The Role of Physiotherapy for Children with Autism

In addition to the behavioural, sensory and social-emotional difficulties, many children with an Autism Spectrum Disorder (ASD) will also experience difficulties with their motor skills and capabilities.

Children with ASD may achieve early gross motor milestones such as sitting, crawling and independent walking within the expected timeframes, but the quality of their movements may be immature or stereotypical when compared with their peers.  These early motor skills provide the foundations for the development of later motor skills which require more refined and sophisticated movement control.  As a result, children with ASD may struggle to master higher level motor skills such as ball skills, skipping, riding a bike, balancing and hopping.  These skills impact the child’s overall participation in peer and community activities, which subsequently will affect their overall development.

Some signs a child with ASD might benefit from the help of a paediatric physiotherapist:

• Delayed achievement of gross motor milestones

• Difficulty with:

  • Throwing, catching, kicking or dribbling a ball

  • Jumping, hopping or skipping

  • Playing on a playground

  • Playing games or sports and keeping up with their peers

  • Participating in community recreational or sporting programs

  • Learning new physical skills

  • Sitting in a chair properly, or for very long without fidgeting

  • Poor posture

  • Clumisness or frequent falls

• Toe walking

A number of motor, sensory and musculoskeletal issues may be underlying the motor difficulties experienced by a child with ASD:

• Low muscle tone – muscle tone is the level of activity present in our muscles at rest. Children with ASD often have low muscle tone, which means that they require to use more strength and energy to move, and also alters the sensory feedback a child receives through their muscles when they move.

• Motor planning difficulties – this affects the child’s ability to optimally time, sequence and execute a movement. This is often seen as clumsiness, frequent falls, poor balance, or poor coordination.

• Poor core strength – as a result of their low muscle tone and motor planning difficulties, children with ASD often also have poor core strength. Children with ASD have difficulty recruiting the correct muscles in their core, and lack the strength and endurance to enable them to engage these muscles for functional activities.

• Poor posture – often develops as a result of the low muscle tone and poor core strength, and impacts on a child’s ability to master more sophisticated motor skills, fine motor skills, and can also impact their attention and participation in the classroom or at school.

• Tight muscles and joints – these develop as a result of the poor motor strategies and posture

• Delayed achievement of, poor or inefficient balance reactions – these include the child’s automatic reactions to keep themselves upright when they start to lose their balance, and the automatic protective reactions to protect themselves from injuries when they fall.

A physiotherapist experienced in paediatrics will assess the child’s overall motor functioning, identify the underlying difficulties, and provide an intervention program to help address or improve these difficulties and subsequently the child’s overall functioning.  Strategies that may be used as part of a physiotherapy intervention plan include:

• Specific exercises or activities for muscle strength, posture, endurance, motor planning and balance reactions

• Sensory feedback strategies to improve a child’s awareness of their body posture and movements

• Recommendations for taping, orthotics, and/or other bracing or positioning strategies and equipment to enhance the child’s body alignment, posture and body awareness during functional or physical activities

• Recommendations and support to participate in community based physical activity programs that will support their physical skills and endurance

Physiotherapy can be a key ingredient in the treatment of motor difficulties for children with ASD.  If you are concerned about your child’s development or their motor skills, or have a child you are working with who you think might benefit from physiotherapy intervention, please contact us at Move and Play Paediatric Therapy so we can assist them to achieve the best possible outcomes.