To Intervene or Not? PT or no PT? Motor Issues in Autism


Here’s something I struggle with every year. That ambulatory, fast, strong child with autism. Gross motor delays? Absolutely. Typical movement patterns? No way.

Do I keep this child on program? Do we want to be making him stronger and faster? What should I recommend?

I remember one year going round and round with a parent who wanted her child to receive PT so he could play ball. We would spend session after session attempting to play ball. After several years, we were finally up to 4 repetitions. Was it because he had no interest? Was it because the frequency of 1 x 30 minutes per week? Was it because the motor planning and attention required was too far beyond his current skill level? Did I give up too early?

One of my biggest struggles in working with a severely autistic child is how to make my extrinsic goals intrinsic to the child. My random, extrinsic-based goals (skipping, ball play, etc) often have little value in the child’s world, and are therefore unmotivating. Without the support of a conditioned-response (ABA) type program, applying value becomes difficult.

Understanding why a child with autism has movement disorder is key in decision making, as is using evidence-based strategies. Goal-setting becomes critical in ensuring that goals are motivating to both the student and the therapist.

To continue this discussion, plan on attending Jennifer Colebourn and Julie Goff’s session, Using Evidence to Help Guide Decisions on Goals, Dosage, Frequency, Priorities, and Interventions for Motor Issues in Autism at the
Eighteenth Annual Therapies in the School Conference – November 16-17, 2017 – Framingham, MA

~Kathryn Biel, PT, DPT