Physical Therapy Key to Enriching Lives of Autistic Children

April 2nd, 2019
By: Content Staff

For far too long, caregivers of autistic children focused primarily on helping them develop language and social skills, but a growing body of research shows that physical therapists also can play a big role in helping these patients lead fuller, more rewarding lives and reach their potential. Just ask physical therapist Karen Tartick, who was profiled along with her autistic 27-year-old son, Eric, by PT in Motion, a publication of the American Physical Therapy Association.

"Autism has been at the forefront of my adult life, on the job and at home," Tartick, a longtime PT for the public school system in Durham, N.C., told PT in Motion.

Tartick wants parents and caregivers to know that PTs can enrich the lives of children with autism in many ways, helping them to participate more fully in daily routines at home and at school, learn new motor skills, develop better coordination and posture, improve their reciprocal-play skills (such as playing catch with another kid), mimic the movement of another person and build their fitness and stamina.

According to PT in Motion, many children with autism must deal with motor impairments that affect muscle tone, motor development, coordination, and motor planning, so physical therapy is vital in addressing these issues. Tartick said physical therapy can benefit autistic children both physically and mentally, decreasing their maladaptive behaviors and aggression, improving their focus and academic performance and increasing their overall quality of life.

By collaborating with special education teachers, occupational therapists, speech pathologists, and physical education teachers, PTs can help autistic children thrive. Teaching these patients how to use basic fitness equipment such as treadmills, exercise bikes or elliptical machines can help them stay active and avoid obesity, a common health problem for autistic children, PT in Motion reported.

"The great thing for PTs is that exercise and structured play groups both are evidence-based practices for children with autism,” Tartick told PT in Motion. “That is absolutely beautiful to me because facilitating and promoting exercise and wellness is such a huge part of what PTs do."

According to estimates from the Centers for Disease Control and Prevention, one in 68 children in the United States has autism – one in 42 boys and one in 189 girls. Back in 2000, the overall figure was one in 150, but the CDC attributes that sharp increase to a growing awareness of autism and better diagnostic criteria – not an increased likelihood of developing autism.

According to PT in Motion, common risk factors for autism include having an autistic sibling, having older parents at the time of birth and being born prematurely or underweight. Symptoms include difficulty communicating, avoiding eye contact, lack of interest in interacting with peers and engaging in repetitive behaviors such as obsessively lining up toys.

Autistic children often struggle to develop motor skills such as walking, jumping, tying their shoes and imitating the movements of others. They may lack coordination, have poor balance and struggle to plan and repeat movements or perform movements in a specific sequence, PT in Motion reported.

Recent studies show that kids ages 12 to 33 months who were later diagnosed with autism typically are 6.4 months behind their peers in gross motor skills and 9.5 months behind in fine motor skills, according to PT in Motion. Additionally, delayed motor skills in children with autism increase with age, and motor skills that are complex and usually develop through social interaction are significantly impaired in autistic children.

Liliane Savard, a board-certified clinical specialist in pediatric physical therapy, told PT in Motion that she has several strategies for helping autistic children learn motor skills, including positive expectancy (instilling in the child confidence that he can do the activity), autonomy support (allowing the child to make some decisions) and external focus of attention (for example, focusing on a ball's movement or a target rather than the body's movement in throwing the ball).

"When you express confidence that a child with autism can do something, set up a task that's relatively easy for him or her to achieve, and provide an environment that isn't overly stimulating, it's my experience that the child can learn to a degree that's often surprising," Savard told PT in Motion. "Also we know from the literature that when you follow the lead of kids with autism, they're more likely to have positive outcomes. Offering them choice – giving them agency – is very important."

Other strategies for helping autistic children gain motor skills include using rhythmic musical activities, dance, and yoga. To help an autistic child become more comfortable using fitness equipment such as a treadmill, a PT could show her pictures of what she will be doing and repeatedly show her video footage of her walking on the treadmill, a technique known as video self-modeling, PT in Motion said.

Anjana Bhat, an associate professor in the Department of Physical Therapy at the University of Delaware, offered PTs working with autistic children the following tips, according to PT in Motion:

  • Encourage motor assessments and intervention for children with autism or risk factors for autism.
  • Look for signs of motor-skill delays in infants who have risk factors for autism. Even if these delays are minor, encourage motor play to address delays, poor posture and lack of movement variability. Infants who have autism may tend to rest in the same body position and move less than other kids their age.
  • Ask caregivers to engage in motor-play activities to foster infant-caregiver interaction.

  • For PTs in school settings, Bhat provided the following recommendations to PT in Motion:

  • Seek inclusion on the Individualized Education Plan (IEP) team if physical therapy is not being given to a child with autism.
  • Recommend motor-skills evaluations for autistic children and share motor-treatment ideas.
  • Recommend adaptive modifications and motor-skills training to aid the child's focus in class, transitions during the school day and peer play in gym class and during recess.
  • Apply a variety of motor-learning principles, identifying themes that best engage the child.

  • “We now know that children with autism face challenges in the areas of complex motor coordination, planning, balance and imitation of and synchrony with others," Bhat told PT in Motion. "There is so much that PTs can do to address these problems now, and so much more that we may be able to do if we continue to focus on developing effective motor treatments."

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