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Deborah Howell: The autism spectrum is something more and more families across America are now negotiating for the first time. Let's learn more about autism spectrum disorders with an expert in the field. I'm Deborah Howell and our guest today, Jordan Wassmer is an occupational therapist at Deaconess the Women's Hospital. Welcome Jordan.

Jordan Wassmer: Thanks for having me.

Host: So let's jump right in. What is autism spectrum disorder?

Jordan Wassmer: Autism spectrum disorder is just a group or a spectrum of psychological disorders and as an OT, how I look at it is that it can affect a variety of different aspects of life so it can impact functional skills, social skills, communication, sensory processing, and so many things. The thing about autism is that each person diagnosed with autism is going to present a little differently. So just like with everyone, those with autism will have areas that they excel in and areas that they will need a little extra help. Being diagnosed with autism requires specialized testing, and that is not performed by occupational therapists. Occupational therapists are not qualified to do any diagnosing. Sometimes children with significant delays or behaviors will be referred to us by a primary care physician or a pediatric specialist prior to any diagnosing, because therapy is needed to address their development and sensory needs at that time.

A child could also be diagnosed with autism and then referred to therapies after diagnosis. And this is also to help with development, sensory processing, social skills, any behaviors. Children diagnosed with autism will often also receive ABA therapy pretty intensely to address behavior, but OT is very important as well because not only are we skilled at working on development and functional skills, but we also look at root underlying causes of any difficulties and we provide supports and tools and address any sensory needs. And all of this is to help with improving their participation and performance with play and social skills, and any functional skills that they might need some help with.

Host: Now what do occupational therapists do with children who are diagnosed with autism spectrum disorder?

Jordan Wassmer: So occupational therapists, they will work with kids with autism to help them develop and improve independence. We'll work on things to regulate their sensory systems. We will learn how to cope with daily tasks that might be difficult for them, and OT is going to look for root causes and try to help children with autism learn how to cope and understand things in their own ways. So we will use like tactile cues, verbal cues, a lot of visual cues, just whatever the child responds to best to help them learn a new task or participate in that activity as independently as possible.

Host: Got it. Now does autism affect progression of developmental skills?

Jordan Wassmer: Children with autism do sometimes have lower scores with developmental testing initially, however, I have seen so many kids perform fantastically with developmental skills, with time, practice and the right tools. Sometimes they just need some extra time or some extra help, or just like a different way of learning to understand that skill or to understand what we're asking of them better. So in my personal experience, I have found that the kids that I work with always have the capacity and the skills to perform the actual tasks that I'm asking of them. But we just have to figure out a way for them to learn it in a way that works for them specifically. And that can take a little while sometimes, honestly. But that's okay because we're all always learning and adapting every day. So we all do things at our own pace and in our own time. And kids with autism are no different and OTs are here to provide the interventions and the support. But honestly the pace is always driven by the child.

Host: Sure. Now what kinds of things do occupational therapists work on?

Jordan Wassmer: So OTs, we will work on fine motor skills, core strengthening, sensory processing, visual motor integration, bilateral coordination, just lots of different things like that. Those are all areas of development that impact our ability to participate in daily tasks. So without those skills, things like playing, jumping, skipping, cutting out a square, copying a diamond, drawing a smiley face, recognizing body parts on a drawing can all be harder than someone might expect. So we help children practice and develop independence. Also with things like functional tasks, like putting on socks and shoes, brushing teeth, buttoning clothes, following simple, what we would think are simple routine tasks using a chart. I mean the list is really endless. We can work on so many things to help children participate in play, and become more independent in daily tasks. And it's our job to help children develop those skills and feel successful while learning these new or more difficult skills.

Host: Well I just have to say as an auntie of my beautiful, beautiful nephew who has autism, your work is so appreciated.

Jordan Wassmer: Thank you.

Host: How do you help kids feel successful in helping them learn a new skill?

Jordan Wassmer: We provide constant support to complete a task, whether a child needs visual cues or verbal cues or extra time encouragement, redirection, reinforcement. Those are all things that we can use in any combination to provide support to a child, to help them feel successful while they're learning something new. And initially we will provide a lot of support to help that child gain confidence with the new skill. But as they get more and more confident and more and more practice, and more used to that skill, we will slowly start to taper or like decrease the amount of support that we provide until eventually they're doing it all on their own.

