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Autism
By: Giselle Campagne &
Vanessa Jaimes
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Autism Spectrum Disorder (ASD)

Autism is a neurodevelopmental disorder

that will typically appear during early
childhood impacting people’s speech,
nonverbal communication, social
interaction, and repetitive behaviors.
Autism differs from person to person in
severity with symptoms being different for
everybody.

There are important social and language

milestones to watch as the child grows for
early signs of autism. Some infants may
begin to show signs in their first months
and be more apparent as they grow. Early
intervention can be crucial to improving the
child's long-term success.
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Early Signs of Autism
Autism impacts children throughout the lifespan and early diagnosis can lead to improved
quality of life. There are simple milestones parents can track for early signs of the disorder in
the first few months of the baby.

6-12 Months
o Baby or toddler doesn’t make eye contact or is limited
o Respond to their name or the sound of a familiar voice
o No sharing of sounds, smiles, or other facial expressions
o Little to no babbling
o Delayed in sitting, crawling, and supported standing

12+ Months
o Has no speech or it’s delayed
o Gets upset by minor changes
o Flap their hands, spin in circles, or rock their body
o Doesn’t point at objects, things of interest, or demonstrate interest
 z Levels
§ The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorize autism into three
different levels to two areas of functioning that include social communication and restrictive, repetitive
behaviors. These levels help reflect the level of assistance a person is likely to need in their daily life as
well as the severity of the symptoms.

Level 1 Level 2 Level 3

Requiring Support: Requiring Substantial Requiring Very
Support: Substantial Support:
This is the least severe
diagnosis of autism. Children People at this level require This is the most severe autism
may struggle in social more support than those at where people show difficulties
situations and they only require level 1. They have more with social skills and
minimal support with their noticeable severe social skills communication. They may
functional activities. Some of and may or may not have repetitive behaviors that
the things they might have communicate verbally. They can affect functional
difficulty with are initiating or may speak in very short independence and activities.
maintaining conversations, sentences, only discuss Many will not communicate or
need help with planning and specific topics, and have will use very few words,
organization, and feel difficulty using or understanding struggle with unexpected
uncomfortable with changing nonverbal communication such events, and be sensitive to
situations. as facial expressions. sensory input.
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Behaviors
People with autism may exhibit
many behaviors such as repetitive
patterns, restricted interests, being
aggressive, echolalia(repeat
words/phrases), and being hyper- or
hypoactive to sensory input, or
display an unusual interest in
sensory aspects of their
environment
o For instance, doing repetitive
movements may include rocking,
spinning, or hand flapping.
o Performing activities that could
cause them harm such as biting
or hitting their heads.
o Being fascinated by details of an
object, developing specific
routines, and becoming upset at
the slightest change.
o Being hyperactive, anxious, or
worried.
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Sensory Processing Disorder
§ Autism’s sensory processing can involve both hyper-sensitivities and hypo-sensitivities to a
wide range of stimuli. Hyper-sensitivities patients may find sounds, smells, and tastes
overwhelming. Also, certain types of touch (light or deep) can feel extremely uncomfortable
for these type of patients due to having hard time with motor skills and sensory processing.
Hypo-sensitivities are likewise common its under-responsiveness to the body signals that help
control balance and physical coordination. This can result in clumsiness, which has long been
associated with autism.

These can involve:

§ Sight

§ Sounds

§ Smells

§ Taste

§ Balance

§ Touch
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Sensory Processing Disorder
Signs
o Stimulation from loud noises or overactive scenery
o Intolerance to textures or favoring certain textures over others
o Food aversions
o Extreme responses to colors
o Difficulty with fine motor skills
o Easily distracted or has trouble focusing on a single task
o Withdrawal from light
o Dislike for teeth-brushing, nail-cutting, hair-washing
o Fearful of crowds
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Interventions
Treatment and Education of Autistic and Related Communication-Handicapped Children
(TEACCH): This treatment uses visual cues such as picture cards to help your child learn everyday skills like
getting dressed. Information is broken down into small steps so they can learn it more easily.

