# Exercise as it relates to Disease/Exercise for Autism?
## Background Information: What is Autism?

Autism is a neurological disorder that occurs across a spectrum of impairments and can include behaviours showing difficulties in social interaction and communication. Typical autism behaviours can also result in self-stimulating and aggressive, repetitive behaviours. Autism is generally known as Autism Spectrum Disorder as specific types of Autism may vary across a spectrum and can include Autistic Disorder, Asperger's Disorder and Pervasive Developmental Disorder. There are no known causes for Autism.
Sufferers of Autism face three main areas of difficulty that include:
* Impairment in social interaction
* Impairment in communication
* Restricted and repetitive interests, activities and behaviours
Major symptoms of Autism and Autism Spectrum Disorders are self-stimulatory behaviours such as nodding, fidgeting and other agitative behaviours. Literature shows that these self-stimulatory behaviours interfere with further development of social behaviours and learning. There are three main diagnoses for a person with an Autism Spectrum Disorder, being Autistic Disorder, Asperger's Disorder and Pervasive Development Disorder. Diagnoses varies on the symptoms observed, and key development limitations observed, such as delay in social, communication and behavioural development. Other repetitive and agitative behaviours may be observed.

## Exercise as Treatment for Autism

Whilst Autism is a disorder that can effect an individual's capacity to perform exercise, exercise has been shown to have significant benefits for social interactions, communication skills and repetitive behaviours. Structured aerobic exercise has been proven to provide a major role in controlling self-stimulating behaviours. Exercise in persons with autism has also reduced aggressive behaviours, self-injurious behaviours, unproductive behaviours and has been shown to improve attention span, work performance and on task behaviours.
Exercise is also used as therapy in persons with Autism Spectrum Disorders to help improve motor skills and sensory integration. These therapies improve the proprioceptive system, vestibular system, motor coordination and skill development.
Persons with Autism Spectrum Disorders also have a greater risk of becoming overweight due to their limited motor functioning. Increasing physical activity in persons with Autism reduces the risk over becoming overweight and other associated comorbidities.

### Exercise Recommendations for Autism

Certain exercise can improve proprioception in persons with Autism Spectrum Disorders. Developing coordination through exercise activity can assist proprioception and general coordination. Activities to benefit proprioception include swimming, playing with weights, use of a trampoline and pushing or playing with large objects. Also, Tai chi, (an adapted form of defensive arts, also includes meditating body movements, which are performed together as a class,) has been proved to help many people with physical problems and could well also help people with mental, as well as muscular-skeletal problems, as it is fairly repetitive, gently stretches the muscles,tendons,joints,connective tissues and if necessary, is also very relaxing.
Autism sufferers generally reduce self-stimulating behaviour during low (50-65% Maximum Heart Rate) intensity exercise. This reduces self-stimulating behaviours immediately for up to 90 minutes. 10 - 20 minute low intensity exercise sessions up to 5 times a week are proven to be beneficial. Long term benefits from these exercise programs have also been proven.
Exercise therapy recommended also includes activities which stimulate the vestibular system. Whilst each person with autism may have a different reaction to sensory motion, exercises recommended include back and forth movements including trampolining can assist in improving balance and coordination both during exercise and during normal activities.
Activities such as swimming and obstacle courses should be prescribed to improve skill development. Obstacle courses with incorporated activities such as skipping, hopscotch and throw and catch can improve sensory integration and hand eye coordination.
The National Center on Health, Physical Activity and Disabilities suggests exercise prescription has greatest effect when it is:
* Set up on a consistent routine
* Predictable activity
* Set up with minimal distractions and sensory overload
* Instructed visually not verbally
* Shorter for those with limited concentration
* Safe as individuals may not be aware of risk

### Limitations and Considerations

Considerations to incorporate when prescribing exercise for a person with Autism include: Sensory hypoactivity or hyperactivity, which is partly due to the impairment of the sensory cortex, a problem in a large number of individuals who suffer from Autism. This means that exercise programs should incorporate activities that will not distress or alarm the person with Autism. Activities should be prescribed to make the person with Autism feel comfortable at all times. Communicating exercise prescription to a person with Autism Spectrum Disorder is a further limitation. Visual cues and instructions should be given, to minimise difficulty processing verbal communication.
Activities should be prescribed as not to overstimulate the Autistic person, as overstimulated can result in increased self-stimulating behaviours and aggressive behaviours.

## Further reading

For further information regarding Autism Spectrum Disorders and exercise prescription contact your health care professional or visit:
* National Center on Health, Physical Activity and Disability, http://www.ncpad.org/315/1928/Autism~and~Considerations~in~Recreation~and~Physical~Activity~Settings
* National Institute of Neurological Disorders and Stroke, 2012, http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
* Autism Fitness http://web.archive.org/web/20120905172540/http://autismfitness.com/Top-8-Exercises-for-Autism-Fitness.pdf
* Autism Help http://www.autism-help.org/family-physical-exercise-autism.htm

## References

* 1 2 National Institute of Neurological Disorders and Stroke, 2012, http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
* ↑ Watters, A. M., & Watters, W. E. (1980). Decreasing self-stimulatory behavior with physical exercise in a group of autistic boys. Journal of Autism and Developmental Disorders, 10, 379–387
* ↑ Allison D.B., Basile V.C., MacDonald R.B. (1991). Brief report: Comparative effects of antecedent exercise and lorazepam on the aggressive behavior of an autistic man. Journal of Autism and Developmental Disorders. 21(1), pp. 89-94
* ↑ Bachman, J. E., & Fugua, R. W. (1983). Management of inappropriate behaviors of trainable mentally impaired students using antecedent exercise. Journal of Applied Behavior Analysis, 16, 477–484
* ↑ Dawson, G., 2012, Sports, Exercise and the Benefits of Physical Activity for Persons with Autism, http://www.autismspeaks.org/science/science-news/sports-exercise-and-benefits-physical-activity-individuals-autism
* ↑ Schmitz, S, Exercise as a Means to Reduce Sterotypic Behaviours Among Children and Adolescents with Autism, 2012, http://youthsports.rutgers.edu/documents/EXERCISING.pdf
* ↑ Autism Help, 2012, http://www.autism-help.org/family-physical-exercise-autism.htm
* ↑ National Center on Health, Physical Activity and Disability, 2012, http://www.ncpad.org/315/1928/Autism~and~Considerations~in~Recreation~and~Physical~Activity~Settings
* ↑ Elliot*, R. O., Dobbin, A. R., Rose, G. D., & Soper, H. V. (1994). Vigorous, aerobic exercise versus general motor training activities: Effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation. Journal of Autism and Developmental Disorders, 24, 565–576.