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  • Writer's pictureSergio Rodriguez, OTR, MOT

Hypotonia and Autism: What Every Parent Should Know

Updated: Jun 13

Child during physical therapy for low muscle tone

Knowledge is power for motivated parents, especially when it comes to understanding their child's unique needs. One common concern is low muscle tone, also known as hypotonia, which is frequently associated with autism. This connection between hypotonia and autism has been the subject of much research, and understanding it is crucial for parents of children with autism.


In this article, we will explore the relationship between low muscle tone and autism, including the signs and symptoms, potential causes, and treatment options. By understanding the impact of low muscle tone, parents and caregivers can better support children with autism and help them thrive.

Key takeaways

  • Low muscle tone, or hypotonia, is commonly found in individuals with autism

  • Infants with hypotonia may exhibit soft muscles, which impact their motor skills and developmental milestones

  • Children with autism and low muscle tone have difficulty with posture, balance, coordination, oral motor and fine motor skills

  • The exact cause of the relationship between low muscle tone and autism is not fully understood, but it is believed to be related to differences in brain development

  • Early identification and diagnosis of hypotonia in children with autism is crucial for early intervention and management

  • Physical therapy, occupational therapy and speech therapy are common treatment options for low muscle tone in children with autism

Understanding Hypotonia in Infancy

baby fatigued because of hypotonia aka low muscle tone

Have you ever noticed that some infants seem to have poor muscle tone, making them appear "floppy"? This condition is known as hypotonia, and it can significantly impact a child's motor skills and overall development. In infants with hypotonia, their muscles have reduced tension, which can affect their ability to move and reach developmental milestones.


Hypotonia, or low muscle tone, means a child's muscles are softer and less firm than usual. This can make it harder for them to sit up, walk, or hold things. Think of it like a loose rubber band that doesn't snap back quickly. With the right support and therapy, children with hypotonia can improve their muscle strength and coordination.


During tummy time, an infant with hypotonia may appear floppy, struggle to lift their head or push up, and tire quickly. They might need extra support, such as a rolled towel under their chest, and frequent breaks to prevent fatigue. Engaging toys and close interaction can help keep them motivated and improve their muscle strength.


If your child has hypotonia in infancy, it's important to be aware of the signs and seek early diagnosis and intervention, as it could be an early indicator of autism. Floppy muscles, delayed motor development, and difficulties with reaching or grasping objects are some of the signs to watch out for. If you suspect that your child may have hypotonia, it is advisable to consult with a pediatrician or seek a neurodevelopmental evaluation to determine the underlying cause and develop an appropriate diagnosis and treatment plan.

Signs and Symptoms of Low Muscle Tone in Children with Autism (Ages 3-5)


signs and symptoms of low muscle tone in children with autism

Children between 3 and 5 years old may appear with general weakness, with difficulty maintaining good posture and needing more support to sit or stand. Children with autism and low muscle tone often are impacted in the following areas:

  • Delayed Motor Skills:

    • Delays in gross motor skills like jumping, running, or climbing. Fine motor skills such as holding a crayon or using scissors might also be affected.

  • Poor Balance and Coordination:

    • Frequent falls, clumsiness, and difficulty with tasks that require balance and coordination, such as riding a tricycle.

  • Fatigue and Endurance Issues:

    • Tires easily during physical activities, often preferring to sit and rest instead of engaging in active play.

  • Difficulty with Daily Activities:

    • Challenges with dressing, feeding themselves, or participating in age-appropriate games and activities.

  • Speech and Oral Motor Issues:

    • Possible delays in speech and difficulties with chewing or swallowing, which can be linked to low muscle tone in the mouth and face.

  • Posture and Movement:

    • Slouched posture, “W-sitting” (sitting on the floor with knees bent and legs splayed out to the sides), and unusual walking patterns, such as toe-walking.

  • Behavioral Signs:

    • Frustration or avoidance of physical activities, which might be mistaken for behavioral issues but are actually due to the physical difficulty they experience.

Autism and Hypotonia

Have you ever wondered why many individuals with autism also experience low muscle tone? Recent research has shown a strong correlation between hypotonia and autism, suggesting that the two conditions are closely linked. While the exact cause of this relationship is not fully understood, it is believed to be related to differences in brain development. Both hypotonia and autism involve the central nervous system. The neurological differences that cause autism can also affect the presence of hypotonia and motor control.


connection between autism and hypotonia

The brain plays a crucial role in motor control, and disruptions in the neurological pathways can result in both low muscle tone and autism spectrum disorder. Studies have found that individuals with autism often have weaker core strength, which can contribute to hypotonia. Understanding these connections can help parents and healthcare providers better support children who exhibit both conditions, leading to more tailored and effective interventions.


Sensory Processing Difficulties

Children with autism often have sensory processing difficulties, which can increase the effects of hypotonia. For example, children with both hypotonia and autism may be more sensitive to touch, making textures or physical contact uncomfortable and everyday activities like dressing or grooming difficult, while also struggling with coordination due to their brains processing sensory information differently.


kid with low muscle tone hypotonia diagnosis

These sensory challenges can cause frustration and anxiety, leading them to avoid activities that build muscle strength and coordination, making their hypotonia worse; therefore, using sensory integration therapy, occupational therapy, and personalized support strategies is essential for helping them manage these difficulties and improve their motor skills.


