1. PEDIATRIC LEARNING DISORDERS
(AUTISM SPECTRUM DISORDERS): MP-05
Presenter: Sunanda Bhowmik
Ph.D Scholar
Roll no:1822758
Date: 07/10/2022

2. INTRODUCTION
• ASDs are a neurodevelopmental disorder in which
persons present with a range of impairments in social
interaction, verbal and nonverbal communication, as well
as restrictions in behaviors and interests.
• Additionally, the majority of the children with ASDs may
have significant perceptual motor impairments that
deserve assessments and interventions

3. CLASSIFICATION

4. Autism
• Autism is characterized by marked abnormalities in social
interaction and communication.
• Symptoms emerging prior to 3 years of age within the
domains of social communication development and
imaginative play.
• Hallmarks of autism include a failure to develop peer
relationships, the lack of spontaneous sharing of interests
and enjoyment, and the lack of social or emotional
reciprocity

5. OTHER FEATURES
• Communication impairments includes:
• Delay or lack of spoken language,
• Impaired ability to initiate or sustain a conversation with
others,
• Impaired Use of repetitive or idiosyncratic language,
• Lack of spontaneous pretend play.
• Restricted repetitive and stereotyped behaviors and
interests include one or more stereotyped patterns of
interest,
• Inflexible adherence to routines and rituals, stereotyped
and repetitive motor mannerisms,

6. • PDD_NOS: The diagnosis of PDD-NOS is identified
when the child presents with fewer symptoms of the
characteristics of autism.
• Asperger’s Syndrome: Asperger syndrome is
characterized by a significant impairment in social
interaction and the presence of repetitive behaviors and
restricted and unusual interests.

7. NEUROPATHOLOGY
Brain development in individuals with ASDs typically goes
through three stages:
(1) Overgrowth in infancy and early childhood;
(2) Slowing and arrest of growth in late childhood;
(3) Degeneration in preadolescence and adulthood.

8.  Head circumference of 1- 2 year old children who later developed
autism was significantly greater than typically developing children,
 The brain overgrowth period mainly affects the frontal lobes,
temporal lobes, and amygdala.
 Brain overgrowth continues into early childhood and is observed in
children with autism with a mean age of 4 years
 there is an overconnectivity in the short-range neuronal fibers and
an underconnectivity of the long-range neuronal fibers.
 The lack of long-range connectivity within the brain leads to the
poor integration of sensorimotor, social communication, and
cognitive functions

9. DIAGNOSTIC TOOL
• Clinicians are able to diagnose ASDs using the gold-
standard tool called the Autism Observation Schedule
(ADOS) and the companion parent interview called the
Autism Diagnostic Interview–Revised (ADI-R).

10. • The ADOS is a 45-minute to 1-hour standardized
qualitative assessment that evaluates a child’s social
reciprocity, nonverbal and verbal communication, as well
as stereotypical behaviors and interests using various
play-based activities with an adult tester. The ADOS can
be administered to individuals from 12 months of age to
adulthood.

11. IMPAIRMENTS
cognitive
ATTENTION
Social skill
Language
Executive
functioning

12. SENSORY
PERCEPTUAL
Sensory
modulation
Atypical
visual,
auditory
perception
Motor
stereotypes
Motor
impairments

13. PHYSIOTHERAPY STRATEGIES

14. Sl
No
PRINCIPLE SPECIFIC STRATEGIES
Structuring
the
environment
Use just the right amount of space for the motor activities to be
performed.
Use the same space to ensure predictability.
Limit the materials to the ones required for the session.
Remove or cover the other distractors in the room.
1
Put up rules sheet, listing of activities, or picture schedules to describe
the expectations from the child and
the structure of the sessions, whenever appropriate.
Follow a predictable routine. You could vary the routine of the child if
that is a treatment goal. Begin with
small (versus large) changes to the routine. When these changes are
made, be sensitive to its effects on the
child.
Promote transitions with the use of picture schedules or predictable
verbal or gestural commands

15. Sl
No
PRINCIPLE SPECIFIC STRATEGIES
2
Instructions
for the
activity
Use the various means of communication available to the child.
Prompting/
modeling/
feedback
Models could be the PT, peers, paraprofessionals, or caregivers who
join the child.
When possible, use group activities because they are valuable for
learning social monitoring.
3
Make sure that the child is attending to you before you begin your
instructions.
hand-on hand feedback could be provided.
Use external props to clarify the goals of the activity.

16. Sl No PRINCIPLE SPECIFIC STRATEGIES
Repetition
Practice is important for motor learning and should be encouraged
within a session but also across sessions.
4 Caregivers should practice the same activities between the two
physical therapy sessions.
Generalization to a different space and a different caregiver will be
facilitated through such practice.
Active
engagement
It is important to allow for free movement and improvisational
activities.
Waiting is critical for the child to explore spontaneously and actively
problem-solve.
5 Prompting could be used in the second trial of the same activity
Allow the child to choose a theme or a set of activities for the
session. Encourage them to move differently
than you. Promote movement creativity and spontaneity.

17. Sl No PRINCIPLE SPECIFIC STRATEGIES
6
Progression
In terms of progression, it is important to create the just-right
challenge for the child. It is important to allow
for success.
Look out for negative behaviours such as tantrums, noncompliance,
and self-injurious behaviours.
Reinforcement
/rewards
Various rewards could be provided.
Verbal and gestural reinforcement in the form of “good jobs” and
“hi-fives.”
7
Breaks from activity to do favorite sensory activities—spinning,
containment, or deep pressure or free play.
Stickers or small toys. Provide if the aforementioned ideas do not
seem to work.
Edibles: Provide if the aforementioned ideas do not seem to work.

18. PHYSIOTHERAPY MANAGEMENT
1
• Team approach
• Applied behavioural analysis
2
• Treatment and Education of Autistic
and Related Communication-
handicapped Children
3
• Picture exchange communication system
• Other approaches(Gutstein and Sheely’s
relationship development intervention RDI)

19. THANK YOU