Physical activity generally refers to exercise and physical fitness as important elements of a healthy lifestyle. Approximately 30 minutes of moderate physical activity is necessary each day for an adult to acquire vital health benefits. Recommendations for children are 60 minutes of moderate physical activity each day (The National Guidelines on Physical Activity for Ireland 2009).
Physical activity can be instrumental in improving sensory integration, coordination, muscle tone, and social skills development for a person with autism (ASD). Disability should not be used as an excuse to opt out of physical activity, when it can only improve ability. This is especially true for individuals with autism who have been found to have little opportunity to be physically active (Pan and Frey 2005). Additional benefits of physical activity for an individual with ASD include reducing stereotypical behaviour, increasing appropriate responses and providing potential social interaction. With increasing numbers of people with ASD, physical activity initiatives are required, not just for children but also for adults, over the lifespan (Todd and Reid 2006).
Participation in physical activity is generally challenging in the modern world, where a sedentary working life provides few opportunities for physical activity. A sedentary level of activity maintains life, but provides no health benefits. Poor motor function, low motivation and poor social interaction make it even more difficult for people with ASD to be physically active, but with support, encouragement, and motivation anyone can improve their level of physical activity and meet the recommended level of physical activity for a healthy life (Department of Health and Children 2009).
A sedentary lifestyle and low fitness levels are commonly reported in studies of people with ASD. However there are only a small number of studies done on physical activity for adults with ASD. Obesity has become a major health concern for people around the world and, in particular, for people with ASD (Curtin et al. 2010). Sustained engagement in physical activity is needed for weight loss and for a healthy lifestyle. Outside help with a qualified coach may provide the start needed for physical activity. Later the coach can be replaced by personal self-motivation or determination to sustain an independent level of physical activity (Todd and Reid 2006). Individuals with ASD may have hypoactive or hyperactive responses to any of the senses, including sounds, touch, taste, and smell. Every individual with ASD is different, yet daily physical activities, including those that are sensory in nature, are important. Exercise plans should be tailored to the needs and wishes of the individual. For example, one individual may need heavier and active routines in the morning and more calming, soothing activities in the afternoon; another may need calming activities throughout the day. Being aware of sensory difficulties that an individual with ASD may have and incorporating individualised sensory activities into daily activities can benefit the individual (National Center of Physical Activity and Disability 2012).
A study by Muller et al. (2008) of individuals with Asperger Syndome and ASD (but not intellectual disability), outlined the benefits gained from physical activities which were used as a strategy to manage social isolation, anxiety and stress experienced by the individuals. Physical activity was found to counter the stereotypical view of ASD as lacking social skill and being aloof. The people with ASD found respite in outdoor physical activities from the social isolation and stress where ‘the outdoors felt like home’. Exercise routines helped reduce social stress and deal with social frustration. People noted that engaging in physical activity with others allowed them to connect socially without the need for too much conversation.
A walking programme is an easy way to start. A study by Todd and Reid (2006) explained how three teenagers with autism and severe disabilities found that walking/jogging promoted their participation in physical activity. A further study by Todd et al. (2010) found that the self-determinant behaviour of cycling was effective in promoting sustained physical activity for adolescents with severe autism.
Physical activity may not appeal to and may sound like a hard task for some individuals with ASD. A small study by Hellier (2011) found that physical activity and relaxation decreased levels of stress and anxiety among individuals with ASD. A 30-year old man with autism and severe challenging behaviour found the use of deep touch pressure was more beneficial than rigorous physical activity (Blairs et al. 2007). The challenging behaviour provided the cardiovascular exercise, while the deep touch pressure provided the flexibility and relaxation elements of physical activity.
Obrusikova and Cavlier (2010) found many barriers to physical activity for children, but they also found ways to overcome the barriers. Individuals may use perceived barriers as an excuse not to engage in physical activities. Within disability, Miller (1995) identified three main barriers: physical, attitudinal, and resource barriers. Chien.Yo Pan (2008) argued that strategies are necessary to plan physical activity for children with ASD in order to meet physical activity guidelines. A strategy, plan and a qualified leader can mean the difference between an effective, enjoyable and safe programme, and a mediocre and possibly even dangerous one. A study of athletes with intellectual disabilities found that they suffered fewer and less severe levels of injuries than the general population of athletes. However, in the study, athletes with autism had the highest rate of sports injury among their peers. This should not discourage such activities, but it does caution on the need for careful monitoring, planning, and support for individuals with autism who partake in athletics activities (Ramirez 2009).
Individuals go through both physical and psychological changes during the course of their lifespan, but early physical activity habits will influence health benefits, regardless of disability and age. Early intervention of physical activity has been shown to be effective in improving the development of children with ASD and the prevention of secondary health conditions (Filipek et al.1999).
Outdoor recreation can provide an opportunity for the entire family to become physically active. Parents and carers may need to take the initiative to establish summer camps to create enjoyable physical activity opportunities for individuals with ASD, or to include them in existing clubs/camps.
A gym or exercise program can be taken up at any time during the year. A regular exercise program needs to address the four components of fitness: cardiovascular, strength, flexibility, and balance. Programs should be simple to start with and progress to more complexity, as desired. Above all, activities should be enjoyable, using the individual’s interests and strengths, always including the four components of fitness (National Center of Physical Activity and Disability 2012).
Cardiovascular exercise (for example, cycling, running or swimming) benefits a person’s heart, lungs and circulatory system. Cardiovascular exercise is important for individuals with ASD, not only for physical fitness, but because studies have indicated that vigorous cardiovascular exercise has beneficial effects on behaviours. Yilmaz et al.(2004) found that cardiovascular, flexibility, balance, and strength exercise levels increased, and that stereotypical behaviours decreased after swimming.
Strength training (e.g. weight training) improves muscular strength and endurance. Core muscles have an effect on other activities, such as balance and coordination. Since individuals with ASD respond best to structured learning, it is important to develop a sequential and consistent strength.training program, incorporating repetition of movements in the same order, with visual cues and exercise diagrams to prepare an individual for changes and to foster their ability to exercise independently.
Flexibility exercise encourages the movement of joints through a full range of motion, for example Yoga and Pilates. Flexibility is an important area for individuals with ASD who often have low muscle tone. (For example, individuals may walk on their toes, resulting in high tone in their calf muscles.) Flexibility exercises may be helpful in stretching the legs and feet.
Balance activities (for example, Tai Chi and Chinese martial arts) develop the ability to stabilise the body. Balance and coordination activities are important for individuals with ASD because they develop the balancing system of the body. Individuals with ASD may have a poor sense of direction and may need visual cues, such as standing on a carpet square or at a mark on the floor. Balance activities, such as using a therapy ball or walking along a line on the floor, can improve balance and coordination.
An exercise program is important for everyone; it can start slowly, but even a little physical activity each day can offer the reward of a more healthy lifestyle…