Original Article By Eric Ries | July 2018
Synopsis/Review by Athena Bellio, PT, DPT, CMT, HHP for Oceanside Therapy Group
Physical therapy services have been a widely accepted form of treatment for decades across multiple populations. However, the role of a physical therapist (PT) in the lives of our children with Autism or Autism Spectrum Disorder (ASD) has not always been emphasized or well-known. In fact, within the last two decades, treatment options for this population of children and families were not as readily available. But, as the treatment paradigm is constantly evolving to encompass the whole child, so is the importance and role of physical therapy in their daily lives.
In this article, written by Eric Ries, he presents the experiences of pediatric PTs working with this wonderful population and how they approached treating and caring for these kids.
Karen Tartick, a school-based PT and parent of a child with Autism, explains her take on the importance of physical therapy in the life of a child with Autism. She shares her own experience with her now adult son, and his limited experience with physical therapy treatment growing up. Tartick goes on to describe that when they first received her son Eric’s diagnosis in 1993, there was less of an emphasis placed on his physical activity during his therapeutic care. She attributes that limited exposure in his youth, in part, to the current challenges Eric faces with poor physical health and limited exercise tolerance. Tartick explains how “tapping into whatever is motivating to the child” is key to having them understand the importance of movement and exercise outside of the therapy world.
Physical therapist, Liliane Savard, also describes her experiences working with children with ASD, claiming that, “most if not all, children with autism have movement difficulty.” She goes on to explain that because PTs are considered movement system experts, they are very adept in figuring out how to design interventions to help these kids participate more in appropriate movement patterns that will allow them to engage in life. Savard emphasizes three main cornerstones to promoting motor learning including: positive expectancy, autonomy support and external focus. In short, if we help our kids to believe they can do something, allow them the freedom and opportunity to make appropriate decisions, and channel their attention and focus to specific elements of a task, we can achieve growth and progress.
The “whole-child approach” is also emphasized in today’s physical therapy treatments. Anjana Bhat, PT, PhD, MS, emphasizes this in her practice with the belief that motor play encourages communication and engagement in a child’s environment as well as with his or her peers. By providing creative play environments, there is, what Bhat calls a “cascading effect” in which PTs help to promote productive solutions and preferred outlets to dealing with maladaptive behaviors. Physical therapists not only treat a movement pattern dysfunction, but also take part in the larger discussion of advocating for children with ASD by enabling and empowering them to “participate in their world.” Bhat goes on to applaud the families and parents of these children, whose determination in empowering their child is inspiring to her as a PT working in this field. She goes on to describe the complexities of this diagnosis with the understanding that our knowledge of best practice for PT and ASD is constantly expanding.
Jan McElroy, PT, PhD, describes the role of a PT best. In a population that is so often misrepresented or “narrowly seen as minimally expressive, behaviorally difficult, and challenging to engage”, PTs bring the fun to these children and families whose lives can often feel stressful. PTs work to address the whole child, find what is salient to him or her and encourage social connections and movement patterns to gain confidence in their newfound independence.
For access to the full article, please see the attached link.
Our OTG family is made up of talented and creative therapists and staff, all working together to facilitate progress and life skills across all disciplines (occupational therapy, speech language therapy and physical therapy). Please contact our PT department for more information on how we can help you and your child reach their gross motor and functional movement goals.
Source: Ries, Eric. “Physical Therapy for People With Autism.” APTA, 2018, www.apta.org/PTinMotion/2018/7/Feature/Autism/.
Q & A with OTG Physical Therapists
Question 1: What's the average length of therapy a child will receive for PT?
KC: The average length of physical therapy will vary child to child. We can possibly see a kiddo for a month or many years. The great thing about physical therapy is that we work on so many areas of the body that a child's sessions are constantly changing and evolving based on what the child is doing.
Chris: Time will vary. Orthopedic-based conditions tend to be weeks/months and developmental-based can be months/years.
Question 2: What's your favorite part about being a PT?
KC: My favorite part of being a PT is helping children and families reach their goals through movement. Improving how a child moves can help them improve social interactions, increase attention, and open up new environments for them to explore. Activity and movement is great for all members of the family and I love helping everyone lead healthy, active, lifestyles!
Chris: I definitely echo the creativity/spontaneous aspect to peds, it's very motivating. Diversity and the apparent need within the peds specialty were specific draws for me coming out of PT school. The diversity in population/background and different family structures we serve are motivating.
Athena: The BEST part about being a PT for me is that it calls for creativity and flexibility with each treatment -- every kiddo is different and special in their own way, which encourages new avenues for exercises and activities. I'm constantly learning from each child and family we treat. Plus, I have yet to find another profession in which busting out in random (Disney) songs is considered appropriate, if not encouraged :)
Question 3: What are your favorite exercises/activities in therapy, what conditions do they treat?
KC: My favorite exercises are SQUATS!!!! Squats are awesome for children with any and all conditions. Working on the gluteal musculature (aka the booty muscles) helps with stability, single leg balance, jumping, running, and walking.
A Final Word from Our PTs
Physical therapists are always here to answer any questions! Don't be afraid to ask anything, even if it seems like a silly question. If we don't know the answer we will do the research and look it up! Our PT team loves to solve any puzzle and are happy to help you with anything for your child's development. Physical therapists are trained and matriculate at a clinical Doctoral level. They are experts in assessing/treating movement-based disorders/pathology in order to restore and maximize function and quality of life.
Written by: Natalie Shilling & the PT Dept. at Oceanside Therapy Group