Physical Therapy and Autism

Autism, or autism spectrum disorder (ASD), is being observed more frequently by rehabilitation professionals each year. In the clinical setting, physical therapists (PTs) encounter this diagnosis group, although it is not the primary category taught in school.

Traditionally, individuals diagnosed with autism receive occupational therapy, primarily addressing skills for daily living. From a PT perspective, the focus is not on treating autism itself but rather on the associated impairments. Many children with autism are often identified as toe walkers, a common concern treated in pediatric PT. Additionally, these children may experience delays in gross motor skills. As a PT, interventions involve addressing issues arising from differences in brain function rather than directly addressing autism. 

With experience, a seasoned PT develops a different approach to treating children with ASD compared to a new graduate. Learnings from occupational therapists and speech pathologists provide creative ways to address these patients. The seasoned PT adapts techniques to simplify cues, making it easier for children to process directions. 

Encountering patients with potential red flags for autism, the PT understands the sensitivity of discussing additional specialist consultations with parents. While unable to diagnose ASD, the PT can refer patients to appropriate specialists, emphasizing trying occupational therapy before considering a neurologist. Regardless of a formal ASD diagnosis, occupational therapy remains a valuable referral and rehab specialty. 

In the PT's assessment, factors like eye contact and the child's engagement are crucial. The PT considers developmental stages, acknowledging that engagement varies across different ages. Short directions and strategic pauses after verbal cues are employed, aligning with recommendations from a speech pathologist. 

Demonstration is another effective strategy, combining verbal and visual cues. The PT may also use manual assistance when necessary, considering each child's tolerance for touch. Employing a picture schedule, especially a "first/then" page, offers structure and choice, empowering the child while maintaining guidance from the therapist. 

The PT emphasizes that autism is a spectrum, with varying signs and impairments. Recommending a comprehensive approach, the PT suggests collaborating with professionals such as occupational therapists, speech and language pathologists, social workers or counselors, neurologists, and behavioral specialists for a holistic continuum of care. 

In closing, the PT underscores the importance of recognizing ASD resources and the willingness of professionals to provide support. 

Physical Therapy
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