TherapyConnect

Therapy explained

Where to start

There are many different therapists and therapies available for children with ASD. Below, you will find a description of some of the therapists who commonly work with children with ASD. It is important to take your time in choosing the right therapy for your child and the right therapist to meet the needs of your family.

Research has shown that a multidisciplinary approach to early intervention in children with ASD provides the best developmental outcomes. The early years are a key time of development for any child. As children with ASD will often have complex needs, accessing multiple therapies together will provide well rounded, holistic care for your child.

A multidisciplinary approach to therapy means that different therapists will be working with you and your child at the same time. Therapists may work within the same clinic or you may access a number of therapists from different clinics. It is important that therapists coordinate with the other members of the team to ensure that goals and strategies being used are shared.

Sometimes therapists may conduct joint therapy sessions. It is important that the team around your child works in a coordinated way. Good practice suggests that one of the therapists who see your child should be coordinating this for you, but in some cases you may be in charge of directing this. Throughout this resource, you will find useful information to help you with this.

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What is speech pathology?

Speech Pathologist

Speech pathologists or speech therapists help children with ASD in the following areas:

A speech pathologist will work with your child to develop their communication skills. When we think of communication, the first thing that springs to mind is usually verbal communication, which refers to speaking and understanding language, either with or without aids for support. Communication also includes non-verbal communication, which refers to elements such as gesture (including signing), facial expression (including eye contact), and body language that help us communicate our message, and understand the messages that others are sending to us.

Receptive Language

Receptive language is how well your child understands language. It can refer to how well they understand information that is given verbally (in words) or in written form. A speech pathologist will usually assess your child’s receptive language and then work with them on various tasks to improve their receptive language. An example of a task that targets receptive language skills could be showing a child a number of pictures on a page and giving the instruction, “point to the yellow box and then point to the blue circle”.

Expressive Language

Expressive language is how your child uses language to express their needs and wants, thoughts and feelings. It includes the use of grammar (for example, “I went” instead of “I goed”) as well as the use of gestures and facial expression. For children who are non-verbal, language may be expressed through key word sign or pictures.

Pragmatic Language and Social Skills

Pragmatic language refers to the social communication and language skills we use in our day to day interactions. It includes what we say, how we say it (both verbally and non-verbally) and how appropriate it is to the given situation. Good pragmatic language is critical for successful social interaction.

Social skills help us in our communication and interaction with others. Speech pathologists might work on your child’s social and play skills to help strengthen their relationship with peers, siblings or adults. The speech pathologist might help your child understand the social rules of conversation (including taking turns in conversation, asking questions about the other person, politely starting or ending a conversation). Social skills might be taught one-on-one (the therapist works with your child alone), or as part of a group of children learning and practicing social skills together.

Visual Supports

Many Speech Pathologists will use visual supports when working with children with ASD. For more information on visual supports, visit our section on Visuals.

Other areas that a speech pathologist may assist with are:

  • Stuttering : Also called disfluency, stuttering affects the child’s fluency of speech. For example, a child might say, “I s-s-s-s-said we were playing dress-ups”.
  • Articulation:  This is how a child makes sounds in words. Children with articulation difficulties might say ‘sree’ instead of ‘three’, or ‘wabbit’ instead of ‘rabbit’.
  • Voice: This includes children that find it difficult to control the volume, pitch, or pace of their voice.
  • Phonological Awareness:  This is the awareness of all of the sounds in words and plays an important role in learning to read.
  • Eating and Drinking: This includes children that have difficulty with the physical mechanisms required for eating, as well as children that have self-restricted diets.

For more information on the areas of development that a speech pathologist can assist with, please see the choosing therapy section.

Speech Pathology Australia is the national peak body for the speech pathology profession. For more information, please visit www.speechpathologyaustralia.org.au

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Example of a speech therapy session

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The role of the speech pathologist

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What is Occupational Therapy?

