Autism Spectrum Disorders and Physiotherapy Intervention

In April we celebrate Autism awareness day. So in this week’s PT weekly,  we will explain what exactly Autism is and how we as physiotherapists can be involved.  Autism, or Autism spectrum disorder (ASD) is a broad diagnosis that characterizes a wide range of symptoms. Typically, Autism is characterised by impairment with social skills, communication and behaviour. Symptoms generally appear in early childhood (mostly detected between 1 and 2 years of age).

Types of ASD

People who are diagnosed with ASD have 5 currently recognised subtypes or specifiers, and one can be diagnosed with one or more of these:

• With or without accompanying language impairment.
• With or without accompanying intellectual impairment.
• Associated with a known genetic, medical or environmental factor.
• Associated with another neurodevelopmental, mental or behavioural disorder.
• With catatonia: abnormality in movement and behaviour.

Symptoms of ASD

People with ASD tend to have problems with social, emotional, and communication skills. They are likely to repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

Symptoms of Autism could include:

• being very interested in people, but not know how to talk, play, or relate to them
• repeating or echo words or phrases said to them, or repeat words or phrases in place of normal language
• having trouble expressing their needs using typical words or motions
• not playing “pretend” games (for example, not pretend to “feed” a doll)
• repeating actions over and over again
• having trouble adapting when a routine changes
• having unusual reactions to the way things smell, taste, look, feel, or sound
• losing skills they once had (for example, stop saying words they were using)
• not pointing at objects to show interest (for example, not point at an airplane flying over)
• not looking at objects when another person points at them
• having trouble relating to others or not have an interest in other people at all
• avoiding  eye contact and want to be alone
• having trouble understanding other people’s feelings or talking about their own feelings
• appearing to be unaware when people talk to them, but respond to other sounds

Also, we often we see other interesting characteristics in individuals with autism. They are often very open and honest and they are commonly very good at learning new facts and talents.

Cause and Risk Factors

While scientists currently don’t know the exact cause of autism, research suggests there is no single cause of ASD. Instead,  it’s likely caused by interaction of genetics, environmental and biological factors. Some of these factors include having an immediate family member with ASD, children born from older parents, individuals with certain genetic conditions or chromosomal conditions such as fragile X chromosome, exposure to drugs such as valproic acid and thalidomide during pregnancy and children born with very low birth weight.

While there is currently no known single cause of autism, early diagnosis helps a person receive the support and services that they need, which can lead to a quality life filled with opportunity.

Treatment

As expected in a diagnosis where symptoms vary greatly,  there is no single definitive treatment. Treatments can include: speech therapy, medication and supplements, psychotherapy, physiotherapy, occupational therapy and dietary changes.

Physiotherapy Interventions

Studies have shown that motor deficit is found among individuals with ASD, including hypotonia, motor apraxia, toe walking and gross motor delay. There is an understanding that motor skills are instrumental for learning skills in other areas such as social behaviour, communication skills, academic engagement and sensory skills.

An individual with ASD will be assessed for motor abilities as well as developmental functional abilities. Intervention is individualised and customised to meet specific needs of each individual with ASD by organising the treatment based on the anxiety level, ability level, ability to accept change. A Physiotherapist will provide appropriate exercises and equipment with the aim of:

• Increasing independence, mobility and muscle strength.
• Improve social skills through activities.
• Teaching hand dexterity.
• Training balance, co-ordination and core stability.
• Reduce physical strain caused by ASD.
• Encouraging planning and organising within peer groups, family and society.
• Enhancement of educational and attentive abilities through sensory organisation and centering (using weighted vest, trampoline, etc.)
• Improving cardiovascular abilities

The therapy sessions are designed in a manner that reduces anxiety and encourages self-regulation which facilitates motor learning. It generally comprises of a series of activities beginning with a more passive activity, proceeding to assisted active participation and to a more active part of the session at higher level of engagement. We at PCA have an in-depth knowledge of issues arising as a result of ASD and can help your child achieve their milestones with a program designed just for their needs.