Barriers and Benefits: Helping Teens with Autism increase their Physical Activity

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is characterized by difficulty with reciprocal social interactions and by a pattern of restricted or repetitive behaviors, interests, or activities.

While adolescents in general are leading increasingly sedentary lifestyles, teens with ASD are at an even greater risk for decreased physical activity and weight gain. In fact, adolescents with ASD were found to be 62% less likely to engage in weekly physical exercise and 81% less likely to have participated in organized sports within the previous year, when compared to their peers without this diagnosis (McCoy & Morgan, 2020). Multiple barriers exist that make participation in sports a daunting task for adolescents with ASD. The social and physical demands of participating in an organized sport can often be intimidating for these youngsters.   Stepping outside of their comfort zone to try a new activity can also be a challenge. With thoughtful accommodations and creative solutions, however, these barriers can be overcome. Participation in sports will not only lead to a healthier lifestyle, but can also help teens with ASD improve their social skills and become more flexible in thinking and behavior.

Part #1: Overcoming Social Barriers

Children with ASD struggle with communication and social interactions, such as making friends, reading social cues, and understanding unspoken rules.  Some teens with ASD are reluctant to join an organized sport because the social demands of such participation may seem daunting. While the social demands are real, there are many ways to support teens and make their participation in sports less intimidating and exhausting. 

Kids with ASD can thrive in team sport environments when provided with extra support from intentional and well-trained coaches. One study found that with the support of their coach, six ice hockey players with ASD were able to increase their social interaction, engage with their teammates in team settings, and improve their social skills during practice (Amatriain‐Fernández et al., 2021). This shows that intervention and support during physical activity can make the experience more enjoyable and may reduce barriers, such as difficulty socializing. 

If team sports are not a good fit for a child, they can still experience the benefits of exercise through individual sports or training programs. One study found that an athletic-based therapy program that included both aerobic and weight training completed in a group setting, increased the kids’ physical fitness, exposure to social interactions, and overall well-being (Jimeno, 2019). In our practice, we have observed children and teens with ASD thrive in a variety of individual sports, such as swimming, tennis, boxing, or fencing.

Thus, while it can be an initial obstacle to involvement, the social aspects of sports do not need to deter youth with ASD from joining in. Participating in team sports with social support from a qualified adult, or getting involved in an individual sport, can be great options to help teens with ASD engage in physical activity and practice their social skills.

Part #2: Overcoming the Reluctance to Try New Things or to Step Outside their Comfort Zone

In addition to experiencing difficulty with social interactions, individuals with ASD are prone to engaging in restricted and repetitive behavior, interests, and activities, which makes it difficult to step outside of their comfort zone and try new things. One study found that teens with ASD felt more comfortable doing sedentary activities, such as playing video games and watching TV.  In addition, these kids often have motor and coordination challenges and may feel intimidated by the physical requirements of sports. For these reasons, they often avoid organized sports or exercise and struggle to start later in life (McCoy & Morgan, 2020). At the same time, researchers have found that adolescents with ASD have positive beliefs about physical activity, enjoy it when they participate in a positive setting, and would like to participate more than they currently do (Stanish et al., 2015). Thus, teens with ASD want to increase their physical activity, but need extra support to overcome the anxiety of stepping outside of their comfort zone.

Incorporating exercise into the daily schedule decreases the stress associated with participating in an unfamiliar activity. Therapeutic schools, such as the Higashi School in Randolph, MA, have proven the success of this approach. They found that 20 minutes of jogging in the mornings reduced challenging behaviors, helped with emotional regulation, and increased classroom engagement in children and teens with ASD (Woodman et al., n.d.). In addition, the school uses engaging and creative forms of exercise including pogo sticking, unicycling, jump roping, swimming, and jogging to increase accessibility (Home – Boston Higashi School, n.d.). Their great success proves that it is possible to make exercise comfortable and enjoyable for teens with ASD who prefer consistent and familiar routines.

Tips for Parents: Much like their children, parents of teens with ASD may feel overwhelmed by the seemingly daunting task of trying to get their child to increase physical activity.  Researchers found that support for parents is an important factor in helping teens with ASD increase participation in sports and exercise. (Sarol et al., 2022). 

Here are five tips for how parents can support their child through this process:

1- Compassion and positivity: Starting a new sport or exercise program can be scary for kids with ASD and the inevitable hard days can be a challenge for both parent and child. Parents can build up their child’s confidence during these times by telling them to focus on their individual progress and reflect on how their skills and fitness have improved rather than how it compares to the other kids. This is their journey. One hard day does not mean they can’t do it or aren’t progressing.

2- Celebrating Accomplishments: A major predictor of sport engagement comes from intrinsic motivation, or the child’s desire to participate for their own enjoyment. Parents can help by celebrating that a child participated in a competition or match with a treat like ice cream, regardless of the outcome. Celebrating effort instead of a result is a great way to make them feel good and keep them excited!

