Surprisingly, it’s a topic rarely discussed by doctors or the early intervention team. While many parents assume their child is getting physical activity through occupational or physical therapy, the reality is that these therapies are not tailored to meet the daily physical activity needs of children and adults with autism. Statistics from the U.S. Centers for Disease Control reveal that nearly a third of children with autism are severely obese, underlining the urgent need for a holistic approach to physical activity.
Compounding their children’s lack of physical activity is the lack of awareness among parents about the mandate for physical education (PE) services according to IDEA Law in the United States. Exercise interventions are not frequently discussed or included in Individualized Education Plans (IEPs). This lack of emphasis on exercise as part of comprehensive support for individuals with ASD can result in missed opportunities for promoting physical health, social interaction, and overall well-being. Even with all the dedicated and tireless research that has shown exercise has a positive impact beyond the health-related benefits, it’s a shock (no, it’s actually sad and frustrating) that exercise is not getting the attention it deserves by more schools.
There is a lack of understanding of how to effectively deliver exercise for those with autism in communities worldwide but that is changing. Successfully engaging a person with autism in any new activity – especially exercise – is achievable. To do so, it will take patience, creativity, and the use of evidence-based teaching practices (EBPs).
Exercise & Movement is one of 28 defined evidence-based practices (EBPs) that support those with autism. In addition to the health-related benefits, Exercise & Movement has been shown to produce positive outcomes in academics, communication, school readiness, behavior, motor and cognitive development.
However, parents and professionals cannot just put their children, clients or students in a physical activity program or environment and immediately expect those results. They need to apply a combination of the remaining 27 EBPs to start making the exercise connection. For example, visual supports, social narratives, video-modeling, and reinforcement are commonly used EBPs in a special education classroom, therapeutic environment and home. These familiar practices promote success for those with autism and should be applied in exercise settings as well. Parents know what strategies have been used to motivate their children, so start by applying those in an exercise program to get your child engaged!
It’s vital that parents have the right perspective when embarking on an exercise program with their autistic children. By way of illustration, let me share a personal anecdote.
I had just completed a successful exercise session with a 10-year old autistic boy. He was engaged the entire session and was making progress in his exercises and his time on-task. When the session ended I walked him to his mother who was waiting in the foyer. Excited to share the news, I noticed a bit of concern on the mother’s face. She then said to me, “What did I just pay for?”
Taken aback, I replied with genuine curiosity, “What do you mean?”
With a hint of frustration, mom elaborated, “He’s not sweating.”
At that moment, I came to understand the urgency of narrowing the gap between mainstream notions of exercise and the subtle – but critical – requirements of autistic individuals success with exercise.
What we have seen on reality fitness shows like “The Biggest Loser” with individuals dripping in sweat does not signify a successful workout, let alone for most people. This approach will likely lead to pulling children further away from exercise.
When you embark on this mission, your goal should be to get your child through the first session in an enjoyable way. If you get them through the first session and willing to try again, you’ve won! When starting, you (and your child) need to be like a tortoise, not the hare.
The American College of Sports Medicine and the World Health Organization recommend that every person do at least 60 minutes of moderate to vigorous-intensity physical activity every day. Resistance and strength training exercises should be done at least 3 times a week.
For families and individuals with motor challenges, sensory differences or busy lives, this can be a huge undertaking. Below are some tips and strategies to getting started and working towards your exercise goals:
Start with 10 minutes a day
Although the recommendations from ACSM are optimal goals, I want parents to know that the most important thing is to get started. Don’t let the recommendations deter you from exercising at all. In fact, a 2017 study from Rutgers University showed that just 10 minutes of low to moderate-intensity exercise each day was able to make a significant difference in the lives of autistic individuals.3 Whether you have never exercised before, or have exercised intermittently throughout your life, 10 minutes a day is an achievable and realistic place to start, with the eventual goal of adding more time.
Start with low-intensity exercises
Much research states that adequate exercise requires high-intensity exercises, including high-intensity cardio. However, for many autistic individuals, these high-intensity exercises should not be the initial focus as they require underlying lying skills such as core stability, balance, and motor planning to efficiently complete. Low-intensity exercises are a great place to start to slowly build a routine of engaging exercises, to build confidence, and to improve core muscles.
