Occupational Therapy; A Solution for a Successful Transition to Adulthood

As an occupational therapist I recognize the many amazing professions out there besides OT that are available to assist individuals on the spectrum across the lifespan. ABA therapists, BCBA therapists, speech therapists, physical therapists, psychologists, psychiatrists, and neurologists are just some of the professions that are able to provide families with continued care to clients on the spectrum over the lifetime. However, over my tenure I have found occupational therapy to be one profession that tends to become a silent or underutilized contributor once adolescence hits. Having worked in public schools, I have found that students on the spectrum are often discharged from occupational therapy at the middle school ages as the focus of traditional educational based occupational therapy is more sensory motor based or academically focused on the writing or organizational aspect of their educational career. From a privatized therapy perspective the majority of OT for clients on the spectrum is performed at the younger ages as well in order to develop those underlying skills necessary to succeed in childhood. That being said, I feel that there is an underutilized niche for occupational therapy in the adolescence through adulthood ages for clients on the spectrum. This is a time period that occupational therapy intervention could be utilized, in my opinion, at its peak. I have been taught to understand that the professional foundation of occupational therapy is focused on obtaining the highest level of independence for each and every client. For parents out there, I am positive they can identify that this is also their goal for their children.

As a professional I have also recognized the statistics for successful transition to adulthood regarding individuals on the spectrum. 85% of adults on the spectrum are unemployed including those with college degrees. An even higher percentage are unable to live independently. I guess my next question to answer is, “why?”. I recognize the client deficits that go along with these statistics, however I can not bring myself to believe that this is the ultimate reason why there is so little success with transition. I do believe that there is such a drop from professional services that our clients on the spectrum fall between the cracks. That’s where I feel occupational therapy could regroup and make a push to change this.

The American Occupational Therapy Association defines occupational therapy as “the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities. Occupational therapy practitioners enable people of all ages to live life to their fullest by helping them promote health, and prevent or live better with injury, illness, or disability”. It sounds like something everyone could benefit from right? Unfortunately, a lot of times people pigeonhole occupational therapists into certain areas such as “the sensory person” or ” the handwriting therapist”, or “the therapist that helps people get dressed”. The facts are that an occupational therapist’s roles are constantly changing depending on the client’s needs and goals in life. From motor specific goals (i.e. coordination, fine motor strength) to cognitive goals (i.e. executive functioning, safety awareness) to psychosocial goals (i.e. identify personal values, implementation life wellness), to daily life skills (i.e. cooking, money management, home management, etc.), an occupational therapist utilizes their skillsets to provide individuals with deficits or limitations in these areas the highest level of functional independence to meet their life goals.
Seems like a lot of ground to cover right? The reason an occupational therapist’s roles have the ability to constantly change has to do with their education. Occupational therapist’s have an intensive education comprised of human anatomy, infant / child / adult development, neurology, kinesiology, behavioral / mental health, psychology, not to mention their occupational therapy specific classes that focus on skill acquisition and life activities. The purpose for studies in all of these areas is to help an occupational therapist understand the “whole person”. Without an understanding of a person as a whole, nobody could ever fully comprehend the needs someone may have. With their education, an OT has the opportunity to understand what may drive their client. They can see what motivates them, what makes them happy, and what fills their void in life. A therapist is able to then take that information and then identify what steps are difficult to obtain. They break those steps down further to then identify any modifcations or adaptations that can assist in the acquisition of those needed skills. As you can see it is a process. But it’s a process that works. Therapists have been doing it for decades with consistent success which is why we have seen their roles expand over time.

So back to the point. If occupational therapists could increase their habilitation based practices they would have more opportunity to assist clients on the spectrum with those transition skills. They could help bridge a client’s transition from the educational realm to the real world. They could use their professional skills to further the independence of a large population that needs it. As a professional that has become my long term goal. I would love to see our profession take on a leadership role in transition. I would love to see us become part of the solution. But for right now I just want to continue to make strides to help our clients succeed one goal at a time.