Abstract:

This paper presents the possibilities of occupational therapy for children with autism spectrum disorder. Autistic disorders are among the severe psychiatric disorders referred to as pervasive developmental disorders.

Autism spectrum disorders can be recognized in a typical triad of behaviours. We see behavioural peculiarities in social interaction, communication and play (Komárek 2004, Thorová 2016). We observe the above-mentioned peculiarities of social behaviour from the first weeks of a child's life. The child lacks social humming, does not enjoy physical contact or lacks a social smile. During further development, we can observe two extreme poles of social behaviour in children with PAS. The lonely pole, where the child turns away during social contact, retreats to a corner, crawls under a table, runs to another room, covers his ears, and shakes his hands in front of his face. The other pole of the child shows disproportionate social activity, making contact with everyone and everywhere. The social norm does not exist for him, he touches people and stares intently into their faces, he can talk for hours about things that are uninteresting and annoying to those around him. The third triad is play and leisure associated with distortion of imagination. The lack of imagination causes a preference for activities and activities common in children of a much younger age, where predictability in activity and adherence to a simple learned stereotype is evident (Thorova 2016).

Typical motor stereotypies, dexterity disorders, uneven motor development, delayed motor development and level, peculiarities of posture and peculiarities of facial expressions are part of motor behaviour. Very often, children with PAS are diagnosed with developmental dyspraxia. Imperfect motor skills complicate and make it difficult to carry out normal daily activities. In an attempt to influence this fact, therapists create appropriate movement programmes for individuals with PAS based on an individual structured learning method and verify their effectiveness by means of functional stress diagnostics, the Masny hand function test and the Barthel daily activities test (Pařízková, Ošlejšková 2011).

Treatment of autism spectrum disorders focuses on pharmacotherapy, medical, social and pedagogical rehabilitation.

Several educational approaches are used in the therapy of children with PAS. The most commonly used in the Czech Republic is the Structured Learning TEACCH - Treatment and Education of Autistic and Communication Handicapped Children. Another method that is gaining more and more supporters is Applied Behavioural Analysis - ABA (Richman 2001) and the Son-rise programme (Hejdová 2009).

Within occupational therapy we use the above approaches. Activities of daily living (ADL) training is carried out through structured learning. With the aim of increasing the independence of not only the children with PAS themselves but also their families. Furthermore, the O.T.A. intervention method developed in the Czech Republic (Straussová, R. and M. Vágnerová), basal stimulation, orofacial stimulation, sensory integration, snoezelen and neuro-developmental stimulation.

The paper then presents case studies of paediatric patients.

Keywords:

Occupational therapy, pervasive developmental disorders.