Occupational Therapist

Occupational Therapists (often called OTs) help children with ASD in the following areas:

Sensory Processing

Sensory processing is how your child makes sense of what they see, hear, touch, taste, smell and feel.  An occupational therapist will be interested in how your child’s understanding of sensory input affects their motor planning, body awareness , and spatial awareness. An occupational therapist will look at how sensory processing affects your child’s functioning in different settings, such as at home, at kindergarten, at childcare or school, at the shopping centre, or at parties or outings. For more information on sensory processing, see the Sensory Processing section.

Fine Motor Skills

Fine motors skills are ones that use small muscle movements usually in the hands and fingers to manipulate and control materials or objects. Occupational therapists might work with your child to improve fine motor skills for everyday tasks. They may work with your child on tasks that involve grasping (for example using a crayon or pencil), manipulating objects (such as moulding playdough, fitting puzzle pieces, using scissors, or sewing) or activities that require hand-eye coordination (like threading, writing, doing up buttons and zips, cutting around a circle or using a computer mouse).

Gross Motor Skills

Gross motor skills are ones that use the larger muscle groups and include activities like running, skipping, hopping, climbing and throwing a ball. An occupational therapist can work with your child to develop their balance, strength and coordination in physical activities. Activities might include completing an obstacle course where they have to run, climb, hop through hoops, throw bean bags into a bucket and walk along a rope.

Self-Care Skills

Self-care skills are skills such as dressing, toileting, bathing, eating, and sleeping. Occupational therapists can develop programs for families to use at home to work on these skills. For example, a program might be created to teach your child how to wash their hair or unpack their lunch box.

Social Skills

Social skills help us in our communication and interaction with others. Occupational therapists may work on your child’s social and play skills to help strengthen their relationship with peers, siblings or adults. Examples might be saying hello and smiling, asking someone to join in a game, or practicing turn taking. Social skills might be taught one-on-one (the therapist works with your child alone), or as part of a group of children learning and practicing social skills together.

Visual Perception

This includes understanding, interpreting and remembering what is seen. Visual perception is necessary when learning to read and write.

Cognition

Cognition is the mental process of acquiring knowledge. An occupational therapist can help your child in this area by working on developing their attention and concentration, problem solving ability, and organisational skills.

For more information on the areas of development that an occupational therapist can assist with, please see the choosing therapy section.

For more information or to look for an Occupational Therapist in your area, please visit the Australian Occupational Therapy Association website www.ausot.com.au.

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Example of an occupational therapy session

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The role of an occupational therapist

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What does a psychologist do?

Psychologist

Psychologists help children with ASD in the following areas:

Behaviour

Psychologists work with you to increase your child’s positive behaviours and reduce or eliminate negative behaviours. They may do some work with your child, but they will usually work with parents to help you come up with ways to manage your child’s difficult behaviours.

Anxiety and mood

Children with ASD can become worried or unhappy and have difficulty finding appropriate strategies to manage this. Psychologists can teach children and parents strategies to help your child relax and improve mood.

Emotion perception

Psychologists can work with children to help them to identify and understand feelings and emotions in themselves and others.

Social skills

Psychologists help children build social and friendship skills. They may give you strategies to encourage your child’s social development, but they will usually work with your child (either one on one or in a group) to teach positive social skills, such as turn taking, waiting, saying hello and being friendly.

Emotional support

Psychologists can provide emotional support to a child with ASD to build their self-esteem, help them to express their emotions, and help them to deal with situations like being teased or bullied.  Psychologists may also help parents, siblings and other family members cope with the stresses of living with a child with ASD.

Cognition

Cognition is the mental process of acquiring knowledge. A psychologist will often conduct a cognitive assessment (or ‘IQ test’) with your child to measure their pattern of strengths and weaknesses to help come up with ways to help them learn. Psychologists can then suggest strategies to work on their attention and concentration, problem solving ability, and organisational skills in different settings such as at home or at school.

