Encounters with Dave

OT’s role with the Autistic Adult—

Susan N. Schriber Orloff, OTR/L

I frequent my local Office Depot often. Dave works there, and over time I have gotten to know him fairly well.  He is an expert in all things electronic. To ask Dave a question is to expect a very long detailed response. It is almost impossible to interrupt him once he starts his explanations and takes offense if you do. 

Ritualistic and unfailingly consistent in all his behaviors, Dave is tolerated by his co-workers, but is never seen in casual conversation.  When not with a customer, Dave is known to spend his time dusting and caring for the equipment in his department.  In one of our conversations, Dave asked me what I did and when I told him, he shared that he “used to be autistic, but now he was cured”.  All of sudden, everything seemed to make sense.

As OT’s we see a lot of autistic children, but what happens when these kids grow up? At least by my observation, aside from low wage jobs in grocery stores, autistic adults almost seem absent from usual daily encounters.  So when Dave shared with me this very personal piece of information, I began to investigate services for autistic adults in my community.  Sadly, there seemed to be very few choices compared to the opportunities for individuals in the 18 months to 22 years.  It seems that when public school services end so do the opportunities. 

There are private post secondary schools, but many of these are expensive making participation not a viable option for many families particularly in this economy.  Vocational training centers seem to be even scarcer.

This is not to discount the existing day programs, the independent living options or state vocational centers. But often these resources come with long waiting lists and in many cases are significantly under-funded.

What does all this mean and what is the impact on occupational therapy within the role of services for the autistic adult?  I propose that OT be an integral part of the high school curriculum for autistic children in grades 9-12.  And that the services include but not be limited to testing for community skills, vocational training, community “fieldwork employment”, and supervised simulated independent living skills. 

The impact of not being proactive with these emerging adults has multiple negative consequences not only for families but the greater community as well. Children generally outlive their parents, so without good community living resources many of these adults find themselves (if lucky) being cared for by siblings or extended family, but in some cases, homeless.  Living “unprotected” carries with it the potential for becoming easy prey and possible involvement in drugs, crime, etc.

Dave appears to be one of the lucky adults on the spectrum.  Employed by a major retailer who obviously knows both his strengths and limitations.  We need to educate the community in order to create more opportunities that promote independence and dignity for the autistic adult.

Occupational therapy has its roots in what historically is known as “Curative Workshops”. Maybe it is time to remake that concept updated for the 21^st century providing services for all autistic individuals—children and adults.