On the pathway to adopting a healthy lifestyle, the exercise experience contains valuable opportunities for individuals with autism spectrum disorder (ASD) to practice adaptive communication and socialization skills. To ensure a safe, enjoyable fitness experience, parents and caregivers may consider accessing the services of a certified personal trainer (CPT). Depending upon the individual’s level of cognitive functioning and sensory processing needs, encounters with a CPT can take place in virtually any fitness environment that supports the safety, success, and unique needs of the individual.

As a trusted source of knowledge, skill, and motivation, the CPT is equal parts trainer, coach, and role model—an empowering mentor who is on a mission to help individuals with ASD explore their unique fitness preferences, develop adaptive skills, and achieve the desired health outcomes that set the stage for an enduring healthy lifestyle.

Communication

Starting with the initial consultation, individuals can hone his/her expressive and receptive communication skills through reciprocal exchanges with the CPT that focus on their health background, goal aspirations, and anticipated outcomes, which also serve to promote realistic expectations, rapport, and trust in the CPT¹. If the individual uses communication supports, the CPT can sequentially arrange context-specific icons (e.g., photos of gym equipment, exercise movements) to correspond with his/her routine. Likewise, if the individual tends toward idiosyncratic language and monologues, or experiences challenges in maintaining conversational reciprocity, the CPT has many opportunities to enhance joint attention abilities through open-ended dialogue that directs the individual’s attention to the ‘here and now.’ For example:

• About the program
  • “We’ve been ending our session with the treadmill for three months now. In order for us to avoid a plateau, now is a good time to change your cooldown What are our options?”
• About biomechanics
  • “If the weight is too heavy and our form is poor, we can accidentally strain our muscles. We always want to avoid injury, right? So, what are some ways that we can avoid injury during the chest press?”
• About goals
  • “You’ve lost five pounds in a month—great job! That takes a lot of dedication. You must be proud…I sure am! We’re a great team! So, tell me—what exercises do you think helped you to lose that weight?”

When communication involves collective language (e.g., “we,” “us,” “our”) the CPT indirectly establishes a team dynamic—the senses of collaboration and inclusion that frame the CPT as a supportive partner throughout the individual’s goal attainment process. Depending upon the individual’s level of functioning and expressive and receptive language abilities, the CPT might employ the following strategies to facilitate effective communication during the exercise encounter:

Use simple, uncomplicated language

• Instead of using scientific jargon (e.g., muscular contraction) and contextual colloquialisms (e.g., “C’mon, let’s get our ‘beast mode’ on!”), the CPT would use simple, motivating phrases that support clear comprehension (e.g., “Okay, get ready—we’re going to do ten chest presses!”).

Limit choices

• In order to avoid decisional challenges, the CPT would offer concrete choices that contain closed-ended questions and are limited to no more than two options. For example, “So, what muscles should we focus on first today—core or upper body?”

Honor learning style

• Given the broad variability in learning styles, the CPT would take the time to gain an understanding about the individual’s unique learning style (e.g., visual, auditory, physical) and comprehension needs, which should be clarified prior to engagement in the exercise encounter.

Establish clear guidelines for appropriate behavior

• Prior to the initial exercise session, the CPT would establish clear expectations of appropriate behavior in the fitness setting. By reinforcing rules of conduct, the CPT can better reinforce structure, minimize confusion, and promote positive participation.

Reward positive behavior

• As a fitness ‘mentor,’ the CPT would seek opportunities to offer behavior-specific verbal praise for task completion that is goal-oriented and progress-focused. Not “Nice job!”, but “Nice job! You finished your 20 minutes on the treadmill! We’re all done here. So, what’s next on our list?”

For individuals who respond to checklists and other visual supports, the CPT would provide a detailed sequence of steps within a task in an effort to promote automaticity and an awareness of the steps required to complete the task^{4, 5}. In this respect, communication exchanges between the CPT and the individual are empowerment focused, highlighting the link between the previous efforts and current outcomes, while reinforcing the individual’s motivation to progress forward on her/his goal path.

