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While autism has been here for many years(Myth #5 debunked!), it still remains an enigma of modern medicine. And over the years it has unfortunately been successful in associating itself with many myths and misconceptions.

So much has been said and written about autism that it might get difficult to separate fact from fiction. Here are a few myths that top the list, but have been debunked using facts and scientific research.

 

MYTH #1 : AUTISM IS CAUSED BY POOR PARENTING OR “REFRIGERATOR MOTHER”

TRUTH: In the 1950s, a widespread myth was that autism was caused by emotionally distant or cold parents, more specifically, a cold and distant mother(how easy is it to blame the mother!). However, a plethora of research has firmly established that the parenting style is not a contributing factor in the development of autism. 

 

MYTH #2: AUTISM CAN BE CURED

TRUTH: This is a multifaceted and controversial topic. Autism presents in early childhood and continues throughout life. No “cure” for autism has been found till date. However, early and intensive therapy interventions can, in many cases, reduce the severity of symptoms and help the individual develop adaptive skills for independent daily living activities, emotional, sensory, behaviour regulation and social engagement. 

 

MYTH #3: AUTISTIC PEOPLE CANNOT GO TO SCHOOL/COLLEGE/HAVE JOBS/GET MARRIED

TRUTH: Some autistic individuals might have difficulty in social situations, communication and flexibility and this has led to a common misconception that they will be unable to attend school or get higher education, have a job or get married and have kids. Total gibberish!

 

MYTH #4: AUTISM IS A MENTAL HEALTH DISORDER

TRUTH: Autism Spectrum Disorder(ASD) is a complex neurodevelopmental condition involving persistent challenges with social communication, restricted interests and repetitive behaviours.

 

MYTH #5: THE APPEARANCE OF AUTISM IS RELATIVELY NEW

TRUTH: Although it was first described in 1943 by scientist Leo Kranner, the earliest description of a child now known to have had autism was written in 1799. Throughout history, one can find stories of children who, in today’s date might have been identified as autistics. Advancements in research and diagnosis have identified that the characteristics of autism exist on a continuum with varying degrees of severity, intensity and frequency.

 

MYTH #6: AUTISTIC INDIVIDUALS ARE ANTI-SOCIAL AND  DON’T FEEL EMOTIONS NOR EMPATHISE

TRUTH: These myths have surfaced because most autistic individuals lack the appropriate social skills, communicate emotions or express their needs or desires. Anxiety when faced with social situations and avoiding face to face contact puts them at a disadvantage uncalled for. They may express their emotions in a less obvious way, but they would more than love to have friends and reciprocate the emotions displayed towards them. 

“I DON’T WANT FRIENDS, ALSO I DON’T KNOW WHAT HAPPINESS, SADNESS AND ANGER ARE.”, SAID NO AUTISTIC PERSON EVER!

 

MYTH #7: ALL AUTISTICS INDIVIDUALS ARE GENIUS/SAVANTS 

TRUTH: “If you have met one person with autism, you have met one person with autism” – Stephen Shore. Just how each one of us is an individual of our own, no two autistic individuals are alike. 

Only 10 percent of autistic individuals display savant skills in the form of exceptional eidetic memory, memorising books easily, playing difficult music on an instrument from a very early age, and calculating difficult mathematical problems quickly. This puts us at fault to expect every autistic child to turn out a savant/some kind of genius. 

 

MYTH #8: AUTISTIC INDIVIDUALS HAVE MENTAL DISABILITIES

TRUTH: Just like many of us, autistic individuals fall into a range of mental capabilities. They can be harder to test, since various factors like social skills, language and interpersonal analysis, sensory integration issues, the environment where they are getting tested come into play, so IQ and abilities can be under or over-estimated.

Many individuals on the spectrum have earned college degrees and entered a variety of professions(scientists, OTs, SLPs, doctors, artists, university professors, tech giants and what not!).

 

MYTH #9: AUTISTIC INDIVIDUALS ARE VIOLENT 

TRUTH: Violence and aggressive acts from autistic individuals usually are the result of sensory overload or emotional distress from the environment, they are never intentional or out of malice nor pose any danger to the society or children around them. 

They won’t harm you unless you cause them harm- as simple as that.

 

MYTH #10: AUTISM IS CAUSED BY VACCINES.

TRUTH: Although this myth has been long proven otherwise, there is still some air around it. A 1998 study linking autism with childhood vaccines has since been retracted and numerous studies continue to negate this flawed belief.

 

MYTH #11: AUTISTIC INDIVIDUALS CAN’T STAND TO BE TOUCHED OR HAVE NO SENSE OF HUMOR

TRUTH: This can be true for some, while standing truly erroneous for others. Sensory sensitivity might lead to touch aversion while many individuals enjoy hugs, gentle or deep pressures and other forms of touch. 

