How Can Occupational Therapy Help Children with Autism?

In 2020, the CDC reported that around 1 out of 54 children in the U.S. is diagnosed with autism spectrum disorder. Many children with autism experience sensory differences, which can include over and/or under-sensitivity to light, sound, smell, taste or touch; unusual interest in the sensory aspects of the environment and obsession with particular types of stimuli; and/or difficulty integrating two or more sensations. These symptoms can be debilitating as they interfere with so many ordinary activities of daily life. Something as simple as taking a shower or getting a haircut can be immensely challenging and feel like an overwhelming amount of sensory stimulation. At the other extreme, some autistic individuals have a reduced sense of pain which can create safety concerns.

Sensory integration therapy is a form of occupational therapy that involves specific activities to help a child appropriately respond and integrate sensation. Researchers like Dr. Roseann Schaaf, PhD, director of the Jefferson Autism Center of Excellence and professor in the Department of Occupational Therapy in the College of Rehabilitation Sciences, are studying how this therapy can improve outcomes for children with autism and help with daily activities. Read on to learn more about Dr. Schaaf’s research.

Q: How long have you been at Jefferson? What led you here?

A: I have been at Jefferson since 1983, first as an instructor and eventually as Department of Occupational Therapy chair and finally, as director of the Autism Center of Excellence.  I came to Jefferson when the program was newly forming.  Our curriculum model was innovative and the other faculty visionary – this led me to choose Jefferson.

Q: Tell us a bit about your field or area of research. What’s one question you’re exploring?

A: I am an occupational therapist and a neuroscientist.  I conduct studies related to autism including studies that evaluate the effectiveness of occupational therapy interventions, and studies that examine the neurological substrates of these sensory features in autism and other neurodevelopmental conditions. Currently my team is conducting a large, NIH-funded clinical trial to evaluate the outcomes of occupational therapy using Ayres Sensory Integration® for children with autism.  Ayres Sensory Integration® is a theory and evidence-based intervention developed by Dr. Jean Ayres, an occupational therapist and neuropsychologist.  Dr. Ayres was the first to recognize that challenges processing and integrating sensation can be an important factor that limits successful participation in daily life activities and tasks. Dr. Ayres identified playful, active, sensory-motor activities that children could engage in, under the direction of a trained occupational therapist. These activities often include playing on different types of swings, crashing into a large, cushioned “crash pad” while playing a find-and-seek game, or crawling through carpeted tunnels to “find treasure.”  Importantly, the activities during therapy are individually tailored to the child’s need, and the child’s response and outcomes are measured during the therapy. In this research we are asking the question: “Can occupational therapy using Ayres Sensory Integration® improve the child’s ability to participate in their daily living activities?”

I am also the principal investigator of a grant designed to study sensory features in autism, which is a collaborative project with researchers from top universities across the country, and in the United Kingdom.  Here, we are asking questions about the “mechanisms of sensory features in autism” and also helping to improve access to needed services. For example, some studies are measuring brain responses during visual and tactile tasks; and others are educating ophthalmologists and other healthcare providers on how to adapt their medical and vision exams to ensure autistic persons are comfortable.

Q: What first sparked your interest in your area of research/your research question?

A: My interest in these topics grew from my early clinical experiences where I saw the power of occupational therapy for helping children become more independent in their daily life, playful and happy.

Q: What’s the fire in your belly that drives your passion for your research?

A: My desire to understand how occupational therapy using Ayres Sensory Integration® works from a brain-behavior perspective is the fire in my belly.  We see the intervention help so many children but we needed data and evidence to show its effectiveness and mechanisms of action.  We manualized the intervention, created a way to measure its use, developed a data-driven decision-making process to guide the clinician’s reasoning during therapy, and then began to study the outcomes.  Now, this intervention is rated as an evidence-based intervention for autism which allows greater access to it for all. Insurance companies such as Cigna recently approved coverage for it – that is a big step forward!!

Q: What’s a cool or little known or unique fact about your work?

A: Many people don’t realize that I have a strong interest in the brain-behavior connection.  Not only do I study this in my research, but I try to live it in my everyday life.  I am a yoga teacher and love to bring my knowledge of neuroscience, sensory integration and the brain to my yoga practice! It’s important that we tune into our senses, pause and experience life in the present moment.

Q: If you had any words of advice for an aspiring researcher or student in this field, what would they be?

A: Persist! Research can be challenging and laborious but it is so exciting to discover and uncover new developments that will help children and families lead more successful and satisfying lives.