Universal Fitness Innovation & Transformation
Arthur is a 19 year-old male. He is overweight and has little experience being physically active. He does not appear to be very coordinated when observing his movements and he doesn’t like to be sweaty. Arthur loves pop music and brings his Ipod and headphones everywhere he goes. Arthur is very verbal, however, it can be difficult for Arthur to attend to us and/or talk about things that are not of interest to him. He may want to give up quickly if he is not experiencing success right away.
Autism spectrum disorder (ASD) is a group of developmental disabilities that includes a wide spectrum of symptoms, skills, and disability levels. ASD is diagnosed by assessment of behavior and development, and can be reliably determined by the age of two years. While some with ASD may also have ID, many do not have ID as a component of their ASD.
Persons with ASD often demonstrate these characteristics in mild to severe degrees:
Persons with ASD also have many strengths and abilities:
Exercise is important for everyone! For people with autism, the benefits of regular exercise include:
Given the individual nature of how people experience autism, this section will highlight the importance of the consultation phase. Many staff are nervous about their first meeting and this section will hopefully make them feel a little more comfortable and better prepared to manage this first step.
Communication is a two-way process that involves sharing information between participant and trainer. The effectiveness of this communication leads to trust and shared understanding, resulting in an appropriate and effective intervention.
Everyone, even those with communication challenges, can communicate in some manner, using language, gesture, pictures or signs, or body language. It is up to you to find out the most effective ways to understand and communicate with the participant (you don’t have to do this alone! You can ask others for help!). AND most important, talk to the participant at an age appropriate level; do not talk to everyone as if they were a child.
Use the consultation as an opportunity to get to know the participant. In addition to gathering medical information and fitness/ physical activity experience, you can also focus on goal setting and learning about participant preferences. In addition to discussing the exercises themselves, ask the participant about how they will get to the fitness centre, and the level of support they need to access the locker room, and prepare for exercise.
Support the participant to be as independent as possible. Depending on the person, this may change over time as they become more familiar with the setting and feel more confident and capable. Some participants may choose to include activities of daily living in their goal setting (e.g., becoming independent in their use of the locker – learning how to open/ close lock without assistance).
When talking about programs, ascertain what the participant likes, and give them choices in what they can do. Provide easy read documents if needed, with simplified text, larger font (14 at least), and illustrations to reinforce your instructions. If the participant cannot read, then provide pictures and/or videos to communicate about your program.
When someone with autism comes in for the consultation you may or may not notice the following:
Individual inclusion and participation in society are influenced by personal and environmental factors as well as health concerns and/or impairments. Each participant needs to be viewed as an individual and their fitness programme should be designed accordingly with their input and the input of those who know the individual well (e.g., family or direct support staff).
Participants with ASD often demonstrate self-stimulatory behaviors, hyperactivity and aggression
Vigorous exercise (>20 mins of aerobic activity) has been demonstrated to decrease these behaviors.
Hopefully this will lead to active community participation and greater independence (Azar, McKeen, Carr, Sutherland, & Horton, 2016)
Keep the environment calm and non-distracting
Focus on fun activities that promote motion and coordination.
Adults with autism tend to be less physically active and are more likely to have poor motor control (Pan, 2014; Sahlander, Mattsson, & Bejerot, 2008)
Pay attention to the individual’s body language- do they need a break? Do they look like they might be getting frustrated with trying to do the new movements?
Get to know the participant- this will help you find ways or things that can increase their motivation. For example- do they have a favourite song? You could use it as an incentive to finish a group of exercises. Play it for the 2nd set.
Use pictures where possible- you can create your own exercise cards, or use ones developed by others (e.g., Special Olympics)
Show the participant where they will sign in, leave their bag, get changed, fill up their water bottle, and meet you.
Where possible, try to maintain consitency in terms of where equipment is located- however, if necessary, remind participant this may not always be possible.
As you use the gym space, model approriate social behaviour to show the person how to act and introduce proper etiquette within a health club. For example, it’s ok to say hello to someone who is exercising, but they may not be interested in starting a long conversation. Keep it short, yet friendly.
Every person is like every other person, like some other person, and like no other person.
Every person is like every other person, like some other person, and like no other person.
It’s really important that people who are new to exercise learn how to monitor and describe how they are feeling or their response to exercise. One helpful way to do this is to introduce the Rate of Perceived Exertion (RPE) scale. The smiley face RPE Scale or the OMNI scale (see below for examples of both) may be more suitable for participants with various disabilities than the age-predicted maximal heart rate (220 – age) (Stanish & Aucoin, 2007).
In the beginning, it is also recommended that participants measure their heart rate (using wearable technology such as a heart rate monitor may make this easier!). This information will help the trainer and participant to work together to learn about how the participant perceives their exertion during exercise and may help to inform programming strategies. For example, a trainer may encourage the participant to work towards a specific level of RPE, which can be complemented with information from the HR monitor to measure exercise intensity. Monitoring HR may also be useful in the event that participants are exercising at a level beyond the recommended intensity, which may happen if the participant is very engaged in the activity or trying to make a positive impression on the trainer
Smiley RPE Scale
Although you will not be administering medication, it’s important that you have a brief conversation with the participant to ensure they are aware of any side effects of their medications that may impact their ability to take part in exercise and/or specific safety considerations.
Individuals with autism may or may not be taking regular medications. Similar to the variability you will find across individuals, you will find that different people are taking different medications to manage different symptoms or secondary conditions (e.g., for anxiety, seizures, etc.). It is recommended that you talk about this during the consultation to see if there are any side effects that you should be aware of. You may also want to check in with them on a regular basis to see if there are any changes or any new information that you should know. It is also important to ensure the individual has the go ahead from their health care provider prior to beginning a new exercise program.
The tips and strategies found within the inclusive TIMES section will help you to create an environment that will support your participant’s participation in physical activity as independently as possible. It is important that you involve the participant whenever possible, along the way to ensure the program that you design will meet their needs physically, as well as emotionally and socially. Introducing a few simple strategies such as offering visual images of the participant’s program will help them to be more independent in completing their fitness programme. Ultimately, they will gain confidence and belief in their abilities (increasing self-efficacy) and experience self-determination (sense of control over their own destiny). This is key to establishing healthy habits that will be adopted for the long term.
Copyright © 2020 by UNESCO Chair , Institute of Technology Tralee
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UFIT c/o, UNESCO Chair, Institute of Technology Tralee, Tralee, Co Kerry. Ireland
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