Before we get into training clients with Autism Spectrum Disorder (ASD), let’s first get a real understanding of what ASD really is. According to the National Institute for Mental Health (NIMH), “Autism spectrum disorder (ASD) is the name for a group of developmental disorders. ASD includes a wide range, “a spectrum,” of symptoms, skills, and levels of disability." Although people with ASD may have difficulty with communication and socialization and are known to have restricted interests, it does not mean they’re incapable of learning new skills.
There are effective techniques for working with clients diagnosed with ASD that a personal trainer can find very valuable when trying to teach them a new skill or exercise. These techniques come from understanding the basics of using "Applied Behavioral Analysis" (ABA) strategies. These strategies include modeling, prompting, redirecting, and offering choices to the client that the trainer is working with. Also, giving the client positive reinforcement when they do something well can be a great motivator and increase their confidence (e.g. “great job following directions!”).
People with ASD, just like everyone else, are going to have activities or exercises that they may like and exercises that they may dislike. Sometimes though, even though you dislike it, it’s still important. That’s where the ABA technique known as the “High Probability Command Sequence” comes into play. The High Probability Command Sequence tells the client that they can receive something of higher preference if they complete a lower preference activity or exercise first (e.g. "Let’s do this activity (low preference), then we can do this activity (high preference)”).
After establishing an understanding of how to effectively communicate with the clients, understanding how to work with them specifically in a gym setting is the next step. As a trainer, you need to know three key variables before getting ready to put a client with ASD through a workout. First, asses whether or not they are physically capable of handling the exercise (know the difference between “I can’t” and “I won’t”). Then, if you know they’re physically capable of handling the exercise, you have to figure out if the client is cognitively able to understand your directions or if the exercise is too complex. Lastly, if you are confident that they can understand your directions, you need to figure out how motivated they actually are and if they are truly willing to do it. If they’re not motivated or unwilling to do the exercise, think of a possible adaptation that will increase their interest. When adapting the exercise is not an option, that is when using the ABA High Probability Command Sequence strategy should come into play.
Another big part of working with clients with ASD is that you may consider not "switching it up” all the time. A lot of people lose motivation after doing the same exercise routine for awhile and need a change to get re-motivated to workout. Those with ASD on the other hand, may actually get increased motivation the longer they stay on the same routine. Attempting to change their exercise routine or teach them a new skill without first pre-teaching the necessary steps that go into that change can lead to problem behaviors such as tantrums, refusals. and increased anxiety.
In conclusion, personal trainers can have success working with clients diagnosed with ASD if they have an understanding of basic ABA communication strategies on top of their knowledge on exercise and fitness itself. If you have patience and the right attitude, who knows how much you could change the life of a man or woman with ASD for the better!
“Autism Spectrum Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml.
Cooper, John O., et al. Applied Behavior Analysis. 2nd ed., Pearson/Merrill-Prentice Hall, 2007.
Quaglio, Laura. “On the Spectrum: Programming for Clients with Autism Spectrum Disorder.”NASM Blog, NASM, 21 Aug. 2013, blog.nasm.org/ces/spectrum-programming-clients-autism-spectrum-disorder/.
Wing, Cary. “ACSM/NCHPAD Resources for the Certified Inclusive Fitness Trainer.”ACSM/NCHPAD Resources for the Certified Inclusive Fitness Trainer, American College of Sports Medicine, 2012.