During one point in our relationship, one of my first and most influential fitness/training/life mentors had me read a copy of Cha-no-Yu, a guide to the Japanese Tea Ceremony. At the time I wasn’t certain whether I was to gain a specific insight via metaphor or he just really dug a well-prepared cup of Sencha. I recall us discussing how preparation for the ceremony, each stage, down to the last leaf being swept into the right pile in the correct location, was essential for the result; a steaming pot of perfectly brewed tea.
There may be no single extractable lesson in it but what we apply to different situations. There is the meditation on details, the importance of order, journey-not-destination concept. What I value most, at least right now, is the setting of the right environment, something that is essential for Autism Fitness programming.
Environment includes the space itself, the choice of equipment, the teaching or coaching style, and the preparedness to lightly boil a cup of Dynamax ball overhead throws. I think. Environment must be conducive to the success of the individual, whatever that may mean for the individual.
Some of my athletes need an environment in which standing on a pair of spot markers and attending to three seconds of instruction provides a wave of high praise and access to secondary reinforcement for long periods of time (Oh the amount of Disney musical numbers I’ve endured). Others need an environment in which I am quietly and with limited input guiding them through their own creative play. Hey, you want to set up the cones in a specific order? Do it. Jumps before squats? Have at it.
We set an environment for success, planning each stage, and being ready to go to plan D, E, or T based on what we are given that day. The contingency between planning for a good fitness session and the desired outcome cannot be overlooked. Maybe that was what Coach D planned for me to discover. Or maybe he was just texting “chalk up.”
A week days ago I received an email from the mother of a new athlete I am working with. Two days prior I had sent over video of the assessment session I took him through. She relayed his comment in her email; “Is that what I look like to other people?” I’m not quite certain what he saw, or what exactly his perception was. I idled around that sentence. I’m a Zen Master of deleting emails, but this one stays in a folder.
“Is that what I look like to other people?”
To me, he looks like bouncing potential. Potential is an unusually complicated term. I watch him and see movement with energy and enthusiasm. I see crawls and jumps and overhead walks that, given some strengthening, will provide abundant physical benefits. I see a proper course of action and a lot of play work to be done. He moves a lot better than most of my athletes when we first start. The deficits in strength and motor planning are often significant. This one, he’s motivated, he’ll progress quickly. He wants to play strong.
What does he think he looks like to other people?
I’m not certain. That’s the thing about this population, being a spectrum and all, but there’s much more to it. We refer to them as “splinter” skills. Not “savant” skills, but certain abilities or thoughts that, with respect to available evidence of cognitive and emotional functioning, you just wouldn’t think would be there. Not in the “I’m so sorry I underestimated you” dramatic fashion, but the eyebrow-raising “Huh, didn’t know that was there” style. Splinter, a small thing that doesn’t appear to fit with the rest.
But not fitting with the rest is a particular issue for those children, adolescents, and teens we might refer to as “mid-range.” They’re often aware of their diagnosis, or at least that they are different in a different way than most “different” kids are different. They, as do most young humans, fiercely desire to be accepted by peers. They want to please at least a few adults, not necessarily their parents, but perhaps one or two older, cooler people. But how?
I am a biased, biased man. I am beholden to the idea that through fitness programs that strengthen and enhance the body, that nurture determination, independence, and social skills, we can build a few rungs on the ladder to a better life for the mid-rangers. Adolescence pretty much sucks. Difficulty socializing does too. Chucking a medicine ball back and forth is not just an excellent way to enhance strength and power in the vertical plane, but a conduit for both socialization and the slow, steady dissipation of angst. Prioritizing fitness doesn’t mean turning things upside down. It means setting things right side up.
So here in this video we have Mr. W performing an exercise chain of squat-to-presses with a 4lb. Sandbell to a Dynamax med ball, followed by three low hurdle jumps.
To get to this point in skill development, Mr. W had to master the following:
- Bodyweight squats to the ball
- Overhead press with the 4lb. Sandbell
- Forward jumps without hurdles
- At least 1 jump over hurdle
The above are all physical abilities. From an adaptive perspective, he needed to be sufficiently motivated to perform these activities. Cognitively, an association or contingency needed to be established between the verbal direction, or name of the exercise, and the performance of that exercise. When I say “W, do seven squats,” he has to understand the word “squat” in order to follow the direction.
From the perspective someone who wants to improve movement qualities (strength, stability, motor planning, and strength endurance), there are a few items in this video that need to be cleaned up.
You see how Mr. W’s head begins to tilt forward? We need to work on that. It is important to hold a neutral spine when squatting.
