by Dr. Ali Clodfelter, PT

When it comes to the link between physical therapy and Autism Spectrum Disorder (ASD), many people do not know how PT can help individuals within the ASD community. Well, we are here to tell you just how we can help! Not every individual within the ASD community has motor difficulties, but some individuals within the ASD community need a little bit of help to overcome different motor challenges that may be preventing them from flourishing as their best selves!

What is Hypotonia (Low Muscle Tone)?

Low muscle tone is often described as having ‘loose’ or ‘floppy’ muscles. This is usually because the muscles are not as firm or tight as expected for the stage of development the child is at currently. Kids who experience low muscle tone may have delayed motor skills, difficulty with motor coordination and weakness in their muscles . Low tone is a term used to describe the baseline stiffness of the muscles. High tone would describe muscles that are in a tighter resting state and low tone describes muscles that are in a more relaxed resting state. For more detail, visit the Kid PT Low Tone page.https://kidpt.com/low-tone/

Is there a link between Autism and low muscle tone?

Sometimes individuals within the ASD community also have a diagnosis of Low Muscle Tone, usually shortened to Low Tone. Kiddos with low tone have a harder time activating their muscles as quickly and easily as those without low tone. It can make dealing with gravity on an everyday basis very challenging. When a child is frequently losing the battle with gravity, there are some clues to look for like:

• they might sit with a very forward, rounded spine,
• they may have difficulty reaching for objects while sitting and standing
• they have trouble getting onto and off of the floor or into and out of a chair
• they may have difficulty keeping their balance when challenged
• they may even have trouble walking or running without tripping or falling

Is Physical Therapy Useful for Autism Spectrum Disorders?

Kids with low tone can really benefit from physical therapy because it helps improve their ability to make their muscles ready for challenging tasks. This means, when they go to try a task where gravity previously won the battle, they know how to activate their muscles beforehand (eventually without even thinking about it), and can perform the task with greater ease and safety. 

Children with Low Tone also have difficulty with postural control. Postural control affects their balance. If your child has difficulty with postural control, it may cause them to have difficulty keeping their balance when sitting in a chair, walking on unstable surfaces or narrow surfaces, and it may make it very hard for them to stand still. Often when a child has difficulty with postural control that affects their balance in standing, they will keep moving or keep taking steps forward just to keep from falling! That is a lot of work that they are doing every day just to keep their balance!

With improvements in muscle readiness and postural control, kids with Autism gain the stability they need to do everyday tasks with greater ease. With greater ease of movement, kids are able to grow and learn to do motor tasks they never thought possible. It is this growth we love to see and support, and it is why we do what we do!

How Kid PT Connects the Dots

Our approach is to respect neurodiversity while supporting the needs of autistic children and teens from a sensory and motor perspective.

Our pediatric physical therapists work with autistic children and teens first seeking CONNECTIONS, building relationships with children, and then building from there. You can read about Autism and our founder, Dr. Joni Redlich’s B”Turn Stumbling Blocks into Building Blocks” here https://kidpt.com/autism/

If any of these descriptions sound like your child, call us at Kid PT today for a free Discovery Visit, where we can discuss if physical therapy is the right fit for your child and why!

by Alison Clodfelter, PT, DPT

April is finally here, and you know what that means, APRIL SHOWERS! With April showers comes so many PUDDLES! We know how much your kiddos probably love to jump in puddles, and while it may get their clothes a little wet, it certainly is fun! Jumping is also great for coordinating the muscles of your tummy and back with your arms and legs because all these different muscle groups need to fire at just the right times. This needs to happen in a certain sequence for each jump to occur, which means it is helpful to practice different kinds of jumps to learn all kinds of coordination patterns!

You and your kiddo may want to pull out your rain boots for these fun puddle jumps to keep your feet dry:

1. Jumping AROUND the puddles: Jumping two feet apart then two feet together: Start with both feet together (in front of your puddle), then jump forward and move both feet apart at the same time (two feet outside of the puddle). Then jump with two feet back together to make it to the other side of your puddle!

2. One foot puddle jump: Start with two feet in front of your puddle, then hop onto one foot RIGHT INTO THE PUDDLE (SPLASH)! Now jump back onto two feet! Turn around and try jumping into the puddle on your other foot!

3. One foot OVER the puddles: Start on the side of your puddle on one foot, quickly bend the knee your standing on and jump sideways OVER the puddle to land on your other foot. Try not to land in the puddle! Keep repeating this and see how many sideways jumps you can do without getting your feet wet!

4. Backwards puddle jumps: Jumping backward gives a whole new moving view of the world to your kiddo while they are trying to coordinate their jumping, challenging their coordination with a new visual flow, making their brain work in a new way to move!

5. Puddle LEAPS: Have your child RUN up to the puddles, lift one foot off the ground, and push off the leg that is still on the ground to do one big LEAP over the puddle. Again, try not to land in the puddle, and see how many you can do without making a splash!

6. Puddle Half Turns: We had to end with one right in the puddle! Start with your rain boots standing in the puddle. Jump UP and turn your whole body 180 degrees to do one half turn. This one is great for coordinating the rotational muscles of your tummy with your jump.

These fun jumps can of course be performed without puddles too if you don’t want to get messy! Happy puddle jumping!

By: Dr. Ali

Do you feel like your child never stops moving? Like they are here, there and everywhere, running in between destinations and fidgeting in their chair while eating a meal? Even if you have asked them to take a pause they seem to not listen, or be physically unable to follow the instructions you are giving to slow down, even if they are traditionally a very good listener? Being in constant motion can be related to certain diagnoses, like ADHD. ADHD often presents with additional signs and symptoms, like forgetfulness, difficulty staying on task, trouble listening while another is talking, excessive talking, unsafe and impulsive behavior, and/or trouble with turn taking. Regardless of whether your child has a diagnosis of ADHD or not, there may be another factor contributing to their need for constant motion.

