Physiotherapy in Autism Management

Autism is a complex neuro-behavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors. Because of the range of symptoms, this condition is now called autism spectrum disorder (ASD). It covers a large spectrum of symptoms, skills, and levels of impairment. ASD ranges in severity from a handicap that somewhat limits an otherwise normal life to a devastating disability that may require institutional care.

People on the autism spectrum have delays, differences or disorders in many areas. In addition to developmental delays, most have low muscle tone and experience difficulty with gross motor coordination (running, kicking, throwing, etc.). These issues can interfere with basic day-to-day functioning, and they’re almost certain to interfere with social and physical development.

physiotherapists are trained to help with these issues. Not only can a physiotherapist help your child to build muscle strength and coordination, but she can do so in the context of sports, recess, and/or gym. As a result, physiotherapy can improve functioning and social skills at the same time.

Causes and Risk Factors of Autism

Scientists don’t know exactly what causes autism spectrum disorder (ASD). Autism was first described in the 1940s, but very little was known about it until the last few decades. Even today, there is a great deal that we don’t know about autism.

Because the disorder is so complex and no two people with autism are exactly alike, there are probably many causes for autism. It is also likely that there is not a single cause for autism, but rather that it results from a combination of causes.

Studies are currently ongoing on the following;

• Gene and ASD
  A great deal of evidence supports the idea that genes are one of the main causes of or a major contributor to ASD. More than 100 genes on different chromosomes may be involved in causing ASD, to different degrees.
  

Many people with autism have slight changes, called mutations, in many of these genes. However, the link between genetic mutations and autism is complex:

• Interactions Between Gene and Environment
  If someone is susceptible to ASD because of genetic mutations, then certain situations might cause autism in that person. For instance, an infection or contact with chemicals in the environment could cause autism in someone who is susceptible because of genetic mutations. However, someone who is genetically susceptible might not get an ASD even if he or she has the same experiences.
  
• Other Biological Causes
  Researchers are also looking into biological factors other than genes that might be involved in ASD. Some of these include:
  

• Problems with brain connections
  
• Problems with growth or overgrowth in certain areas of the brain
  
• Problems with metabolism
  
• Problems in the body’s immune system, which protects against infections

Symptoms of Autism

The symptoms of one person with autism can be very different from the symptoms of another person with autism. Health care providers think of autism as a spectrum disorder—which means that there is a range of similar features in different people with the disorder.

Despite the range of possible symptoms, there are certain actions and behaviors that are common in ASD and could signal that a child is on the autism spectrum. Parents and caregivers who notice these “red flags” should speak to their child’s health care provider about autism and screening the child for ASD.

In general, the main signs and symptoms of ASD relate to:

• Communication and interactions with other people
  
• Routines or repetitive behaviors, sometimes called stereotyped

Below are some noticeable symptoms of autism into “red flags” to help parents and caregivers know what to look for as children grow and develop.

• Communication
  
• Does not respond to his/her name by 12 months of age
  
• Cannot explain what he/she wants
  
• Doesn’t follow directions
  
• Seems to hear sometimes, but not other times
  
• Doesn’t point or wave “bye-bye”
  
• Used to say a few words or babble, but now does not
  
• Social Behavior
  
• Doesn’t smile when smiled at
  
• Has poor eye contact
  
• Seems to prefer to play alone
  
• Gets things for him/herself only
• Is very independent for his/her age
  
• Seems to be in his/her “own world”
  
• Seems to tune people out
  
• Is not interested in other children
  
• Doesn’t point out interesting objects by 14 months of age
  
• Doesn’t like to play “peek-a-boo”
  
• Doesn’t try to attract his/her parent’s attention

Stereotyped Behavior

• Gets “stuck” doing the same things over and over and can’t move on to other things
  
• Shows unusual attachments to toys, objects, or routines (for example, always holding a string or having to put on socks before pants)
  
• Spends a lot of time lining things up or putting things in a certain order
  
• Repeats words or phrases (sometimes called echolalia)

Management of Autism

Managing ASD involves a multidisciplinary approach. Below are the lists of Professionals who might be involved in the management of ASD:

• 
  Behaviour Analysis
  
• Clinical Dietetics
  
• Developmental Paediatrics
  
• Neuropsychology
  
• Nursing
  
• Occupational Therapy
  
• Pastoral Care
  
• Physiatry
  
• Physiotherapy
  
• Recreation Therapy
  
• Social Work
  
• Speech-Language Pathology

In this article, emphasis we will be played on Physiotherapy role in the management of ASD.

Physiotherapy role in autism spectrum disorder

The basic role is to help children who have difficulty with functional movement, poor balance, and challenges moving through their environment successfully. Some children with Autism Spectrum Disorder (ASD) have low muscle tone, some have poor balance, others may not be well-coordinated, and still others may have a combination of all of the above. These are all areas that a physiotherapist can be of great help.

After an assessment, the physiotherapist will design and implement a program that will help to improve the individual child’s areas of need and increase overall function and participation.

Specific Physiotherapy Areas of Intervention

• Gross Motor Skills: Using large muscles for sitting, standing, walking, running, etc.
  
• Balance/Coordination Skills: Involves the brain, bones, and muscles in a coordinated effort for smooth movement; for example, climbing stairs, jumping, etc.
  
• Strengthening: Building muscle for support and endurance; for example, to walk for a distance without becoming tired.
• Functional Mobility/Motor Planning: Moving through space, day to day, for independence and efficiency; for example, to climb onto the rocking chair and make it rock back and forth.

The Importance of Motor Skills

Gross motor skills enable children to explore and learn from their environment. Young babies’ neck muscles develop, allowing them to hold their head up and see things from an upright position. Trunk muscles strengthen, enabling children to sit and soon after crawl and begin to explore their surroundings on their own. Toddlers learn to walk, climb, and eventually run. As children become adults, motor skills continue to be important for independence.

Book an appointment today with us at PCA for your assessment and management.