“I run fitness sessions for adults and teens with autism”
“Oh, that’s awesome that you do that for kids with autism.”
“No. Adults and teens.”
This is a conversation I have often and it dawned on me recently that there are two things at play here;
Thing 1: Nearly everyone associated nearly everything to do with autism with children.
Thing 2: Something about the word ‘fitness’ connotates a young population.
So what do I really do? I get individuals with ASD stronger, build their core stability, and improve motor planning skills so they generalize to everyday activities (ADLs). Is this important for children with autism? Of course. For teens and adults? Even more so.
Parents of teens and adults with autism often cite the lack of exercise and fitness programs for the teen and adults with ASD. I know it indirectly from the families who have contacted me for 1-to-1 training sessions; “There are so few services for teens and young adults.” I’m aware. And when it comes to physical activity and exercise there may be no more important stage than the adolescent and teen years to introduce strength training not only as an “extracurricular” but as a life skill.
A Needs-Based Approach to Strength Training for Teens and Adults with Autism
As a result of both neurological and neuromuscular complications inherent to autism, there are patterns of physical dysfunction that are common. Many parents are familiar with the early diagnoses of “low tone in autism” or “low core strength in children with autism.” These deficits can continue, detrimentally, into teen and adult years.
How do these show up in everyday life for teens and adults with autism? With slower, often-inhibited movements, gait pattern issues (shuffling feet or externally rotated feet), postural issues, and motor control during tasks. These strength and motor control deficits can affect independence and quality of life, everything from carrying groceries to climbing stairs to personal hygiene.
Fortunately, there is much to be gained from implementing strength-based programming for teens and young adults with autism. There’s also never a “too late” time to start. In my own Autism Fitness practice ages and abilities range significantly from children as young as 5 to adults into their 60’s. At any age and any level of ability progress in strength and movement is possible.
Also good news is that while effective fitness programming takes into account individual abilities and differences, we don’t have to reinvent a new class of movements. Please run from anyone who claims there are super-specialized exercises for the autism population. Nope.
There are no autism-specific exercises. When developing fitness or adapted PE programs for children, teens, or adults with autism, we need to remember that it is still all human movement. Guidelines for fitness and adapted physical education program design should always focus on the current needs, and which exercises are proven to develop those skills.
Exercise Selection Matters
“I saw you have one of your athletes doing a heavy carry with a sandbag. Why do you have them do that?”
A coach who planned on hosting our Autism Fitness® Certification seminar was asking about this over the phone.
“So they get better at carrying things.”
“That’s it?”
“That’s it.”
Here’s the secret about strength programs for the autism population; there’s no secret. There’s no secret but there needs to be a system.
Exercise selection matters. Coaching matters. Identifying potential issues in a movement matters. These are part of a greater plan to have strength training work to the benefit of our teens with ASD.
The Movements that Matter Most for Teens and Adults with Autism
Strength is often overlooked in fitness and exercise programs for teens and adults with autism. While the perception of effective fitness programming may sometimes include fast-paced cardio or calisthenics, the real difference-maker is strength. Now, we’re not talking about maximal strength “How much can you lift!?” style, but having stability and control in a full range of motion.
We focus on the following major movement patterns for strength;
- Squatting
- Pushing
- Pulling
- Carrying
Squatting
Squatting is a fundamental movement skill that most of us engage in every day, multiple times. Dysfunction in the squat by way of low strength may eventually turn into a low back pain issue. Healthy squatting patterns strengthen the low body and can, in combination with other mobility exercises, enhance gait pattern skills as well.
Squats performed correctly can improve lower body strength, core stability, and motor control for teens and adults with autism.
Pushing
Pushing/Pressing movements develop upper body strength and can aid in shoulder stability and grip (we see a lot of grip dysfunction in our athletes). In Autism Fitness programming overhead pressing is used to strengthen the shoulders, upper back, and incorporate trunk stability.
Pulling
Pulling exercises are equally challenging and beneficial for individuals with autism. Band rows and pull-downs can improve shoulder and upper back strength, grip strength, and arm strength as well.
Carrying
As the dialogue above covered it, carrying heavy objects (safely) makes us better at carrying heavy objects. See also; groceries, laundry, garbage bags. We use two basic carrying movements in our programs; farmers walks (one sandbag or other loaded object per hand) or chest carries (one heavy object held at chest level).
The Methods of the Movements that Matter Most
There are two concepts/practices that are critical for any of these strength exercises to “work” or help develop new skills; progressions and modifications.
Progressing an exercise refers to increasing the level of challenge. With strength movements, we’re typically adding more weight (within reason and according to performance), or more repetitions. Progression is going to be individually-based. We also rely on certain pre-requisites before progressing. In our strength-based exercises, we require the athlete be able to perform 3 sets of 10 repetitions with a particular weight (or bodyweight) before moving on.
We require these standards as proof that the athlete has mastered the skill independently. Independent mastery is the best indicator that the individual has developed the ability of a point where it can generalize beyond the mere confines of the gym (wherever that gym may be).
Regressing an exercise is particularly important when discussing the ASD population. Because we’re often working with some strength and motor deficits, we need to find the point at which the athlete is successful with the exercise. Success has a few possible definitions here so it’s time to mention the PAC Profile®.
In Autism Fitness® programming we use the PAC Profile® method to assess physical, adaptive, and cognitive abilities as they relate to physical activity. Physical refers to the current ability to perform a particular exercise. Adaptive skills are the relative motivation to perform that particular exercise, and cognitive skills refer to how the athlete will best be supported in learning the exercise. A lot more to it than that but it shall do for now.
So when we talk about “physical” success with an exercise, we mean the athlete can perform it safely and effectively. Do they have full range of motion? Are they controlling the movement? When we regress the exercise we are providing a less-challenging variation that will still provide the athlete a way to get stronger and more stable. As they begin to develop the abilities necessary, we can gradually progress the exercise. For squats, we often begin with an elevated platform/box to reduce the range of motion, at least temporarily. With presses and pulls, we’re often providing guidance via a physical prompt or mirroring. Of course, our eventual goal is to have the athlete master the full movement independently.
Teens, particularly those with ASD, need a physical outlet. The introduction of well-designed strength programs can enhance not only physical attributes that may inhibit life skills and opportunities for independence, but adaptive/behavioral health as well. We know these benefits to be true for the neurotypical population, and yet it largely goes neglected for those with autism. Is it the same in terms of implementation? Certainly not. Is it just as, if not more important? Certainly so.
Eric Chessen, M.S., is the Founder of Autism Fitness® An Exercise Physiologist with an extensive ABA background, Eric has spent 20 years “bridging the gap” between the fitness and ASD communities. He is the developer of the PAC Profile® Method and Lead Instructor for the Autism Fitness© Certification. He is a frequent contributor to numerous autism/special needs publications and has presented at TEDx. Eric resides in Charlotte, NC. More information at AutismFitness.com