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Recreational Therapy: An Introduction
Chapter 6: Autism
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Autism
“Autism (ASD) is a complex neurobiological
condition affecting the ways an individual
processes and responds to information and
sensory stimuli, which may cause a ‘restricted
repertoire of activities and interests’ as well as
impairments in social and communication skills.”
(Gray, 2015, p. 123)
Autism Spectrum Disorder (defined by DSM-5)
…is characterized by persistent deficits in social communication
and social interaction across multiple contexts, including deficits in
social reciprocity, nonverbal communicative behaviors used for
social interaction, and skills in developing, maintaining and
understanding social relationships. In addition to the social
communications deficits, the diagnosis of autism spectrum
disorder requires the presence of restricted, repetitive patterns of
behavior, interests, or activities.
ASD (DSM-5 continued)
Within the diagnosis of autism spectrum disorder, individual clinical characteristics
are noted through the use of specifiers (with or without accompanying intellectual
impairment; with or without accompanying intellectual impairments; with or
without accompanying structural language impairment; associated with a known
medial/generic or environmental/acquired condition; associated with another
neurodevelopmental, mental, or behavioral disorder), as well as specifiers that
describe the autistic symptoms (age at first concern; with or without loss of
established skills; severity).
Challenges with individuals with ADS
 Staying focused due to level of interest
 Being over- or underwhelmed from sensory
input
 Impulsivity causing problems with waiting
patiently
 Impaired social interaction skills, including
inability to read social cues
 Impaired verbal and nonverbal
communication
 Difficulty with recreation and leisure
participation skills
 Not trying new activities due to a strict
adherence to routines or fear
 Difficulty in general comprehension skills
 Problems in maintaining good sleep behavior
and nutrition
 Low to moderate processing times
 Excessive fear and/or anxiety
 Difficulty with organizational skills
 Difficulty with direct application of known skill
sets.
Summary of challenges with individuals with ASD
Challenges may create limitations for individuals with ASD in
the areas of “communication, self-care, social situations,
school or work activities, and independent living.”
(Porter & burlingame, 2010, p. 88)
Potential strengths of individuals with ASD
 Exceptional visual learning
 Displays sense of humor
 Early development of reading skills
 Can maintain perspective
 Strong memory skills (e.g., words, numbers, dates,
sequences)
 Can be passionate
 Strong literal comprehension skills
 Fast fact-finding
 Exceptional spelling skills
 Good supervisory skills
 Perfectionism
 Works well alone or with adults
 Functions well under stress
 Good endurance and stamina
 Consistency in skill performance
 Enjoys routines
 Gives attention to detail
 Can be loyal
 Can be hardworking
 Can be creative
Goals for individuals with ASD
“Since ASD is a lifelong, pervasive condition, and in
itself is not progressive, targets or outcomes for
treatment, in general, would focus on the
remediation of current skills and functioning as well
as the enhancement and/or rehabilitation of skills
and functioning over an individual’s lifetime.”
(Gray, 2015, p. 126)
Specific outcomes for individuals with ASD
“Specific outcomes sought for individuals with ASD include
reducing impairments in body structures and functions by
increasing physical and cognitive functioning; reducing
activity limitations and participation restrictions by increasing
physical, cognitive, social, psychosocial, and environmental
functioning; and identifying, overcoming, and/or removing
environmental barriers to participation.”
(Gray, 2015, p. 126)
Interventions by RTs with individuals with ASD
“Common techniques (used by RTs) include leisure education
(leisure counseling); purposeful recreation, fitness, and games;
support in community recreation; social skills training;
biofeedback; progressive relaxation training; aquatic therapy;
assertiveness training; animal-assisted therapy; creative arts
(dance, music, art); technology; and sensory training.”
(Gray, 2015, p. 126)
Approaches with individuals with ASD
“For recreational therapists, a client-centered and holistic approach to service
delivery supports meeting individuals at their current level of functioning and
allowing them a ‘voice’ in their movement toward optimal functioning and
fulfillment. Community and collaboration play a large part in acceptance and
assistance of those with ASD and their families; furthermore, to open the dialogue
with individuals, organizations and other service providers need to ensure services
are of high quality and accessible by both cost and location.”
(Gray, 2015, p. 135)