What is Autism Spectrum Disorder?
“Autism spectrum disorder (ASD) is a developmental disability resulting in social, communication, and behavioral challenges. Symptoms begin in early childhood and continue throughout the lifespan. While many terms previously were used related to autism, in 2013 all autism disorders were merged into 1 umbrella diagnosis of ASD. This change conforms to the May 2013 release of the American Psychiatric Association’s new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is used by many organizations, individuals, and governments to classify diagnoses, including ASD. The use of the term “spectrum” allows for the variations in symptoms and behaviors identified among children with this diagnosis.
All of the causes of ASD are not yet known, but specific environmental, genetic, and biological factors may predispose a person to develop ASD. The number of children being diagnosed with ASD is increasing, and may be related to better efforts at diagnosis or to an increase in causes of ASD not yet understood.
Motor (movement) skills are impaired in individuals with ASD. Research has shown that motor coordination, postural control, and learning of skills through imitation of the movements of other persons may be limited, and planning and completing new motor tasks are challenges for many children with ASD. Early motor delays in children with ASD may contribute to difficulty acquiring social skills.
Research also shows that early intervention services can help children with ASD learn important skills and improve development. Early diagnosis can help a child with ASD achieve full potential. Physical therapists are members of teams that provide services to children with ASD and their families from early childhood, through the school years, and into adulthood.
How Can a Physical Therapist Help?
Physical therapists can work with your child, family, and educational team to help your child:
- Improve participation in daily routines at home and school
- Acquire new motor skills
- Develop better coordination and a more stable posture
- Improve reciprocal play skills, such as throwing and catching a ball with another person
- Develop motor imitation skills (seeing another person perform an action and then copying that action)
- Increase fitness and stamina
A physical therapist will conduct a thorough evaluation of your child that will typically include a health and developmental history and assessment of:
- Postural strength and control
- Functional mobility (eg, walking and running)
- Body and safety awareness
- Play skills
- Interests and motivators
- Ability to change between different activities
- Strengths and challenges in making large body movements, such as jumping, hopping, pedaling a tricycle or bicycle, and skipping
- Participation in daily routines in the home, community, and school
Your physical therapist will work with you to develop goals to help your child participate as fully as possible in daily routines at home, in the community, and at school. Your physical therapist will then develop a comprehensive plan to meet your child’s, and your whole family’s needs. No “standard” treatment exists for children with ASD. Each child’s challenges and goals are different. Your physical therapist will design an individual program to meet the strengths and needs of your child. The therapist will work with you to monitor how your child progresses, and collect data to make sure that the treatment plan is leading to positive outcomes for your child.
Physical Therapy in the Early Years: Birth to Age 3
Physical therapists work with families and caregivers to increase a child’s participation in routines of daily life that are challenging. They promote opportunities during free play and structured play to develop and practice the movement skills common to your child’s age group. Physical therapists work on increasing strength and coordination, and walking safely and efficiently in all needed environments, such as negotiating stairs. Priorities may include developing imitation skills (eg, performing actions to songs like “Head, Shoulders, Knees, and Toes”) and indoor and outdoor play skills. Guidance is provided to include structure, routines, and physical boundaries to daily activities to promote positive behaviors.
Physical Therapy in the School Years (Including Preschool): Ages 3 to 18
Physical therapists work with parents and teachers to increase awareness about the impact of ASD on school functioning. They use the latest, most effective treatments based on medical evidence to minimize each child’s challenges and help make the school experience a positive one. Physical therapists recommend modifications and accommodations to support learning. Examples include using ball chairs to reduce “out-of-seat behaviors,” and using hula hoops, carpet squares, or specially placed seating to identify personal space. They provide whole-class movement breaks, and use strategies like “motor learning” to teach the movement skills needed to participate in social games and peer interactions.
Physical therapists provide direct help when needed to improve a child’s ability to negotiate challenges, such as school bus steps, crowded hallways, cafeterias, and playgrounds. They work together with school teams to promote skills like self-regulation, listening, and taking turns. Strategies are provided to teach the child how to imitate the movement activities of other children, develop directional concepts, body and spatial awareness, and coordination as well as to promote success in physical education and fitness activities.
Physical Therapy During Adulthood: Age 18+
Physical therapists work with adults with ASD to promote success in daily life. They recommend community resources to increase movement opportunities. They develop individualized exercise routines to promote body coordination and walking skills. They work with each individual to help improve movement, function, and fitness so the individual can hold a job, function at home, and enjoy leisure activities.”