Neurodiversity
OT is often the first referral after an autism diagnosis, and the most confusing. Here is what occupational therapy for autistic children actually involves, what it can and cannot do, and how to find a good therapist.
If your child has recently been diagnosed with autism, there is a reasonable chance that your first referral, from your paediatrician, from the NDIS, from the school, is to an occupational therapist. Most parents arrive at that first OT appointment with a general sense that it will be helpful and very little understanding of what it will actually involve.
OT is one of the most valuable supports available for autistic children. But the scope is broad and the approaches vary significantly between therapists. Understanding what to expect helps you evaluate the therapy you are receiving and advocate for your child effectively.
What occupational therapy covers for autistic children
The name 'occupational therapy' can be misleading, it is not about career preparation. 'Occupation' in OT language refers to the meaningful activities and routines that constitute daily life. For children, this means: school, self-care, play, social interaction, and all the sensory and motor skills that underpin these.
- Sensory processing: assessment and support for sensory over- and under-responsiveness. Development of a sensory diet, a structured programme of sensory activities that supports regulation across the day
- Fine motor skills: pencil grip, handwriting, cutting, manipulating small objects, skills that affect academic participation
- Gross motor skills: coordination, balance, body awareness, physical participation in sport and play
- Self-care and daily living skills: dressing, eating, hygiene, toileting, developing independence in the routines of daily life
- Executive function: organisation, task initiation, planning, sequencing, supporting the skills that underpin academic and daily functioning
- Emotional regulation: working alongside other therapists on the practical and environmental supports for regulation
- Environmental modification: recommending changes to the home and classroom environment to better support the child's sensory and motor needs
What happens in a first OT appointment
The first appointment is typically an assessment, the OT is gathering information about your child's profile, challenges, and strengths. This often involves: a detailed interview with parents about daily functioning, observation of the child in structured and unstructured activities, and sometimes standardised assessment tools. You may see the Sensory Profile, the Vineland Adaptive Behaviour Scales, or the Beery VMI, among others.
After the initial assessment, the OT should produce a report with specific findings and recommendations. Goal-setting follows, the goals that will guide the therapy should be developed collaboratively with you and, where appropriate, your child. If the first appointment produces vague statements about 'addressing sensory needs' without specific measurable goals, ask for more specificity.
How to find a good OT for an autistic child
- Look specifically for OTs who list autism, sensory processing, or paediatric neurodiversity as their area of practice
- Ask directly about their approach to interoception, sensory integration, and emotional regulation for autistic children
- Ask whether they take a neurodiversity-affirming approach, this means working with the child's profile rather than normalising it
- Occupational Therapy Australia (OTA) has a find-a-therapist directory that allows filtering by specialisation
- Word of mouth within your local neurodiversity community is often the most reliable source of specific practitioner recommendations
“OT goals should be specific and measurable. 'Addressing sensory needs' is not a goal, 'child will initiate use of noise-cancelling headphones in classroom settings before sensory overwhelm' is a goal.”
How OT is funded in Australia
For children on the NDIS, OT is typically funded as a capacity-building support under Improved Daily Living. OT can also be partially funded through Medicare's Better Access scheme or a Chronic Disease Management plan, depending on the referral pathway. For children moving through the Thriving Kids program from October 2026, OT is intended to be one of the core therapies available, the details of funding and access under Thriving Kids are still being confirmed by state governments.
Neurodiversity
A note on accuracy:While every effort has been made to ensure the information in this article is accurate at the time of writing, facts, policies and research can change. We're human, and sometimes we get things wrong. If you spot something that needs updating, we'd genuinely love to hear from you.
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Dave Harrison
ESW · Neurodiversity Advocate · Podcast Host
Dave Harrison is currently working in Australian schools as an Education Support Worker. He's the founder of THRVHUB, host of the Different Is Normal podcast, and a parent of a neurodivergent teenager, writing from both sides of the classroom.
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