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Commentary on “A Therapeutic Skating Intervention for Children With Autism Spectrum Disorder”

Bhat, Anjana PT, PhD; Bubela, Deborah PT, PhD

Pediatric Physical Therapy: July 2015 - Volume 27 - Issue 2 - p 177
doi: 10.1097/PEP.0000000000000140
CLINICAL BOTTOM LINE

Physical Therapy Program, University of Delaware, Newark, Physical Therapy Program University of Connecticut, Storrs

Physical Therapy Program, University of Connecticut, Storrs

The authors have no conflicts of interest.

“How should I apply this information?”

Children with autism have a variety of sensorimotor and social impairments that may affect their play and physical activities. Physical therapists should advocate for enhanced physical activity, functional skills, and recreational participation for their clients with autism. Standardized motor and functional measures such as those included in this study should be used to document change over time. Creative movement using music, dance, or yoga and sports such as swimming, walking, or skating are possible activity choices. Ice or roller-skating is an especially interesting choice as it provides vestibular input and balance and strength as was evidenced in this study. Interventions should involve individualized, engaging activities that promote substantial repetition, structured environments such as a physical space that is consistent across sessions, and a space devoid of distractions such as bright lights and sounds. Instructions and feedback should be simple and incremental with verbal, visual, and then manual feedback. As mentioned in this study, 2 intervention phases, early individual sessions and later group-based activities, allow for planned integration into the community and perhaps assist in task generalization and functional carryover. If the therapy activities are difficult, a child may not effectively communicate and may show noncompliance, tantrums, or self-injury. A break or a favorite activity could be used before continuing with the activities.

“What should I be mindful of when applying this information?”

Intervention choices should be consistent with the child's preferences and interests to ensure sufficient repetition and a lasting change. Intervention should promote lifelong skills or enhance foundational elements such as strength, balance, and flexibility. Study generalizability is limited because of only 2 participants. The use of multiple baselines was not demonstrated and no statistical analysis was performed. The inability to easily access a skating rink and safety concerns may limit the application of this approach.

Anjana Bhat, PT, PhD

Physical Therapy Program

University of Delaware, Newark

Physical Therapy Program

University of Connecticut, Storrs

Deborah Bubela, PT, PhD

Physical Therapy Program

University of Connecticut, Storrs

Copyright © 2015 Academy of Pediatric Physical Therapy of the American Physical Therapy Association