Physical Therapy and Autism

 

Autism is a complex developmental disability. Recent studies show that 1 in every 88 children is diagnosed with autism.  Autism is different for every child and can range from mild to severe – which is why it’s termed autism spectrum disorders.

One area of development for children with autism which is often overlooked is that of a child’s gross motor skills.  Movement is an important part of our lives because it allows us to explore our environment and interact with others.  From early infancy, children develop motor skills such as holding their head up, kicking their legs, sitting, crawling, etc.  As the child gets older, skills such as walking, jumping and balance come into play.  For children with autism, they may have difficulty coordinating these motor movements – which may make it difficult for them to explore and interact with others.

Children with autism may have difficulty with motor planning, sensory processing, reflex development and underlying decreased tone.  Motor planning includes the ability to time, sequence and execute a movement – such as reaching for an object or activating a toy.  Sensory processing occurs when a child has difficulty taking in and processing information from the environment.  The child may be over or under sensitive to sight, smell, sound, touch or movement.  Children with underlying tone issues may difficulty with motor movements , which will alter the sensory feedback they receive during movement (Redlich, 2010).

As a child with autism gets older, issues with more advanced motor planning skills may become evident.  These may include decreased protective reactions (catching yourself when falling), difficulty with balance and coordination, persistent “w” sitting, toe-walking, postural instability, etc.  (Redlich, 2010).

If issues with gross motor skills and coordination are noted, a physical therapy evaluation may be recommended.  During the evaluation, the physical therapist will assess the child’s ability to take in and process sensory input and assess the child’s ability to walk, jump, run, climb stairs, kick a ball, etc.  During play activities, balance and protective reactions and motor planning skills will be assessed.

Goals for physical therapy will vary from child to child, but typical gross motor goals include:

  • Improving postural control to increase stability
  • Improving balance and coordination
  • Improving the sequencing, timing and execution of motor planning
  • Increasing sensory processing and organization skills
  • Increasing gross motor coordination and planning to explore the environment and interact with others

If you suspect your child is having difficulties with their gross motor skills, please talk to your pediatrician or your child’s teacher to request a physical therapy evaluation.  To find one in your area, please visit the APTA (American Physical Therapy Association).

 
For more information about the motor connection and autism, please visit Kid PT.

 

 

 

 

 

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Occupational Therapy and Autism

Autism is a complex developmental disability. Recent studies show that 1 in every 88 children is diagnosed with autism.  Autism is different for every child and can range from mild to severe – which is why it’s termed autism spectrum disorders.

Occupational therapy is defined as “skilled treatment that helps individuals achieve independence in all facets of their lives.  Occupational therapy assists people in developing the ‘skills for the job of living’ necessary for independent and satisfying lives.”  Since play is the job of childhood, occupational therapy is important for children with autism because it not only helps them focus on becoming independent during daily activities (e.g. dressing, eating, etc), but it also helps them interact and play with others in their environment.

According to the AOTA (American Occupational Therapy  Association, Inc), occupational therapists work with children with autism to address the following:

  • Determine if he or she has accomplished developmentally appropriate skills needed in the areas of grooming, play and leisure
  • Provide interventions to help the child respond to information coming through their senses
  • Provide developmental activities, sensory integration or sensory processing play activities
  • Facilitate play activities to encourage the child to interact with others
  • Develop strategies to help the child transition from one setting to another, from one person to another and from one life phrase to another
  • Collaborate with the child and family to identify safe methods of community mobility
  • Identify, develop or adapt equipment needed in order to participate in daily activities that enhance the child’s life and functional skills

Many children with autism also experience difficulty with sensory processing skills.  Sensory processing disorder (SPD) is a difficulty or difference in the brain’s ability to receive and process sensory stimulation from the body and the environment.  It is a neurological disorder where the connections in the brain appear to be too strong, too weak, or mis-wired – resulting in difficulty participating in normal daily activities.

Children with sensory processing disorder take in and process sensory information differently than the general population.  Normal sensory events and information are often reacted to in and under or over-responsive manner.  The senses impacted by SPD include our 5 senses of sight, sound, taste, smell, and touch.  It also includes 2 lesser-known senses including the proprioceptive and vestibular systems.

