Recreation Therapy for Autism

Recreational therapy is the process by which children and adults with autism can learn about, participate in, and even excel in activities that they actively enjoy — while building social, physical, and cognitive skills in community settings.

According to the National Council for Therapeutic Recreation Certification, "The purpose of the RT process is to improve or maintain physical, cognitive, social, emotional and spiritual functioning in order to facilitate full participation in life."

In addition, the Council states, "Recreational therapists treat and help maintain the physical, mental, and emotional well-being of their clients by seeking to reduce depression, stress, and anxiety, recover basic motor functioning and reasoning abilities, build confidence, and socialize effectively."

Recreation Therapy for Autism
Verywell / JR Bee 

Why Recreation Therapy?

Children on the spectrum may be in various therapies for hours every day. In fact, most children with autism receive speech, occupational, and behavioral therapy in school. Many are also in social skills therapy groups and may participate in other therapeutic programs such as floortime play therapy or relationship development intervention (RDI). On top of all this, they may also visit a psychiatrist or psychologist, go through evaluations with developmental pediatricians, or see a developmental neurologist.

With so many types of therapy already on their schedules, why add yet another form of therapy to the list? Dr. Rhea Fernandes, Senior Vice President and Chief Operating Officer at Devereux Advanced Behavioral Health explains:

"Recreation is about engaging in activities and experiences which produce feelings of enjoyment and satisfaction; it connects us with opportunities to experience our own creativity and to achieve and master new skills and to build meaningful relationships with others in doing so. It’s needed as part of the human condition: we all value recreation; it’s part of being human."

Recreation therapy is also a very useful tool during the transition between childhood and adulthood.

Through recreation therapy, young adults can begin to discover their own recreational interests, strengths, and preferences. Recreation therapists can also suggest resources, provide support, and serve as liaisons to help young adults on the spectrum to find appropriate programs and/or integrate into community opportunities.

Says Dr. Fernandes, "Recreation therapy can help with the process of crystallizing an individual's leisure identity, developing a sense of self and self-efficacy, improving pro-social adaptive skills, and gaining mastery over one's own environment."

How It Works

According to Dr. Fernandes, "A good working definition of recreational therapy would be activities that utilize various modes of expression from the arts and performing arts to physical activity that help to stimulate overall health and well being of people with special needs. It includes art therapy, drama therapy, aquatics, equine therapy — all are special activities that fall under the larger umbrella of recreational therapy." These activities are meant to work toward relationship-building.

Recreational therapy sessions are goal-oriented, but unlike more traditional techniques such as physical therapy (often recommended for children on the spectrum), they work toward a wide range of physical, social, and emotional goals in settings where clients can pursue their interests and strengths.

Where It Takes Place

Settings can range from hospitals or day programs to community locations such as swimming pools, gyms, art centers, skating rinks, theaters, or YMCAs. Depending on the needs and abilities of the client, recreational therapy may be provided 1:1, in the context of special needs programs, or as part of an inclusive community program.

The Steps of Therapy

As with most forms of therapy for children with autism, recreational therapists go through a series of steps:

Observation and Evaluation

In order to develop a program that will effectively meet a person's needs, a recreational therapist will observe the individual in one or more settings and conduct evaluations to determine the individual's recreational interests, strengths, and challenges as well as strengths and challenges that could potentially be improved or remediated through therapy.

Creation of Measurable Goals

The only way to determine whether a particular therapy is effective is to know where they started and where they're headed. A recreational therapist will focus on specific skills and record the individual's current status and measurable goals. A goal might, for example, relate to the ability to kick a ball, cheer on a teammate, manage frustration, or stay focused on an activity for a period of time.

Hands-On Therapeutic Activity

In some cases, recreational therapists work directly with clients; in other cases, they formulate plans to integrate the recreation into an individual's program and support others as they execute the plan. A recreation therapist might work with a physical or occupational therapist, a community-based instructor, a parent, or a teacher to provide the tools for integrating the recreation into an individual's daily life.


Credentialed recreation therapists are known as Certified Therapeutic Recreation Specialists (CTRS). To become a CTRS, an individual must earn a bachelor's degree, go through a clinical internship, and pass a national competency exam overseen by the National Council for Therapeutic Recreation Certification (NCTRC). In addition, some states require licensing. Recreation therapy, however, is still a small field—there are only about 19,000 practicing recreation therapists in the United States.

While it may be tricky to find a credentialed recreation specialist in your area, other types of therapists may be able to fill the same niche.

For example, a credentialed art, music, or drama therapist may be able to provide recreation therapy even without the official NCTRC seal of approval. The same is true for occupational or physical therapists who may support individuals in activities ranging from swimming and horseback riding to team sports.

If you do pursue this route, though, take time to interview the therapist in-depth to be sure that they are working on a wide range of physical, emotional, and intellectual skills rather than sticking entirely with physical competencies such as "throw a ball underhand," and similar tasks.

It's helpful to know that, in many cases, insurance or school districts will pay the costs associated with physical, occupational, and social skills therapy but may not pay for someone with the title of "recreation therapist." In fact, in most cases, recreation therapists are hired not by individual families but by organizations and institutions.

Other Options

For many families, formal recreation therapy is either locally unavailable or financially impractical. When that's the case, there are other options for helping a child, teen, or adult with autism to develop recreational interests and skills. Here are just a few ideas to consider:

  • Work with your child's in-school therapists to select appropriate activities and pinpoint community resources.
  • Check-in with local autism support groups — in some cases, other parents know of programs and resources, or you may find others interested in starting up recreational opportunities.
  • Drop-in at your local YMCA to see what kinds of programs and supports they may be able to offer.
  • Make good use of programs such as Special Olympics and Challenger Club, which support individuals with special needs including autism as they build physical and social skills as well as relationships.
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