Early Identification and Diagnosis of Hypotonia in Children with Autism

Early identification of hypotonia in children with autism is of utmost importance for early intervention and management. The sooner hypotonia is diagnosed, the earlier appropriate therapies and interventions can be initiated to support the child's developmental concerns.


Medical professionals use various assessments and evaluations to diagnose hypotonia in children with autism, including a thorough physical examination, a careful review of medical history, and neurodevelopmental evaluations.


If you suspect that your child may have hypotonia, it is crucial to consult with their pediatrician or seek a developmental specialist. They can conduct a comprehensive assessment and provide a definite diagnosis. Initial assessment and early intervention, such as physical therapy, occupational therapy, and speech therapy can make a significant difference in improving muscle tone, motor skills, and overall development for children with autism and hypotonia.


pediatric occupational therapist for hypotonia and autism

Impact of Low Muscle Tone on Everyday Activities for Children with ASD

Have you ever wondered how low muscle tone can impact everyday activities for individuals with autism? From walking and sitting to writing and self-care tasks, low muscle tone can present challenges in various aspects of daily life. Individuals with low muscle tone may struggle with poor posture and coordination, which can affect their ability to engage in physical activities.


Participating in physical activities is crucial for individuals with autism as it helps improve their motor skills, muscle strength, and overall well-being. However, low muscle tone can make it difficult for them to perform certain movements and tasks. They may require additional support, accommodations, or modified exercises to fully participate and benefit from physical activity.


Understanding the impact of low muscle tone on everyday activities can help you create a supportive environment that takes into account your child's unique needs and challenges.


Home exercises for Low Muscle Tone in Children with Autism


home activities for hypotonia and autism

Activities for Children Aged 1-3 Years

Oral Motor Activities:

  1. Blowing Bubbles: Enhances lip rounding and breath control.

  2. Chewing on Chewy Tubes or Toys: Improves jaw strength and stability.

  3. Blowing Whistles: Helps with breath control and oral muscle strength.

Note: consult with Speech and Occupational Therapist

Fine Motor Activities:

  1. Finger Painting: Enhances finger strength and coordination.

  2. Stacking Blocks: Improves shoulder strength the higher they stack them.

  3. Playing with Playdough: Squeezing and molding strengthen hand muscles.

Note: consult with Occupational Therapists

Core and Posture Activities:

  1. Tummy Time: Promotes core muscle strength and stability.

  2. Rolling a Ball: Encourages trunk rotation and balance.

  3. Crawling Through Tunnels: Builds core strength and coordination.

  4. Squatting Activities: Improves balance and leg strength.

Note: consult with an Occupational and Physical Therapist

Bilateral Upper and Lower Extremities Activities:

  1. Catching, Throwing, and Kicking Balls: Enhances coordination and strength in both arms and legs.

  2. Climbing Stairs: Builds leg strength and bilateral coordination.

  3. Push and Pull Toys: Encourages bilateral arm and leg movements.

  4. Dancing to Music: Promotes coordination and strength in upper and lower extremities.

Note: consult with an Occupational and Physical Therapist


home activities for low tone ages 3-5 with autism

Activities for Children Aged 3-5 Years

Oral Motor Activities:

  1. Blowing Up Balloons: Strengthens the diaphragm and oral muscles.

  2. Using a Variety of Straws (e.g., curly, thick): Improves oral muscle coordination and strength.

  3. Whistle Games: Helps with controlled breathing and oral muscle strength.

  4. Chewing Different Textures: Encourages oral muscle development.

Fine Motor Activities:

  1. Cutting with Scissors: Enhances hand strength and coordination.

  2. Lacing Cards: Improves fine motor precision and bilateral coordination.

  3. Using Tweezers for Small Objects: Builds hand strength and dexterity.

  4. Drawing and Coloring: Develops hand-eye coordination and fine motor control.

Core and Posture Activities:

  1. Obstacle Courses: Promotes balance and core muscle strength.

  2. Yoga for Kids: Enhances core strength, flexibility, and balance.

  3. Balance Beam: Improves posture and core stability.

  4. Ball Activities (e.g., sitting on an exercise ball): Strengthens core muscles.

Bilateral Upper and Lower Extremities Activities:

  1. Wheelbarrow Walking: Builds upper body strength and coordination.

  2. Bike Riding or Tricycle: Enhances leg strength and bilateral coordination.

  3. Swinging: Improves bilateral coordination and core strength.

  4. Hopping Games: Develops leg strength and bilateral coordination.

insurance coverage for sensory integration therapy in san antonio
 

Pediatric Providers at Pediatric Constellations

If you are seeking reliable recommendations, consider Pediatric Constellations. Pediatric Constellations was founded by two pediatric therapists, Rosa Benavidez (Speech Therapy) and Sergio Rodriguez (Occupational Therapy). They have personally worked with and met every therapist listed under Pediatric Constellations to know the latest availability around San Antonio, Texas, making it easier for you to find not just who is available today but who would provide the best care for your family. Use their resources to save time, avoid frustrations, and bypass long waiting lists for services.

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