If your child has been recommended for Brecksville early intervention services, either due to developmental delays or a diagnosis of a condition like autism, Down syndrome, or cerebral palsy, odds are you’ve heard the term “neuroplasticity.”
That’s a somewhat intimidating word, but the concept is fairly straightforward – and important to understand if you’re considering the value of early intervention services, which are initiated before a child’s 5th birthday, or sooner if possible.
Neuroplasticity is the brain’s ability to change – to relearn, rewire, establish and strengthen important connections. If the brain is injured or developing atypically, neurons can be damaged, altered, or lost. The good news is that the brain can establish new pathways. There is a brief window of time with young children where the brain’s ability to form and reorganize synaptic connections – especially in response to learning or experience – is especially effective. This is called neuroplasticity.
Children’s minds are like little sponges, absorbing everything around them. It’s what gives them the “superpower” of learning the fundamentals of movement, language and basic independence (walking, talking, feeding, etc.) in just a few short years. If a child has a developmental delay or a condition that has made reaching typical developmental milestones challenging, intervening early with services like speech therapy, occupational therapy, ABA therapy, and physical therapy allows us to leverage a child’s natural neuroplasticity to help their brains create and reinforce new neural pathways that allow them to glean new skills, habits, and ways of thinking.
Child developmental regression is when a child loses certain developmental skills they previously acquired. It might seem as if they’re almost moving backward in their development. This is different from developmental delay, when kids reach certain milestones later than expected or their developmental progress flattens or stalls.
The condition is pretty rare, though it is sometimes associated with a number of diagnoses, each warranting prompt attention and intervention. The good news is that for the more common conditions, treatment can be effective when problems are caught early.
Examples of the conditions most commonly associated with child developmental regression are:
- Autism spectrum disorder. This condition isn’t always associated with child developmental regression, but as researchers have noted, it is the most frequent condition in which regression is diagnosed. In rare instances, it can be associated with Heller’s Syndrome, also known as child disintegrative disorder (CDD). This is characterized by late onset (age 3 and older) developmental delays, social function, motor skills, and even cognitive function. Children with CDD will develop typically for the first 2 to 10 years before sharply regressing.
- Neurodegenerative disorders. These include conditions like Rett’s Syndrome and Metachromatic leukodystrophy.
- Trauma or stress. Traumatic or stressful events can cause some children to regress in some respects or act younger than their age. Examples of this include things like potty accidents, sleep disturbances, decreased independence and behavior disruption.
For this article, we’re focusing primarily on regression as it pertains to autism. It should be noted though that with the other conditions, medications, therapies, and other supports are known to help manage symptoms, prevent complications, and improve life quality.
What We Know About Child Developmental Regression and Autism
Regression with autism appears to occur very rapidly or gradually. In either case, the child struggles to regain skills they’ve lost.
Some researchers have concluded that while regression among some kids with autism can be very real, many instances are more likely a pileup of deficits and missed indicators that finally become unmistakable. Parental reports that classify the onset of autism can often be flawed – not because parents aren’t paying attention to their kids, but because they usually aren’t child developmental experts who even know what to watch for.
In other words, loss of social interest or communication deficits can take place at varying ages and to different degrees – it just becomes more noticeable at certain points. When it happens to kids who are little older, it can appear drastic and sudden. When it happens in kids who are a lot younger, it can seem very subtle.
In the past, doctors used to think that “regressive autism” was a subtype of autism, but the more we learn about the condition, the more those lines have been blurred. One study published in the Journal of Developmental and Behavioral Pediatrics found as many as 1 in 5 cases of autism involved regression – a rate that has risen as we’ve grown to include more people with unique presentations of autism.
Often, it looks something like this: An 18-month-old who seemed to be developing typically “withdraws suddenly,” ignoring his own name, talking less (to the point of not talking at all), ignoring engagement with other kids to play almost exclusively with inanimate objects, losing previous interests, and appearing to obsessively focus on a few things or activities. This may occur at the same time as the child begins to display behavior characterized as “odd” and repetitive.
