Wednesday, 6 November 2013

Kinesiology and Autism Spectrum Disorder


Kinesiology and Autism Spectrum Disorder

I joined the BC Association of Kinesiologists in 2013 to support my practice in providing exercise as therapy for children with special needs.  Although the purpose may have been more practical as a source of insurance for my services when working with clients I have found the response of belonging to an association of professionals very positive, especially when speaking to members of like minded individuals who belong to other professional associations like the  College of Physical Therapists of British Columbia and the College of Occupational Therapists of B.C.

My practice is unique in that I focus on working with children with special needs, in particular, children on the autism spectrum disorder.  It may sound odd, but I am servicing my clients as a personal trainer and focus on the (perhaps not so) unique physical limitations of children on the autism spectrum.

Physically speaking, children with ASD suffer from poor muscle tone and core strength, motor planning deficiencies, balance, coordination, and cardiovascular fitness.  This is in part due to fewer opportunities to play with peers effectively because of social limitations they may experience, but also because of the limited opportunities they may have in participating in the typical group activities (like gym class) because of their unique personalities.

My practice focuses on a few basic principals:  strength, balance, cardiovascular fitness, sport and play rules or etiquette.

For strength I rely on plyometric activities using weighted balls for throwing and catching and hopping/bounding for leg strength.  Hand grip strength is a valid tool to determine overall strength ) and it has been shown that individuals diagnosed ASD have significantly lower handgrip strength than neurotypical children (Kern et al., 2012).  Overall strength greatly affects a person’s ability to perform gross (like 2 foot hopping) and fine (like printing) motor skills .  As wel,l hopping up, down, and over benches and picnic tables provides equipment that one can rarely see in a fitness centre!
Dynamic movement is the goal of the plyometric exercises.

Balance is provided by feedback from both our proprioceptive and vestibular systems.  My goal with my clients is to provide them an opportunity to blossom into ‘Secret Ninja Agents of the Playground’.  I incorporate the use of slackline work, stepping stones, bongo boards, bicycles, scooters, and roadside curbs, and of course “playground follow the leader” to engage and practice these skills.  I often apologise to parents if they suddenly find their child attempting to climb over things that may not be part of the walk they envisioned with their child!

Cardiovascular training is a little tougher….not many people on a fitness program want to run.  What about flying a kite?  This can be very effective for raising the heart rate especially when there is little or no wind!

Hand eye coordination is also a very important concept to teach: it involves the concept of motor planning. Catching and throwing a ball, catching and throwing a ball while standing on a ‘wiggle seat’, hitting a tennis ball on solid ground and on the wiggle seat, juggling, hitting a golf ball, or hitting a baseball.  All of these activities require effective thought processing, planning, and execution.  For some it is a natural progression of active play and movement literacy, for others the lack of these skills can be a source of embarrassment and exclusion.

A dimension of ASD has a social aspect and impacts their ability to participate in group activities.  In turn, the peer acceptance can be a major stumbling block for people with ASD to participate in group or team activities.  Essentially these two concepts act as a negative feedback system for the individual.  It is paramount to try and teach individuals with ASD the social skills around play and sports in order to join their peers on the playground as an equal.

The most exciting thing I am learning about exercise in relation to my practice is the body’s response to increasing the production of brain derived neurotrophic factor (BDNF).  BDNF acts as an agent for neuron protection and defense, neurogenesis, synaptic growth, particularly in the hippocampus--the region of the brain associated with learning.  There has recently been a tremendous amount of investigation into the effect of exercise and neuroplasticity (think motor planning abilities), as well how exercise can affect conditions of anxiety and depression (both highly comorbid with ASD).

At the end of the day all of us practitioners can state that exercise is good for everybody, but as we learn more about special populations we can state with even more confidence that exercise is not just good for everybody...it is essential.



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