AUTISM SPECTRUM DISORDER AND SPORT
The prevalence of ASD has increased significantly in recent years(11). For example, in Australia, it grew 79% in the period 2009-2012(1). Critical challenges of ASD refer to emotional and cognitive tasks, communication, mobility, socialisation and the risks of increased heart disease, obesity and diabetes that the largely sedentary lifestyle associated with ASD implies(1; 7; 16; 15).
Exercise ‘is a sensible approach to addressing a variety of problems associated with ASD’(15), particularly in the motor and social spheres(14). In this framework, participation in sport can be considered ‘essential, as it provides a sense of normalcy, allows the children to experience a fun activity with their peers, and develops important interpersonal skills’(6). Nevertheless, in order to provide favourable environments for participation, the program design needs to emphasise adaptations of physical activity (PA).
Increasing PA in people with ASD can be difficult because of low motivation, poor motor functioning, difficulties in self-monitoring, socialising, and planning(12; 17). Individuals with ASD tend to have a great variety of abilities, with a variation of impaired and spared emotional, motor, social, creative, cognitive and sensory abilities. This implies that any given group of people with ASD will have a variance in individual ability differences in relation to sport.
The complexities of ASD make the role of coaches and sport managers particularly important to create supportive environments where participants can improve their skills, learn to relate to specific sports, enjoy peer companionship and feel accepted in a team sport setting.
However, while specific/specialised training would help coaches to gain an appropriate understanding of ASD, coaches are often volunteers, lacking access to specialised support and/or knowledge of effective practices to coach people with a developmental disorder(13).
In an attempt to bridge the gap between ASD and sport participation, a team of researchers and sport experts from the University of South Australia, led by myself, has conducted some innovative work in partnerships with schools and sport organisations in Adelaide and Whyalla (SA) in the last 2 years. In particular, the team looked at good-practice coaching strategies to promote sociability and to engage with people with ASD through sport.
THE PILOT PROGRAM AND ITS RESULTS
This pilot program, named ‘Supporting Success’, ran for 1 school term, every Friday afternoon for 1 hour, delivered by volunteer coaches with the assistance of school staff. Sports were selected in consultation with students and families, and comprised adaptations of cricket, soccer, netball, dance and lawn bowling. 10 coaches were recruited among university students with a significant background in sport, supplemented by 7 school staff who were familiar with all participants. Coaches were provided with general community coaching training freely accessible from the Australian Sports Commission and with basic knowledge of working with youth with ASD provided by the school, but did not undergo specialised training about sport and autism, as this was not readily available.
A group of 24 participants (18 males and 6 females) aged 13-19 was recruited among students of the Modbury Special School. Participants were initially organised in 3 groups based on the classes that they were normally attending during school hours. These reflected their cognitive abilities, but not their age, gender or motor skills. This approach was suggested by the school and agreed upon by coaches as they did not know participants well enough to group them by other criteria (e.g. motor skills).
Several coaching challenges were identified, referring chiefly to verbal communication, content/design of activities and coach-participant ratio. Several participants needed 1 on 1 support to grasp the basic concepts behind some of the sporting tasks.
Coaches were especially challenged by explaining activities involving rules or more than one instruction, and giving directions to low-functioning participants. Breaking skills down into series of micro-steps helped to mitigate the issue and improved participants’ focus.
Engaging all participants regardless of their level of functioning was an important part of the project (with reference to UDL and its flexible approach to coaching) and it also proved challenging. This implied the need for micro-adaptations within each activity to maintain the interest of the most motor skilled participants whilst ensuring accessibility for the less skilled ones. For example, this included increasing/reducing the size of equipment (e.g. balls) or the distance of a kick/pass within the same exercise according to each participant’s abilities, or rolling a ball on the ground instead of throwing it in the air. It also included the use of cue words and an effort to retain a consistent and predictable structure/routine and to design activities organised in stations.
Activities in enclosed spaces (i.e. the gym) generally proved more complex for coaches as they provided more proximity with other groups of participants and so more opportunities for distraction.
Initial consultation with school staff suggested that approximate coach-participant ratios of 1:3 or 1:4 would be satisfactory. However, when the program commenced, coaches identified that more resources were needed to ensure all participants received attention at all times and suggested that a desirable coach-participant ratio would be as high as 1:2.
