Physical therapists have unique training in child development and motor control. This expertise allows them to assess a child’s motor delays and functional performance. Physical therapists work with your child, the family, and your child’s school to help them:
- Engage and improve in daily routines at home and school.
- Acquire new movement skills.
- Develop better coordination and a more stable posture.
- Improve play skills, such as throwing and catching a ball with another person.
- Develop motor imitation skills (learn by copying another person’s actions).
- Increase fitness and stamina.
A physical therapist will evaluate your child thoroughly. This will include taking a health and developmental history. Your child’s physical therapist also will assess:
- Postural strength and control.
- Functional mobility (such as walking and running).
- Body and safety awareness.
- Coordination.
- Play skills.
- Interests and motivators.
- Ability to change between different activities.
- How your child jumps, hops, pedals a tricycle or bicycle, and skips.
- Daily routines in the home, community, and school.
Your physical therapist will work with you to develop goals to help your child participate as fully as possible at home and school. Your physical therapist will then create a plan to meet your child’s and your whole family’s needs. No “standard” treatment exists for children with ASD. Each child’s challenges and goals are different. Your physical therapist will personalize a program to meet the strengths and needs of your child. They will work with you to monitor your child’s progress. They also will collect data to ensure their plan is helping your child and adjust the plan as your child makes progress.
Physical Therapy in the Early Years: Birth to Age 3
Early delays in your child’s movement skills may predict ASD. Reporting symptoms right away can enable early diagnosis so your child can get the help they need sooner.
Physical therapists work with families and caregivers. Their goal is to increase a child’s ability to engage in the daily routines that may challenge them.
Physical therapists work with your child to develop age-appropriate movement skills. They use free and structured play to teach your child and help them practice skills. Physical therapists work on increasing your child’s strength and coordination. Their treatment plan can include helping your child walk safely and efficiently or how to use stairs. Your child’s physical therapist may prioritize the development of imitation skills. They may work with your child to perform actions to songs like “Head, Shoulders, Knees, and Toes” and indoor and outdoor play skills. Physical therapists guide you and your child on adding structure, routines, and physical boundaries into daily life. They promote positive behaviors and help your child play with their peers.
Physical Therapy in the School Years (Including Preschool): Ages 3 to 18
Physical therapists work with parents and teachers. They increase awareness about children with ASD. They also help school staff understand your child’s ability to function in school. Physical therapists use the most effective treatments to minimize your child’s challenges. Your child’s physical therapist will work with you to help make the school experience a positive one. Physical therapists also recommend changes at home and school to help your child thrive, support learning, and teach movement skills. These may include:
- Using ball chairs to reduce “out-of-seat behaviors.”
- Hula hoop, carpet square, or special seat to mark personal space.
- Whole-class movement breaks.
- Strategies to teach skills needed to play social games.
Physical therapists provide direct help when needed to improve a child’s ability to handle challenges. For example, they work with your child to help them deal with school bus steps, crowded hallways, the lunchroom, and the playground. Physical therapists also work with school teams to promote skills like self-control, listening, and taking turns. They teach your child methods that promote their ability to:
- Copy the movement activities of other children.
- Develop concepts of direction, body and spatial awareness, and coordination.
- Take part in physical education and fitness activities.
Physical Therapy During Adulthood: Age 18+
Physical therapists work with adults with ASD to promote success in daily life. They recommend community resources to increase movement. Physical therapists also design personalized exercise programs. These exercises will promote physical fitness, body coordination, and recreation skills. Physical therapists help adults improve movement, function, and fitness. These skills help people with ASD get and hold a job. They also help them function at home, enjoy activities, and keep a healthy lifestyle.
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.
Physical therapists are trained to help with these issues. Not only can physical therapists help your child to build muscle strength and coordination, but they can do so in the context of sports, recess, and/or gym. As a result, physical therapy can improve functioning and social skills at the same time.
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The Role of a Physical Therapist
Physical therapists (often called “PTs”) are trained to work with people to build or rebuild strength, mobility and motor skills. Many physical therapists hold a Masters Degree or Doctorate in physical therapy and have worked in the field as an intern before working on their own.
They must also be board certified by a national and/or state governing board. According to the APTA (American Physical Therapy Association), “APTA’s vision is that by the year 2020, the majority of practicing physical therapists will possess a DPT [Doctor of Physical Therapy] degree.” Physical therapy is typically considered to be medically necessary and is usually paid for by medical insurance.
Dance and movement therapy, hippotherapy (therapeutic horseback riding), aquatic therapy (therapeutic swimming), recreational therapy, and even play therapy may also be offered by people with a background in physical therapy. While none of these specialized services is likely to be supported by medical insurance, many may be right for your child.
What a Physical Therapist Does for People With Autism
Children with autism often develop typically for a short period of time and then present symptoms as toddlers. Physical symptoms that may be treated by a PT range from difficulty with coordination to lack of muscular strength. Balance may be an issue: children on the spectrum may find it very hard to ride a bike or use skates.
Perhaps most significantly, autistic children are likely to have difficulty with “motor planning.” In other words, they may have the skills to climb onto a swing and be able to hang on—but they may have a very difficult time coordinating their bodies to “pump” and get the swing moving.
Physical therapists may work with very young children on basic motor skills such as sitting, rolling, standing, and running. They may also work with parents to teach them some techniques for helping their child build muscle strength, coordination, and gross motor skills.
As children grow older, physical therapists are more likely to treat young clients at the child’s preschool or school. There, they may work on more sophisticated skills such as skipping, kicking, throwing and catching. These skills are not only important for physical development, but also for social engagement in sports, recess and general play.
In school settings, physical therapists may pull children out to work with them one-on-one, or “push-in” to typical school settings such as gym class to support children in real-life situations. It’s not unusual for a physical therapist to create groups including typical and autistic children to work on the social aspects of physical skills. Physical therapists may also work with special education teachers and aides, gym teachers, and parents to provide tools for building social/physical skills.
How to Find a Qualified Physical Therapist
Most of the time, physical therapy is included in early intervention programs offered by school districts and other local providers. Physical therapists are likely to be subcontracted on an hourly basis.
It’s also relatively easy to find a physical therapist through local hospitals and rehabilitation centers, though those individuals are less likely to have specific training and experience with autism.
If you are seeking a private physical therapist, it’s a good idea to start with your own pediatrician. Ask for a prescription, since this will probably allow your therapist to bill his or her hours to medical insurance.
“Autism has been at the forefront of my adult life, on the job and at home,” says Karen Tartick, PT. “I understand it as a physical therapist and I understand it as a parent.”
What Tartick, a longtime physical therapist (PT) for the Durham Public Schools in North Carolina, understands professionally is that PTs like her, working with other members of an Individualized Education Plan (IEP) team, can enhance the lives of children with autism. She knows—from a growing body of evidence-based research and her own practice—that PTs can help children with autism more fully participate in daily routines at home and at school, acquire new motor skills, develop better coordination and more stable posture, improve their reciprocal-play skills (such as throwing and catching a ball with another person), develop motor imitation skills (copying an action performed by someone else), and increase their fitness and stamina.
“The great thing for PTs is that exercise and structured play groups both are evidence-based practices for children with autism,”1,2 Tartick says. “That is absolutely beautiful to me, because facilitating and promoting exercise and wellness is such a huge part of what PTs do. And it’s been shown to have positive effects in children with autism that extend beyond physical health. It can decrease their maladaptive behaviors and aggression, make them more on-task, improve their academic abilities, and have a big, positive impact on their quality of life.”
