4 Features of Total Fitness
“Did you wash your hands really good?”
I inquire suggestively to my 11-year old athlete as he quickly exits the bathroom. “Yes!” is the nearly instantaneous reply. “Okay cool, let me see.” We go back into the bathroom and I observe as he turns on the faucet, misses the liquid soap as it drops to the sink counter, and proceeds to scrub his hands for a total of five seconds, drying them on the towel for nearly a pro-wrestling three-count.
“Let’s slow it down. Pump that soap into your hand. Nice getting the soap. Show me some good scrubbing…” I am not, nor could I possibly be a hypochondriac working with the autism and special needs populations. Having spent over a decade nonchalantly dealing with nearly all bodily fluids (there must be one or two withstanding), I can say that “germaphobe” does not define my outlook. But washing hands after using the bathroom, or rendering a tissue to confetti, is not without significant merit.
There are four concrete pillars upon which optimal health can be built. They are also four pillars that are overlooked, often sailing away in the “We’ll get to that eventually” enchanted canoe. Physical activity, hygiene, nutrition, and sleep are each significant in boosting all the other things we care about; emotional well-being, independence, general/medical health, cognitive functioning, and socialization. As should be tattooed next to my autism puzzle piece motif, there is saying, and then there is doing.
Feature 1: Hygiene
What: I need to change my Autism Fitness intake to ask whether or not the athlete can wash his/her hands. I tend to work on that a lot with my athletes. Similar to movement skills, this often seems the kind of ability that people assume an individual already has. Teaching a student to use the bathroom and then clean up can be a decent challenge in single-digit and early double years. At eighteen it can pose some problems. In addition to any behavior, speech, and motor interventions, teaching independent hygiene skills gets my stamp as a “must” to the best possible ability of the individual.
How: Hygiene skill acquisition is a hands-on process that should have a quick exit strategy (absolutely no pun intended). Hand-over-hand prompting for cleaning routines should be incorporated with fading procedures, moving from the most-to-least effort on the part of the instructor. Here is a recent teaching analysis (TA) I wrote for one of my athletes:
TA for Going to the Bathroom: Voiding
- Complete urination in toilet
- Pull up pants
- Zip (if pants have zipper)
- Buckle belt (If belt is on)
- Close toilet lid
- Flush
- Wash hands
Now each of these steps would be taught to mastery for the entire chain to become independent. With such a strategy, the learner gets accustomed to performing each step in order and correctly. Visual aids can also be employed as can social stories (narratives with pictures) in hard copy or on tablets (there are some great programs for the iPad).
Hygiene is certainly one of the less-thrilling life skill endeavors, but it is highly important for the self-efficacy, independence, self-esteem, and social acceptance, not to mention health, of each individual.
Washing Hands
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Feature 2: Nutrition
What: Books and more books about specific and amaaaaaaazingly miraculous diets to cure all sorts of symptoms overnight! Mostly bunk, but nutrition is highly important for general health and cognitive functioning, and works in conjunction with physical activity as a cornerstone for better living. Recent and well-conducted studies suggest a growing trend towards obesity and medical conditions (Type II Diabetes) in individuals with ASD as a result of poor diet and restricted access to appropriate physical fitness programs. Nutrition can be made relatively easy or secret-level-of-Tetris complicated.
How: Real food. Minimally processed. Proteins (meat, chicken, fish) and vegetables should make up the majority of diet with some healthy fats (coconut oil, nuts, unheated olive oil), and some (SOME) healthy carbohydrates (oats, potatoes/yams, rice). Allergies can be serious and dietary choices should reflect any true intolerance or inability to digest specific foods. Just because something says “gluten-free” does not make it a healthier option. Labels [2] can be misleading, particularly when “natural” and “organic” show up to the party. Juice sucks. Would you feed someone 12 oranges in a sitting? Probably not, but it seems that if it is in a glass or rectangular box then it’s just dandy. That, unfortunately, is not the case.
Many individuals with ASD can be picky eaters. I’ve learned to adopt a few mid-term strategies that have proven effective:
- Offer vegetables in small servings if they are not routinely eaten. Just leave a piece of cooked broccoli on the plate. Or on a plate next to the plate. Or across the table. Keep repeating until it is one day accepted and eaten, or at least tasted.
- Cook vegetables to a pleasing texture. Roasted or mashed cauliflower is much more appetizing than the steamed version.
- Get creative with spices. Sauces can be sugary, but the right combo of salt-and-whatever can change worlds.
- Avoid using edibles as reinforcers unless absolutely necessary for serious behavior situations. Pairing candy and processed snacks with appropriate behavior can lead to some issues.
Feature 3: Sleep
What: Sleep regenerates the body and brain, regulates hormones, and is necessary for emotional health. Sleep should be made a priority, though the process is often difficult for individuals with ASD and other developmental disabilities from the falling asleep stage to waking up at 3am. We want to aim for 7-9 hours of sleep per night on average.
How:
- Logging off. Gradually reduce computer/TV/screen access the hour prior to bed time.
- Getting into a pre-bed routine. This can include reading the schedule for the next day, brushing teeth, and other almost-at-pillow activities.
- Have low-octane sensory activities prior to bed. Calming music, soft light, and items that promote relaxation (these can vary for different individuals).
- Keep a consistent bed time. Within about half an hour each night. Unless there are piñatas.
Feature 4: Fitness
What: I write about it in every column. Yes, I’m biased, but I’m also backed by piles of research and anecdotal evidence. Fitness is absolutely essential for the autism and special needs population. Regular physical activity that incrementally develops strength, stability, coordination, and motor planning is key to the best possible outcomes in the short, intermediate, and long-term.
How:
- Develop fitness programs that take into account the Physical, Adaptive, and Cognitive needs of the individual
- Focus on big motor skills (crawling, squatting, pushing, pulling, climbing, jumping)
- Objectives over objects (consider the goal rather than “hey we have this treadmill so let’s use it”)
- Pair physical activity with behavior-specific praise and access to non-edible reinforcement
- Begin with the most basic version of the movement/exercise that the individual can perform successfully
- Include fitness programming in the classroom, Adaptive PE gym, and at home
- When creating home programs, opt for short (5-10 minute) periods of activity throughout the day (or time spent at home)
- Support and encourage through movement activities. Let the athlete know what he/she is doing correctly
There are your four features. Granted books have been written about each, so I wanted to provide the fundamentals. A shift towards a more health-centered approach to education and life skills for the autism and special needs population can result in an extraordinary future.
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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 [4] for more information.
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Helpful Articles
- Puberty and Hygiene: How to Support Our Children [6]
- Sleep for Your Child with Special Needs – Why It’s Crucial and How to Get More of It! [7]
- The 7 Habits of Highly Successful Fitness Programs [8]
- Benefits of Special Diets for Special Needs Children [9]
- A Complete Guide on Dental Care for Children with Special Needs [10]
- Ask the Nurse: Staying Healthy In School [11]
- Spa Day [12]
- Be Active and Healthy [13]
- Simple Finds: Encouraging Good Hygiene & Independence [14]
- Safe and Easy Bathing with Lathermitts, Because Bath Time is Supposed to Be Fun [15]
- Their Tears and Fears. Masks and More: How to Really Help Your Child Thrive in the New Normal [16]
This post originally appeared on our March/April 2015 Magazine [17]