ASD and Physiotherapy – Overlooked Needs
Most people know that a child with ASD needs to see a speech pathologist, an occupational therapist and even a psychologist. But, what you might not know is the important role of physiotherapists in helping children with ASD. Unfortunately, this is an overlooked and often misunderstood need.
Children with ASD may have:
low muscle tone
poor co-ordination
a difficulty with functional movement
reduced balance
postural challenges when moving through their environment.
Can Children with Autism Spectrum Disorder Benefit from Physiotherapy? Autism Spectrum Disorder (ASD) is a diagnosis that describes children with significant social, communicative and behavioural challenges. Whilst the diagnosis is mostly associated with difficulty in communication, children with ASD experience physical issues. Children with ASD can have difficulty with a number of complex postural tasks such as sitting, walking, running, jumping and balance. Studies have shown the prevalence of low muscle tone (hypotonia), toe-walking, ankle stiffness, motor apraxia (inability to carry out planned movements or to handle small objects which they are familiar with) and increased motor stereotypes (rhythmic, repetitive, fixed, predictable, purposeful but purposeless movements such as waving arms, flapping hands, head nodding, and rocking back and forth) in children with ASD. Hypotonia is the most common symptom. Studies have shown the prevalence of low muscle tone (hypotonia), toe-walking, ankle stiffness, motor apraxia (inability to carry out planned movements) and increased motor stereotypes (rhythmic, repetitive, fixed, predictable, purposeful but purposeless movements such as waving arms, flapping hands, head nodding, and rocking back and forth) in children with ASD. Hypotonia (floppy or weak muscles) is the most common symptom. Physiotherapy that addresses sensory processing needs and behavioural tendencies of Autism Spectrum Disorder (ASD) can assist children with the associated gross motor delay. Children with ASD experience delays in the development of basic skills in specific areas. They have reduced social communication and interaction and also exhibit limited and repetitive behaviour patterns. They prefer structure and routine for activities of daily living, and can be very sensitive to change in their environment. Acquisition of motor (movement) skills is often delayed and there may be difficulty with motor co-ordination, balance, posture control, motor planning and sequencing for new tasks and copying the movements of others. Early motor delays in children with ASD may contribute to difficulty acquiring social skills.
How Can Physiotherapy Help Children on the Autism Spectrum? Research on toddlers and pre-school children with ASD has shown that those with better motor skills have improved socialisation and communication. Autism Spectrum Disorder has a wide range of presentations and physical limitations. Physiotherapists can assist in improving daily functioning from early infancy to adulthood. Here are just a few of the reasons Physiotherapy for children with ASD is important:
Physiotherapy can address a child’s balance and posture control to encourage improved endurance and attention with school activities.
Limited social, behavioural, speech and motor skills can lead to difficulties at home and at school.
Poor balance, co-ordination and motor control skills hamper the child’s ability to perform effective functional movement and to engage in play with peers.
Physiotherapists can provide information and resources about physical performance and behaviours driven by sensory processing dysfunction.Children with well-established gait deviations and musculo-skeletal compensations can benefit from treatment sessions that address orthopaedic and developmental needs.
Movements that hinder social participation are reduced and movements that promote functional independence are encouraged.
Physiotherapists can assist acquisition of confidence and skill development required to navigate different environments and to perform challenging tasks at school and in the community as the child with autism moves towards adolescence and adulthood.
Large, quality movements are encouraged through age-appropriate play as the focus for therapeutic exercises for children with ASD.
A child who walks on the toes requires passive joint mobilisation and exercises to increase ankle mobility as well as calf muscle stretching to promote flexibility for heel-toe gait.
The “floppy” child who struggles to stay upright at school requires core stability exercises for postural control.
Children who are unable to hop or skip need to improve static and dynamic balance through strengthening of lumbo-pelvic musculature.
What Can a Physiotherapist Do to Assist Child with ASD? Your Therapy Alliance Group physiotherapist can work with the child, family, teacher and other health professionals to assist the child:
Develop better co-ordination and more stable posture
Improve participation in play skills (throw/catch ball)
Develop motor imitation skills (copy action performed by another person)
Increase fitness and stamina.
What Will a Physiotherapist Do to Assist Child with ASD? A physiotherapist will firstly conduct a thorough assessment of the child that includes health and developmental history as well as directly assessing:
Postural strength and control
Functional mobility (walking, running)
Body and safety awareness
Co-ordination
Play skills
Interests and motivators
Ability to change between different activities
Strengths and challenges in making large body movements such as jumping, hopping, pedalling a small bike, skipping)
Participation in daily routines at home, community or school.
– by Sandra Knight