Parents will often email me saying they are interested in getting their child with autism enrolled in a fitness program, but don’t know if they are ready or able to participate in organized exercise. This is understandable because up until recently there were little to no personal trainers, specialized in working with people with autism. I explain to parents that I am trained in applied behavior analysis, ABA and am experienced in adapting my programming to fit the needs of the individual. This oftentimes means dealing with and managing unexpected behavioral challenges. These behaviors may be mild, such as not attending or they may be more severe actions, like aggressive or self-injurious behaviors.
Maladaptive behaviors are defined as “any behavior that inhibits a person from adapting to his or her situation appropriately” (Maladaptive Behavior Examples, Definition and List, 2018). These types of behaviors are one of the most common concerns from parents when exploring the possibility of adaptive personal training. In effort to ease parent’s concerns I tell them about past experiences I have encountered in my training. I have worked with clients who would pinch and hit me. Clients who flop or bolt and even try to hurt themselves to escape exercise. ABA (applied behavior analysis) training prepared me to know how to remain neutral, overcome these challenges and focus on the goal of participation in an exercise program. This is not always as easy as it sounds. Exercise requires people to do often novel types of movements and these may be challenging or uncomfortable at times. The response to teaching these new skills is not always positive.
The first step to learning how to manage maladaptive behaviors is to learn about the individual. When first meeting a new client (and their family), I do my best to obtain as much knowledge about their history, likes, dislikes, lifestyle, medical history and previous experiences with exercise. Documentation from other professionals such as an Individualized Education Plan (IEP), Physician’s recommendations, Physical/Occupational Therapist recommendations, a Behavior Support Plan, Speech and Language recommendations and a Medical history can be valuable in devising an exercise program. The most important piece of documentation in terms of managing maladaptive behaviors is the Behavior Support Plan (BSP). This plan is created by a BCBA (Board Certified Behavior Analyst), which is a professional in the space of ABA. Not every athlete with autism will have a BSP, but if they engage in high rates of maladaptive behavior, that interfere with their daily lives, there is a good chance they will have on in place. This plan will list the specific maladaptive behaviors that athlete engages in, with definitions and instructions on how to respond (or not) to these behaviors. For further instructions or guidance in following a BSP, you can contact the athlete’s BCBA (Board Certified Behavior Analyst) or ask for them to supervise during an exercise session. If the athlete does not have a BSP in place and you encounter maladaptive behaviors that interfere with their exercise training, remain neutral, provide no extra attention to the behavior and redirect the athlete to the task at hand.
Documentation such as a Behavior Support Plan is invaluable, but you MUST establish rapport, so that the athlete is comfortable working with you. When introducing yourself to a client, try and make yourself reinforcing by talking about their likes, pairing yourself with reinforcing activities and emitting a positive attitude. This means being positive even when they do not respond well to you being there. Rapport with your client is an essential component of their success in an exercise program (Creating Rapport: The Doorway into an Effective, Enduring, Training Relationship, 2011). Every person is different so establishing rapport is a fluid and evolving process. Rapport is not something that you should just focus on establishing early on, but continue to develop and foster over the course of their sessions. A few different strategies to establishing this rapport are communication, choices, and positive reinforcement. Communication, this means explaining why you are there, why exercise is important and explain what you are doing. This also means conversing with your clients, try talking about things they are already interested in. This may be forced, because many people with autism struggle with social skills. Another technique trainers can use is by offering choices. This allows the client to feel more in control and an active participant in the process. You can offer choices of exercises, equipment, numbers of sets or reps. If your client is receiving ABA services you may want to ask their parents or BCBA if they have had a preference assessment. This is a strategy used to measure how reinforcing different activities are. Positive reinforcement is one of the easiest ways to build rapport. You can praise any positive behaviors no matter how small. For a client who really is struggling to participate you may praise them holding their weights or for a client who is progressing, you could praise their performance. One strategy of positive reinforcement that is extremely effective is behavior specific praise. This is another strategy we borrowed from ABA. This means to specifically point out what the client is doing and praise it. An example would be praising “nice job pushing all the way up” when a client is performing an overhead press. Or to say “great job bending your knees” when performing a squat. This gives concrete feedback to the client on what they are doing. This ABA strategy is great for reinforcing specifics or subtleties in exercise form.
Unexpected challenges with behaviors will arise when teaching people with autism exercise programming. It is your responsibility as a personal trainer specializing working with people with autism to know how to manage these behaviors.
Clarke, M. (n.d.). Maladaptive Behavior Examples, Definition and List. Retrieved August 12, 2018, from https://www.psysci.co/maladaptive-behavior-examples/
Mantell Michael Mantell Contributor Michael Mantell earned his Ph.D. at the University of Pennsylvania and his M.S. at Hahnemann Medical College, M. (2011, June 10).
Creating Rapport: The Doorway into an Effective, Enduring, Training Relationship. Retrieved August 12, 2018, from https://www.acefitness.org/education-and-resources/professional/expert-articles/1521/creating-rapport-the-doorway-into-an-effective-enduring-training-relationship