Physical Therapy and Motor Skills

In a significant portion of children with autism, gross motor skills (balance, coordination, muscle tone) can develop in patterns that differ from typical development. In this chapter, we'll look at the role of physical therapy in autism care.

Motor Signs in Autism

Research has described balance difficulties, low muscle tone (hypotonia), coordination difficulties, and unusual walking patterns (such as toe walking) in a significant portion of children with autism. Even though these motor differences aren't a direct part of the DSM-5 diagnostic criteria, they can noticeably affect daily life (taking part in sports, playing with peers, self-care).

Toe Walking

Toe walking is a common and multi-layered finding in children with autism. It can involve a sensory preference (reducing the touch input to the soles of the feet), a search for movement/balance input, and in some children a structural component such as a shortened Achilles tendon. Persistent, pronounced toe walking calls for a physical therapy evaluation; in some cases an orthopedic evaluation may also be needed.

The Goals of Physical Therapy

• Improving balance and coordination supports taking part in peer activities like riding a bike or jumping rope
• Supporting muscle tone and trunk stability builds the foundation for sitting posture and hand skills
• Assessing the walking pattern and, when needed, corrective exercises
• Increasing physical activity matters for motor development as well as for overall health and emotional regulation

Tip / Practical Suggestion

Find a physical activity your child enjoys (swimming, trampoline, cycling) and make regular time for it. Beyond motor skills, don't overlook the positive effects that regular physical activity has on sensory regulation, sleep quality, and overall mood.