Let’s Get Kids with Autism Physically Active

Last post, I shared 3 hopefully compelling reasons  why kids with autism, along with the rest of us, need to be physically active. These kids need at least 60 minutes a day of moderate intensity physical activity to ward off obesity, cardiovascular disease, diabetes as well as to decrease stereotypic behaviors, gain focus and attention, and encourage participation in common childhood activities.

Huffington Post Adrian Murray

photo by  Adrian Murray

But for children with autism, the access to these types of activities becomes more difficult and challenging. Why?

Motor skills which are behind their peers:  Children with autism often struggle with obtaining motor skills. Oftentimes, children with autism have low muscle tone  or “hypotonia” which makes it more difficult for them to stabilize their body (for example, hold their body in one place steadily while they throw a ball) or to generate a muscle force (to jump off the ground or propel themselves forward when running or biking). As a result, they often become frustrated and tire quickly. They may avoid  physical activities, retreating to activities that seem to make more sense to their body systems.

The waiting area at my pediatric practice fills almost daily with kids with autism and other neuromotor difficulties who have poor endurance, muscle weakness, postural problems, and motor deficits.  I gently ask about their recent physical activities, such as “Have you played outside in the last couple days?” Sadly, the answer is consistently “no.”

Several of the characteristics of children with autism make participating in group physical activities challenging.

  1. Communication/language impairments may impact their activities and participation including the inability to understand other participant’s facial expressions or body language, their tone of voice or expressions that aren’t meant to be taken literally.

2.  Social challenges such as:

-difficulty imitating others while trying to learn something new such as rules of the game (you run the bases counter-clockwise always)  or a new skill (holding your bat with a specific grip)
– a preference to play alone, controlling the play, or repeating the same activity over and over
– challenges with regulating emotions, with no “gray areas”
– difficulty understanding and participating in social games
– decreased skill to maintain a social interaction (letting the other person finish speaking before you speak, staying on topic, being interested in other’s ideas, following someone else’s rules)
– unusual repetitive behaviors and/or a tendency to engage in a restricted range of activities, with limited play variations and limited toy options
3.  Sensory issues: Many people with autism have unusual responses to sensory input. They have difficulty processing, making sense of or utilizing  basic sensory information or “stimuli,” such as sights, sounds, smells, tastes and/or movement. They may experience seemingly ordinary stimuli as painful, unpleasant or confusing. Being “tagged” may be perceived as uncomfortable, for example. Group cheering for a runner may be too loud.

Think about the seeming simplicity of a common active childhood game such a “tag” or “hop-scotch. ” There is the physical activity involving specific motor skills, such as running to “tag” your friend, or hopping on one foot to progress through the hop-scotch game. Additionally, there are many social nuances: taking turns, waiting for your turn, encouraging your friends (“good try – try again!”) as well as learning to be a good sport. Obtaining these skills is often a difficult challenge for children with autism, and they often quickly learn to avoid these typical physical playground or neighborhood games.

Riding a bike involves strength, postural control, coordination and balance. Many kids with autism have difficulty learning to pedal a 2 wheeler, especially without training wheels. But bike riding is an excellent family activity and can be a life-long physical activity. How do we encourage our kids with autism to learn to ride safely and efficiently so they enjoy it and benefit from it?

Sometimes we are so busy getting our kids to attend therapy sessions to work on their impairments and skills that we miss the naturally occurring opportunities for fun physical activities in our homes, neighborhoods, and communities. Attending a PT session may be important and necessary at different key points in a child’s life, but regular, community-based physical activity is a lifelong opportunity we can give kids with neuromotor impairments to encourage healthy habits, attention, and participation.

But how? Here’s 10 strategies to help……

  1. Don’t underestimate the cumulative impact of physical activities within daily routines: walking to the bus stop, climbing up and down stairs to help put away laundry, helping to rake leaves or shovel walkways, walking rather than driving to get a treat.
  2. Go apple picking in the fall, sledding in the winter, start a garden in the spring, and swim or bike in the summer.
  3.  Limit screen time! A good rule would be 60 minutes of active play time earns a specific, limited amount of screen time each day.
  4.  Problem-solve with the child, his parents, and other team members about the perceived barriers and possible supports and modifications needed for success. Other team members (OT, ST, behavioral specialists) may have a key idea for making a motor activity successful.
  5. Pre-teach the skills needed and the rules of the game, using visual  cues, stories or scripts for consistent support.
  6.  Include other children in your therapy treatment sessions so social skills, waiting, turn taking, and good sportsmanship can be practiced in a supportive setting.
  7. Search for small group, non-competitive activities in the community as an easy entry point. Yoga, movement or dance classes, snowshoeing, geocaching, rock climbing, scavenger hunts or visiting local playgrounds and hiking trails with friends. Consult to these group classes in the beginning, so the instructors understand what modifications might be helpful and ways to help.
  8.  Get the whole family involved! Encourage parents of children to make physical fitness a frequent family activity – and make sure you model it yourself! 😉 We will all benefit.
  9. Use technology as a motivator:  have a challenge using a Fitbit or other step counter. Teach kids how to monitor their heart rate and log their “training time.”
  10. I recently learned from my team OT to use patterns to encourage motor activities. Make  visual symbols for 5+/- different fun exercises, then make a pattern the child has to follow:  5 “egg rolls,” 5 crab walks, 5 basketball shots, 5 chair squats, 5 butterfly legs – repeat the pattern as per the child’s endurance.

What other suggestions and successes can you share from your experiences? Comment below!



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