Personal Training for Children With Autism [Complete Guide]
Training clients who are affected by autism presents a unique set of challenges unlike what you’ll experience with typical clients. In spite of the challenges, training this population can be a very rewarding experience as you can have a profound impact on the lives of your clients.
Trainers who specialize in working with clients with autism and other special needs show remarkable patience and empathy in addition to having unique education and training. But you don’t have to be a specialist to help a client with autism; any trainer or fitness instructor could be presented with the opportunity to work with one of these unique clients.
In this guide, we’ll give you some background knowledge on autism and its effects plus easy-to-use advice from the experts on the best practices for training clients with autism.
What Is Autism?
Autism is a developmental disability characterized by challenges to communication, social interaction, and behavior.
Autism Spectrum Disorder (ASD) is the name given to describe three conditions which were previously diagnosed separately- Asperger Syndrome (AS), Autism Disorder (AD), and Pervasive Developmental Disorder (PDD).
- People with Asperger Syndrome are often called high-functioning due to their normal or above-average intelligence but have impaired social skills and physical coordination. In adulthood, people with AS face a higher likelihood of experiencing anxiety and depression.
- Autism Disorder refers to the group with more severe impairments to social skills and communication who also commonly struggle with cognition and repetitive behaviors.
- PDD refers to the wide range of cases between Asperger syndrome and autism. People in this group were not diagnosed with AS or AD but lie somewhere on the spectrum.
While all causes are not known, ASD is known to be hereditary and can often be observed before age three. It occurs in all ethnic groups and affects males at four times the prevalence of females.
According to the Centers for Disease Control and Prevention, Diagnoses of ASD have increased over the years from 1 in 150 people in 2000 to 1 in 59 people in 2014. The increased estimate of prevalence may be due to a combination of factors: the broadened definition of autism, improved detection and testing, and possibly a true increase in the number of children born with ASD.
What Are the Effects of Autism?
People with autism might:
- have trouble understanding other people’s feelings or expressing their own feelings
- appear to be unaware when people talk to them
- repeat or echo words or phrases said to them
- repeat physical actions over and over again
- have trouble relating to others or not have an interest in other people at all
- have trouble expressing their needs using typical words or motions
- have trouble adapting when a routine changes
- have unusual reactions to sensory stimuli
Autism is frequently compounded with other genetic disorders and developmental challenges. Additionally, it can contribute to other serious, non-genetic challenges with anxiety, depression, and obesity due to the unique difficulties and limitations people with autism often experience.
Each person living with autism has a unique set of challenges which, along with their unique personality, greatly affects the approach of treatment by medical and exercise professionals.
How Is ASD Diagnosed?
Because there is no medical test (blood test, CT scan, etc.) which identifies ASD, doctors observe behavior during the developmental stages of childhood to make a diagnosis. This is done through a developmental screening in which the doctor talks or plays with the child to test for delays in speech and movement.
Children that present with signs of ASD in an initial screening would move on to a comprehensive diagnostic evaluation involving in-depth testing of vision, hearing, genetics, and neurology with specialists such as developmental pediatricians and child psychologists.
There is no cure for ASD; children who are diagnosed will live with its effects throughout their lives. However, early intervention can improve development during childhood and a treatment program involving medicine, diet, and exercise can improve the quality of life for all people affected by ASD.
Tips for Training Clients With Autism
#1 – Consider the client’s autism symptoms from the moment they enter your gym, not just during the workout.
Moreso than with typical clients, it is important to consider how your client with ASD will experience the gym environment from the moment they come in the door to the moment they leave. Anything which affects them negatively could throw off the exercise session or cause them to have an undesirable reaction to future visits. Consider this in particular:
Environmental stimuli that would be unnoticed or a minor annoyance to most of us can cause great distress to people with certain ASD symptoms. A flickering light bulb, music coming from another room, feet pounding a treadmill could be distracting and cause behaviors that counter your efforts in training.
Make your best effort to eliminate all possible sources of undesirable stimulus in the gym. To do this, it’s a good idea to leave a longer preparation window between the end of your previous training session and the arrival of your client with ASD so you can perform a quick inspection of the gym and fix anything that’s out of place or potentially disruptive.
#2 – Build multiple forms of communication into your training.
Because people with autism can have difficulty interpreting your intentions and may not be responsive to verbal instructions, reinforce what you say with additional, redundant methods of communication.
You may, for example, place an arrow shape on the floor to remind them of the direction they should walk while doing high knees. You may, additionally, say the number of repetitions for an exercise and hold up a card on which the number is printed.
In both examples, you’re providing an auditory and a visual form of communicating what you want from the client increasing the likelihood that they understand.
#3 – Give the client choice while remaining within the framework of your training.
As the trainer, you know best about what the client needs physically; but allowing them some freedom of choice can be beneficial in increasing their cooperation with instructions, enhancing their enjoyment of the activity, and giving them the chance to practice communicating what they think or want.
To be clear, it wouldn’t be advisable to leave this too open-ended by asking questions like, “What to do you want to do today?” Instead, think of giving your client options within a predetermined framework which you know addresses their needs. Here’s an example:
In the workout, you have a lower body exercise slot and ask them to choose between step-ups or squat-to-box. You’d ask, “Would you rather step up onto the box or sit down and stand up from the box?” Along with the question, it will help to perform a couple reps of each exercise to refresh their memory of what each exercise entails to help them decide.
