Theraputic interventions

Occupational therapy and Physical therapy.  

Occupational therapy or most commonly called OT is the first therapy that is recommended when a child is diagnosed with ASD.  People hear so much about OT but do not fully understand what exactly it means. Most people confuse it with physical therapy or any physical work out done to control abnormal behaviors and keep the person occupied. Well OT is much more beyond that.  Though the activities do involve physical movements but the approach is completely different. Occupational therapy not only helps an individual to cope up with his physical aspects but also helps in overcoming the issues related to neurological disorder and sensory processing disorder.

The approach is to use the work as a tool to develop the skills in the child. In real sense occupational therapy is the way by which one can develop or recover or sustain the skills related to physical, mental or neurological disorder. So it is a therapeutic way to develop skills used in daily life, which includes independence in every task like self-care, work and leisure.

Motor movements like fine motors and gross motors are impaired in kids with ASD. Research has shown that motor coordination, postural control, and learning of skills through imitation of the movements of other persons may be limited, and planning and completing new motor tasks are challenging for many children with ASD. Early motor delays in children with ASD may contribute to difficulty acquiring social skills.  Occupational therapy and physical therapy help in overcoming these issues at the individual level

Though the goals and activities of occupational therapy and physical therapy overlaps, both focus on improving the physical limitations and disabilities but occupational therapy approach focus more towards meaningful activity.  It has to be connected with some functional aspects of daily life.  Occupational therapy would try to create individual’s interest in performing an activity.  In physical therapy intense movement practice is done irrespective of the fact whether the movement is associated with some play or activity of daily life. For e.g. if a child needs to learn kicking, OT will make kicking as a task and will try to play football, with an aim to kick the ball in the net. So this also fulfills the goal of teaching a child a sport, whereas a PT focus only on the kicking movement, with a repetitive kicking with no fun or sport involved.  

In OT the program is created in such a way that skill building and task completion can be achieved at the same time. Individual or child is the key factor in this.  The goals and activities are decided based on child’s areas of interest.  Child should be happy and motivated to perform the task . The functions of an OT have no limitations and can be performed in any setting depending on the requirement and needs of the child.  Be it school, home, hospitals or clinics, OT can fit into any environment.  No matter which setting it is, the goal is to develop or maintain the skills, along with adapting to the environment to meet the required objective in making life of a child independent and trouble free.

A physical therapist and Occupational therapists will conduct a thorough assessment of your child including a health and developmental history and assessment of:

  • Postural strength and control
  • Functional mobility (e.g. walking and running)
  • Body and safety awareness
  • Coordination at different levels.
  • Play skills
  • Interests and motivators
  • Ability to accept transition in activities
  • Level of gross motor skills (jumping, bicycle, skipping hopping etc.) and fine motor skills (writing, picking small objects, pinching, pointing etc.)
  • Participation in daily routines at home, community, and school

 

Both PT and OT work with the parents to make goals to help a child to participate fully in daily routines at home, school or in the community. There is no standard protocol exist with kids on the spectrum. Each child’s needs and goals are different. An individual based plan is made to meet the needs of the child. A regular follow and monitoring is very important to ensure that everything is going in right direction.

Suggestion:

Both PT and OT should certified and experienced in treating individuals with ASD, but in case of child a person with experience and focus in pediatrics should be preferred. Also a doctor who has completed study in pediatrics, physical therapy would be a good choice.

Speech Therapy

Apart from physical and occupational challenges children on autism spectrum may have difficulty  with both verbal and non verbal communication. Verbal means speech and language and non verbal means actions or gestures. Due to this, social interaction also is a big challenge for them. Speech  therapy can address wide range of  communication problems .This is the reason why speech therapy is considered as an integral part of the ASD treatment.

ASD can affect speech, language development, and social communication in many ways. Common speech problems with such kids are

  • Does not talk
  • Tone of voice is unexpressive
  • Does Babbling with words sounds
  • Make sounds, grunts, cries, shrieks, or throaty
  • Talks in a musical way.
  • Talks like a robot.
  • Repeat what other person says.

Due to ineffective production of correct sound verbal communication is also impaired. And the list of issues keep increasing with time if no required intervention is made. Communication challenges are

  • Making an eye contact or gestures
  • Difficulty in generalization of words or phrase or activity
  • Memorizing things with visual clues or image
  • Imitating the language or word and repeating it again and again.
  • Difficulty in understanding the meaning of a words or symbol
  • No creative language 

 

A child with Autism not only has to learn how to speak but also how to communicate. Which includes how to do a conversation using both verbal and non verbal skills along with tuning in with gestures like body language, facial expression and voice tone.

Role of Speech therapist and ASD

Speech therapist is a very important member of ASD treatment team. He also helps in early screening and detection of ASD in kids. Once Autism spectrum disorder is diagnosed in a child, speech therapist assesses the child and makes a plan in coordination with the family members and others who are associated with the child.

Various techniques are being used depending on the person’s ability to communicate. If a person is a non-verbal then electronic talker, picture boards or typing methods are used to make him communicate. Singing songs, making sounds, massaging, exercise of mouth and tongue is done to overcome the speech production barriers. Speech Therapist has to work on both speech and language development. There are also medical professionals who work on speech development. They use various techniques if the child has some difficulty in producing speech due to physical issues. If the speech therapist after assessing your child feels that he should be examine by a medical professional in order to rule out some physical issues then one should consult the Speech and hearing medical professional

Does the speech therapy helpful?

Off course, speech therapy benefits person a lot. It improves both speech and communication skills. Along with communication skills it improves both language and social skills as well.

In general, speech therapy helps in following areas.

  • Articulation of words.
  • Verbal and non-verbal communication.
  • Ability to comprehend both verbal and nonverbal communication.
  • Communication initiation
  • Develop conversational skills
  • Exchange ideas
  • Communicate in ways to develop relationships
  • Enjoy communicating, playing, and interacting with peers
  • Learn self-regulation

  When to start speech therapy ?

There is no fixed age to start speech therapy, though it is be better to start as early as possible, then only it will have more impact. Autism spectrum disorder symptoms become more evident after the child is 18 month old, but language delays can be identified as early as 10 to 12 months. So the moment parent notices the delay of any kind, child should be immediately taken to the pediatrician for assessment. In case of any kind of diagnosis, immediate intervention should be made so that whatever challenges, be it communication delay or speech delay or physical delay, which are about to come can be controlled and improved immediately.

As per the article by webmed, two out of three preschoolers with autism improve communication skills and spoken language skills when identified early and intervened. Also various research says that more therapy a child gets, more improvement is seen in him.

So be proactive and well read about each and every aspect of ASD. ASD parents have to be a smart parent.

 more coming soon...........

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