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Would siblings of children with Autism Spectrum Disorder benefit from early physical therapy interventions compared to no physical therapy interventions?

Jessica PlummerBellarmine University DPT Class of 2015

Background

Autism spectrum disorders (ASDs): neurodevelopmental conditions characterized by impairments in social interaction and communication, and tendency toward restricted and repetitive movements.3

Twenty perfect of infant siblings of children already diagnosed with ASDs are at high risk for developing ASDs There is an additional risk of 25-50% for developing milder impairments such as language, social, and sensorimotor delays which together define Broader Autism Phenotype (BAP).1

In the 32% of siblings of children with ASD that showed delays in cognition and language at 24 months, 50% received therapy intervention and 8% were later diagnosed with ASD. These siblings by and large caught up by the age of 54 months.2

Early identification of ASD or BAP allows families to proactively find resources to improve the development of their child.

While social impairments are the defining feature of ASDs, motor functioning often is abnormal in one or more ways. Early motor delays within the first 2 years of life may contribute to the social impairments of children with ASDs and their siblings.1

How motor impairments impact social impairments1 Skills focused on during physical therapy interventions of infants at risk for ASDs1

Conclusion

Literature Cited

Early detection is essential for facilitating access to interventions that can shape neural connections during sensitive periods of development.3

Given that interventions for motor impairments are a vital component of physical therapy practice it is important to identify mild impairments seen early in siblings of children with ASD and provide interventions to improve these delays.

1. 1. Bhat AN, Landa RJ, Galloway JC. Current Perspectives on Motor Functioning in Infants, Children, and Adults With Autism Spectrum Disorders. Physical Therapy Journal. 2011;91(7):1116-1128.

2. 2. Gamliel I, Yirmiya N, Sigman M. The Development of Young Siblings of Children with Autism from 4 to 54 months. J Autism Dev Discord. 2007;37:171-183.

3. 3. Mulligan S, White BP. Sensory and Motor Behaviors of Infant Siblings of Children with and Without Autism. The American Journal of Occupational Therapy. 2012;66(5):556-566.

4. 4. Orsmond GI, Seltzer MM. Siblings of Individuals with Autism Spectrum Disorders Across the Life Course. Mental Retardation and Developmental Disabilities Research Reviews. 2007;13:313-320.

5. 5. Petrus CP, Adamson SR, Block L, Einarson SJ, Sharifnejad S, Harris SR. Effects of Exercise Interventions on Stereotypic Behaviours in Children with Autism Spectrum Disorder. Physiotherapy Canada. 2008; 60(2):134-145.

6. 6. Toth K, Dawson G, Meltzoff AN, Greenson J, Fien D. Early Social, Imitation, Play and Language Abilities of Young Non-Autistic Siblings of Children with Autism. J Autism Dev Discord. 2007;37:145-157.

Poor coordination and slowed movement are linked to poor social participation and increased anxiety during playtime in the preschool and kindergarten years

Friendship and social connections are made through shared experiences among children during the several hours of playtime

Motor clumsiness could result in missed opportunities and reduced engagement with coordinated and agile peers

Lack of social engagement limits the initiation and maintenance of friendships and may contribute to delayed social skills

Difficulties with social adjustment in children are also linked to their emotional as well as behavioral problems

Locomotor

Objective exploration

Fine and gross motor

Balance

Imitation

Postural

Joint action

Social communication

Chart 11

Comparison of Cognitive and Language Delays in the First 54 Months of life2

  Siblings of children with ASD

Siblings of typical developing children

4 Months

No delays No delays

14 Months

20% showed delays No delays

24 Months

32% showed delays 5% showed delays

36 Months

32% showed delays No delays

56 Months

No delays No delays

Future Research

Do siblings of children with ASD develop milder impairments due to genetic vulnerability, such as BAP, or environmental factors including modeling of atypical behavior and reduce opportunities for proper social engagement?