You see that third jump he does? Feet come apart. His ability to generate power and stabilization during the movement is lacking. Since he can perform the first two jumps well, our next goal is to get that third one more efficient.
Of course, Mr. W will know absolutely none of this. A different coach might tell an athlete what they’re doing incorrectly, and say “no, not that way,” or “You can do that better!” And that coach could also do us a favor and walk off a cliff so nobody is inconvenienced. ”You can do better” is not an intervention for a physical skill set that needs proper development.
To progress from where he’s at in this video may require some visual cuing. I might have W look at a cone I’m holding while he squats to get his head in proper alignment. To master those 3-in-a-row jumps, I may push that hurdle farther back to provide a few extra steps and recovery. Perhaps for now the third jump can be to a pair of spot markers without the hurdle.
We can progress movement patterns through adding weight, adding additional movement, adding repetitions, and adding time. For any of these progression options, the pattern should be as stable and safe as possible.
A friend and fellow fitness professional recently shared this article on his Facebook page: http://thefederalist.com/2014/01/17/the-death-of-expertise/
In addition to citing the autism/vaccine issue (which is only an issue in that the connection myth continues to persist and, as a result, a host of previously near-eradicated illnesses are rising), author Tom Nichols addresses the blurred distinction between expert and lay opinions, along with the idea that a person’s belief is equivalent to expert opinion.
Among fitness professionals, particularly those of us who are skilled (our athletes progress, do not sustain injury under our guidance, and in most cases, are motivated to continue leading an active lifestyle), it is common to be confronted with the dreaded; ” Oh yeah, I strength train. I do Extreme Turbo DVD Volume 1.”
Sometimes it is used as a way to connect socially, other times we are told how challenging the workout is and how it “totally burns your core” with a look of anticipated approval. And we stand there and, as many of us have learned to do, say “I’m glad that’s working for you” and attempt to change the subject. Granted most competent fitness professionals have spent far more hours learning through experience and application than academically, because criteria for professional status (certifications and degrees), let alone expert status, in the industry fluctuates greatly depending on the circumstances. The byline for a fitness celebrity will often read “expert” when marketing is the individual’s true area of enhanced ability.
Please keep in mind that those of us (trainers, coaches, exercise physiologists, etc.) who are worthwhile learned both theory and application of a science (in some cases, including my own , multiple disciplines). Accepting this, maybe, just maybe, we know something more than what the 14 Minute Xtreme Abs DVD offers. Perhaps merely walking into a gym and letting the placement of the machines or the “How To” posters on the wall guide a training session is not ideal. It is entirely possible we’ve cultivated some knowledge concerning what programming, based both on personal goals and our assessment of movement/strength/stability, would suit an individual.
I have been asked whether I do “yoga” or “Zumba” or “Insert sport here” with my athletes on the autism spectrum. Recently I was told about an inclusive running program and it was suggested that I partner with them. My answer of “I’m not a proponent of distance running” most certainly landed me in the asshole box. But lookit; I know what I’m doing.
The highest compliment I’ve received is that my approach “makes sense.” It isn’t the hyperbolic “Amazing,” “Incredible,” or “Awesome.” It is the recognition that my athletes needs are being met and rather than espouse the bullet-point benefits of fitness (self-esteem, socialization, independence), there is clear indication that the athletes are doing something well that they were not able to do before.
Usually the yoga or Zumba question arises from the belief that there is some deeper connection (merely typing “mind-body” makes me want to throw a rock at a glass window) through these oft-trademarked programs than, say, stepping over some low hurdles before doing frog hops and overhead medicine ball throws.
Dr. Kwame Brown, Jeremy Frisch , David Kittner, Dave Gleason, and David Jack are on my list of the best trainers specializing in youth fitness. I’m certain they receive questions/accusations concerning “X program” or “Sport-specific training” at least once a fortnight. It is fine, even recommended, that parents ask about programming, goals, and philosophy. You should. But keep in mind that expert trainers do not hold that distinction because they memorized a protocol in a book or DVD. They’re not waiting for the next “it” product to land so that next week’s program can be written. They balance exercise and play science in their own approach.
We’re all guilty of bias. As professionals we can fall victim to the “Curse of Expertise,” or forgetting what it is like not to know a lot about something. Lay people forget that a lot of learning and practice goes into true professional expertise, and that the “next big thing” is usually a rehash or watered-down piece of something far less exciting/effective. Based on our history, credentials (academic or otherwise), references, and successes, trust that we know what we’re doing. Because we do.
