Pilates & Autism
The article below is from
http://www.mentalhealthireland.ie/a-to-z/autistic-spectrum-disorder/
Autistic Spectrum Disorder
Autistic Spectrum Disorder (ASD) is an umbrella term that covers everyone with conditions within the spectrum of autism. ASD is thought to affect around one in 200 children and adults, although this is likely to be an under-estimate.
There are differences between the subgroups but all children and adults with an ASD will have the following core difficulties.
Non-verbal and verbal communication
People with ASD have difficulty in understanding the communication and language of others and also in communicating themselves. Many are delayed in learning to speak and some do not develop speech.
Social understanding and social behaviour
People with an ASD have difficulty in understanding the social behaviour of others and can behave in socially inappropriate ways. People with ASDs are very literal in how they think and interpret language and are unable to read social context. Children with an ASD often find it hard to play and communicate with other children, who may be confused by their behaviour and may avoid or tease them.
Thinking and behaving flexibly according to the situation
People with an ASD tend to have special interests in particular topics or activities, which they may pursue obsessively. They may struggle to generalise skills to other activities. They will also have difficulty adapting to new situations and often prefer routine to change.
Sensory perception and responses
Some people with ASDs are either very sensitive or very insensitive to certain sounds, sights and textures. This can affect their responses to things like clothes or food and noise. They may also make unusual eye contact – ie. they may not talk and look at someone at the same time.
The article below is from
http://occupational-therapy.advanceweb.com/Features/Articles/Pilates-and-Autism.aspx
A fun way to help children on the spectrum boost body awareness and core strength
By Angelique Micallef Courts, OTR/L
Posted on: August 15, 2013
Pilates is one of the fastest-growing forms of exercise, so it is not surprising that it can be an effective tool for occupational therapists working with children on the autism spectrum - one of the fastest growing disabilities in children.
According to the CDC, the number of children with autism has increased from 1 in 150 in 2000 to 1 in 88 as of 2008.
With more parents seeking creative therapies for their children, OTs can capitalize on the many benefits Pilates offers.
Most children with autism have poor body awareness, core strength, stability and motor control, which limit functional performance and impact their ability to play and interact with their peers appropriately.
Because Pilates incorporates principles focusing on core strength, it can provide proprioceptive awareness to help children with autism - especially those who toe walk.
Pilates exercises can also increase bilateral coordination and disassociating of extremities from the core (called segmental stability in Pilates).
This will ultimately help with increasing body and spatial awareness for children on the autism spectrum, improving their ability to play in all environments.
Bicycle pedals exercise: The child lies supine and moves his legs in and out as if pedalling, first slow and then faster all while maintaining core control.
If the child loses control, add resistance at the ankles to help him refocus. ADVANCE thanks Angelique Micallef Courts
Lower Extremities
Exercises such as leg circles or heel squeeze and lengthen can help with toe walking. These exercises give input to a child's legs similar to joint compressions and provide stretching to tight heel cords, all while strengthening and disassociating the lower extremities from the core.
To perform leg circles, the child lies supine and lifts his feet in the air, drawing imaginary circles with his heels on the ceiling.
The therapist helps facilitate by stabilizing at the child's heels. You can accomplish a lot of goals with just a 30-second exercise.
Even children with low functionality enjoy these activities and have shown carry over within my practice.
Core
One of the best Pilates principles is core posture, which can help with stability. I like to use a coffee cup to describe this: a stable pelvis is like a coffee cup and should just sit stable on a desk, but a child with a pelvis that is tipped either forward or backward has trouble balancing; he is constantly moving.
If a child has good core posture, he can work on the activity at hand and not focus on maintaining a stable balance.
So for children always on the go, stabilizing their core with Pilates exercises is an effective way to start a therapy session.
Such exercises as the Pilates one hundred, roll-ups, alligator and bicycle pedals provide children with movement and increased core awareness so that they are then ready to sit at a table in good posture and work.
During the one hundred exercise, children maintain a supine flexion position and flap their arms with small pulses by their knees and, depending on the child's age, they might imagine spelling words or their own name in the air.
In the alligator exercise, children lie prone with their arms extended and chop like an alligator eating small or large bites.
As soon as the posture starts to decrease and the fidgetiness resumes, it's time for an exercise break to get up, move around and return the child's body back to stability.
There are several fun ways to help children activate their core during Pilates exercises. Have the child pretend his tummy is a drum or a pint of ice cream that you have to scoop out, or ask him to sink his belly button down to the ground while supine.
Finally, vibration or even tickling can help with activating core muscles to contract.
Breath
Breathing effectively can also help children execute activities of daily living with ease and better endurance. Children with autism who have poor respiration patterns cannot focus on the task at hand because their desire for adequate oxygen is more important than the activity you have set up.
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Pilates can be an effective intervention for strengthening and improving motor control for children with neuromuscular disorders.
Using Pilates to strengthen the thorax will help with such respiration issues. Again, the exercises will focus on the core as well as the breath.
In Pilates, you should inhale through your nose and exhale through your lips. For children, I like to use the imagery of "smell the birthday cake and then blow out the candles."
Exhaling should be done while keeping your core contracted during the exercise to protect your body from injury.
Muscle Control
Children with autism often have difficulty understanding and practicing muscle control. Many are like a light switch; they are on or off. They do not know how to slowly "come on" or "dim down" activation of their muscles.
The Pilates concept of core control can help therapists, and adding exercise variance will help children increase their awareness and ultimately motor control.
To vary the necessarily repetitive activity, both Pilates sets should not be the same. One should be fast and then slow and then medium.
This works great with the bicycle pedals exercise, with the child lying supine moving first slow and then faster all while maintaining core control.
If the child loses control, add resistance at the ankles, again adding variance. Another option is to set the range of motion to where the child is at first, then smaller and then biggest at the end or vice versa.
This unpredictability helps significantly with motor planning and helps teach children all the varying degrees of motor control, not just on or off.
Adaptability
All these exercises can be completed in a fun and functional way with easy adjustments for children with limited attention span, communication or sensory motor processing skills.
Using balls to squeeze between their legs or heels, or placing a basketball under their legs are easy, fun accommodations for postural support.
Exercise bands or tubing can help facilitate and allow for variance in exercise sets, and therapy balls can provide children a way to work on core stability on an unstable sitting surface.
Finally, singing songs and using rhythm is a fun way to engage children and keep them interested and motivated to attend to the task at hand.
The children with autism I work with don't even realize they are doing Pilates because it is fun and functional. They love the exercise break that gets them to the place of focus, and they have increased functional performance as a result.
Angelique Micallef-Courts, OTR/L, is a pediatric occupational therapist with 20 years of experience and is a fitness (yoga/Pilates) instructor.
She works at Central Florida Therapy Solutions in Longwood and Orange City, Fla. and travels nationally through Educational Resources Inc. to teach yoga and Pilates for children with special needs.
She is also creator of Giggleyolates, a yoga and Pilates exercise DVD and protocol for children with special needs.
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