The vestibular system is related to the inner ear, and processes our body’s position in space and sense of movement.  How we react to swinging, roller-coasters, or being upside down is determined by the vestibular system.

Proprioception is the body’s sense of placement in relation to itself and the environment and is sent to the brain through receptors in joints and muscles.  Proprioception is the ability to close your eyes and know what position your arms and legs are in.  Children with proprioceptive problems often have uncoordinated motor skills and frequently trip and run into objects.  Many children with SPD often crave this proprioceptive input and are constantly prefer wrestling, jumping, and squishing activities that makes them feel secure by being aware of their bodies.

Occupational Therapy (OT) is the therapy domain that primarily treats SPD.  A sensory processing evaluation is done with a child and it is determined which senses are impacted and how it affects the child’s daily functioning.  Each system is examined and it is determined which senses are hyper-responsive or under-responsive.  Most children have a mixture of both, depending on the sensation.  Children with SPD usually have trouble with eating (picky eaters), dressing (tolerating the feel of certain clothing), play (avoiding messy textures, fear of movement, or playing too rough), and transitioning between activities and to different environments.

Treatment for SPD includes working with the child’s parents to create a Sensory Diet, which is a program designed for that child to provide his/her body with the sensations they need or crave to function optimally while also slowly and systematically exposing them to the sensations they do not tolerate well to desensitize their nervous system.  Through OT, we can actually re-wire those brain connections so children can function more effectively in their daily lives.

For more information on occupational therapy and sensory processing disorder, please visit these sites:

AOTA Autism Webpage

Sensory Processing Disorder

Sensory Integration Network

Sensational Brain

 
If you suspect your child may have a sensory processing disorder, or could benefit from occupational therapy, please talk to your child’s pediatrician or school to request an occupational and sensory processing evaluation.

 

 

 

Speech Therapy and Autism

Autism is a complex developmental disability that causes problems with social skills and communication.  Recent studies show that 1 in every 88 children is diagnosed with autism.  Autism is different for every child and can range from mild to severe – which is why it’s termed autism spectrum disorders.

Children with autism may have difficulties with communication, social skills and reacting to the world around them.  According to ASHA (American Speech-Language Hearing Association), the possible signs and symptoms of autism spectrum disorders include:

  • Not speaking or very limited speech
  • Loss of words the child was previously able to say
  • Difficulty expressing basic wants and needs
  • Poor vocabulary development
  • Difficulty following directions or finding objects that are named
  • Repeating what is said (echolalia)
  • Difficulty answering questions
  • Speech that sounds different (e.g. “robotic” speech or speech that is high-pitched)

Not every child with autism will have a language delay.  A child’s ability to communicate will vary, depending on his or her cognitive and social skills.  Some children with autism may be nonverbal (unable to speak) while others may have wide vocabularies and produce words and phrases without difficulty.  However, most children with autism will have difficulty using language effectively.  These difficulties may include expressing their thoughts to others, understanding words and maintaining two way conversations.

Repetitive Language (aka “echolalia”) is exhibited when children may say words that are out of context. Sometimes they repeat words immediately and sometimes they repeat words they’ve heard earlier or on TV shows.  Many children with autism will have difficulty with nonverbal communication, such as gestures and facial expressions.  They often avoid eye contact, which can make them seem inattentive.  They also have difficulty picking up on social cues and other nonverbal communication from others.

Once the child receives a diagnosis of autism, a referral for a speech and language evaluation is made. This evaluation is completed by a certified and licensed speech-language pathologist.  Helping children with autism communicate is essential to helping them reach their full potential.  It is best to start therapy as soon as a diagnosis is made in order to have the best outcomes.

For younger children, therapy will focus on pre-language skills (eye contact, gestures, babbling, etc) and other vocalizations.  Sign language may be introduced in order to provide your child with a way to communicate before they can say the words.

For older children, therapy will focus on the functional use of language.  This includes having conversations with others, maintaining topics and taking turns while speaking.

