Motor skills in children with autism

This article arises from a question from a parent of a child with autism whose son, who is entering puberty, has begun to bend his foot, making it difficult for him to walk. The message was very nice but I prefer to answer on the blog in case this information helps any other family. On the other hand, I have already mentioned other times that I do not answer clinical questions, nor do I comment on diagnoses. It seems a huge risk to search for health information on a page that is not of a prestigious public service, I think it is irresponsible if someone diagnoses a person without seeing them and my advice is always the same: put yourself in the hands of a professional who knows About ASDs and avoid those that promise miracles, easy and expensive solutions, and “alternative” therapies: if an “alternative medicine” works, it is called “medicine.”

People with autism have difficulties with gross motor function (which involves large movements of the arms, legs, torso, or feet) and with motor coordination, the coordinated functioning of different muscles, joints, and bones. In children with autism, alterations have been observed in the milestones of motor development (at what age they crawl, at what age they take the first steps), hypotonia (low muscle tone), muscle stiffness, akinesia (lack or loss of movement), bradykinesia ( slowness of voluntary movements associated with a decrease in automatic movements (such as arm strokes when walking), alterations in posture control and abnormal gait.

With regard to Autism motor coordination on average, half a year behind their peers. Although this phase of motor development does not depend on the social context, it must be remembered that it is normally mastered by observing others and imitating what they are doing. They may also have to do with a reduced attention span, lower skills for the game, or an excess of tactile sensitivity and other aversions.

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In relation to hypotonia, a child with this low muscle tone is usually “soft”, always leaning on something and often being unable to stay upright for a long time. Things like sitting down or picking up an object from the floor give the impression that they cost more than other children and can cause problems with balance, clumsiness, frequent falls, difficulties to be with peers, tires easily or any simple task seems to him requires more effort than others.

Muscle stiffness generates the sensation that the child is tense, when you touch it, you can notice that characteristic stiffness but it is more rare in children with autism than hypotonia.

The most studied are the anomalies in the step or gait. For example, children with autism tend to reduce their stride length, increase their stride width thereby increasing the base of support, and increase the time in the stance phase, the time the foot is on the ground. . All this increases its stability. Many children with autism have a tendency to walk on their toes, something that can decrease their balance, increasing falls, and also decreases their stamina, increasing their fatigue and participating less in social activities. These motor symptoms can affect the child’s ability to carry out activities of daily life such as playing, playing sports, walking. In turn, a rare gait can cause pain, fatigue, calluses, weakness in some muscles, joint stress, which in turn can affect a child’s functional abilities. That is why it is important to know the neuromuscular and biomechanical function of children with autism.

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Some children with autism also have motor planning difficulties. This process is what allows us to understand a movement, imagine how to do it, coordinate the different muscles that must intervene and execute that activity. Some movements, such as traversing a crowded space from one place to another as a playground, can be complex and some children may have difficulty planning or carrying out the movement, which can cause them to collide with other children or objects.

Physiotherapists are trained to help children with all these movement-related topics. If the problem is a delay in gross motor skills, they can teach exercises that can be practiced at home to teach movement patterns and improve balance and coordination through functional play. If gait is the problem, they can teach the child how to stretch shortened muscles or strengthen weaker ones while working on the biomechanics of the gait. While tone is inherent in the neuromuscular system, muscles can be strengthened to compensate for these differences, and motor planning can likewise be improved by working on specific exercises, setting goals, and working with the child and parents.

Gait analysis of children with autism can be helpful in establishing treatments and tracking their gross motor skills. Finally, it is possible that these subtle problems detected in children with autism, which in most boys go unnoticed, may significantly affect their way of walking and, consequently, their mobility, participation in educational and work activities and leisure and, in short, their quality of life.