Developing group activities for young people, or any people, with autism presents the challenge of having a significant variance in physical, adaptive, and cognitive abilities. This is why sports or competitive activities, even when they are labeled or marketed as “adaptive/adapted” (I’ve been redressed for using either term), don’t work too well. It is damn near impossible to take a competitive activity with specific skill sets and progress/regress it for everyone in the group without wasting chunks of time.
Selecting activities that allow for in vivo adaptation allows each participant to actually participate. Rather than leaving those behind who cannot conceptualize the activity (too many steps or too abstract), inclusive programming leaves room for variability in performance.
At our (Autism Fitness and the National Autism Association) second annual “Fitness in Central Park” event, a big group of individuals showed up. Watch the video below featuring kangaroo hops. While the entire group starts off at the same place, you can appreciate the range of abilities including physical performance, modeling (following/imitating a visual guide), and task-adherence (performing the entire activity from beginning to end).
This was not a structured teaching situation where the skills would be developed to any meaningful point, but an opportunity to engage in some (probably) new movements and activities while getting outside. The goals were simply to explore and enjoy.
I am bringing Autism Fitness programming to the Family Center for Autism in Garden City, NY. Both 1-to-1 and small group classes will be offered that really and actually develop physical skills in a supportive, reinforcing environment.
A few weeks ago I partnered up with the NY Metro chapter of the National Autism Association for our 2nd Autism Fitness in the Park event. On paper it reads great. Outdoor environment, free to attend, all ages and ability levels, fitness activities. Allow me to let you in on a couple of oh-so-important matters and considerations that existed:
1) To just get it out of the way, I had to park on Manhattan’s Upper East Side
2) Many families signed up, but it is indeterminate how many would actually show up
3) With about two exceptions (both surprises), I had never met or worked with any of the kids/teens who participated
4) Because of that, I was completely unsure of the 3 crucial variables with regard to programming: Physical, Adaptive, and Cognitive abilities
Why it Was Successful:
1) Scalability: Each activity, from our warm-up animal movements to the individual stations could be progressed (made more challenging) or regressed to the skill set of every participant
2) Movement-based activities rather than sport- or practice-specific. If you have a magic wand you can get a random group of young people with autism to play kickball, soccer, or do yoga. You can automatically account for that fact that most of them will have poor motor control, some strength deficits, and often a bit of difficulty understanding the abstract concept of game play. I don’t have a magic wand, so I use activities that introduce and enhance basic strength, stability, and coordination.
3) Exercise Stations. Stations take a specific activity or exercise and focus on it. Athlete stay at that station for a minute or three getting to practice the movement before going to the next activity. At each station we can progress/regress the movement immediately for each participant. It also eliminates long waiting periods and allows for…
4) Breaks. Take a break whenever you need/want to. Those who want to continue playing can without any interruption.
6) Letting the Wheels Fall Off. It was a free, open event that lasted 90 minutes. At some point, and I was surprised how far we got, it was going to disintegrate. The kids would get tired or interest begin to wane. Completely cool. Autism Fitness rule # 1 is “You can’t force fun.” I was happy enough having each participant actually participate. Taking multiple turns at each station was all bonus.
Controlled chaos means allowing some latitude within the structure. It is an important step toward autonomy and integral to having fun.
As the culmination of 33 2/3rd years of having a right foot that is externally rotated, five years on and off with Brazilian Jiu Jitsu, and roughly 15 years of mostly intelligent training with little direct coaching, I am currently restricted from overhead pressing, which sucks. Being told “no” sucks if you don’t know what to do with it. But as they may say with a sliver of ennui in some Frenchly colonized isle somewhere; “The word no, eet ees ze window to other possibilities.”
Via the expert prescription of my movement analyst/interventionist, I am regressing and redeveloping proper technique and function. Meanwhile, the three monkey tattoos on my person let out a collective grumble on the lack of chin-ups and climbing. Bah Humbug (which used to be the equivalent of M-Fer). But restriction can be freeing, and not in the Orwell 1984 double-speak sense.
My strength programming must coincide with the unavailability of overhead movements. While I cannot perform snatch variations, presses, or overhead squats, I’ve noticed improvements in both my squat cleans and power cleans. Not only from focusing on proper technique, but from doing them more. Same with deadlifts, same with front squats, same with weighted pushups.
This concept is not revolutionary or revelatory. One of my greatest influences, Dan John (whom I’ve spoken with on the phone TWICE), has written plenty regarding the joys and benefits of minimalist/simplified/monk-inspired training. It invites focus and progress. It nudges one towards discipline.