That “thing” is something we PT’s call postural control. Postural control defined as the act of maintaining, achieving, or restoring a state of balance during any posture or activity (1). When someone has a very “fine tuned” postural system, their body, vestibular system (little balance center in the ears), and eyes are telling their brain where they are in space and what position their body has to hold. Then their brain sends signals to the muscles to hold that specific position. In order for all of this to work, the eyes, the vestibular system, and the body have to send accurate signals, the brain has to correctly process this information, and the body must be able to coordinate muscles on all sides to hold the position steady. Phew, even thinking about this long process can make someone tired! 

When there is misinformation, trouble processing the information, or trouble coordinating the body in response to the brain’s signals, it will show in the body. When this happens, the child’s body may sway back and forth while they are trying to sit still in a chair, they may need to continuously move their feet instead of standing still, or they may just keep changing position when the one they are currently in becomes too hard to hold. When children are in constant motion, it often shows us PT’s that they are stuck constantly “restoring” their state of balance, as opposed to “maintaining” as the definition says above. Their body feels like it is always at risk of falling, so they move to catch themselves and prevent this. It may not look like that is what is happening when they are step, step, stepping, but if they are stuck constantly restoring their balance with decreased postural control, this is what their body is telling them is happening. 

When we see kids who show us this constant need for motion, we help them improve their postural control so that they can achieve and maintain steady postures. This is important for so many reasons other than just giving them greater stability. Sometimes when postural control improves, a child has an easier time paying attention to tasks and school lessons, because part of their brain isn’t being used to keep them on balance. All of that brain energy that was being used to signal movement that would prevent them from falling can be allotted to other things, because their balance system is operating on autopilot!

If you see your child having difficulty staying still and want to get another opinion, come in to KidPT for a free discovery visit, and a PT can answer any questions you may have about this topic!

References: 

1. https://pubmed.ncbi.nlm.nih.gov/10945424/#:~:text=Postural%20control%20is%20defined%20as,change%2Din%2Dsupport%20response.

Parents often ask us the difference between school physical therapy and private physical therapy.

I mean, why should a parent pay for a service they can get for free at school??!!

I totally get that, so I thought I would explain more in a blog post.  Because If they were the same, you would be right!  There would be no reason to invest in therapeutic care for your child that is being provided for free at school.

Let’s get into how they’re the same and how they’re different beyond their location of services.  

Isn’t Physical Therapy, Physical Therapy?

Physical therapists are all licensed to provide physical therapy and to work with all ages and all settings.  However, not only do goals change depending on the setting and the individual, but the role does too.

The role of physical therapy in the school is to support a child’s access to education.  It is to support their ability to participate in the least restrictive environment and support the motor skills needed at school.  The services are determined by the student’s IEP, Individualized Education Plan, and is a related service based on education law.  

Private physical therapy can look outside of the child’s education to look at the bigger picture of a child’s life today and in the future.  Private physical therapy can focus on goals from all parts of a child’s life, from keeping up with the family at the park to protecting a child’s joints so that they will be strong, healthy and pain-free for the future.  

Many children will benefit from physical therapy services in both settings to help them achieve success at school while also being able to guide the child towards their own personal potential.  

If you have questions as to the best ways to support your child, reach out to us today and one of our physical therapists can hop on the phone with you and chat about your options.  We are here to support you and your child and to help guide you to know your options so that you can best advocate for and support your child on their journey!

If you’ve ever watched a pediatric physical therapy session, you will often see us putting a toy or desired object just out of a child’s grasp so they are inspired to roll, crawl, walk, scoot, or reach for it. Setting up the environment this way helps us to encourage kids to utilize emerging motor skills and strengthen those skills while building confidence. When we set our environment up, we are always thinking about where the “goalpost” is and whether or not the goal we are setting is attainable for the child at that time. If it seems too hard, we have to adjust the height, distance, or surface where the toy is located so that the child we are working with is working hard but can still be successful!

Setting attainable goals is so important when kids are learning new skills because we want them to build confidence as they are building skill and we want them to enjoy practicing and learning. One way we see kids get really frustrated or discouraged when learning a new skill is when the goalpost is frequently changing as they are working to reach it. An example of the “changing goalpost” that often causes our kiddos to get upset is when they are a new walker, taking unsteady steps to reach mom, dad, or a toy, and who or what they are trying to get to keeps moving backward. We TOTALLY understand the desire to do this, it gets them to walk more, which is good right? While the easy answer would be “Yes, they are walking more”, it is more complex than this. While they are chasing the desired person or object, they are thinking “Gee, I only had to walk that short distance to mom when I started, and I definitely thought I could do this, but now she is getting farther and farther away, and I am getting tired. I don’t know if I can do this anymore.” Even though they definitely CAN do the skill for short distances, their confidence is then starting to decrease, and they may not want to try again because it takes SO MUCH effort to be successful. 

Don’t worry, this is a very easy fix! Say they are a new walker, have them start with a short distance first. Let them reach the object or person they are walking to and then let them play with the toy, hug mom or dad, and revel in the joy of their success with that mobility. Let them feel that joy for a few minutes while playing with the toy or hugging a parent. Then, once they have played for a short time, move the toy and redirect their attention to have them practice the skill again. Maybe even try to place the goalpost a little further next time, building on their ability as their confidence grows. Now they are learning that they can be successful with that motor skill, they are building confidence in it, while also learning that it is a new way of mobility they can use to reach things they want (a win, win, win)! Learning new motor skills takes a lot of patience, but overall the success your child will experience when moving and reaching each goal is worth the wait!