Picture Exchange Communication System (PECS): This is another visual-based treatment, but it uses
symbols instead of picture cards. Your child learns to ask questions and communicate through special symbols.
Occupational Therapy: This kind of treatment helps the child learn life skills like feeding and dressing
themselves, bathing, and understanding how to relate to other people. The kills they learn are meant to help
them live as independently as they can.
Sensory Integration Therapy: If child is easily upset by things like bright lights, certain sounds, or the
feeling of being touched, this therapy can help them learn to deal with that kind of sensory information.
Medication: There is no cure for autism spectrum disorder and there’s currently no medication to fully treat
it. Some medicines can help with related symptoms like depression, seizure, insomnia, and trouble focusing.
Studies have shown that medication is most effective when it’s combined with behavioral therapies.
Risperidone (Risperdal) is the only drug approved by the FDA for children with autism spectrum disorder. It can
be prescribed for children between 5 and 16 years old to help with irritability.
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Risk Factors
The exact cause of developing autism is unclear, but there may be many factors that
make a child more susceptible to having autism including genetic and environmental
factors.

o Having an immediate family member with autism

o Genetic Mutations
o Fragile X syndrome
o Fetal exposure to the medications valproic or thalidomide
o Exposure to heavy metals and environmental toxins
o Advanced parent age
o Pregnancy or birth complications (low birth weight, extreme prematurity)
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Diagnosis
Autism spectrum disorder (ASD) can be diagnosed by 18 months of age while others may
report 24 months is the earliest an accurate diagnosis can be made. It can be difficult to
diagnose autism because there is no medical test and it’s based on careful observations of the
child’s behavior and developmental history.

Developmental Monitoring & Screening

Children should be observed on how they grow, change over time, and whether they’re meeting
the typical developmental milestones in speaking, moving, playing, behaving, and learning.
Screening is a test that can be done during regular doctor check-ups where they ask parents a
series of questions, combine parental feedback with information from ASD screening tools, and
observe the child. Routine screening is recommended at 18 months or 24 months of age. If
there is a high risk for ASD a continued evaluation will be given with other healthcare
professionals (pediatrician, child psychologist, neuropsychologist, speech pathologist) who are
experienced with ASD. The evaluation will assess the child’s language and cognitive abilities,
and age-appropriate skills.
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Prognosis

Patients who are low-functioning may never live independently and they will typically need
home or residential care for the rest of their lives. Higher functioning patients may live
independently and have jobs successfully. Since children learn through play, physical therapists
use child-friendly, especially chosen toys and activities to motivate and encourage their patients to
participate in therapy. Typically, the therapist will find balls, swings, and slides in a pediatric therapy
gym. Children are encouraged to have fun while they work hard to accomplish the tasks their
therapists set for them. In Early Intervention, the focus is to coach and educate families and caregivers
on how to use physical therapy activities to encourage increased participation in the child’s routines at
home and in the community. For example, this may include helping a child to learn to move as
independently as possible throughout his home and at the playground. School-based physical therapy
supports the child’s ability to get around the building and classroom in order to access to the
educational program and promote learning.
 Impairment
z of Body Function and Structure
Neurological: Studies have found differences in the development of
several regions of the brain. Disruptions in normal brain growth early in
development can result in defects in genes that control brain
development and regulate how brain cells communicate with each
other.

Musculoskeletal: Children often have difficulties with posture,

balance, coordination, functional mobility, strength, and motor planning.
This can be seen as early as 6 months during movement transitions
and can interfere with their independence later in life.

Gastrointestinal: Children with autism tend to have more GI

problems compared to other children. Common symptoms experienced
are constipation, diarrhea, abdominal discomfort, and inflammatory
bowel. It is suggested that these symptoms may be due to the side
effects of the medication being given. This can further contribute to
behavioral problems, limiting learning, and interrupting sleep.

Pulmonary: In some cases, children may be more prone to over-

breathing or hyperventilation, but it is not as common to see it in
autism.

