Autism and Social Success - AOTA Everyday Evidence

Listen to the AOTA Everyday Evidence Podcast on Autism and Social Success on Stitcher.

Check out the March/April 2014 issue of the American Journal of Occupational Therapy (AJOT) to read the study discussed in the podcast (funding for the study was provided by the National Institute of Child Health and Human Development and the American Occupational Therapy Foundation as part of Dr. Grace Baranek's Sensory Experiences Project at University of North Carolina at Chapel Hill). For more information about occupational therapy and autism read the Occupational Therapy Guidelines for Children and Adolescents with Autism


Stephanie Yamkovenko: Birthday parties are more than ice cream and cake. They are learning experiences. Children learn how to negotiate friendships, how to share, and other important social skills.

New research from a team of occupational therapists found that children with autism are not participating in social activities as often as other children. But why is this important?

Lauren Little, lead author and assistant professor of Occupational Therapy at the University of Kansas Medical Center explains.

Lauren Little: So it’s really in the children’s daily routines and natural context that kids have learning experiences And kids that have those fewer social experiences or lack of engagement in social activities, they’re having fewer opportunities to practice skills that other kids their age are practicing.

Yamkovenko: Children with autism are missing out on those experiences because they participate less frequently and with less variety than other children. Because they miss out on social activities, Little says we need to ensure that they are not missing out on learning.

The researchers discussed the idea that a lack of social activities in young children can have lasting effects.

Little: And when we talk about that cascading effect, we’re really talking about a domino effect potentially on the development of kids’ participation over a longer period of time.

This highlights the importance of occupational therapy in targeting social skills for kids with autism as well as the importance of early intervention.

Yamkovenko: How can occupational therapy help? Occupational therapist Melissa Stutzbach and contributor to the AOTA Evidence-Based Practice Project explains.

Melissa Stutzbach: Well to begin, occupational therapy practitioners work with the child and family to figure out what motivates that child and then makes sure that those interests are incorporated into social activities. Depending on the child’s needs, skills addressed can vary from turn taking, to sustained eye contact and attention, communication of needs, to initiating social interactions.  Because the environment has a powerful influence on social behavior, social skills are practiced in a variety of settings with different levels of structure.

Yamkovenko: This new study sheds light on how to find activities that children with autism may enjoy. The researchers found that younger children with autism are participating more in household activities, cleaning their rooms, picking up toys, and older children are participating more in community and faith-based activities such as going to church and being in girl scouts or boy scouts.

Little: And this likely reflects just typical developmental change. So younger children with ASD may engage in cuddling with a parent or doing a puzzle more frequently than an older child. Just part of development. And as kids get older, whether or not they have autism, they’re likely having other interests that are outside of the home. And what we found is that the older kids with autism were having increased participation in some faith-based activities and more structured activities. So more rule bound activities, more structured activities may fit the types of activities that kids with autism are interested in.

Yamkovenko: With an estimated 1 in 88 children being diagnosed with autism by the age of 8, ensuring that these children avoid social challenges and isolation now can affect whether they will be able to have a productive and independent adulthood. Occupational therapy can help achieve these outcomes.

Stutzbach: The evidence tells us that structured, intensive occupational therapy services can lead to positive outcomes for children with ASD. Social isolation does not need to be a reality for people with ASD at any point in the lifespan.

Yamkovenko: To learn more about this study, published in the American Journal of Occupational Therapy, visit


Little, L., Sideris, J., Ausderau, K., & Baranek, G. (2014). Activity participation among children with autism spectrum disorder. American Journal of Occupational Therapy, 68(2), 177–185.