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.

Team Spirit: Benefits of Organized Sports in Adolescence

Adolescence is a tumultuous time. Children have to adjust to their changing bodies, develop a unique, individual identity separate from their parents, and learn about the complexities of life and the world around them. Physical activity is proven to have many mental health benefits for teenagers, including a positive impact on well-being, resilience, and emotional functioning (Hale et al., 2021). A major avenue through which adolescents engage in physical activity is organized sports. Besides the obvious positive effects on physical health, organized sports can provide teens with a sense of peer belonging, help them develop a positive self-concept, and teach discipline. Thus, organized sports can help children master developmental tasks of adolescence and put them on a path towards becoming successful adults.

Peer Belonging: During adolescence, kids must step out from the confines of their immediate family and develop their sense of self within a group of peers. A sense of belonging within a group of friends or teammates helps inspire feelings of competence and provides community and support from peers who are going through similar experiences. Extracurriculars are the common ground on which teenagers can bond. They provide access to diverse groups of people from different racial backgrounds, ages, and even school systems. 

Among the long list of extracurriculars, team sports provide the most robust array of mental health and social benefits (Oberle et al., 2019). While improving physical fitness and strength, teenagers in sports have opportunities to take on leadership roles and responsibilities that stretch their expanding physical, emotional, and intellectual abilities. Team sports provide opportunities to practice social and communication skills as teens work towards a common goal (Oberle et al., 2019). These opportunities foster bonding and a sense of peer belonging which explains why team sports have greater mental health benefits than individually oriented sports and extracurriculars (Oberle et al., 2019). Researchers found that consistent participation in extracurricular activities decreased adolescents’ proportion of risk-taking friends and predicted having a higher proportion of peers who value academic achievement and have strong educational goals (Oberle et al., 2019).

Positive Self-Concept: Adolescence is a time of intense change during which children work through questions about independence, identity, and their place in the world. Their changing bodies can induce intense insecurity and hyperfocus on comparing themselves and how they look to those around them. Sports help teens reorient how they think about their bodies. Instead of focusing on what they see as different, weird, or embarrassing, they are encouraged to focus on their strengths and ability to contribute positively to a team goal. Feelings of competence also come from seeing themselves acquire new physical skills through practice and hard work. Getting leadership opportunities through sports also gives teens a sense of responsibility, accountability, and purpose. These opportunities are crucial for the development of positive identity and confidence as well as navigating questions of individual identity and independence (Hale et al., 2021; Oberle et al., 2019; Bruner et al., 2017).

During adolescence, kids practice skills that they will need for the rest of their adult lives. Sports in middle school and high school are rich with important character-building experiences. Organized sports provide opportunities to develop resilience and self-reflection, as well as improve time management and organizational skills while working on a team. These are all skills they will need to be successful in college, the workplace, and when facing general life stressors. 

Moral Development: Sports provide structure and positive role models, through coaches and peers, that teach them how to be a better person, teammate, and competitor (Agans et al., 2018). Researchers found that peers who put the team and their teammates before personal ambition promoted honesty, selflessness, and diligence in others (Gough, 2013). It is important that coaches promote these qualities in their athletes and that teens have the opportunity to interact with teammates who encourage them to adopt these qualities. Morality is a key aspect of character development and applies to many facets of life. Sports present athletes with many chances to establish values which guide their behavior, such as deciding whether to cheat in order to win or work hard and possibly lose with integrity. These are important character-building opportunities for teens. Repeated exposure to these experiences, coupled with guidance from coaches, can solidify their moral code (Gough, 2013). As is the case with physical skills, repeated practice making morally good decisions will become second nature and carry over into adulthood. Consistency and focus are key to creating these “moral habits” (Gough, 2013). Such discipline becomes ingrained in athletes and is a crucial skill to have when deciding between what is right and what is easy.

