Physical Therapy for Autism: What Parents Need to Know

Autism spectrum disorder (ASD) is a condition that includes a wide range of symptoms. These symptoms include challenges communicating with others, struggles with social skills, repetitive behaviors, sensitivity to sensory input, and many more.

Many of these symptoms are seemingly unrelated and require various treatments to alleviate them. While other commonly used therapies like applied behavior analysis, speech therapy, and occupational therapy address behavioral and communication aspects, physical therapy offers different support. Children with autism often face physical difficulties (things like motor skills, coordination, and fitness) that can be improved with physical therapy.

Physical therapy can be a beneficial addition to the treatment package for children with autism. We will cover how it can improve motor skills and physical abilities, and how it can work alongside the other types of therapy to help best support their development.

Understanding Physical Therapy for Autism

The first time that I had heard about physical therapy as a treatment for children with autism, I was a bit confused. I was under the assumption that physical therapy was for people who had muscular disorders, recent surgeries, or were in similar situations. Physical therapy aims to improve physical function and mobility, so it makes sense that children with autism would benefit. For autistic children, physical therapy focuses on addressing specific developmental and motor challenges that are associated with ASD. This includes gross motor skills (think walking, running, coordination, etc.) and fine motor skills like grasping and manipulating objects.

Physical therapy also improves things like balance, strength, and flexibility. Many children with autism are prone to injuries as a result of a lack of coordination or balance. Physical therapy can help to significantly reduce their risk of injury. It can also help with their independence in daily living skills. Things like buttoning buttons, tying shoes, or writing all involve a level of coordination that may not come as naturally to children with autism as it does to neurotypical children.

Physical therapists, much like other professionals in the field, like SLPs and BCBAs, use individualized therapy plans that help children with autism on the individual level.

Physical therapists assess the child and figure out a detailed plan for sessions that are unique to them. They assess motor skills, sensory processing, and physical challenges to design interventions that specifically target the types of skills that will be most beneficial to them.

Physical therapists can also work closely with families, and teach them how to incorporate exercises and activities into everyday routines. This significantly helps to generalize skills into the natural environment. Physical therapists also often collaborate with other professionals, such as occupational therapists, SLPs, and BCBAs. This collaboration can be incredibly beneficial for the child. It allows for the practice of skills to occur across all types of therapy sessions.

Benefits of Physical Therapy for Children with Autism

As mentioned above, physical therapy can offer great benefits for autistic children by improving both gross and fine motor skills.

For gross motor skills, therapy can help improve overall coordination, balance, and strength. For gross motor skills, it’s all bigger types of movements. Moving entire limbs, walking, swinging arms, more general types of movement. Activities like jumping, running, and climbing build muscle and endurance. These can help children better navigate their environment, especially if they are prone to accidents.

Fine motor skills require a bit more dexterity than gross motor skills. Fine motor skills are needed for things like using a utensil, typing shoes, writing, and other more complex movements. For fine motor skills, physical therapists use exercises and tasks that promote hand-eye coordination, such as picking up small objects or using different types of tools. Both gross and fine motor improvements can lead to greater independence and confidence in everyday tasks.

Physical therapy can also have a positive impact on things like self-care routines and school performance. As a result of physical therapy, children with autism may find it easier to perform everyday tasks like dressing themselves, teeth brushing, or using utensils. This increased proficiency can reduce frustration and greatly improve confidence and self-esteem.

Improved motor skills can also translate into better participation in school. Common school activities like writing, arts and crafts, and physical education can be daunting for children with autism who have motor skill deficits. Physical therapy addresses these types of activities directly and, as a result, can positively influence academic and social experiences.

The benefits mentioned above can all be easily translated into improvements in social interaction and behaviors. Not only do the improvements already mentioned allow for more independence and reduced frustration, but engaging in more types of activities allows these children to be more involved with their peers. They can become more involved in things such as sports or art classes, being able to keep up with the types of movements required. With less overall frustration as a result of being unable to complete motor-skill-based activities, a reduction in problem behaviors can also be possible.

Common Physical Challenges in Children with Autism

Children with autism are more likely to suffer from physical challenges than their neurotypical peers, which impact motor abilities and overall daily functioning.