Host: Got it. Jordan, I know you spoke a little bit about this before, but let's get into it a little more. How can occupational therapy help children with autism?

Jordan Wassmer: An occupational therapist is going to look at things like sensory processing, performance with functional skills and underlying causes that might be affecting a child's participation or performance in play or ADLs. And an ADL for a child would be like play, brushing your teeth, brushing your hair, taking a bath, putting your clothes on. But we try to provide sensory input, help to establish routines and habits, address improved participation in functional skills and improve play and interaction skills. So what is amazing about working with children with autism and really all children, is that they are also uniquely different and have different needs and different qualities and different strengths. So an occupational therapist is going to tailor the activities during the therapy session to meet a child, right where he or she is at every session because it's going to be different every session. And, we just try to create an environment in which we can address the deficits but provide enough assistance to create a positive and encouraging environment.

Host: Great. Now you mentioned ADLs. I just want to make sure our audience knows what that is.

Jordan Wassmer: So, an ADL is an activity of daily living, so like it's like brushing your teeth, putting on your clothes, taking a shower in a way for like children though, I mean ADLs go across occupational therapy for the whole lifespan, but play would be an activity of daily living and necessity for children cause that's how they learn best.

Host: Absolutely. How do occupational therapists support families who have a child with autism?

Jordan Wassmer: Occupational therapists will spend a lot of time talking with parents about behaviors and their sensory needs and any kind of difficulties that they're having at home or in social settings. We'll work with families to help problem solve through these more difficult situations and try to provide tips or ideas and activities, to help their child tolerate, socialize or thrive in situations that they might be struggling with. This is always based solely on the family though because each family has different needs. So what might work for one family may not work for another. We just always try to make sure that we build a relationship with families and stay involved with parents, and take time each session to make sure that we're answering any questions they may have or discussing any ideas that they might want to try. Now I will say for myself, I don't always have the answer. And my OT professors always said there's no true cookbook to occupational therapy. And I think that's so true. But I'm learning every day. And the families always teach us new things and they always have different priorities. So we just try to brainstorm ideas together and come up with things that work for each family.

Host: Sure. And what should a family do if they think their child might be showing signs of autism?

Jordan Wassmer: My suggestion is always, always be really, really open about your concerns. Changes in behavior and development or things that you might have noticed about your child with the pediatrician. They are one of the first people who will be alerted to your concerns and they will assist with pointing you in the right direction for referrals. They will likely ask you more questions about your concerns and send out referrals to different disciplines based on your concern. So they may recommend official autism testing done by a practitioner who is qualified to perform that testing. But at that time they may also send out referrals for therapy interventions like OT, PT, and speech, just depending on the child's struggles or their performance with functional and developmental skills. And their ability to communicate those therapies might be warranted even before the diagnosis. A parent is the expert on their child. So the picture that you as a parent paint to your doctors and therapists is what helps us to understand your child and figure out your struggles and helps us to get a family involved with this support systems that they need.

Host: Right. So if you see something, say something right, especially to your, primary physician Jordan, what's your favorite part about working with children with autism?

Jordan Wassmer: My favorite part about working with children with autism, and probably all kids in general, is just getting to be a part of helping them learn something new. When you see like the pride in their face after they've finally done the thing you've been working on, it's just kind of the best part about my job. But also my workdays are so different always. And I really like that. I mean, I could make a detailed plan for each kid and have all of these activities set up and ready to go, but that really doesn't matter because about 75% of the time, at least part of my plan goes out the window and I have to have alternate activities and be able to get creative and think on the fly. So I like that part.

Host: Well, this is some really good information, Jordan. Thanks for all your expertise and for being with us today. This is the Women's Hospital, a place for all your life. To schedule an appointment or to learn more about the autism spectrum at the Women's Hospital, head on over to www.deaconess.com/highpoint to get connected with one of our providers. I'm Deborah Howell. Thanks for listening and have yourself a great day.