Physical Therapy Helps to Close the Developmental Gap for Neurodiverse Children

Autism Spectrum Disorder (ASD) is an increasingly well-known developmental disorder that affects 1 in 40 children. It is most often characterized by a lack of social reciprocity, delayed or absent verbal communication, presence of repetitive behaviors, and severely restricted interests. Difficulty processing and subsequently responding to internal and external cues has been implicated as a cause of these behaviors. For example, an individual with ASD may not be able to create an appropriate verbal response during a conversation. He can hear the words being spoken, but he is not able to sort out the verbal input and create an appropriate response. Instead of sustaining two-way dialogue, he may change the subject entirely to something of greater interest to him or completely check out of the conversation. Alternatively, if a person with ASD is not able to process an internal sensation and its meaning, such as a growling stomach meaning hunger, he may respond to the discomfort by performing repetitive movements such as rocking or hand flapping instead of seeking out food.

58% of children with ASD have a separate diagnosis of a communication disorder, which grants access to speech therapy. 40.8% have a diagnosis of ADHD and 17.9% are diagnosed with a learning disability, both of which allow a child to access specific learning supports, psychological intervention, and behavioral therapy. In contrast, only 15.1% carry a diagnosis of Developmental Coordination Disorder (DCD).1 Per the DSM-5, the criteria for diagnosis of DCD are: impairments in gross and fine motor coordination, not related to a specific medical or neurological condition, that significantly affect a child’s academic achievement and daily functioning. Analysis of data from the Developmental Coordination Disorder Questionnaire, an inventory completed by parents of children with concerns for motor impairments, showed that 86.9% of children with ASD had “definite motor impairments,” with another 10% “at risk for motor impairments.”1 Despite the high incidence of motor impairments in children with ASD, only 31.6% receive physical therapy as part of an IEP. Compared to other ASD services, i.e.: Applied Behavior Analysis, (86.5%), behavioral/developmental intervention (63.2%), social skill intervention (47.1%), speech therapy (82%), and occupational therapy (79.8%) this is a severely undertreated problem in this population. As a child grows, the gap in motor development compared to typically developing peers continues to widen.

Physical therapists provide intervention to close the gap in gross motor development. Physical therapy acts as a complement to other therapies; as coordination, strength, and endurance improve, a child is better able to participate in games with peers that involve running, jumping, throwing, kicking, and catching. This provides opportunities for team play, which are important for communication and cooperation with peers. At the same time, children learn to tolerate internal discomfort and respond in an appropriate way with their physical therapist’s guidance. As a child grows and becomes more independent, improved gross motor abilities allow him to find and thus pursue activities for physical fitness, a necessity for overall health and wellbeing.

Physical therapy provides another avenue for neurodiverse children to close the developmental gap with neurotypical peers. Despite strong evidence that gross motor delays affect overall wellbeing and participation in school and recreational activities, they are infrequently addressed. If you have questions or concerns regarding your child’s gross motor development, please contact Dr. Claire Kopko at Freeform Physical Therapy.

Phone: 614-245-5359

E-mail: Claire.kopko@freeformphysicaltherapy.com

1.       Bhat, A.N. 2020. Is Motor Impairment in Autism Spectrum Disorder Distinct from Developmental Coordination Disorder? A Report From the SPARK Study. Physical Therapy Journal. 100:4, 633-644.

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