Research on the Neuropathophysiology of Autism and its Implications for Occupational Therapy

Abstract

Basic research has linked autism to an underlying neuropathophysiologic substrate, but, for the most part, educationalplanning for autistic chzldren has yet to undergo significant change as a consequence ofthese findings. With occupational therapy's emphasis on the neurobiologic substrates offunctional performance, it may be that researchers in this profession can, based on the current etiologic breakthroughs, develop new theories ofpractice, or refine existing ones, pertinent to autism. This article reviews rece.nt research on the etiology ofautism and discusseseducational assessment andprogramming in light of these findings. Implications for occupational therapy are addressed, and it is recommended that occupational therapist involvement in autism be expandedthrough instrument development and refinement of theories used in clinical practice. Through this enterprise, occupational therapy may further establish its role in the educational management of autistic chzldren, clanfying its relationship to special education.

Looking Backward, Thinking Forward

“…Three articles (Clark, 1983; Nelson, 1982; Peterson, 1986) were categorized as discussions. The content focused on occupational therapy’s emerging role in evaluation and intervention with children with ASD and highlighted the lack of clarity and confusion within the profession.…”

“…Peterson (1986) highlighted the “absence of a solid theoretical basis for OT intervention” (p. 71), thus the need for a variety of treatment techniques. Nelson (1982) questioned whether occupational therapists should be generalists or specialists, focusing on sensorimotor/sensory integration, while Clark (1983) encouraged an “intermeshing of occupational therapy and neurobiology” (p. 17).…”

Supervision of the Certified Occupational Therapy Assistant

“…Likewise, Wolkowicz, Fish and Schaffer (1977) found that the use of sensory integrative therapy was beneficial to four children with autism in increasing sensory integrative functioning and improving behavioral and social skills after a four month treatment period. All of these studies appear to indicate the possibility that at least some children with autism benefit from sensory integrative therapy (Clark, 1983). All of these studies appear to indicate the possibility that at least some children with autism benefit from sensory integrative therapy (Clark, 1983).…”

“…Schlopler (1965) noted that children with autism respond abnormally to sensory stimulation, while Rimland (1964) hypothesized that the brain stem reticular formation somehow relates to the disorder. Studies pursuing this line of inves- tigation may be classified as those proposing (a) a sensory processing disturbance, (b) aberrant cerebral specializations, and (c) atypical memory, arousal, and attentional mechanisms (Clark, 1983).-In addition, Nelson (1984) discusses evidence indicating that children with autism have a disorder in the modulation between sensory input and motor output, which may explain their inconsistent motor responses. Studies pursuing this line of inves- tigation may be classified as those proposing (a) a sensory processing disturbance, (b) aberrant cerebral specializations, and (c) atypical memory, arousal, and attentional mechanisms (Clark, 1983).-In addition, Nelson (1984) discusses evidence indicating that children with autism have a disorder in the modulation between sensory input and motor output, which may explain their inconsistent motor responses.…”

“…A number of well executed studies have suggested that perceptual disturbances may contribute to the etiology of autism (Clark, 1983). Many of these neurophysiological findings point strongly to the presence of a vestibular disorder in autism.…”