Although doctors used to consider “regressive autism” to be its own subset of the condition, physicians increasingly argue that such classifications aren’t as pertinent because most kids with autism lose some skills, and there is a lot of variation on the types of skills they lose, to what degree, and at what age. A study published in the journal Autism in 2016 found that there were a range of onset patterns, with some parents reporting early developmental delays with no skill loss to no delays and then a clear loss of skills. Ultimately, this may tell us something about the onset of the condition, but it doesn’t necessarily change the approach and treatment in helping kids “catch up” in their social, emotional, and communication skills.
Child developmental regression typically occurs among children younger than 3, with the average age being around 21 months. The risk of children losing their developmental skills becomes increasingly unlikely the older they get, but early intervention speech therapy, occupational therapy, and ABA therapy can help them retain what they have and make gains where they’ve fallen behind.
Early Intervention Therapies Can Help Kids Who Have Developmental Regression
When it comes to children with autism, regardless of the onset pattern, waiting for the child to “catch up” on their own simply isn’t going to work.
Our Brecksville speech therapy, occupational therapy, ABA therapy, physical therapy, and special education team work together as a team in formulating an early intervention plan that can help children on the autism spectrum communicate, play, and learn. Our approach is going to be based on the skills they have compared to the skills they should be displaying for a child their age.
Therapy is not a “quick fix” solution. It is a commitment for families, but is well-established as one of the most effective means of treating children who’ve experienced developmental regression attributed to autism.
Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy, occupational therapy, ABA therapy, physical therapy, and special education services to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, vocational counseling and more. Call us at (330) 748-4807 or send us an email.
Why Act Early if You’re Concerned About Child Development, U.S. Centers for Disease Control and Prevention
More Blog Entries:
At What Age Should My Child Begin Brecksville Speech Therapy? Oct. 16, 2021, Brecksville Speech Therapist Blog
When a child has a dual diagnosis of Down syndrome and autism spectrum disorder, therapy and education approaches must be specially tailored to their needs and the way they learn. At Therapy & Wellness Connection, our speech therapists, occupational therapists, physical therapists, and ABA therapists are committed to ensuring that every child is properly diagnosed and receives therapy that is going to help them thrive and reach their full potential.
In the past, it was presumed that autism was fairly rare in people with Down syndrome. We now know that’s not the case. Per the Down Syndrome Resource Foundation, it’s estimated autism is about 10-25 percent more common among people with Down syndrome as it is for the typical population. However, diagnosis of autism typically comes much later in kids with Down syndrome than it does for other kids. According to DSRF, the mean age of an autism diagnosis for a child with Down syndrome was about 14.4 years. It’s been well-established that the sooner kids receive early intervention treatment for autism, the better their long-term prognoses on several fronts.
There are several reasons for the delay in autism diagnosis for kids with Down syndrome. For one thing, while Down syndrome is almost instantly recognizable (and verifiable with a blood test), autism spectrum disorder is not. It is subjective, based upon observed social communication and behavior patterns.
A delayed diagnosis does put these kids at a disadvantage developmentally, academically, and socially – even compared to kids who only have one of the two disabilities. For example, there is a faulty assumption that all people with Down syndrome are “outgoing” or “charming.” But when a child with Down syndrome also has autism, they may struggle to relate socially, failing to live up to the unrealistic expectations of social strengths. (However, there is some evidence that kids this dual diagnosis may have stronger social skills than those solely diagnosed with autism.)
Parents of children with Down syndrome who are also on the spectrum may at first think they’ve done something wrong, particularly when they notice their child is making fewer strides or exhibiting more behavioral problems compared to other kids with Down syndrome.
Our ABA, occupational, physical, and ABA therapists work with lots of kids who have dual diagnoses of Down syndrome and autism. We can help parents recognize the signs and help them navigate the process to obtain ADOS testing and a diagnosis, which can help open the door to additional services.
Diagnosing Autism in a Child with Down Syndrome
It’s generally accepted that a child with autism will present some combination of the following:
- Pervasive deficits in social interaction and social communication, not accounted for by general developmental delays.
- Repetitive, restricted behavior patterns, activities or interests.
- Hypo- or hyper-reactivity to sensory input.
- Symptoms present in early childhood.
- Combined symptoms limit everyday function.
We often hear parents of kids with a dual diagnosis of Down syndrome and autism say they recognized something was different early on, but they couldn’t tell exactly what. This is understandable because many of the characteristics of autism are also routinely observed in kids with Down syndrome – especially the social communication component. Lots of children with Down syndrome have difficulty with expressive language, speech sound production and voice, as well as underlying cognitive deficits. That makes a dual diagnosis tricky!
