Occupational Therapy Interventions to Enhance Activities of Daily Living and Social Engagement in a Young Child with Mild Autism Spectrum Disorder: A Case Study

ADL and Social Outcomes in Mild Autism

Abstract

Background: Autism Spectrum Disorder (ASD) during early childhood is often associated with severe impairments in sensory integration, motor and social interaction, which further hinder the acquisition of independence in Activities of Daily Living (ADLs) and interacting with others.
Methods: The mixed-methods and single-subject design used in this case study was aimed at assessing the effects of a 6-month, client-centered, occupational therapy (OT) intervention on the outcomes of a 3.5-year-old, nonverbal boy with mild ASD. An integrated evaluation made use of the Short Sensory Profile-2 (SSP-2), WeeFIM, Occupational Therapy Profile, and that of the International Classification of Functioning, Disability and Health (ICF). The intervention included ADL training (inclusion of toileting and dressing), strategies of sensory integration, Picture Exchange Communication System (PECS), and organized social play.   Results: The child showed observable improvements in the post-intervention period: parallel play duration went up to 10 or more minutes, the duration of eye contact was up to 4-6 seconds in 8 out of 10 attempts, and he could pull up elastic-waist pants without much assistance. Self-care (WeeFIM Self-Care score) functional independence has increased to the 20 (moderate dependence) level, down to 12 (complete dependence). The sensory processing scores (especially in tactile sensitivity and filtering in auditory) shifted into the typical range of performance.   Conclusion: Occupational-based OT holistic intervention was found to be effective in improving the ADL performance, sensory regulation, and the basic social skills of a young child with ASD. The results highlight the importance of regular treatment, goal-setting, and involvement and support of a caregiver in the most effective way to achieve results.