Autism spectrum disorder (ASD) is a neurobiological disorder that affects communication, social interaction, and behaviour. While symptoms vary, ASD typically presents in childhood and affects approximately 1 in 150 children in Australia with males being 4 times as likely to have it as females. While the disorder does not typically affect a person’s ability to breathe or walk, it can present a number of physical challenges, including limited motor skills, motor impairment, poor balance and strength, and difficulty swallowing and speaking.
Key benefits of physiotherapy for ASD
There are often developmental delays that are associated with Autism Spectrum Disorder which can have profound effects on a child’s ability to join in social activities with their peers; which can increase the social challenges that may be present in people with the disorder. The Australian Physiotherapy Association has identified that physical activity is lower in children with Autism Spectrum Disorder and that Physiotherapy interventions are effective at improving this over time.
One of the key areas that Physiotherapy can help with is motor skills and movement. It is important to address these challenges in the early stages of development because they are the fundamental building blocks for other social sporting activities. And physiotherapists are the best-placed healthcare professionals to guide and support children.
Physiotherapists are experienced in working with children who have the condition to develop these foundational skills, such as running, jumping, hopping, clapping, skipping, kicking, and throwing, using a wide range of visual and auditory cues that are designed to work around the communication obstacles that may be present. Teaching these skills will often be performed in a game-based environment where the child leads the sessions through exploration of a carefully set up environment.
Assessment & identification
Autism Spectrum Disorder is identified in early childhood, typically after a parent, nurse or doctor identifies delays in developmental milestones as well as indicators from the following categories:
- Behaviour
- Sensory
- Communication
- Play
- Social Skills
The identification of ASD can be clear for some children, whilst for others, it may happen over a period of months or years. Autism Spectrum Disorder is, as the name suggests, a wide-ranging spectrum of different signs and symptoms, that affects all children in different ways. Physiotherapists often identify movement disorders in children with ASD, prior to their first ASD diagnosis; which can lead to the child being referred off to the appropriate medical expert to get help early on – which has many benefits for the long-term outcomes for the child.
The diagnosis of ASD includes a thorough assessment of social and communication skills in combination with both restricted and repetitive interests and stereotypical patterns of behaviour that may be expected. The importance of receiving an official ASD diagnosis is that children are then eligible to receive services and funding to allow them to achieve their full potential.
How do Physios manage ASD patients?
Physiotherapists are experts at supporting children with ASD to improve their motor, skills, strength, and coordination through game-based activities in an environment that has been carefully set out to allow the child to guide the session as they explore the different movement opportunities available to them.
Physiotherapists have also had training in different methods of communication to help connect with children who have the condition, ranging from auditory to visual methods, with a deep understanding that creating a strong relationship and consistency is one of the key components of the communication process.
Through improving movement outcomes, Physiotherapy has been associated with an increase in sporting participation and social skills in children with Autism Spectrum Disorder; which is associated with an improved quality of life.
Hydrotherapy for children with ASD
Hydrotherapy has been used widely to help children with to achieve their movement goals through physiotherapy due to a few key factors:
- Hydrotherapy can help to improve behaviour during sessions
- Hydrotherapy has been shown to help with social interaction and attention
- Hydrotherapy increases sensory input
- Hydrotherapy decreases relative body weight, helping with movement and balance issues
- Hydrotherapy offers essential learning in water safety
From the current research, it is accepted that hydrotherapy offers an environment of stimuli that is calming for children with ASD through a combination of warm water on the skin, buoyancy, and slow controlled movements. This has been shown to help with communication and behaviour challenges through a number of studies listed above.
In addition, it also offers an important opportunity for children to learn aquatic skills and water safety – which is incredibly important as Royal Life Saving Australia has identified that children and adolescents with Autism Spectrum Disorder are three times more likely to drown than children without ASD.
Types of exercises
Coordination & motor skills
- Bear crawls are a typical exercise that we would perform when working with children with ASD. This exercise helps children with their proprioception (body awareness) whilst improving their coordination and strength in their core and upper body.
Fitness and stamina
- Star jumps are a fantastic exercise for children with ASD to increase their fitness and stamina – they also encourage coordination between the legs and arms.
Balance
- Interestingly, interactive videogames have been shown to improve balance in children with ASD, providing a fun and meaningful way to work through what can sometimes be more challenging exercises (https://ei.northwestern.edu/videogame-balance-training-autism)
Strength
- Medicine ball slams are an exercise that we would prescribe for upper body strength. This exercise can be progressively overloaded by increasing the weight of the ball and also improves coordination between the upper and lower limbs of the body.
Posture
- Exercises on monkey bars and safety frames where children are incorporating strengthening the muscles in their back that pull them up are a great way to encourage the development of proper posture through a fun and engaging environment.
Frequently Asked Questions
How can physiotherapy help your child who has autism?
Physiotherapy can help children with autism to improve their motor skills, balance, and strength in order to be able to achieve their goals around activities of daily living. This can also be achieved in small group settings which enhance the positive effects of social interaction for these children.
Can children with autism spectrum disorder benefit from physiotherapy?
Children with autism will directly benefit from physiotherapy to help them to improve their activities of daily living through strengthening and balance exercises; which can be conducted in small groups to enhance the development of social skills in a supportive environment.
What is the difference between physiotherapy and athletic therapy?
The key difference between physiotherapy and athletic therapy is that athletic therapy is generally delivered as therapy to athletes who are playing sporting events, whilst on the sports field, whereas physiotherapy covers a much more broad aspect of musculoskeletal conditions.
What training do physiotherapists undertake?
Physiotherapists undertake a 4-year bachelor’s or 5-year master’s degree for their initial qualification. Once qualified there are certain ongoing professional development requirements that must be met to maintain registration, as well as a diverse range of specialisation pathways that can be undertaken.