If you suspect your child might have autism, it’s important to talk to the members of your professional support team, including your pediatrician, speech therapist, ABA therapist, physical therapist, occupational therapist, child psychologist, teachers, etc. Get their input and guidance. Ultimately, an autism diagnosis will be made by a physician or psychiatrist, but having feedback from the other professionals who know your child well can be valuable when presenting your concerns.
Treatment for Kids With a Dual Diagnosis
Many of our pediatric patients at Therapy & Wellness Connection have comorbidities (more than one condition). Those diagnoses can provide access and a road map, but ultimately, our therapies and education services are tailored to the individual child. Kids with both of these conditions often benefit from multiple, early intervention therapies, including speech, occupational, ABA, feeding/swallowing and physical therapy.
If your child has been diagnosed with both autism and Down syndrome or are concerned your child with Down syndrome might be on the spectrum, we can help.
Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy, speech therapy, occupational therapy, and physical therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, homeschooling, alternative schooling, virtual therapy and education, vocational counseling and more. Call us at (330) 748-4807 or send us an email.
Down Syndrome and Autism Spectrum Disorder Dual Diagnosis: Important Considerations for Speech-Language Pathologists, Dec. 14, 2020, American Journal of Speech-Language Pathology
Both occupational therapy and physical therapy practitioners are committed to improving lives. But often when parents come to us for services, in some cases recommended for both types of therapy, they aren’t all that clear on the unique role each plays. Physical therapy is generally better understood than occupational therapy, but both are equally vital in helping children with injuries, disabilities and delays reach their full potential.
The fields are quite similar, but they’re also unique in both scope and focus.
What is Occupational Therapy?
It’s probably worth first explaining occupational therapy. The name throws a lot of people off, as if it might have something to do with one’s job. The reality is that our Brecksville occupational therapists assist kids and young adults with a wide range of tasks that “occupy” their life. Many of the kids we work with are far too young for jobs, but offering assistance in finding and maintaining work could be goals for some of our teen or young adult patients.
Occupational therapists can help individuals focus on one major thing or just a few things, but are also dedicated to treating the “whole person.” That means we can help with everything from handwriting to self-care to social interactions to play. Occupational therapists in Ohio must have a master’s degree and be licensed through the state to practice.
What is Physical Therapy?
These are our movement experts! Physical therapists are committed to helping children with conditions that impede their ability to move and can often offer ways to prevent injury, provide surgery and minimize pain.
Physical therapists in Ohio are required to earn a doctor of physical therapy (DPT) to practice. In addition to studying anatomy, kinesiology and neuroscience, these practitioners also study things like communication, child development and ethics. They too must be licensed through the state.
In What Ways Are Pediatric Occupational and Physical Therapists the Same?
As previously mentioned, both types of practitioners (OTs and PTs) are committed to wellness. Beyond that, both evaluate patients and offer customized plans of care. Treatment plans are monitored routinely for progress and also whether changes are needed.
They also treat many of the same conditions, such as brain injuries, spinal cord injuries, autism, down syndrome, torticollis, reflex integrations, proprioceptive awareness and neurological conditions. Further, both work with caregivers and family members to ensure patients have the support they need to thrive. Although OT and PT practitioners can both work in clinics, hospitals and nursing homes, ours practice in our Brecksville clinic as well as in patient homes and schools.
Both can become certified in specialties like pediatrics.
So What’s the Difference?
The primary difference between physical and occupational therapy practitioners is the scope of what they do. While physical therapists want to help people move better, occupational therapists are more focused on a holistic function that can include social, emotional and work-related scenarios. Whereas the physical therapist would be focused primarily on facilitating movement, the occupational therapist would also be concerned with developing/restoring the ability to complete certain functions.
If your child needs physical therapy, occupational therapy or both, our Brecksville pediatric therapy clinic is a one-stop-shop for both.
Therapy & Wellness Connection – your connection to a life without limitations – is a pediatric therapy center providing occupational therapy, physical therapy, speech therapy and ABA therapy to children with special needs in Northeast Ohio. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email. Serving Brecksville, Akron, Cleveland and surrounding communities in Northeast Ohio.
