April 1, 2015
In recognition of Autism Awareness Month in April, specialists from FauquierHealth’s Outpatient Pediatric Clinic have provided information on therapeutic techniques for children with autism. Christina Sink, MS, CCC-SLP, a speech language pathologist; Courtney Albrecht PT, DPT, a physical therapist; and Sherrie Beres MOT/L, an occupational therapist will also give a talk on this information on Wednesday, April 8 at 7 p.m. in Fauquier Hospital’s Sycamore Room.
The three have devised a program that demonstrates how children with autism can greatly benefit from a combination of pediatric physical therapy, occupational therapy and speech therapy. This team approach addresses balance, coordination, strength, self-regulation, and self-care skills, including dressing/feeding independence, sensory skills, language and social interaction.
Autism is a serious neurodevelopmental disorder where a child’s ability to communicate and interact with others is impaired. In addition, the child can exhibit repetitive behaviors, and limited interests and activities. All of this may lead to significant impairment in social interaction, mobility, function and quality of life. The Centers for Disease Control states that one in 68 American children are on the autism spectrum, and Mayo Clinic states the number of children diagnosed with autism is rising.
“The use of the word ‘spectrum’ means that some children are low functioning and others are high functioning; every child presents differently,” explains Albrecht. “Early therapy intervention is very important in assisting with many of the child’s symptoms that interfere with daily functioning.”
Many children may present with poor balance and coordination, and may display decreased strength and endurance, which makes it difficult for them to perform daily tasks. Other potential concerns may include poor muscle tone, toe walking, flat feet and posture problems. The Fauquier Health therapists recommend a good physical therapy and exercise program that promotes higher muscle function and a combination of body movements. For infants, rolling, sitting up, crawling and walking are appropriate, and for toddlers, running, jumping and riding a tricycle are good muscle-building activities. For older children, stair climbing, jumping jacks, hopscotch, skipping and ball skills can help develop strength and coordination.
The therapists have found that anything that makes the activities fun helps to keep children interested and engaged. They also caution that parents may not see results or engagement right away. “It often takes a lot of daily repetition before these children begin to respond,” added Albrecht. For children with severe low muscle tone or weakness, water activities are very good and aquatic-based physical therapy may be beneficial — in water that is a warm therapeutic temperature.
Community activities are also highly recommended for children with autism — horseback riding, ballet, swimming, soccer, Special Olympics and karate are all programs that offer big benefits. In addition to physical therapy, occupational therapy can help children with coordination (motor skills) as well as daily functions (dressing, bathing, feeding) and play skills. Working on hand-eye coordination can help promote legible handwriting. Anything that keeps lessons interesting and fun can be useful -- picture games (finding hidden pictures, connecting the dots, etc.), the use of clay, chalk, or changes in paper textures or designs (using graph paper for math or simplified writing paper).
Opening containers and finding items inside, or using buttons, zippers and snaps to open and close containers helps to keep kids interested and learning how to cope in the world. “When you have a child with autism, you have to be very creative and keep them engaged,” said Beres. “These children struggle with things that we do day-to-day. To teach them, you have to break through with interesting, different and fun approaches.”
Even eating can be a fun activity. Many children with autism are extremely sensitive to textures; they may like apples, for instance, but turn up their noses at apple sauce. The therapists suggest that when trying a new food, some children will respond positively if they touch it first, then practice licking it, then practice holding it in their mouth before chewing and swallowing. When children hear positive praise for each of these steps, they will eventually be able to eat a greater variety of fruits, vegetables and protein that are crunchy, chewy and pureed.
Children with autism often react positively to different sensory stimulation: auditory sounds like classical music; visuals such as a fish tank or lava lamp; and different movements such as running or doing a “wheelbarrow walk” (holding child’s ankles while he/she walks his/her hands along the ground). If they have this sensory stimulation throughout their daily routines they may feel calm throughout the day.
For situations that cause sensory overload (such as the noise of the vacuum cleaner), parents can try providing a gradual tolerance. For example, try doing a pleasant activity while the vacuum is running on a different floor of the house, then in the room two doors down, then in the next room, and eventually in the same room with the child. As another example, if a child is sensitive to sirens, a parent could find pictures of fire trucks to color. If the parent were to make the sound of a siren at home and find books on police cars and fire trucks, it may encourage the child to react to sirens in a positive way.
Lastly, speech therapy can help a child with autism better communicate with those around him or her. Sink recommends using a variety of methods to maintain attention and listening so that information can be processed. Children with autism often have difficulty following directions and responding to questions appropriately, and they are often very literal. It is best to avoid using figurative language, metaphors, and similes (i.e. it is raining cats and dogs, time is money, light as a feather). Therapy may address teaching specific metaphors and similes so they can understand what they mean.
Putting thoughts into words and logical sentences to communicate wants, needs and feelings can be very difficult for children with autism. Learning verbal and nonverbal communication skills will help both parents and children. Sign language, or using a Picture Exchange Communication System (PECS) may be helpful for many children, as is working on body language -- eye contact, facial expressions and gestures.
The best option for children with autism is to get them into a program as soon as possible that provides physical therapy, occupational therapy and speech therapy. The National Research Council reports that children in intensive intervention before the age of 3 have better success than those beginning after age 5.
For more information or to schedule an evaluation, contact one of Fauquier Health’s Pediatric
Rehabilitation Clinics at 540-316-2770 (Warrenton, Va.) or 703-743-7350 (Gainesville, Va.). For more information on the programs at Fauquier Health, visit www.fauquierhealth.org.