Likewise, they may express or share humor in non typical ways that are harder to recognise. Families have reported incidences of their autistic family members testing, telling jokes, goofing around, anticipating others will be entertained.

Ask families with autistics members about stories and they will fill you with loads of them.

 

Honorary mentions: 

1. Excessive screen time/lockdown/less interaction with other children “led” the child into autism.
2. Developing eye contact will help the autistic individual socialise and be more attentive.
3. Identity-first language(saying “autistic” instead of “person/child with autism”) is offensive.

 

Recommended Reads:

Cohmer, Sean, “Early Infantile Autism and the Refrigerator Mother Theory (1943-1970)”.

Wing L. The History of Ideas on Autism: Legends, Myths and Reality.

Davidson, Michael. “Vaccination as a cause of autism-myths and controversies.”

John RP, Knott FJ, Harvey KN. Myths about autism: An exploratory study using focus groups.

Bölte, S. (2014), Is autism curable?.

Speech-language pathologists (SLPs) also called speech therapists work to assess, diagnose, treat and help prevent speech, language, social communication, cognitive-communication, voice, swallowing, fluency and other related disorders in children and adults.

SLPs work with people of all ages, from babies to adults. SLPs treat many types of communication and swallowing problems.

Speech-language pathologists work with a variety of clients including but not limited to:

• Infants with feeding/swallowing difficulties
• Toddlers with delayed language development
• Preschoolers and school age children with articulation and phonological disorders, language delays/disorders, delayed play skill development, delayed pragmatic language skills.
• Children with Autism or other syndromes
• Children with language processing disorders and language-based learning disabilities.
• Individuals who stutter
• Individuals with voice disorders
• Individuals with difficulty swallowing
• Hearing impaired individuals
• Individuals who have a stroke, head injury, or neurological disorders that affects speech, language, cognition, or swallowing
• Individuals who wish to modify their accent.

 

WHAT IS SPEECH LANGUAGE THERAPY?

Speech Language Therapy is an evidence based rehabilitative procedure undertaken in order to help the people having any kind of communication disorders or problems and some swallowing problems.

Speech Language Therapy techniques are used to improve communication. These include articulation therapy, language intervention activities, and others depending on the type of speech or language disorder.

 

SPEECH LANGUAGE THERAPY FOR CHILDREN

For your child, speech language therapy may take place one-on-one or in a group depending on the speech and language disorder. Speech language therapy activities and exercises vary depending on your child’s disorder, age and needs.

During speech language therapy for children, the SLP may:

• Interact through talking and playing, and using books, pictures other objects as part of language intervention to help stimulate language development.
• Model correct sounds and syllables for a child during age-appropriate play to teach the child how to make certain sounds.
• Provide strategies and homework for the child and parent or caregiver on how to do speech therapy at home

How does speech language therapy work?

Pediatric speech therapy helps treat children with communication challenges, both in how they speak and how they understand communication. Speech therapy also treats oral motor concerns, such as chewing and swallowing, as well as articulation, auditory processing and social skills.

The first step is usually an evaluation with a speech-language pathologist to determine what challenges your child is facing. SLPs will work with you and your child to create a customized plan to help address the issues.

Sessions usually last about a half-hour. After your initial appointment and diagnosis, the team will work with you to set up a schedule that works best for you and your child.

HOW TO KNOW IF YOUR CHILD NEEDS SPEECH AND LANGUAGE THERAPY?

Your child will need speech and language therapy if they show signs of a speech and/or language delay or disorder. If you’re concerned about their development, start by paying attention to which age-appropriate speech and language milestones your child meets, and which ones they don’t (yet). If you think your child needs support from a speech-language pathologist, don’t hesitate to book an evaluation!

 

1) LOOK FOR SIGNS OF A LANGUAGE DISORDER
According to the American Speech-Language-Hearing Association (ASHA), signs your child may need speech and language therapy because of a language disorder include:

• Not smiling or interacting with others
• Not babbling (4-10 months)
• Making only a few sounds or gestures, like pointing (7-12 months)
• Not understanding what others say (7 months-2 years)
• Saying only a few words (12-18 months)
• Not easily understanding words (18 months-2 years)
• Not putting together sentences (1.5-3 years)
• Struggling to play and talk with other children (2-3 years)
• Having trouble with early reading and writing skills (2.5-3 years)*

You may be wondering, “What are early reading skills?” Early reading skills include:

• Making sounds or saying words when looking at pictures in books (1–2 years)
• Pointing or touching pictures in books when you name them (1–2 years)
• Turning pages in books (1–2 years)
• Knowing that books have a front and back (2-3 years)
• Enjoying books that have rhymes (2-3 years)
• Pointing to and naming many pictures in books (2-3 years)