Progress is another aspect worth discussing. My athletes on the autism spectrum perform a few variations of the same exercises over and over because the whole idea is to independently master the movement. That does not happen without a pile of practice. Two weeks ago the father of an athlete asked about including some sport-specific activities because 1) They were doing a basketball unit in school and 2) It had “been a year” since I started working with him.
Do not confuse time passage with progress. Progress occurs with motivation, proper practice, and an environment conducive to success. Simply because a year, or five, or thirty have gone by does not guarantee that a technique is mastered. We evaluate, adjust, improve, and continue. I could write “2,006 Fitness Activities for the Autism Population,” but the truth is that on a regular basis I use a couple variations of maybe eight exercises, because those are foundational movements and they will take a while to develop.
Doing a lot with little consistency creates the illusion of progress. Balance between well-thought goals with enough variety for movement and fun’s sake leads to more immediate and long term improvement.
This morning during our session at the park, my athlete “Jay” and I began with the following cone touch activity:
1) Athlete stands on foot-shaped spot markers
2) Athlete touches red, blue, or green cone (placed about two feet in front of him) upon instructor’s cue
I dig this activity as a warm-up because it provides some information about today’s receptive language skills (cognitive functioning), how well he performs the action of bending his knees and touching the cone (physical functioning), and how long he will perform the activity before wandering off (adaptive functioning)
After about a dozen cone touches, we switched roles. I stood on the red feet awaiting his direction. After having me touch the cones in sequential order (red, then green, then blue), he began calling them out very quickly, his attention quickly dropping off and him veering off in another direction. That’s the autism for ya.
Jay does not have much of an idea about what it’s like for me to perform the cone activity, but his instruction provides some insight about what it is like for him to initiate and interact. It gives me opportunities to understand how he operates from a cognitive perspective and develop cues and teaching strategies that work better for him.
Empathy is inherent to good coaching.
What is it like to be you doing this?
I’ve read articles/ posts that use the term “empathy” but relate the idea that since someone has autism or any related developmental disorder that they should be left to “just be themselves” and “not be forced to learn our rules,” which is the equivalent of saying “Let’s not even try,” and/or “This person does not deserve to have an enriched, more productive life because there are some obstacles in teaching them some basic skills.” Screw that. There is the potential for skill development if we have the conceptual info and concrete practice.
No, Jay won’t win blue ribbon cone game caller anytime soon, but he did have fun, the opportunity to tell me what to do for a few seconds, and I get to be a better coach for him.
In addition to physical fitness, good nutrition is a highly important part of optimal development and leading a productive, healthy life. Families of individuals with autism come into contact with an array of dietary interventions that can boggle the mind in terms of food selections, macro and micro nutrients, ways to prepare food, and magical diets that will eliminate all need for other forms of therapeutic intervention.*
*See also; Complete crap.
To provide some expert sanity, I recently met with Richard Kahn, PhD, RD (the RD is Registered Dietitian). Richard takes a family-centered and behavioral approach to nutrition, pointing out that much of our consumption of and relationship with food has a psychological component. Richard was kind enough to provide a guest post for my blog. He can be reached through his site, RichardKahnNutrition.com
Eric asked me to summarize my 15 years of nutrition practice with atypically developing children. Here is the short answer: Relationships matter! Whatever the dietary needs, parent-child, parent-parent and sib relationships usually play a part. Children may have special dietary needs but the needs are met in the context of the family. When the family is awry over food, the child will find a way to make as little change as possible. When the family adjusts, the child can begin to adjust.
Kids on the spectrum may often drive parents to exhaustive attempts of trying this and that food, diet or supplements. Meanwhile, all kids look for understanding. When parents calm down and begin to think, there is hope. That narrow, perserverative diet, likely, has a relational component. Mealtime stressors include parental pressure, TV, iPads, and an understandable lack of patience after years of frustration. Disagreeing over feeding strategies at the table is not an appetizer.
Good nutrition does matter. Diets high in carbs and dairy are low in zinc. Zinc deficiency can lead to altered taste perception, Dysguesia. And, if a child is zinc deficient, there’s a good chance of iron deficiency. Iron deficiency is associated with poor attention. Iron and zinc adequacy combine to improve immunity. A comprehensive mineral supplement may be in order
Eliminating certain foods, diagnosed allergies or special supplements may be necessary. Meanwhile, kids on the spectrum, like all children, still need parents who know how to provide, love, care, and discipline along with that extra measure of understanding the neuroatypical require. Good enough parenting around food helps all kids eat better. It is the brave parent that looks to their own parenting in relation to the challenges the child presents. Kids can’t help it. Parents can.
- Richard Kahn, PhD., RD