Why Might Physical Therapy Benefit Children With Autism?

Autism spectrum disorder — which, as the term "spectrum" reveals, comes with a broad range of different manifestations — is clinically defined by a set of unusual traits in two different domains:

• Social communication and interaction. This can include, for instance, finding unwritten social rules difficult to comprehend, being really bad at "small talk", not being sure how to slide into a conversations, trouble making friends and nurturing friendships, and having a hard time discussing or identifying feelings. Unusual nonverbal behavior, like avoiding eye contact or having an atypical gait, are also common.
• Fairly narrow and repetitive behaviors and interests, which may be marked by a strong need for routines and sameness, passions a person becomes totally absorbed in, an intense sensitivity to external stimuli like sounds, lights, and noises, and also so-called "stereotyped or repetitive" motor movements, a phenomenon also known as "stimming". 

What is physical therapy?

Physical therapy is a kind of therapy that can help a person improve motor skills, build strength, work on better posture, and find better balance. It be an integral part of recovery after an injury, but can also play an important role in the treatment of chronic conditions. A wide variety of different strategies can be employed over the course of physical therapy, ranging from massage and heat treatment to exercises and evem mobility aids like braces. 

Why might autistic people benefit from physical therapy?

Research has uncovered that autistic people often have motor delays or challenges in childhood, for instance:

• Low muscle tone (hypotonia) — one study found that just over half of autistic children have lower muscle tone. 
• Motor apraxia — finding it hard to consciously direct movements in a purposeful manner even though no physical cause is present. This may affect as much as 34 percent of autistic children. 
• Walking on their toes (19 percent). 
• Generalized motor delays (nine percent). 

Dyspraxia (a disorder that affects motor planning and results in "clumsiness") and trouble with coordination are also not unusual among people on the autism spectrum. Some researchers even see these motor challenges as an integral part of autism. Where motor difficulties exist, physical therapy can often help. 

How can physical therapy help autistic children improve their motor skills?

A good and effective physical therapy program is, of course, tailored to the individual's needs, and depending on what those are, physical therapy may benefit an autistic child in specific ways:

• Improving posture. 
• Improving gait — toe walking, for instance, can lead to poor balance, strained muscles, and pain. 
• Improving spatial orientation and hand-eye coordination. 
• Teaching specific skills needed in daily life where needed, such as dressing one's self. 
• Assisting in making useful adaptations at home to suit the child's needs. 
• Improving general physical fitness and cardiovascular health. 

Some studies have found that physical therapy reduces the "sterotyped, repetitive motor behaviors" also known as stimming that are so common among autistic people (if you don't know what we're talking about, head over to Repetitive behavior and autism: What is stimming?). Autistic people may stim in various ways, some of which involve motor movements — hand-flapping, spinning, and rocking, for instance. It's natural and often a way to cope with both distressing situations and positively exciting ones. 

If a physical therapy program, which can include things like going for walks, reduces stimming because it reduces stress, that is surely a positive thing. Stimming is a completely normal autistic behavior, however, so unless a particular stim is poses a danger to an autistic child or those around them, "making it stop" shouldn't be one of the goals of physical therapy. 

Physical therapy can take place in a one-on-one setting or in a group setting with other children — in this case, the idea is that the presence of peers will motivate the child and give them the option of imitating others, and physical therapy may be a portion of a wider therapeutic program that also aims to teach social skills. It is not unusual for a physical therapist to visit clients at home to assess how a home could better be adapted to meet a person's physical needs, either, and children attending physical therapy will probably be assigned exercises to practice at home, too.

What should you do if you believe your child could benefit from physical therapy?