Occupational Therapy for Self-Diagnosed or Late-Diagnosed Autism or ADHD

First, a functional evaluation to assess your baseline level of function, strengths, and identify areas of need. 

Then, treatment - which can address: 

• Understanding your brain -- How autism or ADHD affects your daily functioning, distilled into the "need to know" for your current goals and struggles
• Putting knowledge into practice -- Implementing neurodivergent-friendly information and skills in your real daily routines
• Personalized accommodations -- Identifying, trialing, and tweaking supports so daily life at home, work, school, driving, cooking, or whatever is important to you feels more manageable
• Adaptive equipment and modifications -- Tools and environmental changes that make everyday tasks easier
• School and workplace accommodations -- Figuring out what to ask for and coaching to advocate for it
• Meltdown support -- Understanding your triggers, stages, and early warning signs, and building coping strategies to reduce how often and how intensely meltdowns happen
• Coaching for your support people -- Education for trusted loved ones so they know how to help during a meltdown or in other areas of daily life
• Unmasking support -- If you choose to unmask: stimming exploration across all 8 sensory systems and advocating for your sensory needs in social and public settings
• Energy and routines -- Activity pacing, energy conservation, and routine modifications
• Nervous system regulation -- Strategies to help you feel more regulated, capable, and in charge of your life

You end with: retesting and a plan for maintaining your progress after we conclude occupational therapy services.

What is occupational therapy?

Occupational therapy enables people of all ages and abilities to participate in daily living. Occupational therapists are Masters or Doctorally educated healthcare professionals.

Not only does self- or late-diagnosis of autism or ADHD come with a lot of new information to process, it can also come with an identity shift, confusion, and overwhelm about how to move forward. Here’s how occupational therapy can support you during this stage of your neurodivergent self-empowerment journey:

Knowledge is Power

Occupational therapists, especially occupational therapists who specialize in autism or ADHD, will help guide you to understand the mechanisms of how your autism or ADHD impacts your daily functioning. Trying to learn this by yourself without support can be isolating, confusing, and overwhelming - think of your occupational therapist as the person in your corner who can distill all the noise and confusion of this learning experience into the “need to know” for you based on your current goals and struggles. Other members of the neurodivergent community can also be an incredible resource during this time.

While a mental health therapist helps you untangle your feelings and relationship to yourself within your autism or ADHD, an occupational therapist helps you actually implement neurodivergent-friendly information, skills, accommodations, adaptive equipment, and modifications during daily life activities with the goal of improving your quality of life and ability to engage in life in the way that is aligned with your values and goals for yourself.

Interoception Skill Development

Interoception is a body sense (just like how vision or hearing are body senses) that gives us the ability to recognize and respond to our body’s internal signals like hunger, pain, or thirst. For individuals with autism and/or ADHD, interoception is often a source of difficulty. Signs you may have experienced difficulty with interoception throughout your life: 

• Not noticing your hunger, thirst, need to use the bathroom, or pain until the sensation has become extreme or urgent 
• Not recognizing you are tired until you are downright exhausted Feeling “off” in your body, but not being sure what you need to do to fix it, so you cycle through a few solutions (like getting a drink of water, eating a snack, taking a nap) to see if any of those fixes the problem 
• Becoming so overwhelmed by one body signal that you have a very hard time sensing anything else from your body 
• Experiencing strong emotions out of nowhere, like agitation or sadness without clear triggers 
• When people ask you how something feels for your body, you have trouble saying anything other than basic descriptors such as “good” “bad” “hot” “cold” etc. 
• Difficulty figuring out whether what you are feeling is anxiety, or hunger, or tiredness, or, or, or… 

The good news is that interoception skills CAN be learned! An occupational therapist can help you develop these skills.

Accommodations

Accommodations are supports or adjustments that enhance your ability to function comfortably and effectively during work, school, or other daily life activities like driving or cooking.

As a late-diagnosed individual, you might feel like you’re years “behind” where you should be when it comes to understanding how to help your neurodivergent brain cope with - and even thrive in - daily life. As a neurodivergent person, you’ve probably already discovered some accommodations that help you.

However, many individuals come to their diagnosis later in life because they’re struggling. Which means that there may be more accommodations that could drastically improve your ability to navigate daily life and hopefully ditch the constant struggle. An occupational therapist is an expert in identifying and implementing personalized accommodations that will work for you. Finding the accommodations that are right for you is a highly individualized process - and it can take time. An occupational therapist can help speed up the process of trialing and tweaking accommodations for yourself - so that you start feeling more regulated, capable, and in charge of your life.

Workplace or School Accommodation Support

Your occupational therapist is uniquely qualified to help you identify and advocate for work or school accommodations. You don’t have to go through this process alone.

Meltdown Support

Meltdowns are no joke. Your occupational therapist can work with you (and your trusted support person, if you want) to understand the triggers and stages of a meltdown. With help from your OT, you and your trusted loved ones can gain increased awareness of warning signs, and then be able to draw from your arsenal of coping strategies to prevent or reduce the intensity and duration of your meltdown. Education for your support people can also be really helpful when it comes to meltdowns. Meltdowns can be difficult for another person to understand and they may not know what to do to help you in this moment; occupational therapy treatment can center around educating and coaching your trusted individuals to increase their comfort and capability to help you out when you’re having a meltdown. Meltdowns are a crisis and can be part of the neurodivergent experience - but that doesn’t mean there isn’t hope for a present and future in which your meltdowns feel less frequent and intense.

Unmasking Support

If you’re in the late-diagnosed sphere online, then you’ve probably seen the word “unmasking” before. Unmasking is the process of recognizing and disengaging from your mask (i.e., learned behaviors that make you appear more outwardly neurotypical) in an effort to show up more authentically as your neurodivergent self. Unmasking is a highly personal journey and choice. During your unmasking journey (if you choose to unmask), an occupational therapist can help you learn and experiment with stimming exploration across all 8 sensory systems (yes - there are more sensory systems than just Sight, Sound, Smell, Taste, and Touch), advocating for and accommodating your sensory needs in social or public settings, activity pacing, energy conservation, routine modifications, nervous system regulation, and more.

• Free 15-minute intro call. We talk about what you are dealing with and see if I'm the right fit. You don't need a referral to book this call.
• Functional evaluation. A 60-minute video visit to assess your baseline level of function, strengths, and identify your goals.
• 50-minute telehealth sessions. Each session is built around your goals, your energy, and your routines. You leave each session with specific strategies you can use right away. Most clients start with weekly sessions.
• Graduate. You end with retesting and a plan for continuing to work toward your goals and maintain your hard-earned quality of life improvements after we conclude occupational therapy services.

 Finding an OT who specializes in adult autism and ADHD can be hard. Telehealth means adults anywhere in New York State can get this support, and new clients can usually start within a week.

In-person OT is essential for instances where hands-on support is needed such as injury rehabilitation, stroke rehabilitation, neuromuscular reeducation, and adaptive equipment implementation. For self- or late-diagnosed adults with autism and/or ADHD, coaching and education are the primary methods for intervention and can be just as effective when provided via telehealth. 

For individuals with sensory needs and increased stress in new environments or around new people, telehealth also allows less sensory overwhelm and allows individuals to be seen in the comfort of their home which creates a calm nervous system which is essential for learning. 

What you'll need: a device with a camera and a stable internet connection.