ABA Therapy

Some psychologists base their therapy on the principles of Applied Behaviour Analysis (ABA). ABA is an intensive and highly structured program that involves breaking down complex skills (or behaviours) into smaller steps and teaching these skills through the use of clear instructions, rewards and repetition. ABA helps children to learn the social, academic, self-help and behavioural skills they need to interact with others and to cope with the challenges of everyday life.

For more information on the areas of development that a psychologist can assist with, please see the choosing therapy section.

The Australian Psychological Society is the professional association for psychologists in Australia, to find out more please visit www.psychology.org.au

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Example of therapy session working on emotions

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The role of the psychologist & ABA programs

Other Health Professionals

Autism Spectrum Disorder is complex, and a number of health professionals might work with your child in addition to psychologists, occupational therapists, and speech pathologists.

It is a good idea to show all of your child’s therapy plans to each therapist or professional working with them, so that everyone is on the same page.

Group Therapy

Group therapy can be a great way for your child to practice the skills they learn with other children in a supported environment.

Some therapy clinics will offer early learning groups, transition to school groups, social skills groups as well as other types of group therapy sessions. There are many benefits to group therapy, and the video below outlines some of the ways that group therapy can help your child with ASD.

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How can group therapy help?

Interactive timetable

To see how many opportunities you already have in your everyday schedule for using strategies learnt in therapy, drag and drop the tiles below into the timetable and watch the hours add up!!

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Morning
Afternoon
Evening

Activities

Total hours: 0

Anxiety is a state of worry or fear about a real or perceived threatening event or situation, which often impairs physical and psychological functioning.

Articulation is how one makes sounds in words.

Auditory processing is the ability to perceive, interpret and respond to sound (auditory) stimuli. For example; a child who experiences difficulty processing auditory stimuli may be respond negatively to noise that you would not typically expect to bother someone, such as a vacuum cleaner. Alternatively, a child may have a decreased awareness of auditory stimuli and may not respond when their name is called.

A baseline is a measurement taken at one point in time against which future scores will be compared to measure progress. For example, before speech therapy begins, a therapist might measure how many objects a child can name. They might then measure this again one month, two months and three months after therapy has started to see how much progress the child has made.

Body awareness is the ability to recognise different parts of your own body, and their relative position.

Cognition refers to the mental process of acquiring knowledge.

A child’s developmental age will indicate where a child is socially, emotionally, physically, and intellectually on their path of development, as compared to typical behaviors and characteristics of that age.

Early intervention means doing something, or intervening, as early as possible to work on your child’s development and support needs.

Explicit teaching involves setting aside a block of time to work on a specific skill or task.

Expressive language is how one expresses their needs, wants, thoughts, and feelings.

Fine motor skills refer to the use of small muscle of the hands and fingers that allow us to manipulate and control objects and materials. This includes tasks that involve grasping (for example using a crayon or pencil), manipulating objects (using scissors) or activities that require hand-eye coordination (like threading, writing, doing up buttons and zips).

Gross motor skills refer to the use of the large muscle groups of the body that enable us to maintain an upright posture and coordinate the two sides of the body. Gross motor skills allow us to run, skip, climb and jump.

Gustatory processing is the ability to perceive, interpret, and respond to taste (gustatory) information. For example; a child who has difficulty processing taste information may have a self-limited diet, alternatively, they may crave strong flavours excessively such as spicy or sour.

A joint therapy session is when there are two or more therapists working with your child at the same time. This is generally two therapists from different disciplines.

Key word sign is the use of manual signs and natural gesture to support communication.  Key word sign is used to encourage and support language development in children with communication difficulties.

A low registering child does not register sensations at a typical level and does not seek out sensory stimulation. For example, a child that does not register auditory input at a typical level, may not notice when their name is being called.

Motor planning is the ability of the brain to plan and organise an action before it is carried out.

