People with autism may struggle with some motor coordination or skills, regardless of the severity level of their diagnosis. Physical therapy can help to improve both gross and fine motor functions using exercise programs and games, which work especially well for children.


Various types of physical therapy focus on building muscle strength, improving posture, and improving hand-eye coordination.


How Can Physical Therapy Help People With Autism?


People who are on the autism spectrum might struggle with motor coordination, posture, balance, and physical strength. In some cases, they may have difficulty taking care of themselves in daily life. Physical therapy helps to improve range of motion, muscle strength and control, and other aspects of physical health that may be impacted by this developmental condition.


Physical therapy is one of the many treatments that people with autism need access to, depending on the severity of the condition. Access to physical therapy may be important in early life, at various points throughout the person’s life, or consistently throughout their entire life. Keeping up with a personalized treatment plan can indicate when physical therapy becomes necessary and to what extent.


Early diagnosis and intervention, typically when a child is around 2 years old, help to keep the child from developing maladaptive behaviors that prevent them from physically growing and developing as they should. Early intervention is also crucial to prevent other damaging behaviors, like isolation.


Physical therapists can adapt programs to age, development, and special needs to support both autistic children and adults.

How Physical Therapy Works


Physical therapy helps a wide array of people improve their physical health, range of motion, and coordination through prescribed exercises. These are often taught and practiced in a clinic, but they can also be performed at home to help the client continue their physical improvement in a familiar environment.


Physical therapists are involved in treating many conditions. They may help a client regain strength in a broken arm, improve heart health during recovery from a heart attack, or keep as much strength and flexibility as possible in arthritic joints. They can also potentially help people with autism.


Autism-Specific Needs for Physical Therapy


Motor skills are important for general communication. Problems with speech or cognition may be part of a larger issue with physical development.


Low muscle tone and “clumsiness” are seen in many people with autism, but these features may be associated with repetitive motor movements and oral-motor problems, or issues with the tongue and jaw that cause challenges with speaking. When these problems combine with each other, overall communication and socialization can be negatively impacted.


Treatments for autism tend to focus on behavioral approaches, like applied behavior analysis (ABA) therapy. But these potential issues with physical development may require a different approach.


While differences in physicality are not one of the core diagnostic criteria for autism — according to the Centers for Disease Control and Prevention, the core components are social, communication, and cognitive struggles — differences in both gross motor skills, like walking, and fine motor skills, like using a pen or pencil, may all show up in people with autism at different levels of severity.


One paper published in 2012 reported that there were measurable differences in the following physical areas:

  • Early motor skills: Around 14 months old, many children with autism showed a slowing of development, including some physical development. One research group found that children with autism were slower to reach mature motor patterns. The group suggested that more sensitive testing would be needed to find motor impairments early in life.
  • Gestures and motor imitation: Children on the autism spectrum typically struggle with communication, which includes physical gestures to express themselves and understanding body language in others. Children under the age of 4 typically mimic the facial expressions and body language of their parents and siblings. Studies have found that children with autism do not, which might impact their physical growth.
  • Postural control: People with autism may struggle with physical balance, which can limit them to more static positions. Lower postural control and stability can make basic activities like walking or standing comfortably more difficult. One study found that postural control did not seem to improve in some children until around 12 years old.
  • Dyspraxia: This is the medical term for general clumsiness, usually associated with developmental disorders like autism. Several lower level studies have reported that fine motor functions and quality of movement were generally lower in children on the autism spectrum, but no larger studies have been conducted to determine the range or cause.

Physical therapists are not integrated into broader autism treatment. Parents and caregivers usually rely on their child’s pediatrician, and then on a behavioral therapist like an ABA therapist, to understand motor control issues alongside developing positive social, cognitive, and communication behaviors.

Suggestions on Approaches to Physical Therapy for Autism


There are some different ways that physical therapists can help people with autism improve motor skills. One of the simplest is exercise in general.


General Exercise


A meta-analysis found that exercises like walking, jogging, horseback riding, swimming, weight training, and bicycling all improved both motor skills and social skills — in part because many of these activities involve communicating with others. The study also found that individual intervention with a physical therapist improved outcomes significantly, compared to control groups who may have been exercising on their own but did not have oversight from a medical professional to develop a treatment plan.


An individual with autism may show a preference for one type of exercise over others, but the physical therapist may need to guide them toward other exercises. While this is not a proven approach to integrating physical therapy into autism treatment, understanding overall needs and finding ways to encourage the child or adult with autism to continue participating can help. This may include working with the individual’s ABA therapist.

Exergaming


Children on the autism spectrum may benefit in particular from exergaming, which involves combining exercise with play. Exergaming supports improvements in executive function, working memory, motor strength, motor agility, and running speed.


Because the exercise is fun for children, it is more easily integrated into daily life with substantial benefits.

Yoga


A study on yoga as an intervention for children with autism found that participating in this activity improved some functions, but not others. The small study involved 24 children on the autism spectrum, between the ages of 5 and 13, who were divided into two groups. One group participated in “academic intervention” with arts and crafts, reading, and related sedentary activities, while the other took a yoga class led by a physical therapist.


At eight weeks, the yoga group had better gross motor performance, but the academic group had better fine motor performance. Imitation skills improved in both groups, although the yoga group showed improvements in this area faster than the academic group. Adjusting for age and associated development showed that academic interventions might work better for older children with autism, compared to younger children.

Insurance May Cover Some Physical Therapy Costs


Physical therapy can be very valuable as an early intervention because it can reduce the need for surgery and medication later in life.


Increasingly, insurance companies are providing some coverage for physical therapy interventions, rather than just medication or surgery. This stems from a greater medical understanding that preventative interventions are vital to long-term health. Talk to your insurance provider about how physical therapy is covered in your plan as it relates to autism treatment.


Treating physical issues like poor posture or weak muscles with exercise first can improve overall outcomes and reduce the cost of medical care over the course of life. Depending on autism severity, the person may still need additional medical treatment, but physical therapy can help to improve range of motion and quality of life.

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