Some studies have shown that 25% of all children with autism may never develop verbal language skills.  If a child is nonverbal, other forms of communication may be implemented.  This may include PECS (picture exchange communication system) or other AAC (augmentative alternative communication) devices.  These AAC devices range from low-tech picture boards to high-tech electronic systems with voice output capabilities.  Your child’s speech-language pathologist will work closely with you and your child to determine which communication system is best for your child.

With advancements in technology, many parents, teachers and therapists are using the iPad and other tablet devices to help children and adults with autism communicate with others.  There are several apps on the market and prices range from a few dollars to a few hundred dollars.  If you are using an iPad with your child, please let your child’s speech-language pathologist know which apps you are using.  Working together, you can ensure that your child will carry over skills in a variety of environments.  For more information about apps for autism, please check out the following links:

10 Revolutionary iPad Apps to Help Autistic Children

7 Assistive Communication Apps in the iPad App Store

Autism Apps (a list developed by Autism Speaks)

Finding Good Apps for Children with Autism

If you suspect your child may have a speech and language delay and you would like to have an evaluation, please contact ASHA to search for a certified and licensed speech-language pathologist in your area.

Autism Awareness


April 2 is World Autism Awareness Day.  In fact, the month of April is nationally recognized as Autism Awareness Month and has been since the 1970’s.

Autism is a complex developmental disability.  It affects individuals differently and to varying degrees.  Currently, there is no known cause of autism.  Recent studies by the CDC (Center for Disease Control) show the prevalence of autism is increasing.  Now, 1 in every 88 children is diagnosed with autism.  There is a higher incidence of boys diagnosed more so than girls, with a number of 1 in every 54 boys.

Children are typically diagnosed with autism between the ages of 18 months and 6 years of age.  While there is no “cure” for autism, early diagnosis and intervention can lead to significantly improved outcomes.  According to the Autism Society, some signs and symptoms of autism include:

  • Lack of or delay in spoken language
  • Repetitive language and/or motor movements (hand flapping, rocking, twirling, etc)
  • Little or no eye contact
  • Lack of interest in peers
  • Lack of spontaneous play or make-believe
  • Persistent fixation on parts of objects

If you have concerns about your child’s development, please speak with your pediatrician immediately.  Ask your pediatrician to screen your child for autism. There are validated screening tools for autism as early as 16 months of age, but the best scenario would be to have a developmental screening completed at each well visit check-up to ensure your child is continuing to meet their developmental milestones.  If any “red flags” are noted, further evaluation should be considered.  If you suspect your child may have delays in his or her development, contact your local Early Intervention program.  In Tennessee, the program is TEIS (Tennessee Early Intervention System).

Throughout the month of April, our blog will focus on autism.  There are many things you can do to help those with autism and their families:

Be Supportive:  There are many events going on around the world to support autism awareness. Fundraising walks, such as the Opening Eyes to Autism 5k, are raising money for programs to support those with autism and for further funding of research.  Panera Bread has partnered with Autism Speaks.  In the Mid-South, a portion of all sales of their Wildberry Smoothies, Blueberry Bagels and Autism Awareness Bracelets will go directly to Autism Speaks – Memphis. Other events like the Light It Up Blue campaign are helping raise awareness.  In Memphis, Graceland is one of the many famous landmarks going blue for autism awareness.

Be Understanding:  Families with children with autism do want to be included in activities.  Invite them to a family BBQ, church or your child’s birthday party.  However, be understanding if they have to make special accommodations for their child.

Be Active:  Many insurance companies do not cover therapy services for children with autism.  Support legislation to increase medical coverage for those with autism.  Sign a petition to prevent delays in diagnosing autism.  Support local organizations providing services for those with autism and their families.  In Memphis, these organizations include:

Autism Society of the Mid-South

Autism Speaks Memphis

Transformations Autism Treatment Center

The ABA Place

The Exceptional Foundation of West Tennesee

Harwood Development Center

Autism is not limited to the United States.  Children around the world are diagnosed with autism every day.  Recent studies show that more children will be diagnosed with autism this year than with childhood cancer, juvenile diabetes or pediatric AIDS combined. Show your support for those with autism.  By doing so, you will help open the doors for further research, legislation and services for children and their families.