Socialization     

For individuals with ASD, social interactions in the exercise setting provide real-time social learning opportunities, such as negotiating semantics, respecting personal space, practicing situationally appropriate behaviors, and developing a level of social comfort that facilitates a successful integration into the community. Given impaired joint attention⁷ and eye gaze abilities and difficulties in understanding the points of view held by others in individuals with ASD, the CPT is there to facilitate novel exchanges with gym members, offering opportunities for individuals to process the views held by others about their unique fitness experiences, while simultaneously decreasing the ritualistic, nonfunctional stereotypy commonly associated with sensory need fulfillment:

• “Hello! How are you?”
• “What muscle groups are you targeting today?
• “Did you warm up yet? Be sure to stretch — you don’t want to injure yourself!”

As gym members share the details of their personal fitness experiences, the CPT can encourage individuals to compare and contrast their own experiences, which can inspire introspection and continued motivation toward their goals. Here, individuals have opportunities to independently initiate pro-social dialogues with gym staff to inquire about gym policies and programs, which can promote reciprocity and awareness:

• “Hi! Can you tell me when my membership expires?”
• “Is the gym closed for the holiday? If not, what are the holiday hours?”
• “Are you going to be offering any new fitness programming options in the future?”

Similarly, the goal-setting phase of the exercise encounter contains opportunities for the CPT to encourage the individual to engage in independent decision making. Open-ended questions, affirmations, and reflection¹² are just a few approaches that the CPT may use to stimulate critical thinking and dynamically explore the individual’s goal aspirations:

• “I’m so happy to be your trainer! Tell me, what are some things about your health that you think we need to focus on?”
• “In the past, what has gotten in the way of achieving your goals?”
• “If we create realistic goals, then we have a better chance of achieving them.”

In an effort to promote success, the CPT would initiate an empowering dialogue that is designed to help the individual to formulate an achievable goal. Instead of “I need to lose some weight,” the CPT would guide the individual to establish a clear, unambiguous set of objectives that are specific, measurable, attainable, realistic, andtime-bound:

• Specific: “I am going to lose…”
• Measurable: “20 pounds…”
• Attainable: “by focusing on proper dietand routine exercise…”
• Realistic: “using the strategies that I enjoy…”
• Time-bound: “within the next three months.”

Over time, the CPT may guide the individual to independently self-monitor her/his progress and initiate adjustments to goals, as necessary. Although cognitively higher-functioning individualsmay appear to derive a greater benefit from a discussion on goal setting than lower-functioning individuals, the benefits of such interactions should not be ignored for lower-functioning individuals, given the importance of promoting an inclusive team dynamic.

At all points within the exercise experience, parents, caregivers, and treatment team members are encouraged to maintain open lines of communication with the CPT, in an effort to remain aware of the individual’s goal progression and to discuss concerns that may arise within the exercise encounter. To ensure continuity between environments, parents and caregivers may encourage the individual to reflect upon (e.g., “What were some of the exercises that you performed during today’s session?”) and express feelings about (e.g., “What do you like and dislike about your sessions?”) the exercise experience. When the contents of the exercise experience are consistently reinforced across settings, enhanced feelings of competence and control may inspire the individual to no longer view exercise as a ‘behavior,’ but as a core value, a mindset, and a sustainable component of her/his lifestyle.

As a silent partner in the health transformation process, today’s CPT can help people on the spectrum to explore the unique preferences, motivations, and aspirations that cultivate their passion for fitness. Whether he/she is modeling exercise movements, promoting effective communication, or facilitating adaptive social interactions, the CPT gradually expands their advocacy role over time to become an unofficial, yet indispensable, member of the individual’s treatment team. When efforts are made to de-stigmatize deficits and capitalize on strengths, individuals with ASD become better poised to embrace their role as an agent, and not a victim, of their health outcomes. As the individual engages in a collaborative, dynamic partnership that is based on reciprocity, respect, and trust, autism can transform “a powerful desire for aloneness” into an empowered sense of inclusiveness.

References

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