On Sunday I had my regularly scheduled AM park session with 9-year-old “Jack,” who has a PDD diagnosis. We set up a fitness rope, Sandbells, small hurdles, spot markers, and a medicine ball on the blacktop. Typically, some other children wander over to our spot (children CANNOT resist heavy, brightly colored, and oddly shaped objects that are throw-able), and as long as they are supervised (because we live in current, overly fearful times), I let them toss or slam the Sandbells, swing the ropes, and…play. It is a pretty good social opportunity for Jack and the onlooking parents seem to thing it’s damn cool. So is this therapy? Is it play? Is it therapeutic for one kid and play for the neurotypical one?
Is Autism Fitness a therapeutic thing or…not? I often get labeled as a “therapy” practice (my original company name, Theraplay-NY does NOT help and that is entirely MY fault), but the assumption, I think, is as follows:
Autism Fitness provides some type of activity for the autism population, therefore, it is therapeutic. Now, “therapy” can have both broad and specific/clinical definitions, however most people do not immediately associate the fitness profession with therapy, they associate it with, typically, health and wellness, strength, conditioning, and athletics, and/or aesthetic enhancement. Because the autism (and a generally younger) population is involved here, there is confusion between Fitness/Active Play and Physical Therapy.
Many young people with autism have physical therapy to enhance poor strength, coordination, stability, and general gross motor skills. There are plenty of good studies, some cited in this article demonstrating that the ASD population has a higher incidence of gross motor delays/deficits than the neurotypical pop. The difference between physical therapy and a fitness/active play approach is the latter, my area, is more robust. There are a good number, I’m sure, of PTs who know what they are doing, and an equal if not greater number who simply apply what they learned in PT school with no conscious or ongoing thought of what, exactly, they are trying to accomplish and whether or not what they are doing is actually accomplishing the goal (I’ve met both kinds). Some PTs can be singularly-focused, with one specific goal for one area of the body or movement pattern meaning they have to focus on a specific gross motor issue whereas I, and other fitness professionals, are not limited to a shoulder or hip.
My two goals for Autism Fitness athletes are: 1) Get them moving better and 2) Eventually find some aspect of movement that is reinforcing for the athlete. The idea is not “success at the enhancement of poor upper body muscle tone,” rather “Establish fitness and the seeking of movement/active play as part of daily living.” While my athletes often do have some motor issues, the programming will include exercises both for that particular deficit and beyond (with other, unrelated movement activities).
The point to all this, I suppose, is that fitness and active play can be therapeutic, but they are separate (and more general) than therapy. Ironically, effective PT programming looks a lot like fitness and active play.