A multidisciplinary team includes members from different healthcare professions with specialised skills and expertise. The members collaborate together to make treatment recommendations for your child.

Non-verbal communication refers to elements of communication such as gesture, facial expression, and body language.

Olfactory processing is the ability to perceive, interpret, and respond to smell (olfactory) information. For example; a child presenting with an olfactory processing issue may smell objects excessively, alternatively, they may be over sensitive to smell information and actively avoid it.

Opportunistic teaching is using everyday ‘opportunities’ or activities to teach and practice the skills outlined in your child’s therapy plan.

Percentile rank is another way of explaining where your child’s score sits in comparison to other children their age. For example, if your child receives a standard score of 85 which is at the 16th percentile, this means that your child’s score was better than or equal to the score of 16% of other children his or her age. Another way of looking at it is that if 100 children completed this test and you lined them up from the person with the lowest score to the person with the highest score, your child would be standing in position 16.

Pragmatic language refers to the social use of language and includes the ability to understand verbal (tone of voice) and non-verbal cues (eye gaze, body language, facial expression)  as well as the social rules of language (turn taking, staying on topic, showing interest in others’ conversation).

Proprioception is the ability to understand where your body is in space. The receptors for this system are located in the muscles and joints of the body. For example; a child who experiences difficulty with the processing of proprioceptive information may have a decreased perception of pain, or seek movement excessively and appear to always be ‘on the go’.

Receptive language is how well one understands language, this includes information that is given verbally or in written form.

Self-care skills can also be referred to as ‘independence skills’. This include skills such as dressing, toileting, bathing, eating, and sleeping.

A sensory avoiding child is one who actively avoids sensory stimuli. For example a child who is sensitive to tactile (touch) information may not be able to wear certain clothing types such as wool.

Sensory processing is the way in which the brain receives, organises and responds to sensory information for everyday use. It also includes our ability to plan our actions and movements.

A child who is a sensory seeker does not register sensations at a typical level so may seek out sensory stimulation with increased frequency and intensity. For example a child who does not register taste information at a typical level may seek out spicy, salty, or very sweet foods.

A sensory sensitive child is easily overwhelmed by small amounts of sensory input. For example: a child with a sensitivity to auditory input may notice sounds that others do not register.

Sequencing is the ability to follow a set of steps within a task.

Skill generalisation is the ability to take a skill learned in one environment and successfully transfer it to another. For example a child first learns to use the toilet at home and then is able to use the toilet at kindergarten.

Social skills enable us to interact with people within our world and understand social rules. For a child, this begins with skills such as turn-taking, saying hello, and waiting.

Spatial awareness is the ability to perceive the position of your body in space.

A standardised assessment is a tool that has been designed to determine a child’s developmental level when compared to other children of the same age. Standardised assessments give a clear score that can be used as a baseline for therapy.

Tactile processing is the ability to receive, interpret, and respond to touch (tactile) information. For example; a child who has difficulty processing tactile information may not tolerate the feel of certain fabrics on their skin. Alternatively, they may not notice touch in the way they would be expected to.

The team around your child is anyone who plays an important role in your child’s development. Starting with the parents/carers, this may also include; therapists, teacher, respite worker, siblings, grandparents etc. The ‘team’ will vary depending on the child’s needs.

Verbal communication refers to speaking, either with or without aids for support.

The vestibular system is located in the inner ear and is responsible for our balance, understanding of motion, and spatial awareness. For example; a child who experiences vestibular processing issues may become distressed when their feet leave the ground, alternatively, they may crave vestibular input and spin or rock excessively.

Visual perception is the ability to understand, interpret and remember what one sees and respond accordingly.

Visual processing is the ability to perceive, interpret, and respond to visual stimuli. For example; a child who has difficulty processing visual information may be easily distracted by visual stimuli within their environment or become focused on a certain part of an object such as watching the wheels of a toy truck spin.