Resilience: Team sports also provide opportunities for children to face challenges and failure in a safe environment. Working through challenges and the emotions that accompany them, encourages resilience and perseverance that will help teens take on life’s uncertainties and “bounce back from adversity” (Luthans, 2002 in Michael, 2021). Approaching success and failure as a team promotes collective, team resilience which helps adolescents work through difficult emotions with the support of their peers, coaches, and trusted adults (Michael, 2021). The individual resilience that they gain from this experience can be applied both on and off the field (Michael, 2021). This skill also comes from the self-reflection and self-awareness that is ingrained in athletes during practice (Gough, 2013). They must acknowledge where they can improve and systematically work towards getting better. Instead of giving up and allowing failure to define them, athletes must move past the temporary set back and see how they can adapt and overcome in order to succeed next time. This increases feelings of agency, competency, and perseverance in the face of adversity.

Time Management & Life Skills: It is no secret that adolescents are juggling a lot. From friendships to school-work to college applications, being a middle schooler or high schooler is a stressful time. Sports have been proven to help teens develop life skills, such as goal setting, time management, problem solving, and decision making which can make balancing these responsibilities less overwhelming. In fact, students who participate in sports report that they gain these skills at a greater level and speed compared to their peers who are not involved in sports (Cronin & Allen, 2018). These skills will help teens successfully manage their increasing responsibilities in college and beyond.

Conclusion: During adolescence, children go through intense physical, emotional, and cognitive changes, which makes this a stressful and vulnerable time. Participating in sports can help buffer the stresses of adolescence by helping teens develop a sense of competence and by exposing them to a group of positive role models that can support them through this transitional period. Team sports foster resilience in the face of failure, self-discipline, and a strong sense of morality. These and other benefits that come from participating in organized sports can help create the foundation for a successful life of independence and achievement.

References

Agans, J. P., Su, S., & Ettekal, A. V. (2018). Peer motivational climate and character development: Testing a practitioner‐developed youth sport model. Journal of Adolescence62(1), 108–115. https://doi.org/10.1016/j.adolescence.2017.11.008

Bruner, M. W., Balish, S. M., Forrest, C., Brown, S., Webber, K., Gray, E., McGuckin, M., Keats, M. R., Rehman, L., & Shields, C. A. (2017). Ties That Bond: Youth Sport as a Vehicle for Social Identity and Positive Youth Development. Research Quarterly for Exercise and Sport88(2), 209–214. https://doi.org/10.1080/02701367.2017.1296100

Cronin, L. D., & Allen, J. (2018). Examining the relationships among the coaching climate, life skills development and well-being in sport. International Journal of Sports Science & Coaching13(6), 815–827. https://doi.org/10.1177/1747954118787949

Gough, R. W. (2013). A Practical Strategy for Emphasizing Character Development in Sport and Physical Education. Journal of Physical Education, Recreation & Dance69(2), 18–20. https://doi.org/10.1080/07303084.1998.10605063

Hale, G. E., Colquhoun, L., Lancastle, D., Lewis, N., & Tyson, P. J. (2021). Review: Physical activity interventions for the mental health and well‐being of adolescents – a systematic review. Child and Adolescent Mental Health26(4), 357–368. https://doi.org/10.1111/camh.12485

Michael, M. A. (2021). Developing Collective Resilience in Teens Through Team Sports. 8.

Oberle, E., Ji, X. R., Guhn, M., Schonert-Reichl, K. A., & Gadermann, A. M. (2019). Benefits of Extracurricular Participation in Early Adolescence: Associations with Peer Belonging and Mental Health. Journal of Youth and Adolescence48(11), 2255–2270. https://doi.org/10.1007/s10964-019-01110-2

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.

How to Talk to Kids about War

Many of us have been affected by the current events in Ukraine.  As adults, we not only have to process these events ourselves but simultaneously figure out how to talk about it with the children in our lives.  Children who have been directly affected by war will need psychological support far beyond the scope of this article.  We wanted to focus on how to talk to children who have been exposed to war second-hand, for example via news, social media, family or peer connections. 