3- Create small goals: When expectations are set so high that a child is unable to meet them, they can experience hopelessness, self-blame, fatigue, and even guilt. Research shows that “feasible, flexible, and pleasurable programs” have the best chance for success. Parents can start by going on short walks with the child, finding a low-stakes intramural sports team in the town, or even asking the child to play with or walk the family pet. As the kids’ confidence grows, so can their goals!

4- Join in: Research shows that modeling is an important learning tool for children. In fact, one study found that more active mothers have children, especially daughters, who live less sedentary lifestyles. Parents can go on walks or hikes with their child, do child-focused yoga videos at home, or engage together in active chores, such as yard work. This a great practice for improving parents’ mental health as well!

5- Find support for yourself: Seeing a child struggling is stressful, and parents may just want to get to the “other side” of the barrier, where the benefits are. This is completely normal and other parents feel this too. Finding support through parent groups, mental health professionals, and friends can help parents navigate this journey. You are learning and deserve compassion as you find what works best for you and your child!

Conclusion: Children with ASD struggle with social interactions and trying new activities that lay outside of their comfort zone. Because of these difficulties, they are less likely to participate in organized sports or in an exercise program. Research shows that advance planning and creating additional support from parents, teachers, and coaches can help teens overcome the barriers to sports participation. In turn, regular participation in sports and physical activity can help increase peer interactions, encourage teens to try new things, and to help them become more flexible in their routines. Once the barriers are overcome, the numerous mental and physical health benefits of sports and exercise will open the door to a healthier lifestyle for teens with ASD.

References

Amatriain‐Fernández, S., Ezquerro García‐Noblejas, M., & Budde, H. (2021). Effects of chronic exercise on the inhibitory control of children and adolescents: A systematic review and meta‐analysis. Scandinavian Journal of Medicine & Science in Sports31(6), 1196–1208. https://doi.org/10.1111/sms.13934

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

Arnell, S., Jerlinder, K., & Lundqvist, L.-O. (2020). Parents’ perceptions and concerns about physical activity participation among adolescents with autism spectrum disorder. Autism24(8), 2243–2255. https://doi.org/10.1177/1362361320942092

Artal, M., Sherman, C., & DiNubile, N. A. (1998). Exercise Against Depression. The Physician and Sportsmedicine26(10), 55–70. https://doi.org/10.3810/psm.1998.10.1171

Beiers, K., Derby, K. M., & McLaughlin, T. F. (2016). Increasing Social Interactions Using Prompts and Rewards for … Educational Research Quarterly39.3, 17.

Home—Boston Higashi School. (n.d.). Retrieved December 1, 2022, from https://www.bostonhigashi.org/home

Jimeno, M. (2019). Improving the quality of life of children and adolescents with autism spectrum disorders through athletic-based therapy programs. The Educational and Developmental Psychologist36(2), 68–74. https://doi.org/10.1017/edp.2019.7

McCoy, S. M., & Morgan, K. (2020). Obesity, physical activity, and sedentary behaviors in adolescents with autism spectrum disorder compared with typically developing peers. Autism24(2), 387–399. https://doi.org/10.1177/1362361319861579

Pahkala, K., Heinonen, O. J., Lagström, H., Hakala, P., Sillanmäki, L., & Simell, O. (2006). Leisure-time physical activity of 13-year-old adolescents. Scandinavian Journal of Medicine and Science in Sports0(0), 061120070736019-??? https://doi.org/10.1111/j.1600-0838.2006.00581.x

Sarol, H., Gürkan, R. K., & Gürbüz, B. (2022). The road to championship: An example of an individual with autism spectrum disorder. Baltic Journal of Health and Physical Activity14(3), Article2. https://doi.org/10.29359/BJHPA.14.3.02

Stanish, H., Curtin, C., Must, A., Phillips, S., Maslin, M., & Bandini, L. (2015). Enjoyment, Barriers, and Beliefs About Physical Activity in Adolescents With and Without Autism Spectrum Disorder. Adapted Physical Activity Quarterly,32(4), 302–317. https://doi.org/10.1123/APAQ.2015-0038

Woodman, A. C., Evans, M., Golden, R., Mori, Y., & Maina, J. (n.d.). The Impact of Vigorous Exercise on Behavior Problems and Academic Engagement among Adolescents with Autism Spectrum Disorder. 1.

Acknowledgments 

This blog post was prepared with the help of Andie Stallman, a graduate student at Tufts University’s Eliot-Pearson Department of Child Study and Human Development who is concentrating in Clinical and Developmental Health and Psychology. A former collegiate athlete on the Tufts University Field Hockey team, Andie is passionate about finding ways to make sports and exercise more accessible, so that everyone can enjoy the numerous benefits of physical activity. Andie is particularly interested in developmental psychopathology, sibling relationships, and experiences of trauma. She plans to pursue a Ph.D. in clinical psychology to help children and families develop skills that will enable them to confidently navigate life’s hardships and achieve their individual goals.