One common issue autistic children face is low muscle tone. Low muscle tone is also known as hypotonia. Low muscle tone can result in reduced strength and stability. This condition often leads to difficulties with activities that require sustained effort or precise control. Activities like sitting upright for extended periods or participating in physical activities like sports or playing can be much more challenging for those with low muscle tone.

Poor coordination is also incredibly common for children on the spectrum. Children with poor coordination may have a level of clumsiness or may have trouble with tasks that require more fine motor skills, like those mentioned earlier. This can affect their ability to perform actions like catching a ball or handling small objects.

Finally, problems with motor planning can lead to challenges in the execution of completing tasks, which can play a big role in how well tasks are completed.

Physical Therapy Techniques and Approaches

Physical therapy uses many different techniques to help children with autism. I am most certainly not an expert in these techniques as they relate to physical therapy, so any questions about the specifics of the different techniques would be best directed towards physical therapists in your area who specialize in working with children on the spectrum.

Neurodevelopmental treatment (NDT)

Neurodevelopmental treatment (NDT) aims to improve motor function through activities that enhance coordination and control. It involves guiding children through movement patterns to develop more effective ways of moving and positioning their bodies. These types of activities can help them to figure out how to best move their body when there are obstacles or other items around them (counters, walls, furniture, etc.).

Sensory Integration Therapy

Sensory integration therapy is also used by physical therapists. This technique can help children better process sensory stimuli by having them participate in activities that stimulate their senses in a more controlled and safe manner. This therapy can help improve how children respond to the stimuli around them. This type of treatment can be particularly beneficial for those with sensory processing issues.

Strength Training

Strength training is another approach used in physical therapy that is used to, unsurprisingly, build muscle strength. Therapists may use resistance training or weight-bearing activities to help increase their muscle tone and improve physical endurance.

Specific activities might involve exercise balls, obstacle courses, structured play activities, arm weights, resistance bands, and many more workout-related tools that incorporate various types of motor skills. These exercises help them to develop greater physical control of their bodies and allow them to better manipulate the objects around them.

Integrating Physical Therapy into Daily Routines

The best part of nearly all treatments for autism spectrum disorder is that they include numerous ways to incorporate the skills learned into daily life.

Integrating physical therapy into daily routines can be achieved with some practical strategies for parents. Parents can make it a point to incorporate exercises into existing daily activities. For example, turning dressing time into a motor skills activity by practicing movements like pulling up pants or buttoning buttons can help to generalize skills into daily life.

Parents can also make a point to try and incorporate their favorite types of exercise activities into their schedules. Mini trampolines, tricycles, and other more exercise-based toys are the way to go. Establishing a routine that includes these activities can make a world of difference.

Making physical activities enjoyable is arguably the most important part of the entire journey. If they aren’t having fun, the odds are that skills are not going to stick as long or be generalized to all areas of functioning.

One way to make sure that learning stays fun is to incorporate the child’s interests into activities. For instance, if a child enjoys animals, creating an obstacle course that mimics different animal movements, like hopping like a frog or crawling like a bear, can make the exercises way more fun.

Including reinforcing things like rewards or praise can also be helpful to make sure that the skills are being applied in new situations. For example, with a child who likes animals, maybe make sure to use new types of animals for each course or change the rules to make sure that the game stays new and exciting.

Using games and rewards, such as small prizes for completing exercises, can also motivate children to participate. Additionally, engaging in physical activities together as a family can make the exercises feel less like therapy and more like bonding time.

Choosing the Right Physical Therapist

When choosing a physical therapist for a child on the spectrum, having a basic physical therapy background may not be enough. Look for therapists who are certified and have training in working with neurodevelopmental disorders. Working with people on the autism spectrum is much different than working with neurotypical children. They process things differently than other children, and so having experience working with children on the spectrum is a must. Patience, flexibility, and an understanding of autism-related challenges are all crucial.

The therapist should be able to create engaging, individualized plans and work well with the family. Observing how the therapist interacts with them during an initial consultation can help to determine whether or not it is a good fit. Finally, I would highly recommend someone who seems fun. Children learn best in fun environments with fun teachers. If the therapy room seems boring to adults, it will likely be incredibly boring to a young child.

Does Insurance Cover Physical Therapy for Autism?

