Exercise: One of the 28 Research Based Strategies...

​Did you know that there are only 27 evidence-based practices (EBPs), otherwise known as ‘things are have a lot of proof behind them that they really work’ in helping people with autism (Wong, 2016)?  As an educator involved in the field of inclusive education and as a parent working to support my own kiddo, I am all about finding what really works.  If you make the mistake of googling how to help people with autism, you will NOT have the time to wade through the millions of ideas and suggestions that will pop up.  Each month, I plan to highlight one of these 27 EBPs for you.  Last month, we delved into the use of visuals and this month we will look at the EBP of using exercise in a therapeutic way. 
            Firstly, why use exercise as an intervention?  Research proves it can help with:
 

• Physical fitness
• Increase desired behaviours
• Decrease inappropriate behaviours
• Social opportunities

 
Honestly, before I studied this in more depth, physical fitness was the only benefit I had considered on my own: the obvious mind/body connection, the endorphins improving mood, taking a stroll for a time out or break to decompress.  It turned out to be so much more!
Desired/appropriate behaviors to target might include:

• academic engagement
• time on task
• correct responses
• task completion

Inappropriate behaviors to target might include:

• aggression (physical and/or verbal)
• self-injury
• self-stimulatory/stereotypic behaviors (which may be further divided into physical/motor stereotypic and visual self-stimulation)
• time off task

Start by identifying a target behavior (increase a behavior you would like to see happen more often/longer or decrease a behavior you would like to see happen less), collect some data/info on how much it is occurring before starting the exercise intervention and then establish a goal to compare if this is successful or not.  It will be easier to tell if its working its evidence based magic that way!
When developing an exercise plan, it is important to ensure that a team has helped create an appropriate plan whether it be taking into consideration physical limitations, OT concerns, health needs in general, the person’s interests/abilities/strengths, access to equipment (home or community center/pool), hygiene considerations, choice, cost, etc.  Once these are considered, it is time to make a plan! Will it be a single activity or series of activities?  How long?  How often?  Develop a routine based on time and location and get started….
Teach the Learner the Routine

• Use Visual Supports (many of the strategies overlap!)

• Model each movement/activity

• Prompt as needed (try least amount needed)

 
Reinforcement (reward, praise, celebration) may be necessary, especially in getting the participant fully involved or even feeling positive about the exercise.  Let’s get real here...I may need a bit of an extra push or reason to get myself moving too!
Aspects of the Routine that may require Reinforcement

• Engagement in the activity itself
• Intensity (getting the cheeks red/increased heart rate for 6-22 minutes is key)
• Completion of the exercise routine 
• Important:  Reduce prompts as quickly as possible and any tangible re-inforcers
• Get learner to check off own chart, checklist, progress chart, etc.

 
 
Please remember this does NOT have to take place solely inside or at a gym environment but outside play/exercise has known benefits as well.  Nature itself can have a positive impact. The more time we spend in a natural setting, the greater ability to focus and concentrate. Even 20 minutes of exercise on a tree-lined street can improve symptoms. Exposure to outdoor activities can help kids (or adults) recover from symptoms like attention fatigue and increase patience and impulse control.
 
This strategy has the research behind it but also the common sense understanding that moving around makes most people feel better.  The endorphins and other health benefits are generally understood, but typically, we do not make it our first ‘go-to’ idea.  Speaking both professionally (seeing this work wonders for kiddos already in my schools) as well as personally (at home with my own child and even me), this is one strategy that can begin to make a difference much sooner than later. Try it out!
Note: If you have more interest in the topic, this fifteen-minute documentary highlights an initiative in Saskatchewan that tried exercise as a strategy with great results (not directly autism related however): Brain Gain – short CBC documentary

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