 

2) LOOK FOR SIGNS OF A SPEECH DISORDER
According to ASHA, signs your child may need speech and language therapy because of a speech disorder include:

• Saying p, b, m, h, and w incorrectly in words (1-2 years)
• Saying k, g, f, t, d, and n incorrectly in words (2-3 years)
• Producing speech that’s unclear, even to familiar people (2-3 years)

 

SEEK A SPEECH AND LANGUAGE EVALUATION

If your child is missing milestones or showing any of these signs, we would recommend seeking a speech and language evaluation. They may need speech language therapy to help them communicate to the best of their abilities.
It’s never too early to seek out a speech and language assessment if you have a concern for your child. I can tell you from my 6 years+ experience that parents never regret going too soon. In fact, it’s the opposite.

 

Autism spectrum disorder (ASD) is a life-long neuro developmental disorder which includes autism disorder, asperger’s syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS), and is characterized by impairments in communication skills, social interaction, and restricted and repetitive behaviors (American Psychiatric Association, 2000). About 1 in 54 children are thought to have autism (CDC,2016). With the degree of severity, an individual with spectrums will experience a combination of a few or all these symptoms which means none of the individuals are the same. Also, spectrum includes a range of other medical conditions such as ADHD, seizures, sleep problems, gastrointestinal disorders, etc.

Signs and symptoms

According to CDC, the most common signs include:

• No pointing at objects which they are interested
• Reduced joint attention
• Difficulty in peer interaction
• Avoiding eye contact and reserved
• Difficulty in comprehending and expressing of emotions (do not have the internal neural mirror capacity for empathy to the point of having no concept of the needs of others or knowing when another is in distress)
• Echolalia (repetition of words or phrases said to them)
• Seems to be unaware of surrounding
• Difficulty in expressing their requirements
• Difficulty in pretend play
• Repetitive actions of motions (e.g. hand flapping, spinning in circles, etc.)
• Restricted routines (narrow interests)
• Unusual responses to sensory stimuli, such as smells, sounds, or flavors
• Loss of skills they used to have

Causes and risk factors

Exact cause for autism is yet to be explained. However, there are other few factors that have been associated with this spectrum.
Other potential risk includes:

• Prenatal exposure to some medications (thalidomide, Valproic acid, Beta 2 adrenergic agonists, antipyretic, etc)
• Premature birth
• Reduced birth weight
• Parental age
• Family history
• Genes
• Infections and vaccinations
• Being male child
• Pollution (expose to environmental
  chemicals)
• Dietary
• Physical/psychological stressors

Diagnosis

No blood test or genetic profile allows a doctor to make a conclusion on autism diagnosis. Only looking at the child’s behavior and overall development are involved in diagnosing ASD.
Most developmental delays or any other disabilities are screened before the age of 30 months by pediatricians. However, if a child has a sibling with ASD or a caregiver has concerns on certain symptoms of ASD, then it is better to talk with your child’s doctor.
First of all, autism screening usually involves checking a child’s developmental milestones involving the parents with questionnaires about the child’s interactions and behaviors.
If there is any indication of autism, a comprehensive diagnostic evaluation is the next step including a thorough child’s behavior examination, vision, hearing genetic and neurological tests referring them to a specialist for further tests.

Treatment

There is no direct medical treatment for the disappearance of symptoms of ASD, however, it can help in managing certain symptoms for depression, seizures, sleep problems, hyperactivity.
A multidisciplinary treatment plan is needed to be involved for certain intervention programs to improve cognition, reduced symptoms, ADL skills where speech therapy and behavioral therapy is used to help a child with communication difficulty and encourage a positive behavior and discourages negative behavior to improve a range of skills respectively. Occupational therapy helps a child to learn a life skill and lead their life independently as they can. Also, Sensory Integration therapy helps them to deal with the feeling of over and under sensory information. Additionally, a proper nutritional diet helps in improvement of symptoms.

 

Yes?
Nope!
Wrong guess.
I take the liberty of negating your ‘guess’ already(an inside OT joke).

We do not help people find jobs or help them with employment(most people’s guess about OT).

The “occupation” in occupational therapy simply refers to whatever “occupies” someone’s time (the old school idea of occupation).

Occupational Therapy(OT) is a unique, client-centred health profession which takes a holistic approach to address and identify the needs of the individual focusing on long term health and well-being.

OTs address a patients’ clinical conditions, recommending interventions, technology and equipment to continue participating in age-appropriate and meaningful day-to-day occupations, thus improving their quality of life.
OT interventions focus on remediation of the biological component, adapting the environment, modifying the task, teaching skills and strategies, and educating the individual/family in order to increase participation in the performance of daily activities, particularly those that are meaningful to the patient.

 

HOW CAN OT HELP YOU?