Insurance coverage for physical therapy for autistic children can vary widely depending on the insurance plan and provider. Many insurance plans do cover physical therapy when it is deemed medically necessary and prescribed by a physician, though there may be limits on the number of sessions or types of treatments covered.

This will most certainly depend on the family’s plan and provider, so definitely make sure to talk with insurance providers directly before making any treatment decisions. If insurance coverage is unavailable or insufficient, parents may explore alternative options such as sliding scale fees from therapy practices or financial assistance from autism support organizations. Some of these options may be harder to access, so doing heavy research is highly recommended.

Working with Schools and Other Therapists

If there’s one thing to remember from any articles written about treatment for autism spectrum disorder, it is that collaboration is key. The best chances of success come from a team that works together to uplift the child. Each facet of the child’s life and treatment should be interwoven so that skills in one area are applied in all others. Parents should work with both the physical therapist and school personnel to ensure that therapy goals are aligned with the child’s educational needs and classroom activities.

This collaboration might include progress reports and adjusting accommodations based on therapy outcomes. A collaborative approach that involves the school, parents, and other professionals (occupational therapists, SPLs, BCBAs, any other healthcare professionals that are involved in the treatment of the child’s autism) is the best possible way to address the child’s needs. This mentality helps create an entire support network, allows for consistency, promotes independence across all facets of living, and is just overall the best possible way to ensure better outcomes.

Challenges and Considerations

As someone who has worked with children on the spectrum for a few years now, I am no stranger to the adjustment period that children may go through when starting treatment. Things like behavioral issues and sensory sensitivities are common.

Behavioral issues such as resistance to new activities or difficulty following instructions can impede progress. Sensory sensitivities, like aversions to certain stimuli, can also make therapy sessions uncomfortable or overwhelming. This is another great benefit to collaboration between treatment teams. For example, the child’s BCBA can take time to focus on listening skills to better prepare the child for physical therapy sessions.

To overcome these obstacles, it is also helpful to create a structured therapy environment, using different tools like visual schedules to reduce anxiety and help the child understand expectations. Gradual exposure to new activities can also ease transitions. Accommodations are also incredibly crucial. Incorporating breaks, allowing for a child to request “all done,” noise-canceling headphones, textured mats, and weighted vests are a few examples of accommodations that can make a world of difference during sessions.

FAQs

Does physical therapy help with sensory issues?

Yes! Physical therapy can help with sensory issues by improving overall motor skills and body awareness, which aids in their ability to process sensory information. If there are more severe sensory issues, however, it may be more beneficial to enroll the child in occupational therapy.

What is the difference between PT and OT for autism?

Physical therapy focuses more on improving motor skills and strength, while occupational therapists work more on sensory issues and sensory processing. There is certainly some overlap in techniques and goals, but have differences. The two are very complementary!

Resources and Support

To find qualified physical therapists specializing in autism, parents can start by exploring resources such as the American Physical Therapy Association (APTA) to find those specialized training in pediatric and neurodevelopmental disorders.

Additionally, contacting pediatric clinics or hospitals with developmental programs can help connect families with therapists who have expertise in working with children with autism. Most importantly, however, I feel as though the best resources and knowledge come from other parents who have gone through the same process. Platforms like Facebook and Reddit are nowhere near perfect, but they are home to incredibly large groups of families that constantly share information.

These platforms also act as support groups and networks for parents of children undergoing physical therapy. They are invaluable sources of advice and tips. Local autism support groups and community organizations often host meetings and provide resources that can help parents significantly. They can also help to connect parents of autistic children on the local level.

As someone who works with children who all receive services in the same area, I can say that word of mouth from other families is one of the most popular forms of learning about providers in the area (and community events, support services, financial services, school recommendations, hairdresser recommendations… I highly, highly recommend engaging with the community in your area, if that wasn’t obvious yet!). These groups can offer emotional support and a sense of community.

Conclusion

Physical therapy is one of the many options that parents have for the treatment of autism spectrum disorder. It can drastically improve the functioning of children who struggle with coordination, muscle mass, balance, and motor skills. It can also contribute to better social interactions and behavioral management through structured physical exercises. Parents are encouraged to explore physical therapy as a supportive measure to boost their child’s physical development and overall well-being.

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