What Does an Occupational Therapist Actually Do?
For children, "occupations" are the activities of daily life: eating, dressing, playing, writing, managing sensory experiences. An OT helps autistic children develop the sensory, motor, and self-care skills needed to participate in daily life more independently.
What OTs Assess (First Session: 60-90 minutes)
- Sensory processing — over-responsive (covers ears, avoids touch) or under-responsive (seeks intense input, unaware of pain)?
- Fine motor skills — pencil grip, cutting, fastening buttons, using cutlery
- Gross motor skills — balance, coordination, physical play
- Self-care — dressing, feeding, toileting independence
- Attention and regulation — staying on task, transitioning between activities
What Happens in Sessions
Young children's sessions often look like play while the OT works toward specific goals:
- Swinging and spinning — vestibular input for balance and body awareness
- Heavy work — carrying, pushing, pulling (proprioceptive input for self-regulation)
- Tactile play — sand, water, play dough, rice bins (gradual desensitisation to textures)
- Fine motor tasks — threading beads, tearing paper, using tongs
- Self-care practice — buttons, zips, utensils in structured ways
Costs and Where to Find OTs in India
- Free: AYJNISHD centers (Mumbai, Delhi, Kolkata, Secunderabad); NIMHANS Bangalore; state government hospitals
- Private: Rs 500-2,500/session in metros; Rs 300-1,000 in smaller cities
- Home visits: Rs 1,000-3,000/session
- Find licensed OTs: Rehabilitation Council of India register at rehabcouncil.nic.in
Is Therapy Working?
Meaningful OT progress takes 3-6 months. Signs it is working:
- Tolerating previously aversive textures without distress
- Improved ability to transition between activities
- Reduced meltdown frequency around sensory triggers
- Gains in fine motor tasks (better pencil grip, managing buttons)
Ask your OT for measurable goals every 3 months. "Will tolerate sand play for 5 minutes without crying within 12 weeks" is measurable. "Improving sensory processing" is not.
Track Behavior -> — Log sensory reactions, self-care successes, and meltdown triggers weekly. Provide your OT with real data on progress between sessions.
Use Visual Schedule -> — OTs recommend a predictable home routine to support regulation alongside therapy. What happens in the clinic should mirror what happens at home.