In this situation, the first thing to remember is that kids are resilient.  Most children who are exposed to war second-hand will be able to process this information without significant negative emotional impact.  Having said that, when talking to children about a topic as difficult as war, adults should consider the child’s individual characteristics.  In this article, we will examine how children understand the concept of war and discuss what to consider when talking to children about this difficult topic.

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Children and Screens During COVID-19

Even before the onset of the COVID-19 pandemic, children’s screen use was a point of concern for many caregivers and professionals alike. Children have watched T.V for decades now, and with the introduction of computers and laptops, followed by smartphones, tablets, and e-readers, children are being introduced to screens at younger and younger ages and relying on screens in their daily lives more and more. Parents and professionals have been asking questions for years about how much time children should spend on screens. In addition, they have been concerned about the content and its influence on children, amongst other concerns.

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The COVID-19 Pandemic: What Has Been Difficult for Children and How They Are Adapting to Change

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It has been over a year now since the beginning of the COVID-19 pandemic. While the world continues to adapt to the changes brought on by COVID-19, it is important to acknowledge the ways in which children have been affected specifically.

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Children’s 3 Basic Psychological Needs and the COVID-19 Pandemic

Child Playing Wooden Blocks

The COVID-19 pandemic has affected the ways in which children around the world are learning, playing, and interacting.

Understandably, parents have felt worried and uncertain about their children’s physical safety, social isolation, and academic progress in school. 

Aside from physical and academic needs, children have basic psychological needs that are essential to their well-being.

When these needs are met, children can continue to grow and thrive, even during times of change and disruption.

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Twice-Exceptional Children: Meeting Their Educational Needs

In recent weeks, the only constant has seemed to be that there is no normal. Every day we are inundated with reports and numbers and projections that do little to quell the collective anxiety we are feeling. Parents, in particular, are struggling to balance suddenly having to homeschool their children in addition to keeping up with whatever demands their work requires. It can be hard to see past the immediate uncertainty and fear, but once we do, we find that much can be learned from this situation about our children, how they learn, and how to educate them most effectively. Remote learning opens up new possibilities for individualizing education.  Individualizing education, in turn, allows us to encourage curiosity, internal motivation and learning beyond studying for tests. One population in particular that can benefit from this kind of individualized approach to learning are twice-exceptional children.

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Twice-Exceptional Children: Why Making Friends Is Hard and How to Support Them

“I want to know: how do I compare in the world of 12-year-olds? How many people in the world are there with a personality like me? Where do I fit in?”

All children need connections in order to thrive. Learning to establish and maintain friendships is a crucial part of every child’s development. Sharing, turn-taking, trusting, communicating, and compromising are some of the vital skills children practice while interacting with peers. Although for some children acquiring these skills comes naturally and making friends is easy, others struggle to find and keep friends. Twice-exceptional children—because of both components of their exceptionality—often have difficulty finding a peer group and maintaining friendships.

Twice-exceptional children are children who are identified as being gifted while also having a disability. While “disability” is not the ideal word, it is the word used by schools and other agencies and, for sake of consistency, will be used here. The disability could be a learning, emotional, physical, sensory, and/or developmental disability (The Twice-Exceptional Dilemma, 2006). Dyslexia, ADHD, Autism Spectrum Disorder, and Generalized Anxiety Disorder are just some examples of disabilities that impact a child’s functioning.

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Twice-Exceptional Children: Who They Are and Why We Need to Talk About Them

Is my child gifted? Is my child delayed? What is my child?”

Gifted and ADHD, how can it be both?“

These, and similar questions were asked by parents of children who were eventually identified as twice-exceptional.

Twice-exceptional children are a misunderstood and under-identified group of children. Many educators, professionals, and parents are not familiar with this term and do not understand the challenges and experiences of these children. It “can feel so overwhelming that you do not know where to start,” stated a parent of several twice-exceptional children. The first step in helping this group of children is to understand what it means to be twice-exceptional.

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