All-Inclusive: 
Adaptations Mean Fun for All - How Parents and Coaches can Encourage Group or Individual Sports 
Involvement for Children with Autism

Written by Ellen Notbohm; Photo: Fotolia.com

Physical wellness in children is an issue for our times. Decreasing amounts of time spent in physical activities, increasing amounts of time spent on electronic activities coupled with poor dietary habits has contributed to the explosion of obesity in school-age children. Unaddressed, these children will grow up to reap the rewards of their sedentary lifestyles: heart disease, diabetes, decreased life span. Scarier than anything is the growing body of data suggesting that our children’s life expectancy will be shorter than that of their parents.

Physical activity is critical not only to bodily wellness but to cognitive, social and emotional health as well. Your child with autism faces even greater challenges than their typically developing peers. Impairments to sensory processing, social cueing and language processing may impede their ability to participate in a general PE class or in team sports. In many cases, these impairments may have little to do with gross motor skills.

Sports participation requires the ability to reliably perform a gross motor skill repetitiously, and then apply it to a specific context. When a child can do this, the opportunities to interact with peers in active fashion increase. With proper accommodation, most children with autism can reap the benefits of participating in physical activity. How can impairments in autism, other than physical, affect the ability of a child with autism to participate in PE or group sports, and how can teachers, coaches and parents modify their instruction in a manner that allows the child with autism to participate successfully and safely? Read on.

Identify problem areas. Become aware of extenuating circumstances unrelated to a child’s gross motor skills that can affect their ability to participate in physical-social activities:

• Child is not physically safe in the PE or sports environment (e.g. runs off, uses equipment improperly).
• Child has difficulty independently performing activities due to attention problems.
• Child needs verbal or physical cueing or assistance to perform activities.
• Child needs modified rules or equipment.
• Child has trouble understanding, processing or following instructions delivered to a large group, or delivered verbally one-on-one.
• Child can perform the skill but not at the pace of the general group.

Communicate using simple, clear, supportive language:

• Keep teaching in small increments. Teach one thing at a time: a motor skill, a set of rules or the language of the game - but not all at once.
• Give instructions one step at a time, checking for comprehension.
• Give instructions one-on-one or in close proximity to the student. The student is not able to filter multiple auditory inputs.
• Repeat instructions throughout the activity.

Provide visual support for activities. These can be written instructions in large, bold serif, double-spaced type on low-brightness or buff-colored paper. If possible, make visual instructions available to the student and family ahead of time. Some children benefit from having the visuals on a flash drive, CD or audio device.

• Have an adult or peer review the visual materials with the student or player to check for comprehension.
• During the activity, define the playing space by setting clear visual boundaries. Set up a visual point or a reward system for following instructions; staying with the activity for a certain number of minutes; completing the activity. Expect progress to come in tiny increments.

Beware of sports idioms and metaphors. Use concrete references:

Encourage two-way communication. Your student with autism processes information more slowly and in a different manner than typically developing kids. Allow plenty of time for them to respond. Be alert to ways in which they may communicate with you other than with words. Body language is communication; behavior is communication. Offer alternative ways in which they can communicate with you other than with words.

Demonstrate!

• Walk the child through steps of an activity, clearly identifying the beginning and the end.
• Assign a peer buddy. Choose carefully; it must be someone who is competent but not superior at the activity (discouraging to the student who struggles) and who likes helping others.
• Place the child with autism third or fourth in line. This gives them a chance to observe their peers performing the activity and motor plan how they will do it, but without the anxiety or frustration of a long wait in line.

Respect the child’s social boundaries

Don’t force physically close interactions. Something as simple as letting the child sit at the end of the bench or on a separate chair or stool can make a big difference. Don’t tousle their hair, pat them on the back, offer them a hug or a handshake without asking the child (or a parent) if this is acceptable.

They may be more comfortable learning or participating with children older or younger than them. Teach to their developmental age - not their chronological age.

The child needs consistency, more so than typical children do. They may take their time getting to know you and trust you. Be patient, results will come when they feel comfortable. 

Avoid an ever-changing lineup of helpers, teachers and assistants. A consistent helper will learn when the child needs help and when to fade, and that’s ultimately what we want on their way to being able to perform independently.

Don’t spring changes on them. Introduce changes well ahead of time to allow the child to adjust. Use visuals to explain changes.

As much as possible, allow the child to self-pace social interactions when focusing on learning motor skills. Many children with autism know when to ‘check out’for a self-regulation break. And all children, like all adults, will occasionally have an off day. Move on. There’s always tomorrow.

The care and prevention of ‘behavior.’ Consistent teaching, predictable routine, clear language and visual supports are the best defence against ‘behavior.’Know the warning signs of an impending meltdown:

• Loss of balance or orientation
• Skin flushes, or suddenly goes pale 
• Child is verbalizing, “Stop!”
• Child steadfastly refuses activity
• Racing heartbeat or sudden drop in pulse 
• Hysteria, crying
• Stomach distress: cramps, nausea, vomiting 
• Profuse sweating 
• Child becomes agitated or angry 
• Child repeats non-relevant phrases or behaviors over and over again (self-calming behavior)
• Child lashes out, hits or bites

If any of these occur, stop the activity at once, direct the child to a calming area or activity until they are ready to re-join the group, or stop for the day. It is wise to have a plan for handling behavior situations before they arise. Consult with the parent, teacher or occupational therapist for effective calming techniques. Many children with autism demonstrate repetitive behaviors that can seem odd. These behaviors fill a need for the child. Attempting to extinguish them without identifying the need behind the behavior will be unsuccessful.

Adaptations for all. Adaptations abound for nearly all sports, so opportunity is everywhere for the child with autism to build skills and experience success. 

Rule No. 1 - Keep it fun; keep it safe.

Golf - Enlarge the hole. Use a larger ball (such as a tennis ball). Use a club with a larger head. Use a lighter or a shorter club. Don’t keep score.

Basketball - Play half court. Identify each team’s basket with a colored cone. Modify the size and the weight of the ball. Lower or enlarge the hoop. Shorten the foul line.

Roller-skating and skateboarding - Acclimate a child to skates by letting them walk around a carpeted area until they get the feeling of balance. Transition to skating using a walker or cross-country roller-ski poles.

Table tennis - Install bumpers (as in bowling alleys) so the ball doesn’t bounce off the table as frequently. Allow more than one bounce. Lower or remove the net. Play two against one; your child and a teammate against a single, more skilled person.

Floor hockey - Use a brightly colored Frisbee or plastic plate rather than a puck. Use brooms instead of hockey sticks. Increase or decrease the size of the goal or playing area as needed. Visually define playing area with bright tape or cones.

Bowling-type games - Use lane bumpers. Ramp the lane slightly downhill (large plastic tubing sawed in half lengthwise works well). Allow a standing start. Shorten distance to pins. Color-code the head pin.

Tag-type games - Tag using a swim noodle, foam pipe insulation or “We’re #1” foam sports fingers rather than hands (maintains proxemic safety zone and limits uncomfortable touching for the child with autism). Create a neutral or safety zone where the child can retreat if they tire or need a self-regulation break.

And above all, praise the effort, not just the result. Always emphasize ability, not disability.

Ellen is the internationally-renowned author of one of the autism community’s most beloved books, Ten Things Every Child with Autism Wishes You Knew, and three other award-winning books that have been translated into more than 20 languages. For more information, visit ellennotbohm.com.