By Professor Tony Attwood
Teenagers who have autism are known to be less physically active than their peers. They tend to have higher levels of obesity, with lower physical fitness scores regarding cardiovascular endurance, upper body and abdominal muscular strength, and endurance and lower body flexibility. Parents recognise that teenagers with autism tend to participate in fewer types of formal and informal physical activities than their peers, especially team and competitive sports.
There is a range of barriers to participation in both solitary and group physical activity programmes, including: poor coordination and ball skills leading in turn to both low self -esteem and a propensity to be humiliated and teased by more physically able peers; behaviour and emotion management difficulties, inhibiting and limiting participation in group physical activities; and a preference for sedentary, screen-based and intellectual pursuits, with resistance to engaging in an alternative activity. Physical activity supervisors often lack expertise in autism, and provide little guidance to neurotypical peers in how to accommodate the characteristics of their autistic classmates or team members. However, we know how important physical activity is for physical and mental health and clarity of thinking. Physical activity is also often an effective component of Cognitive Behaviour Therapy programs for the reduction of anxiety, depression and anger.
A recent detailed review of the research on the value and effectiveness of physical activity interventions in children and teenagers with an Autism Spectrum Disorder confirmed the value of physical activity as an evidenced-based strategy (Healy et al. 2018). The analysis confirmed a positive effect on manipulative skills, locomotor skills, skill-related fitness, social functioning and muscular strength/endurance and agility.
A variety of interventions were examined including the Young Athletes programme, trampoline training, horse riding, computer-based activity programmes such as Nintendo Wii exergaming, running and jogging, and aquatic exercise programmes. It is interesting that horse riding also facilitated the development of a relationship with the horses which had a positive effect on reducing social withdrawal.
There may need to be careful consideration of which physical activity meets the physical and psychological needs of each teenager. There may be value in an assessment by a physical trainer or physiotherapist/occupational therapist to determine the teenager’s body type, level of physical fitness and profile of motor abilities. A personal trainer can also design a personalised physical fitness programme and facilitate motivation, engagement and a sense of achievement.
Thus, parents and teachers need to include regular physical activity in the school and home life of teenagers who have an ASD, to improve their physique, physical and mental health, cognitive abilities and self-esteem. From my extensive clinical experience, when participating and practicing a specific sport that has become a special interest, the teenager with autism may develop physical abilities that are of Olympic standard.
Healey et al (2018) The effect of physical activity interventions on youth with Autism Spectrum Disorder: A meta-analysis. Autism Research 11 818-833.