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#4 – Make repetitive physical behaviors work for you
People with autism sometimes present repetitive behaviors which are unhealthy such as hitting their head, but other repetitive actions like running or throwing things are not necessarily bad in the appropriate setting. You can even engineer your exercise program to take advantage of a particular client’s tendencies toward these actions.
For instance, if you train someone who does not like to remain still and runs around the gym, rather than demand that they perform only stationary exercises, you can incorporate locomotion exercises like lunges, long jump, and bear crawls.
Say the client has an affinity for throwing things they pick up; rather than fight it, direct it into an exercise that’s safe and contributes to the exercise goal like a medicine ball throw.
By doing so, you’re likely to increase their enjoyment of exercise and avoid situations in which you act as a disciplinarian who must constantly tell them no.
#5 – Give specific praise/feedback
A good bit of advice for all of your clients, and those with ASD in particular, is to very clearly communicate what you’re giving feedback about. For anyone you train, simply saying “good job” after a set may be a nice compliment but it’s too vague to reinforce what they did that made it good.
Your client with autism may also have difficulty understanding how your statement correlates with the instructional cue you told them before the set.
The solution is to say the feedback or praise with the specific action that warrants it. So, instead of “Good job,” it’s “Good job lifting your knees up high” or “You stood up tall and that was great!”
Remembering that clients with ASD can benefit from multiple types of communication, giving a high five when they’ve done something well provides a tactile and visual signal of approval. Just be sure that the client has not shown any aversion to physical touch.
#6 – Make things consistent and predictable
Individuals with autism tend to learn better and experience less anxiety when activities are structured in a consistent way that they can get used to. Some of the ways that should be taken into account as you work with them are:
- Scheduling – put these clients in time slots which you know you can maintain long-term and don’t alter them unless you have no other choice.
- Location – stick to the same room or area in the gym for each appointment. If you must move to do a particular activity, let the client know well in advance so there’s no surprise.
- Sequence – a consistent order of activities can promote the client being more comfortable and their behavior more predictable. Set a pattern for your sessions that they can rely on.
- Expectation Setting – beginning each session with an introduction to the workout can be both educational and improve your client’s comfort. This is also a good time to make use of visual aids that show the exercise names.
#7 – Factor in fun, not just fitness improvement
Most people who come to you can probably accept the logic of doing some things they dislike in the short-term in order to accomplish a long-term goal. For clients with autism, it may be difficult or impossible to accept that rationale. Thus, it’s more important for your clients with autism to enjoy their gym experience than your typical clients.
Like anyone else, clients with ASD need to be challenged in order to improve, but as a trainer, you should make every effort to make it enjoyable and give them a positive association with exercise and the environment of your gym.
Doing so will help their caregiver gain their cooperation when its time to bring them to their appointment, help you build rapport, and will most importantly help the client by providing stress-relief and enjoyment.
As is true with typical clientele, the younger the individual, the more important it is to make exercise less rigid and more like play. When training youth with autism, think of ways you can achieve a high level of physical exertion while keeping it fun and light-hearted.
#8 – Be adaptable and take what they give you.
When training clients with autism, inside-the-box thinking will likely lead to frustration for you and sub-optimal fitness improvement for them. As a professional, you should plan ahead and be prepared, but in the case of these special clients, you should also be ready to adapt and sometimes let go of rigid expectations.
If the client is not cooperative with your strictly timed circuit, have an alternative way to accomplish the exercises like letting them pick a number of reps from flash cards.
Some trainers who work with children with autism report watching them run and kick a ball for half the session before they did the planned workout. If it’s active and safe consider it a win.
As previously mentioned, training clients with special needs is challenging and can take more emotional energy than your work with typical clients. Being flexible and even changing how you define success can be important for keeping up your morale and preventing burnout.
#9 – Set them up to feel successful.
Just like for your typical clients, it’s the challenge of training that gives it it’s value to clients with autism. The trick is to challenge just the right amount but assure they always get to feel successful at the end.
Take this into account with the selection of exercises. It’s better to underestimate their ability and then advance than to assign an exercise that they’re not ready for and have to regress from; if they know they didn’t meet expectations, they may quickly feel defeated or lose interest.
Another tip specialists recommend is to end each session with a review of what they did and reinforce their improvements and accomplishments.
#10 – Praise effort, not just proficiency
Activity on any level is a win for someone living with autism. Particularly when you can get them interested and willing to invest effort, that is something to be celebrated regardless of how they perform compared to typical fitness standards.
Seek improvement, not perfection and always positively reinforce your client’s efforts in the gym. Although measurable improvements in fitness may be slower than you’d like, look on the bright side:
The broad range of challenges for people with autism presents a great number of opportunities for you to have a far-reaching impact. For example, even when a client didn’t show improvement on an exercise they may have become a little better at expressing themselves or a little more comfortable around other people as a result of their visit to your gym.
With the unique challenges of training individuals with autism can come unique rewards. Although it can seem like a long road to improvement by the standards to which we hold most clients, there can be even more small victories along the way.
With the tips provided in this guide along with additional resources like the National Center on Health, Physical Activity, and Disability (NCHPAD), we hope you feel more ready to take on clients with autism who can benefit profoundly from your work.
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Colton Tessener is a Strength & Conditioning Coach and gym owner from North Carolina. He has a Bachelor’s degree in Exercise Science from UNC-Wilmington and has 10 years of hands-on experience in coaching clients of all types on improving physical performance. His gym, Arise Athletics, has been recognized locally as Small Business of the Year and named one of the Best Gyms in Wake County (Raleigh, NC).