context: A person who has autism spectrum disorder ( ASD) often has trouble communicating and interacting with other people; his or her interests, activities, and play skills may be limited. Occupational therapy may help people with autism develop these skills at home and in school. Occupational therapists study human growth and development and a person's interaction with the environment through daily activities. They are experts in the social, emotional, and physiological effects of illness and injury. This knowledge helps them promote skills for independent living in people with autism and other developmental disorders. Occupational therapists work as part of a team that includes parents, teachers, and other professionals. They help set specific goals for the person with autism. These goals often involve social interaction, behavior, and classroom performance. Occupational therapists can help in two main ways: evaluation and therapy. The therapist observes children to see if they can do tasks they are expected to do at their ages -- getting dressed or playing a game, for example. Sometimes, the therapist will have the child videotaped during the day in order to see how the child interacts with his or her environment so that he or she can better assess the kind of care the child needs. The therapist might note any of the following: Attention span and stamina Transition to new activities Play skills Need for personal space Responses to touch or other types of stimuli Motor skills such as posture, balance, or manipulation of small objects Aggression or other types of behaviors Interactions between the child and caregivers Once an occupational therapist has gathered information, he or she can develop a program for your child. There is no single ideal treatment program. But early, structured, individualized care has been shown to work best. Occupational therapy may combine a variety of strategies. These can help your child respond better to his or her environment. These OT strategies include: Physical activities, such as stringing beads or doing puzzles, to help a child develop coordination and body awareness Play activities to help with interaction and communication Developmental activities, such as brushing teeth and combing hair Adaptive strategies, including coping with transitions The overall goal of occupational therapy is to help the person with autism improve his or her quality of life at home and in school. The therapist helps introduce, maintain, and improve skills so that people with autism can be as independent as possible. These are some of the skills occupational therapy may foster: Daily living skills, such as toilet training, dressing, brushing teeth, and other grooming skills Fine motor skills required for holding objects while handwriting or cutting with scissors Gross motor skills used for walking, climbing stairs, or riding a bike Sitting, posture, or perceptual skills, such as telling the differences between colors, shapes, and sizes Awareness of his or her body and its relation to others Visual skills for reading and writing Play, coping, self-help, problem solving, communication, and social skills By working on these skills during occupational therapy, a child with autism may be able to: Develop peer and adult relationships Learn how to focus on tasks Learn how to delay gratification Express feelings in more appropriate ways Engage in play with peers Learn how to self-regulate You may have heard a lot about sensory integration therapy. That's because some researchers estimate that eight out of 10 children with autism have problems processing sensory input. For example, they can't filter out background noise. Other signs of processing issues include: Problems with balance Problems with body position in space Oversensitivity to touch and the feel of certain types of clothing, such as socks with seams With autism, social, behavioral, or attention problems can be partly a result of these sensory challenges. Although more research is needed, OT can help with sensory integration and some of the related behavioral problems. Research suggests sensory integration therapy is less helpful in improving academic performance. Examples of sensory integration therapy include: Being brushed or deeply touched and massaged Compressing elbows and knees Swinging Spinning on a scooter Wearing a weighted vest You can obtain occupational therapy services either privately, through a statewide early childhood intervention program, or at school. Public law requires schools to provide certain types of occupational therapy to those who need it. Private insurance also usually covers OT. In addition, Medicaid may cover occupational therapy for autism, even for families with higher incomes. School-based OT tends to be more functional in nature. Typically, it works as an adjunct to educational goals, such as improving handwriting, so the child can keep up by taking notes. Private therapy will be more medically intensive.