“Wow, how did you get him/her to do that?,” parents often ask me. Whether their seven-year-old son just performed a jump for the first time or their seventeen-year-old daughter triumphed over a Dynamax ball squat, Sandbell slam, and bear walk combo, one of the highlights of my profession is demonstrating capabilities. And it isn’t quite a “me getting them to do it” situation so much as setting up an environment for success. Because fitness and physical activity should be fun, accessible, effective, and not overwhelming. There are some concepts and activities that have worked enormously well for my athletes with autism over the last decade, and I am happy to share.
Fitness is one of those words that conjures up a variety of different images. Sure, fitness is certainly a “good” thing, but what makes up a “good” fitness program? Is it found at most commercial gyms lined with “low impact” cardio machines? (Super hint: No.) Does it require expensive equipment that takes up room you don’t have to spare? (Super hint revisited: No.). One of my biggest fears for the young autism population is that the most problematic trends in the fitness industry, including focus on machine-based, cardio-intensive, and sport-specific activities will become the basis for most programs. We can do far, far better. Let’s discuss how with six steps to creating fitness programs just about anywhere, but particularly in the home.
- Make it about movement. Fitness programs should focus on strength and stability first. To perform any type of physical activity safely and efficiently, there has to be a foundation of strength. Pushing, pulling, hinging (the “picking stuff up” movement), squatting, and locomotion (getting from point A to point B). These are the movement patterns that we perform on a regular basis and those that need the most emphasis in programming for any ability level.
Developing strength and stability in these basic movement patterns generalizes to other life skills. I’ve been told on numerous occasions that my athletes are sitting up straighter, walking better and playing longer on the playground. We spent no time working on “chair posture” or walking up and down flights of stairs. Instead, the strength that developed through our regular fitness activities crossed over into different areas of ability.
- You can’t force fun. Tug-of-war is a nifty physical activity, but does not serve well as an instructional strategy. You cannot tell an individual that he/she is “having a good time” when they are clearly not. So how do we make fitness really, actually fun? By incorporating the super secret STAL strategy, or “Stuff They Already Like.”
In Applied Behavior Analysis (ABA) terms, Stuff They Already Like is referred to as a “secondary reinforcer.” A secondary reinforcer is an object or activity that is known to be preferred and enjoyed by the individual. I will readily admit that many of my athletes do not hop right into jumping (or any structured fitness activity) in the first few sessions. Breaks combined with STAL strategy helps to pair the non-preferred activity (exercise) with something fun (like the famous cartoon movie video on YouTube that is watched 459 times a day, preferred music, or some free play time). The STAL strategy also tends to lower anxiety. Rather than announcing that for the “next forty five minutes straight it is strength and movement time!” we can introduce physical activity in shorter, more tolerable intervals, which leads to the next item…
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- Incorporate short exercise sessions. Particularly at home, the short-but-steady approach to introducing fitness programs just works. By starting with 2-5 minutes of activity, we have the advantage of single-serving activities that focus on a particular movement (squatting, hinging, pushing, pulling, locomotion). Shorter periods of activity are proactive in avoiding anxiety and aversion to new activities and instruction.
In a living room or den, some space can be made for a few hops, animal-style crawls, or squats to a medicine ball. We could use this popular sequence:
Squat to Dynamax ball 5x à 5 hops to spot markers on floor à Bear walk back to the ball
This takes about two minutes, about ten feet of space lengthwise, and can be repeated throughout the day, afternoon, or evening. It can also be progressed or regressed as needed.
- Progress and regress for success. Quite possibly the best aspect of movement-based as opposed to sports-based physical activity is that the former can be easily progressed and regressed based on the ability level of the individual or group participating. Progressing an activity is when we make it more challenging by adding more weight, more repetitions, or an addition movement.
Progressions should only be incorporated once the individual has mastered the activity independently, meaning he/she can perform it without an additional prompt (physical guidance or modeling/demonstration). Once Carly can perform 10 overhead presses with a 4lb. Sandbell 10 times, we have some options for progression, including using a 6lb. Sandbell, or adding a push throw after each press.
While progressions are important, regressions are often more important both for building the physical ability and confidence of the individual. We regress an activity when it is too difficult for the athlete to perform independently. This may be due to either the physical difficulty or low motivation to perform the exercise.
From a physical perspective, we can use less weight, teach a simpler version of the movement, and incorporate physical prompting, guiding the athlete through the exercise. Some of my athletes find a hand-over-hand prompt helpful for learning overhead presses, or holding onto my hands or another secure object while squatting.
From a motivational/adaptive perspective, an activity that is too long or complicated can be aversive. A simplified or physically prompted regression of the exercise can bring success quicker and provide opportunity for behavior-specific praise.
- BSP, I’m down with thee! Behavior-specific praise refers to acknowledging exactly what the individual did correctly (even if it wasn’t the whole movement). If Mark is doing hurdle step-overs with arms up and drops his arms halfway through, I can still commend him with “Good picking knees up on those hurdle steps!” I want to focus on everything he’s doing correctly and plan appropriately for tweaking the rest.
Did you know that pointing out what an individual is doing wrong actually causes them to focus more on it? The “No, don’t do it that way,” or “You can do it better…” is the motivational equivalent to nails on a chalkboard. It doesn’t help. It never helps. I know it’s tempting, but we want our athletes to actually enjoy the fitness experience. It should be considered play time. Play time should suck as little as possible.
- Objectives over objects, but pick the right objects. “Someone donated these weight machines so these are what we’re using for our adaptive PE program” an instructor once told me. By that logic, I suppose if someone had donated fish scales and expired milk that would be on the cafeteria menu the next day. Along with appropriate activities and exercises, there is equipment. My go-to choices can be used with just about any ability level, and are both space- and cost-effective, especially in consideration of more “mainstream” equipment. They include:
- Dynamax balls for squatting on, a wide array of throws, overhead walks, and carries.
- Hyperwear Sandbells for throws, presses, slams, carries, and additional weight in the squat
- Short hurdles (6″ and 12”) for steps, jumps, hops, and as obstacles
- Spot markers (many shapes, colors, and varieties available) for visual start/finish points, jumps, steps, and use with throwing games
- Colored cones for visual start/finish points, jumps, steps, bending/tapping, and for obstacle courses
- Fitness ropes for double and single arm swings, alternating swings, jumping swings, and support while squatting
If we agree that fitness is an essential life skill and that the current issue of inactivity among the young autism population needs to be addressed, home-based exercise programs can be a foundation for a healthier, more independently capable generation. Though it can seem overwhelming in the beginning, the numerous benefits of regular and progressive physical activity cannot be underestimated. Try the strategies out and build a program that supports small successes. They will lead to big ones.
This article was featured in Issue 27 – Embracing a New Year