November 25, 2006

August 3, 2006

A Can-Do Approach to Autistic Children and Athletics

By ANAHAD O’CONNOR

THE members of the swim team at Bloomington High School South in central Indiana cheer wildly every time Nathan Buffie races. In his two years on the team, Nathan has never won first place at a meet. Often, he finishes far behind.

But it is the fact that Nathan even goes into the water and manages to compete at all that his teammates find so remarkable. Nathan, a trim 16-year-old with a boyish smile, has autism, the devastating developmental disorder that makes his participation in any sport or social activity a struggle.

“He is probably the worst swimmer on the team, but he keeps getting better and he wants to win,” said his mother, Penny Githens. “He tells his teammates this, and they just get so excited for him.”

For years, children with autism were left on the sidelines, a consequence of a widespread belief that they were incapable of participation in athletics. But while it is true that autistic children can be difficult to motivate and resistant to exercise, they are now being pushed to take part in physical education programs, encouraged by experts who say that certain sports can ease repetitive behaviors like pacing and head-banging as well as provide a social outlet.

Autistic children, even those who are considered low functioning, can excel at activities like swimming, martial arts, running and surfing — sports that don’t entail having to read social cues or figure out when to pass the ball.

“A lot of autistic children are never going to play on a team, but they can do really well in individual sports,” said Donna Asher, the camp director at the North East Westchester Special Recreation Program in Hawthorne, N.Y. “It’s not their physical skills that keep them from participating, it’s their social skills — not being able to interact with others or having a breakdown on the field in the middle of a game.”

Athletic programs for autistic children, often called adapted sports programs, are designed to sidestep social and behavioral problems.

Many autistic children — up to half, according to some studies — are prescribed antipsychotics and other drugs that can produce fatigue and swift weight gain. Studies show that about 17 percent of autistic children are overweight and another 35 percent are at risk, figures that mirror the rate among American children in general.

Experts hope that teaching autistic children how to be active will stave off problems later in life. “What we’re trying to do is to make sure that they won’t be at high risk for obesity and coronary artery disease,” said Dawn D. Sandt, an assistant professor of adapted physical education at the University of New Mexico who has studied the activity levels and the body mass of autistic children.

Still, for parents of autistic children, locating an adapted sports program can be a low priority. More often than not, they are consumed with struggles to find speech therapists, behavioral intervention services, special education classes and a health insurance policy that will pay for it all.

“Parents of autistic kids have a lot of battles to fight,” said Georgia Frey, an associate professor of kinesiology at Indiana University in Bloomington, who founded an adapted physical education program in 2001. “So when it comes to getting their kids involved in recreation and physical activity, it can seem too exhausting. But I do think that parents see the value in these programs, because the demand for them is very high.”

Researchers say the value of sports for autistic children is well documented but often overlooked. Studies dating back to the 1980’s have found that brisk physical activity increases attention span and reduces repetitive behaviors.

But the catch is that the exercise must be moderate to vigorous. One early study of autistic children found that 15 minutes of jogging “was always followed by reductions in stereotyped behaviors” such as hand-flapping and rocking. But 15 minutes of playing alone with a ball, considered mild exercise, had “little or no influence” on behaviors.

John O’Connor, an associate professor of adapted physical education at Montana State University-Northern, explained why. Running and swimming involve rhythmic movements that are similar to stereotypical behaviors, and may distract people with autism the same way flapping their hands or walking on their toes does.

“People with autism experience levels of sensory perception that most of us wouldn’t know or understand,” Dr. O’Connor said. “It overloads them, so they engage in behaviors that distract them. Exercise gives them the same benefits but it doesn’t have the negative social connotations.”

As many as 1 out of every 166 children born today has autism, according to the federal Centers for Disease Control. No organization tracks the number of participants in adapted physical education programs or how many such programs exist.

Because the severity of the condition varies, the challenges instructors face are never the same. Some children are withdrawn, others will engage. Some speak fluently, others are mute.

The Aqua Pros Swim School in San Diego has a program called Pool PALS (Persons with Autism Learning to Swim). There, teachers incorporate pictures and marker boards into their lessons to demonstrate proper stroke technique to children who have trouble communicating. The school also has a mechanical platform that can be lowered into a pool inch by inch to gently introduce reluctant children to watersports.

Tammy Anderson, the private swim instructor who runs the program, started it about five years ago after she met a woman who doubted that her nonverbal, tantrum-prone 7-year-old daughter would ever swim a lap. “I saw that as a challenge,” Ms. Anderson said. Every lesson had to be broken down into small steps that were demonstrated with flash cards and other visual cues. After a month and a half, she said, the girl could swim across the pool “with a pretty decent stroke.”

“Her mom came back to me in tears and said it was the first thing that anyone has ever been able to teach her daughter,” Ms. Anderson said.

Pool PALS now has more than 100 students, up from 30 when it started. It spawned a surf program with 80 participants, up from 14 when it began in 2001. Both programs have waiting lists.

Because autistic children often do better with routines, most programs are highly structured. At the Westchester camp, which serves children with developmental disabilities and emphasizes fitness, campers are provided with a detailed daily schedule. Instructors keep the campers engaged and ready to participate. “Left to their own devices, these kids will retreat into their own little worlds,” said Ms. Asher, the camp director.

The hope of the adapted programs is that participants will pursue a sport for life. Then there are the best-case scenarios like Nathan Buffie in Indiana, who started in an adapted swim program at a Y.M.C.A., graduated to a community program and eventually proved capable of swimming for his high school team. He also participates in an adapted martial arts program at a Y.M.C.A.

His mother, Ms. Githens, said that Nathan stumbles sometimes. He doesn’t always line up when he should, and he has problems controlling his voice. But the swim team has embraced him nonetheless.

“When he is out in the water,” she said, “his teammates yell and scream for him in a way that they don’t for anyone else.”