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Pediatrics Physical Therapy: Children With Autism And Down Syndrome

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Pediatrics Physical Therapy: Children With Autism And Down Syndrome Question: Describe about the Essay on Pediatrics Physical Therapy for Children With Autism and Down Syndrome?   Answer: The core signs that signify that a child has autism are difficulties in interaction and communication and a tendency to behave in a restricted and repetitive manner. In this case, Benjamin is having some communication, behavioural and coordination problems that indicate the possibility of him to have autism. First of all, he enjoys staying and playing with his toys alone without any interruption, and he has a diagnosed speech delay. Instead of using words to communicate he uses body language, smiling and crying and very occasionally he babbles. He has avoidance towards anyone’s physical contact. He is not able to follow instruction and visual prompts. He is not able to keep his toy car on the track or his ball in the basket. He often does some repetitive activities like clapping his hands over his ears or grinding his teeth out of no reason. He kicks his legs whenever he is angry. He has some obsessive practices like always holding something in his hand, playing with the same toy in a same way, etc. He faces a difficulty in standing without support, walks using a push toy and creeps on hands and knees. He is unable to imitate new activities shown by his therapist. He feels problem in sitting still, and there are some problems with his sitting posture. He sits in a w-sitting posture with a posterior pelvic tilt, back and soldiers rounded. He cannot hold his bottle while drinking and is not able to eat himself. As a professional physical therapist, I will say that Benjamin has Autism. By analysing his activities we can observe that he faces some difficulties in communicating with people, he has a problem with sitting, standing and walking, he is unable to follow instructions that are given by others and these are the symptoms of an autistic child. Family centred care is an important part of the treatment of a child with autism. FCC or family centred care plays a role in all aspects starting from assessment throughout the treatment. The FCC practices emerged as the System of Exclusion, and its key factors are 1) The Fight, 2) Roles and restrictions of care and 3) Therapeutic Rapport (Daniels et al., 2012). These three factors of FCC include: Learning about the system of the family and developing the respect for the preferences, culture and system of the family can help to overcome these hardships as everyone in the child’s family gets affected by the increased stress and financial problem. Developing proper learning opportunities and teaching strategies for the child and taking regular feedback from the teachers. Developing the communication and managing the behaviour of the child. Involving the members of the family in the therapeutic sessions and their feedback should be taken on a regular basis. The opinion of the family about the child’s interests and needs should be taken before starting the therapy (Dabrowska & Pisula, 2010). Transcranial direct current stimulation can be an effective intervention strategy for motor development for Benjamin. In this method, an electrical energy of low intensity is applied to the cerebral cortex in order to fluctuate the magnetic fields coming from any external source.  A DC is continuously applied through electrodes that are attached directly to the scalp which is just above the selected region of the brain. The excitability of the neurones is altered by this current either positively or negatively which leads to a change of the brain functions. TDCS has been proven successful to improve the communication skill, language skill and behavioural performance of children with autism. In recent days, it is being used as a potential treatment of language skill and speech of young minimally verbal and non-verbal autistic children. However some medical, practical and ethical challenges of these types of interventions are there related to the children (Reaven et al., 2012). An effective home programme for autistic children can be set at home based on some treatment methods by the parents. These types of programmes will help them to understand their children in a better way and will also help to improve the behavioural factors of the children.   Relationship Development Intervention is a parent-child programme that mainly gives emphasis to the improvement of the social interactions and emotional responses of the child. RDI programme works on the understanding of a child towards nonverbal clues, social behaviour and an awareness of others emotions (Griffith et al., 2010). Applied Behavioural Analysis is a one-to-one plan that focuses on appreciating the right behaviour and avoiding bad behaviour for encouraging the correct responses. It requires reinforcing the good behaviour, a repetitive and structured teaching. The Floortime is a treatment method that encourages the children to be more interactive through various games and activities. By investing more time, parents can select proper activities for their children and expand their social communication (Daniels et al., 2012). Wraparound is a special programme where autistic children have a one-to-one session with a specialist. Such programmes are conducted at home, school and in other organizations. Parents can make their children participate in such activities (Griffith et al., 2010). As a physical therapist, my role is to work with the child along with his family with the help of certain activities. Improving the participation of the child in various activities of his daily life at home and school by helping him to acquire new motor skills. Development of coordination and stability of posture by some reciprocal play skills such as catching and throwing a ball with another person or copying the activity of someone. Evaluation of the improvement child by the assessment of his functional mobility, postural strength and control, awareness of body and safety, play skills and coordination, motivation, interest and emotional responses and participation in the activities of daily life. Monitoring the improvement of the child, collect data and designing various programmes that will lead to a positive outcome (Dabrowska & Pisula, 2010).   References: Dabrowska, A., & Pisula, E. (2010). Parenting stress and coping styles in mothers and fathers of pre‐school Children With Autism And Down Syndrome.Journal of Intellectual Disability Research, 54(3), 266-280. Daniels, A. M., Rosenberg, R. E., Anderson, C., Law, J. K., Marvin, A. R., & Law, P. A. (2012). Verification of parent-report of child autism spectrum disorder diagnosis to a web-based autism registry. Journal of autism and developmental disorders, 42(2), 257-265. Griffith, G. M., Hastings, R. P., Nash, S., & Hill, C. (2010). Using matched groups to explore child behavior problems and maternal well-being in children with Down syndrome and autism. Journal of autism and developmental disorders, 40(5), 610-619. Hebert, E. B., & Koulouglioti, C. (2010). Parental beliefs about cause and course of their child’s autism and outcomes of their beliefs: A review of the literature. Issues in comprehensive pediatric nursing, 33(3), 149-163. Mahajan, R., Bernal, M. P., Panzer, R., Whitaker, A., Roberts, W., Handen, B., … & Veenstra-VanderWeele, J. (2012). Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. Pediatrics, 130(Supplement 2), S125-S138. Reaven, J., Blakeley‐Smith, A., Culhane‐Shelburne, K., & Hepburn, S. (2012). Group cognitive behavior therapy for children with high‐functioning autism spectrum disorders and anxiety: A randomized trial. Journal of Child Psychology and Psychiatry, 53(4), 410-419. Speaks, A. (2011). What is autism. Retrieved on November 17, 2011. Spek, A. A., Van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Research in developmental disabilities, 34(1), 246-253.

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