Getting the Most out of Therapy: 

So often children who are diagnosed with a disability are provided a plethora of services which can be overwhelming to parents. This is especially true for younger children with recent diagnosis due to the proven efficiency of early intervention. Parents who are just learning about the needs their children have are given several referrals for services they have never heard of. This is such an emotional process for any parent of a child at any age and they are rarely given one person to make sense of it all. This series it meant to help explain the services your child may be receiving as they relate to ABA, how these services can be used to support an ABA program, and how to facilitate this collaboration between providers who can also be unfamiliar with each other’s specialties.

Part 3: Physical Therapy and Applied Behavior Analysis 

Does your child receive physical therapy services? How is this therapy helpful to my child?  Physical therapy is most often associated with sports injuries or car accidents and the like, so when it is suggested for a child with disabilities parents are often confused as to why their child needs these services. This is especially true when your child may not have any obvious signs of injury or the inability to perform gross motor movements. One distinction to make is the difference between gross motor and fine motor (fine motor is typically addressed by OT, which was discussed in the previous part of this series).  

Motor skills are skills that enable the movements and tasks we do every day. Fine motor skills are those that require a high degree of control and precision in the small muscles of the hand (such as using a fork). Gross motor skills use the large muscles in the body to allow for balance, coordination, reaction time, and physical strength so that we can do bigger movements, such as walking and jumping. (Very Well Family, 2021)

These skills usually develop in a sequence in typical children; however, this sequence does not always apply to children with autism. As mentioned, PT focuses on gross motor development, which may not be an obvious area of need for your child. Physical therapy for children with autism can also focus on developing skills that they may be physically capable of doing, but because they don’t do them, the children need to develop a muscle memory or train their muscles to be more adept at the skill. 

Physical therapists (PTs) are movement specialists. They are in a unique position to help children with ASD. PTs help children with ASD develop their gross motor skills and basic movement skills. These skills help children with ASD play games, sports, and take part in physical education with their peers. (APTA, 2021)

Does ABA overlap with physical therapy services? YES! 

PTs have unique training in child development and motor control. This expertise allows them to assess a child’s motor delays and functional performance. PTs work with your child, your family, and your child’s school to help them:

• Engage and improve in daily routines at home and school

• Acquire new motor skills

• Develop better coordination and a more stable posture

• Improve play skills, such as throwing and catching a ball with another person

• Develop motor imitation skills (learn by copying others’ actions)

• Increase fitness and stamina

(APTA, 2021)

This list should include things that are being worked on by your BCBA during ABA therapy. Behavior therapy, especially in young children, has a heavy focus on targets such as play skills and imitation. Having two therapists targeting the same skills can be a help or a hinderance. Consider if the child is being taught how to throw a ball in two different ways? As with anyone, this would make the skill take longer. A PT is a specialist in knowing exactly which muscles are involved with throwing a ball and what type of coordination is needed for those movements. Your child’s PT would be able to identify if there are prerequisite skills missing in the child’s ability to throw a ball. This therapist has frequently seen children with gross motor targets that are never mastered due to unidentified deficits. Another area that the PT can assist is if these deficits are muscular, meaning they can be trained and taught, or if it is a neurological problem. An example of this is a child who drags their foot when they walk, which can be muscular or neurological and thus delt with very differently. By identifying the goals that are overlapping between therapies, interventions specified by the PT could help your child acquire targets in their ABA program faster and more efficiently. 

Can these therapies support each other considering how different the focus is? Absolutely! Once you have learned what a PT is focusing on, then you can communicate that to your behavior therapist. Like the other services discussed in this series, PT is best implemented on a consistent basis. This is just as important as regular implementation of anything else as PT focuses on training the muscles and creating muscle memory. Like in rehabilitation of an injury, these skills need to be repeatedly implemented in order for efficient skill acquisition. Since PT is not offered at the same frequency as ABA, getting the therapists to collaborate so that the behavior therapy incorporates the PTs interventions will create a situation where your child is practicing on a regular basis. 

Reviewing your child’s program on a regular basis is an imperative part of maximizing the potential of the individual interventions. The purpose of this series was to give a brief overview of these services and how they can support each other. By being aware of how they work and which aspects overlap, you can create a collaborative program that encompasses all the needs of your child. This is rare in early childhood programs because it is difficult to do. Therapists are not educated on each other’s specialties or interventions and parents are rarely aware of how therapies can be coordinated with each other. One of the best ways to do this as a parent is to observe your child across different services and stay current with the goals they are working on. When and if you see something similar, it is most likely an opportunity for collaboration. As a parent, you want the best for your child and gathering the knowledge is half the battle. 

Author:

Sheila Panno, MEd, BCBA, LBA

BCBA Clinician

Works Cited:

National Information Center for Children and Youth with Disabilities. (1996). General Information About Speech and Language Disorders . Retrieved from LD OnLine: http://www.ldonline.org/article/6336/

Very Well Family. (2021, April 3). Therapy and Social Involvement. Retrieved from Fine and Gross Motor Skills in Children: https://www.verywellfamily.com/what-are-motor-skills-3107058