Thursday, December 7, 2017

TRAINING THE AUTISM POPULATION


If I wanted to be a jerk about it, I could claim the title of “America’s Most Hardcore Trainer.” Sure, the powerlifting, linebacker, MMA clientele is a tough demographic, but my athletes can, on occasion, bite and scratch. Fortunately, I’m slightly less a jerk than that, but I do work exclusively with the autism population, developing fitness and active play programs that focus on strength, stability, and motor planning. In the last two years my inbox has been rife with questions from trainers and coaches who want to know just how exactly to work with clients on the autism spectrum.
I had a light bulb moment after attending an FMS seminar in Boston about five years ago. Looking over the list of assessment exercises, it seemed that I needed an assessment in order to perform the assessment. There are a several variables that make themselves apparent when training those with autism. There is a high incidence of strength and motor deficits within Autism Spectrum Disorder (ASD). This does not necessarily correlate with other functional abilities (more on this next section). Both the disorder and the high rate of inactivity among young people with ASD contribute to poor physical functioning.

I) RECOGNIZING ADAPTIVE AND COGNITIVE COMPONENTS

To strengthen, we must introduce strength exercises. There are two additional components that must be addressed for this to happen. Adaptive functioning refers to the level of motivation an individual has to perform a given activity. If physical activity is aversive, it will be difficult to provide instruction and enough performance for enhancement. When adaptive functioning is higher, the individual is more likely to engage in the target activity (squats, med ball throws, crawls, whatever), thus allowing more opportunity for teaching and mastery.
Cognitive functioning refers to learning styles. Is the athlete more of a visual or kinesthetic learner? If I demo this overhead squat for him will he be able to imitate it, or do I need to get more hands-on with my cuing?
Cognitive functioning will also dictate how many instructions you provide and how the instruction is conveyed. Many of my athletes have difficulty following multi-step directions, for example: “Do a push throw, then bear walk to the green cones, then do five jumps” may be too much info to process in one cerebral gulp.
Fortunately we have options.
We can give directions for the second activity once the first is complete and directions for the third activity once the second is completed. We can also use visual aids (pictures or symbols for the exercise) as cues. Interestingly, when one of my athletes masters (can independently perform) an activity, it makes adding a second movement much easier. When one of my athletes demonstrates proficiency in squatting to a medicine ball, I may add an overhead press or a jump. The enhanced motor planning is only possible if the foundational (single-step) exercises are first mastered.
Assessing and developing programs for the autism/special needs population requires

II)  CUING AND LEARNING STYLES

Good verbal cuing is akin to writing a haiku, succinct and conveying everything it needs to and nothing it doesn’t. I try to keep all verbal cues to four words or less, often an exercise in restraint;
Squat to the ball”
“Do an overhead throw”
“Do an overhead walk”
“Twenty big rope swings
Minimal verbal cuing helps to keep athletes on-task and develops contingencies between the word and the action (jump means the action of jumping, scoop throw means the action of doing a scoop throw).
Individual learning styles will be a mix of visual and kinesthetic cuing. My 11-year-old athlete Warren needs minimal hands-on prompting to perform most activities, while 19-year-old Fidele requires prompting through the full range of motion. Physical prompting (hands-on), needs to be faded (diminished) over time to ensure the athlete can perform the movement independently.

III) VIABILITY OF VARIETY

Young populations thrive on variety in physical education, though there needs to be a balance between novelty and consistency. Between the existing physical abilities/deficits, adaptive and cognitive variables, and number of sessions per week, there is a limit to the amount of exercises and activities that can be implemented. I have about a dozen go-to exercises with progressions and regressions for each. I may regress a bear walk to a quadruped crawl or a med ball push throw to simply handing the ball back and forth.
Programming around quality rather than quantity ensures more efficient performance. If I attempt to teach my athlete eight new exercises in the first two months, it is doubtful he/she will master them. Teaching and mastering four movements means I can then take those and progress them, either by adding resistance to the exercise itself or adding one movement to another (multi-step).

INDEPENDENTLY MASTERED BODYWEIGHT SQUAT + INDEPENDENTLY MASTERED JUMP = SQUAT AND THEN JUMP UP

IV)  GOAL SETTING

Goals can focus on any or all three abilities (Physical, Adaptive, Cognitive). In order to develop physical skills further, adaptive functioning is required. To improve cognitive functioning (as it relates to physical activity), each activity should be mastered. Again, once that squat looks good, we can add a press, throw, jump, etc.
Adaptive functioning is invaluable here. The more motivated the athlete, the more time we have to provide training. In my practice the two primary goals are; Improve basic physical skills and 2) Find ways to make physical activity reinforcing/fun for the athlete.
Yes it is nuanced. Sure, it is complex. Occasionally overtly ridiculous? Check. However the autism population continues to grow, and doubtless you know, are related to, train, or live down the block from someone with autism. As a training population, it is time they receive more of our attention. If that is not enough motivation, a center recently opened boasting that their ASD-focused programs will feature machines and an upper-lower split along with cardio equipment. Cardio. Equipment. 
 Eric Chessen, M.S., is the Founder of Autism Fitness. An exercise physiologist with an extensive academic and clinical background in Applied Behavior Analysis (ABA), Eric has been developing and implementing fitness and active play programs for over a decade. In addition to working with his athletes, Eric consults with parents, educators, fitness professionals, and therapists worldwide in addition to providing live Autism Fitness workshops and speaking engagements. He is the creator of the PAC Profile Assessment and author of several E-Books which can be found at AutismFitness.com He is an avid weightlifting enthusiast and the co-founder of StrongerthanU.com

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