Coaches and school staff identified several strategies as effective to engage participants on the basis of their observation of the willingness/enthusiasm showed by participants in response. In particular, these referred to positive reinforcement/encouragement and relationship-building strategies. For example, coaches deliberately celebrated all the successes – even minor achievements – of participants. This included both verbal and physical explicit displays of approval (e.g. high fives, fist bumps, victory dances) and proved very popular with participants showing appreciation and initiating celebrations themselves in several instances. Coaches also provided much encouragement (both verbal and body-language) for participants before, during and after activities. Importantly, by the end of the 6-week pilot, participants started to encourage their peers verbally very noticeably.
Another example referred to the inclusion of ‘walking warm-ups’ at the beginning of every session, which proved effective in giving participants an opportunity to talk amongst one another and to chat informally with coaches. During these times, participants typically asked numerous questions about the forthcoming sessions, for example about the nature of planned activities and their location.
An important feature of the project was an excursion to the Adelaide Oval in the last week of the program, including a visit and a cricket clinic delivered by South Australian Cricket Association coaches in conjunction with the regular volunteer coaches. Participants showed much engagement and enthusiasm during the excursion, despite finding themselves at an unfamiliar location and outside their typical routine. Several participants kept mentioning the excursion and writing about it in their recount journals for several days after its occurrence. This was uncharacteristic as they had not displayed an interest in sport previously, but, building on this, the school decided to incorporate cricket as a topic of formal conversation classes, where students practice social and communication skills with teachers and peers. School staff suggested that participating in the program helped students to establish a good relationship with their volunteer coaches and that experiencing some aspects of the game of cricket in the weeks preceding the excursion helped participants feel comfortable and engage with the day’s activity.
The evaluation of the program indicated that the great majority of participants enjoyed themselves, enjoyed playing with coaches and peers, and would like to keep playing sport beyond the program.
HOW COACHES CAN PUT THIS INTO PRACTICE
This project showed that it is possible to use sport to work with adolescents with ASD and suggest that this may facilitate the development of a positive environment to engage participants in activities targeting socialisation and promoting PA. It also emphasised that the role of coaches is paramount to engage participants on a personal and individual level. Coaches need to understand the discrete needs and abilities of all participants in order to sensibly and fluidly adapt activities ‘on the go’ to maximise motivation. Activities should be kept as simple as possible, suitable adaptations should be planned for, session plans should be clear, coaches should have prior knowledge of the participants’ abilities, and sessions should be planned to be consistent and predictable, yet flexible enough to allow for late modifications.
A high coach-participant ratio is critical to ensure individualised support throughout activities. However, to maximise socialisation outcomes, it is critical that the experience of participants is carefully monitored by coaches to ensure a balance between individualised support and the provision of an environment that may foster interaction and socialisation among participants. Pairs or trios – as opposed to groups of six to eight – seem a viable solution, providing opportunities for individualised support as well as more interaction with coaches and a reasonable degree of interaction with peers.
Group selection is another critical point. Levels of motor and social functioning may differ greatly within a cohort of participants and coaches should be aware that cognitive functioning may not reflect motor abilities and be prepared to continuously monitor the experience of participants and re-arrange pre-determined groups if necessary. Future adaptations of the program will need to consider a more careful approach to group selection, for example after a series of ‘come and try’ sessions aimed at grouping participants with peers displaying similar sport-related and social abilities.
Coaching knowledge and training is crucial, particularly about key paradigms of ASD and PA. However, given the importance of high coach-participant ratios, the general lack of specialised ASD training available for sport coaches, the obstacle that securing highly-trained coaches generally requires high fees and the endemic fund drought that community sport programs face (at least in Australia), it is unrealistic to expect community programs to be staffed by a majority of highly specialised coaches. To mitigate this issue, it is beneficial that program design is informed by a true community development approach(18) and includes at least one specialised organisation, which undertakes the task to prepare volunteer coaches to work with adolescents with ASD and provides specialised on-site support. It is important that future adaptations of this project recognise the need for a specific coach education program that goes beyond currently-available generic, simplified approaches to sport and mental disability, that is informed by principles of UDL, and is designed/delivered in collaboration between sport and ASD experts.
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