Use evidence-based Strategies in your exercise program
Rarely are evidence-based practices used in the physical education environment. Work with your child’s school, sports team and personal trainers to help them implement an exercise program with visual supports, structured routines, sensory considerations, individualized goal-setting, positive reinforcement, adapted equipment, and progress monitoring. By incorporating these approaches, instructors can create a supportive and inclusive environment that caters to the unique needs and abilities of autistic individuals.
Provide Structure and Routine
We know that autistic individuals typically thrive on structure and routine. It is important to have the same application and methodology in exercise. Choose the same day and time every week to schedule exercise. Provide the same exercises each week in the same order and then slowly build on that foundation.
Consider a gym membership and/or a personal trainer
Autistic individuals often benefit from one-on-one instruction. This type of instruction is especially effective for motivation and using a customized exercise routine. Participating in exercise in a gym setting also allows for increased community engagement and the opportunity to improve social skills. Seek out qualified professionals within your community to assist in developing a healthy relationship with physical activity.
“A study from Rutgers University showed that just 10 minutes of low to moderate-intensity exercise each day was able to make a significant difference in the lives of autistic individuals.”
Low-intensity exercises are an excellent place to start because they require limited or no equipment and provide significant benefits. These are also excellent exercises for parents to participate in with their children.
What to do
– Have your child lie on their backs with their knees bent, feet flat and neck relaxed.
– Have your child lift their butt or tummy up so the knee, hip and shoulder are in a straight line.
– Control the movement on the way down and repeat.
– Parents or coaches can stand by their feet and show the visual support card.
How much, how often
– Perform 2–4 sets of 6–12 repetitions each. (Focus on proper form)
Coaching Tips
– Try to not let the butt hit the ground, so as to help reduce the risk of injury while also challenging the muscles.
– If your child begins doing this exercise fast, that’s okay: They’re moving! In future workouts coach them and demonstrate how to make it a more controlled movement
What to do
– Have your child start on their hands and knees then lift their butt in the air.
– Place the visual support card on the ground in their line of vision.
How much, how often
– Have your child do 1–4 sets of 10–20 seconds each.
Coaching Tips
– If your child’s hands are not pointed straight ahead, don’t adjust in the first attempt. Just have them try to complete the duration.
– Make sure your child is breathing through the exercise and not holding their breath.
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What to do
– Show your child the visual support card.
– Model how to get onto the foam roller.
– Be prepared to spot your child, staying close beside them.
– Make sure your child’s head is always in a neutral position on the “log.”
How much, how often
– Begin with 30–60 seconds. If your child wants to stay on longer, that’s okay as long as they are in a safe postural position.
Coaching Tips
– Palms should face up.
– If the hands are not on the ground, that is okay. Don’t force them down, as this means that the muscles of the neck and shoulder girdle are tight. This will improve over time.
– As your child becomes independent and confident in this position, you can add various arm movements to work on muscle tension reduction and motor planning.
– Practice, practice, practice.
Our motto at Exercise Connection, a company passionate about building autism-inclusive exercise solutions, our motto is “Persistence, not perfection”. Even basic exercises can be complex for autistic individuals, so it is essential to recognize that perfection isn’t the immediate goal. I acknowledge the importance of biomechanics and correct body positioning, but initially, the priority should be to simply to engage in 10 minutes of physical activity every day. As the relationship between the child and their support system, whether it’s a parent, OT, or trainer, strengthens and trust develops, there will be opportunities to refine body movements and strive for perfection. Most importantly, provide your child with an exercise program that is as accommodating and enjoyable as possible, so they can continue a life-long routine of regular physical activity.
References
Toscano, C. V. A., Ferreira, J. P., Quinaud, R. T., Silva, K. M. N., Carvalho, H. M., & Gaspar, J. M. (2022). Exercise improves the social and behavioral skills of children and adolescent with autism spectrum disorders. Frontiers in psychiatry, 13, 1027799.
Rafie, F., Ghasemi, A., Zamani Jam, A., & Jalali, S. (2017). Effect of exercise intervention on the perceptual-motor skills in adolescents with autism. The Journal of sports medicine and physical fitness, 57(1-2), 53–59.
Schmitz Olin, S., McFadden, B. A., Golem, D. L., Pellegrino, J. K., Walker, A. J., Sanders, D. J., & Arent, S. M. (2017). The Effects of Exercise Dose on Stereotypical Behavior in Children with Autism. Medicine and science in sports and exercise, 49(5), 983–990.
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