Occupational Therapy Versus Physical Therapy, June 22, 2021, Medically Reviewed by Poonam Sachdev, MD, WebMD
More Blog Entries:
When Your Child Can’t Write His Name Yet: Tips From an Akron Occupational Therapist, June 18, 2021, Brecksville Occupational Therapy Blog
Down syndrome, sometimes called Trisomy 21, is one of the most common chromosomal genetic disorders, affecting approximately 1 in every 700 babies born in the U.S. Most experience developmental and physical delays, and often have several physical conditions that require additional treatment.
There are many ways our Akron physical therapy services can help children with Down syndrome, working with them from infancy through adulthood to help them reach their maximum level of functioning and go on to lead healthy, productive lives.
How Does Down Syndrome Impair Physical Function?
Babies born with Down syndrome have an extra copy of chromosome 21, altering the typical development of both the brain and body and resulting in varying ranges of both intellectual and physical challenges.
Therapy & Wellness Connection offers Akron physical therapy in your home, school or work environment, working side-by-side with our patients and their families to help sidestep or minimize some of the most common complications of the condition, such as obesity and developmental delay, as well as help improve and maintain cardiovascular fitness, as between 40 and 60 percent of those with Down syndrome suffer some type of congenital heart disease.
One of the defining physical characteristics of Down syndrome is low muscle tone, lower bone density, decreased strength and trouble with posture/balance – all of which can delay motor development (movement). They also frequently have problems with feeding and hand use challenges, and sometimes intense pain from joint problems. Each of these can be addressed and improved with help from our Akron physical therapy services.
How Akron Physical Therapy Can Help Children With Down Syndrome
The good news is that many teens and adults with Down syndrome go on to be active participants in family and community activities, leading lives that are both active and productive.
Our dedicated physical therapists work with individuals, families and other health care providers to reduce the impact of these conditions – in some cases preventing them from developing in the first place. Best results are when a child is receiving adequate medical services and supportive home and educational environments that incorporate physical therapy.
Physical therapists work to help children with this condition improve their muscle strength, coordination, movement, balance and gain their peak level of independence in activities of daily life.
The Top 5 Ways Physical Therapists Treat Children With Down Syndrome:
- Strength-building. There are a number of exercises we can practice to help you child increase their strength.These can include fun games, adjusted to their abilities as they grow, to help maintain heart health and lower the risk of obesity.
- Developmental skills. Children with Down syndrome are delayed when mastering motor skills like crawling, standing, walking and safe eating. We can work on this in the clinic, as well as at home and in day care settings, giving parents and caregivers training for how to support these emerging skills in a way that’s safe and efficient.
- Improvement of balance, coordination and control of posture. This often starts quite early, with exercises like using a ball to help improve the child’s ability to hold their head up or maintain a sitting position. Other things like jumping or throwing a ball can be worked into a fun physical therapy regime.
- Improving physical fitness. Promotion of healthy living choices can help reduce some of the common complications that stem from cardiovascular problems and obesity.
- Educating parents and caregivers. Little of what we do will have the maximum impact if we don’t educate parents to carryover these skills and incorporate these exercises in everyday life. It’s a critical part of therapy and the child’s success.
Therapy & Wellness Connection – your connection to a life without limitations – provides physical therapy to children with Down syndrome in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.
Facts about Down Syndrome, U.S. Centers for Disease Control and Prevention
More Blog Entries:
NEW: Functional Fitness Class by Brecksville Occupational Therapist, July 25, 2019, Akron Physical Therapy Blog
Raising a child with Down syndrome is full of so many unique joys and challenges. With loving parents, proper medical care and early intervention therapy (some combination of speech therapy, occupational therapy and physical therapy, starting before age 5) many children with Down syndrome go on to lead healthy, happy and productive lives.
While many parents of a baby or toddler with Down syndrome can see the value of speech therapy and even occupational therapy (skills of independent living). Physical therapy for Down syndrome may seem unnecessary because parents are already expecting delays characteristic of the diagnoses. Most children with Down syndrome DO learn to do all those things, albeit at around 24 months rather than 12 months for typically-developing children.
When physical therapists work with children who have Down syndrome, they aren’t as concerned about those missed milestones as we are that WHEN they walk, run, play, skip and jump, they will be less likely to develop some of the functional and orthopedic issues to which people with Down Syndrome are prone.