Cardiac: Will commonly not affect people with autism.

 z Activity/Participation Limitations
Activities
It is important to always stay with the child, remove dangerous objects from
People with autism can be challenged when
area, and choose interventions appropriately. Precautions should be taken
mastering tasks such as dressing, self-feeding,
when treating them due to potential for :
and toileting which are crucial to a person’s
independence. Learning, applying knowledge, • Wandering behavior
and communication can have a huge impact on • Self-injurious behavior
their success in school or work. In some cases, • Poor safety awareness
poor postural control, balance, and strength will • Poor impulse control
affect the development of fundamental motor • Communication deficits
skills such as running or jumping. PTA ‘s should
strategize these activities through play time
using toys/objects to motivate them to
participate in therapy as well as including
parents or other peers. Social, motor, and
sensory issues can all affect them when
performing or completing these tasks. For
instance, sensory can affect a child when trying
new foods due to the smell or texture.

Participation

People with autism may have trouble engaging

in social situations which can affect them when
playing with their peers, participating in sports,
attending school, or finding a job/working.
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Interventions
Goals: Increase postural strength and control, functional
mobility (walking and running), body and safety awareness,
coordination, and play skills.

o Heel Walking: Works on the muscles that support the front

of the ankle and helps contract the abdominal muscles.

o Crab Walking: Works on various muscles that include the

triceps, hamstrings, glutes, abdominals

o Balancing on Tilt/Wobble board: Practicing on the board

will offer an unstable surface that provides sensory input
and helps improve the child’s coordination, balance,
proprioceptive awareness, and automatic postural
reactions.

o Bear Crawls: Develop kinesthetic or body awareness,

trunk strength, shoulder stability, and motor planning. Can
be performed forwards, backwards, laterally.

o Overhead throws and slams with ball: Increases core

strength, balance, and can have some implications in
stimulating brain centers responsible for short-term
memory. Progressions can include jumping and throwing.

o Back-to-back ball passes: Increases core strength,

balance, and enhances socialization skills and teamwork
when done with other peers.
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Evidence Based Article
The article “Moving Along and Beyond the Spectrum: Creative Group Therapy for Children With
Autism” discusses the benefits of small group activities with children with autism that are
nonverbal, or they can communicate. Doing exercises/activities that involve working with other
peers such as overhead throws or ball passes can help enhance the child’s motivation for
movement through peer imitation and peer observation. As treatment sessions progress, children
are able to be more explorative, take more initiative, and become familiar when engaging with
other people. These type of activities can not only improve social skills and communication
through play, but exercises can overall improve the child’s balance, strength, coordination, and
safety awareness if needed.
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Resources to Aide Families
The Importance of Support: Parents of a child with ASD must have a good support system in place.
This will help the child cope with the unique aspects of his or her disorder. It will also help the
patient's family learn how to manage the patient's feelings when faced with challenges. Also looking
for a sibling support group that can provide a safe place for patients with ASD to talk and share their
feelings and fears. Part of this support will come from the healthcare team that is treating the patient
and educating the family members. There is no cure for ASD, but most children can lead a happy,
productive life by taking part in therapy.
Therapy addresses the 3 main symptoms of the disorder:
o Poor communication skills.
o Repeated routines.
o Physical clumsiness.
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References
• “Autism Spectrum Disorder.” National Institute of Mental Health, Mar. 2018,
http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml.

• Rudy, Lisa Jo. “Making Sense of the Three Levels of Autism.” Verywell Health, 24 Nov. 2020,
www.verywellhealth.com/what-are-the-three-levels-of-autism-260233.

• “Causes of Autism Spectrum Disorders.” Autism Spectrum Disorders - Causes | BNC, VIC
3108, www.adhd.com.au/autism/causes.

• “Activities of Daily Living.” Interactive Autism Network , 5 Dec. 2013,

iancommunity.org/cs/challenging_behavior/activities_of_daily_living.

• Vaisvaser, Sharon. “Moving Along and Beyond the Spectrum: Creative Group Therapy for
Children With Autism.” Frontiers in Psychology, 12 Mar. 2019,
www.ncbi.nlm.nih.gov/pmc/articles/PMC6423063/.

• “Physical Therapy Guide to Autism Spectrum Disorder.” American Physical Therapy

Association, 23 Oct. 2019, www.choosept.com/symptomsconditionsdetail/physical-therapy-
guide-to-autism-spectrum-disorder.