Parenting Special Needs Magazine - March/April 2017
Eric Chessen 2017-03-17 12:32:09
CLICK HERE TO LISTEN TO AUDIO VERSION OF THE ARTICLE. the folly of fitness focus a user’s guide Alright, so this being the health issue should make my contribution easy, right? Then there’s the specificity of why fitness is important for health, or what health actually means, or what fitness actually means. When we hear or read “fitness” and “heath” we may have an idea, maybe an image, perhaps some stock photo of neon-clad folks running and a basket of red peppers. But what is fitness with respect to health and how do we apply it to daily life, particularly for the autism and special needs population? Enter the efficiency and digestibility of lists! Go. The Hierarchy of Fitness Needs Fitness is our ability to perform a physical activity safely effectively, with energy left over to spare. Among the autism population the most common deficits I address are those of strength, stability and motor planning, so it would follow (logic and whatnot) that these should be the primary focus for physical fitness programs? Want to incorporate yoga (whatever that means because there are many variations and implementation)? G’head. They love swimming? Add it in. But optimizing strength and stability for general ability, meaning life skills, is going to come from performing strength-based activities. Most of my athletes, at least initially, have difficulty with low body and upper body strength, and stability during movement. So that’s what we work on. A lot. Anything else would be spending 8 hours making sure those little doilies on the turkey legs are straight but ignoring the fact that you have a 22lb chunk of poultry to cook. Doilies are dandy but they’re not making that bird any more edible. My athletes perform squats, overhead presses, band pulls and pulling variations, and weighted carries because these are the activities that will make them strong. And since we focus on strength first, this becomes the focal point of programming. Rule 1: Strength Exercises Above All Others Stability comes second, and is enhanced through strength activities. Stability is out ability to hold a position with postural integrity, meaning no shaky movement. I observe a lot of gait pattern issues with the ASD population. Difficulty walking and some interesting shifts or leans to get from point A to point B. Greater trunk stability (midline of the body) can help to erase some of these movement issues and provide the basis for doing more challenging activities. There is a tendency to try and create balance with environmental instability, those balance beams and wobble boards, thinking that this will build a more “stable core.” It’s one of those concepts that seems correct and has been proven otherwise but just won’t go away because it seems so right. If our athletes have difficulty performing Task A (walking without physical compensation) training them at Task Y (Balancing in a wobble board) is not going to develop the response we want. It invites more compensation. I don’t care if the wobble board has space ships and aliens on it, even though that’s pretty cool. So where does this stability come from? “Maybe there’s some in this truck!” (Simpson’s reference: https://www.youtube.com/watch?v=liiVX55tJ7E ) First we need rooting. Rooting, simplified, is the feet staying in position on the floor when they need to stay in position on the floor. My go-to’s for developing baseline stability are hurdle steps and medicine ball throws. Have your athlete stand in a colored circle or on two spot markers. Take a 2lb. Dynamax medicine ball and have them perform a push throw from the chest. They should be able to do several throws without the feet coming up or moving forward, but this is not often the case. Rather than giving the athlete more instability, we want them to develop rooting ability in place first. The medicine ball throws provide a dynamic activity for the upper body, while the trunk and lower body are stabilizing. For hurdle steps, the athlete must root each foot as he/she steps over the hurdle. This too creates a situation where the trunk has to stabilize during a dynamic movement. We can change the level of challenge with lower or higher hurdle steps depending on the ability level of the athlete. A lower hurdle step provides the athlete with more opportunity to succeed with the exercise by avoiding further compensation of the movement (hips turning way in/ out). Lately I’ve been incorporating a lot of fitness rope swings in programming. The athlete has to root the feet while swinging the rope vigorously for repetitions or time (we usually get upwards of 100 swings or about a minute of activity). In addition for this being an outstanding opportunity to elicit verbal counting, there is a good amount of trunk stabilization that needs to occur for the individual to stay put in one spot. Rather than challenge balance directly, we gain it through rooting and progressive enhancement of trunk stability. Rule 2: Stability Exercises to Improve Balance and Coordination Motor planning includes the generalization of movement skills, memory, and task focus. Motor planning can have great carryover the Activities of Daily Living (ADLs), and demonstrate some short-term recall skills as well (see also; primed for learning). Motor planning requires baseline skills being challenged in different ways. My go-to motor planning activities include cone touches, crawl patters (bear walks), and carrying stuff from one place to another (yes, this is the biomechanically technical terminology). Motor planning is holiday headquarters for play skills. Once our athlete has an exercise down (they can perform it without a prompt or guided intervention), we can chain it together with another exercise. When one of my athletes mastered cone touches in a zig-zag pattern, and can also carry a light Dynamax ball or Sandbell (4-6lbs), we can combine the two activities. The combo exercise becomes touching each cone with the Sandbell, adding a weighted component to the exercise. The key to motor planning is adding movement to movement. Got push throws mastered? Add touching a cone on the right and one on the left between throws. Bear crawls look great? Include a backwards movement or touch different colored spot markers on the floor. Chaining together these activities gives our athletes a new stimulus with movements that are already familiar. Rule 3: Mastered + Mastered = Motor Planning Often when you tell someone you’re a fitness/strength coach, they’ll tell you “Oh, I go to the gym.” Lovely, but what do you do there? Does it coincide with you needs in addition to being something that you enjoy doing? The same litmus test should exist for our individuals with autism and special needs. Do their physical fitness and adapted PE programs account for strength, stability, and motor planning? Are the skills generalizing to ADLs? Ask the right questions and it can lead to some helpful answers. Helpful, of course, when you use them. Eric Chessen, M.S., is the Founder of Autism Fitness. An exercise physiologist with an extensive ABA background, Eric consults with families, educators, and fitness professionals around the world. Eric works with his athletes in the NY metro area and is the author of several E-books. Visit AutismFitness.com for more information.
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