Helping the individual perform appropriate and meaningful occupations is how we bring a substantial difference in their lives.

In adults, this might mean being able to dress themselves or meal preparation after a stroke or moving around the community independently.

In children, this might mean writing and reading, playing with friends and learning new things.

In OT language, these are called “Activities of Daily Living” or “ADLs”.
ADLs can be affected following an injury, impairment, disability, or illness, and OT professionals help patients develop the skills to participate in these activities independently.

 

 

Here is the complete list of the activities an OT can help with:
Bathing and Showering | Toileting and Toilet Hygiene | Dressing | Eating and Swallowing | Feeding | Functional Mobility | Personal Device Care | Personal Hygiene and Grooming | Sexual Activity | Care of Others | Care of Pets | Child Rearing | Communication Management | Driving and Community Mobility | Financial Management | Health Management and Maintenance | Home Establishment and Maintenance | Meal Preparation and Clean Up | Religious and Spiritual Activities and Expressions | Safety Procedures and Emergency Responses | Shopping | Rest and Sleep | Education | Work | Play | Leisure | Social Participation

 

HOW DO WE ACHIEVE THAT? – OCCUPATIONAL THERAPY PROCESS

OTs recognize the need of a PERSON FOCUSED care pathway. We work to understand what matters the most to each individual i.e. being able to participate in daily life activities and return to the life they want to live.

It begins with a very thorough evaluation of the patient, where the occupational therapist collects information on a patient’s health history, occupational profile and functional activities that are currently limited.

Occupational therapists utilise their knowledge of a spectrum of diagnosis and choose standard assessments accordingly to create individualised intervention processes.
The intervention process includes specific goals- short term and long term- and the treatment techniques to be implemented to help a patient achieve those goals.

 

WHY DO CHILDREN NEED OCCUPATIONAL THERAPY?

 

 

A child’s occupation is to learn, play and thrive.
Participation may be affected due to a variety of health conditions and we support children by identifying their unique strengths and utilise it to sail them through the challenges they face.

Some of the common diagnosis we see in childhood include:

1. Autism Spectrum Disorders
2. Motor Disorders
3. Cerebral Palsy
4. Developmental Delay
5. Intellectual Disabilities
6. Genetic disorders
7. Rare Diseases

 

OCCUPATIONAL THERAPY TREATMENT

A holistic plan of care combines physical, sensory, emotional and/or cognitive interventions to help a client achieve their goals.
Environmental modifications are also considered in the plan of care.

Some examples of treatment include:

1. ADL Training
2. Assistive Technology Assessments
3. Brief Emotional/Behavioral Assessments
4. Community/Work Reintegration Training
5. Debridement of Wounds
6. Development of Cognitive Skills
7. Development Screening
8. Manual Therapy Techniques
9. Neuromuscular Re-Education
10. Self-Care/Home Management Training
11. Sensory Integrative Techniques
12. Therapeutic Activities
13. Wheelchair Management

 

 

HOW TO BECOME AN OT?

In South Asian countries, you have to go through high school and get an undergraduate(bachelors) degree in occupational therapy. Post graduate degree is called Masters in Occupational Therapy.
Once you get through OT school, you’ll need to get registered in the respective national medical council to practice.
In western countries, you have to get through high school and college and then choose a graduate program in Occupational Therapy.
Interested candidates go for further Post Doctoral courses.

 

AREAS OF SPECIALIZATION

The scope of Occupational Therapy is very broad. One can pursue a number of specialisations and advanced certification in specific areas of interest. Common areas of specializations include:

1. Pediatrics
2. Developmental Disabilities
3. Hand Rehabilitation
4. Neurology
5. Geriatrics
6. Sensory Integration
7. Orthopaedics
8. Ergonomics
9. Assistive Technology
10. Low Vision Therapy
11. Stroke Rehabilitation
12. Hippotherapy
13. Mental Health
14. Productive Aging

AREAS OF PRACTICE

Occupational therapists generally practice in:

• Government organizations / institutions / hospitals / projects
• Non- government organizations
• Private sectors like:
  • Acute care hospitals & nursing homes
  • Rehabilitation centers and clinics / centers (like developmental therapy clinics, neuro-rehabilitation facilities, de addiction centers etc.)
  • Special and mainstream schools
  • Chronic care facilities
  • Social agencies/Community Based Rehabilitation (CBR) & Disaster Management Projects
  • Hospice care facilities
  • Mental Health Setups /Institutions and Hospitals
  • Industries
  • Self employed

 

CONCLUSION

I hope this helped you gain a little insight into the fabulous world of occupational therapy.
It is a profession as unique as each one of us and we approach healthcare with compassion in our heart and science in our mind. Backed by research, occupational therapy is gaining momentum as one of the most valued healthcare professions.