are equipped with the right strategies and mindset. This article provides an overview of essential strategies and considerations for supporting students with severe autism, based on the experiences of a pediatric occupational therapist.

Understanding the Landscape

Before embarking on the journey of working with students with severe autism, it is vital to develop a deep understanding of their areas of interest, communication preferences, and goals. This knowledge will serve as the foundation for effective interventions and can significantly enhance your impact on their lives and those of their families.

1. Identifying Student Interests and Communication Styles

Understanding the student's interests, likes, and dislikes is crucial. Adopt a strength-based approach to identify and leverage the student's areas of strength. Additionally, observe and understand their communication methods, which may include behavior, picture-based communication, or verbalizations. Behavior that appears challenging is often a form of communication. By asking yourself, "What is the student trying to tell me?" you can gain valuable insights into their emotional and social needs.

2. Setting Clear Goals and Expectations

Setting clear and specific goals is key to effective intervention. These goals should be understandable and achievable, and they should align with the student's interests and abilities. When expectations are clear, you can prioritize your efforts and ensure that your interventions focus on the most important areas for the student.

3. Identifying Triggers and Sensory Preferences

Observe and document any environmental triggers that may affect the student's behavior. Consider the sensory preferences of the student, as certain sensory experiences, such as music or lighting, can either calm or upset them. Understanding these triggers will help you create a more supportive and inclusive environment for the student.

5 Effective Strategies for Intervening

1. Effective Use of Reinforcement

Use the student's areas of interest as a powerful tool to motivate them to learn. Reinforcement should be gradually phased in, and it should be used to increase desired behaviors, such as engaging in academic activities, rather than to prevent undesirable behaviors. For example, using a student's favorite toy to encourage them to work on their math problems is a form of successful reinforcement, whereas offering a cookie to stop hitting is bribery.

2. Simplifying Language and Instructions

Keep your instructions simple, direct, and to the point. Break down complex instructions into smaller, manageable steps, such as "First, let's do your math, then we'll move on to reading." Providing choices can also make the instructions more engaging and less overwhelming for the student. For example, asking, "Do you want to start with math or English?" can help the student feel more in control and engaged.

3. Utilizing Visual Supports

Visual aids can be invaluable in providing clear expectations and reducing the need for verbal instructions. Use visual schedules, task lists, duration boxes, environmental cards, and other visual supports to help the student understand and transition between activities. Visual supports can significantly increase the student's independence and decrease their reliance on verbal directions.

4. Modifying Academic Work

Academic challenges can often lead to problematic behaviors in students with autism. By modifying the academic work, you can make it more manageable for the student. This might include shortening assignments, providing more breaks during work, or adjusting the level of difficulty. When you observe challenging behaviors around academics, consider the following questions:

Is the work too hard? If so, modify the assignments. Is the work too easy? If so, provide more challenging tasks. Is the student not motivated? Provide more reinforcement to increase their engagement.

5. Emphasizing Inclusion

Inclusion is a critical component of supporting students with autism. Sociability is often a deficit for students with autism, and they require opportunities to interact with their peers without autism. Inclusion not only benefits the student with autism by teaching them social skills, but it also benefits the students without autism, as they learn from their peers with different abilities. Inclusion can serve as an effective anti-bullying campaign by promoting understanding and acceptance among students.

Conclusion

Working with students who have severe autism can be both challenging and rewarding. As a pediatric occupational therapist, your role is crucial in supporting these students in their educational and social development. By understanding their interests, communication styles, and goals, and by implementing effective strategies such as reinforcement, simplified language, visual supports, academic modifications, and inclusion, you can make a positive and meaningful impact on their lives. For more information on supporting students with autism, please refer to the following websites:

Autism Speaks National Autism Association Celebration Autism