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TEACHING FUNCTIONAL FITNESS TO STUDENTS WITH AUTISM SPECTRUM

DISORDER

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 TEACHING FUNCTIONAL
FITNESS TO STUDENTS WITH
AUTISM SPECTRUM DISORDER
HYUN-KYOUNG OH GUILLERMO ESCALANTE CHRISTOPHER GENTRY
California State University, California State University, California State University,
San Bernadino San Bernadino San Bernadino

Abstract Adapted physical education and general physical edu-

cation teachers have faced challenges in teaching and pro-
Adapted physical education and general physical education
moting general physical activity and fitness; however, im-
teachers may face challenges in teaching and promoting
plementing functional fitness activities may help them to
general physical activity and fitness. Implementing func-
engage students more effectively and help students become
tional fitness activities, which integrate motor skills to carry
more active (Menear & Neumeier, 2015; Shields & Synnot,
out activities for daily living, may help teachers to effectively
2016). Engagement in physical activity can serve as a pow-
engage students with autism spectrum disorder (ASD) to
erful promoter of health and well-being in adults and youth
become more active. Because students with ASD often lack
with neurologic disease (Quinn & Morgan, 2017). The func-
motor coordination and have low levels of physical activity,
tional fitness activities presented in this manuscript may
functional fitness training can be a fun and effective tool that
provide ideas of exercises for teachers to implement with
helps them improve their fitness levels and potentially as-
their students to add variety to their programming.
sists them in their activities of daily living. The purpose of
According to the American College of Sports Medicine
this article is to demonstrate how simple functional fitness
(ACSM, 2017), functional fitness training is a type of neuro-
activities can improve activities of daily living that require
motor exercise program that integrates motor skills such as
strength, endurance, flexibility, and stability. These activi-
balance, coordination, gait, agility, and proprioceptive train-
ties are meant to be stimulating and purposeful. 
ing. This type of training program challenges the muscles
to work in a coordinated fashion to simulate tasks that are
Keywords: autism; ASD; physical education; fitness
commonly performed in activities of daily living. Instead of
single-joint movements, functional fitness training utilizes
multi-joint exercises that target more than one muscle group
Autism spectrum disorder (ASD) is characterized by two
at a time. In addition to multi-joint movements that require
categories in which individuals with ASD demonstrate deficits
some strength, functional fitness exercises also require a
in social interaction and communication and/or resistance to
level of coordination, agility, and/or balance for students to
change (American Psychiatric Association, 2013). This devel-
perform the movement successfully. Because students with
opment disorder is considered to be a neurodevelopmental
ASD often lack motor coordination and have low levels of
disorder of unidentified etiology with heterogeneous behav-
physical activity (Reid & Collier, 2002; Todd & Reid, 2006),
ioral symptoms (Dawson, 1996; Ghaziuddin & Butler, 1998;
functional fitness training can be a fun and effective tool that
Reid & Collier, 2002; Sokol & Edwards-Brown, 2004). Al-
helps them improve their fitness levels and assists them in
though most students with ASD hit major motor milestones
activities of daily living (e.g., routine activities that people do
(e.g., creeping, crawling, and walking) during their infant and
every day without needing assistance such as eating, bathing,
toddler years, noticeable deficits remain in motor coordina-
dressing, toileting, and walking). The benefits of functional
tion, physical fitness, and physical inactivity as students with
fitness training have been shown to lead to improvements
ASD age (Pan, 2014; Reid & Collier, 2002; Watson, Baranek,
in balance, agility, and muscle strength in older adults; col-
& DiLavore, 2003). For example, students with ASD often
lectively, this has reduced the risk of falls and fear of falling
encounter challenges for participating in physical activity
(Garber et al., 2011). Hence, integrating this type of fitness
because of their low physical fitness levels and poor motor
training early into students’ lives will likely help them to be-
coordination (Reid & Collier, 2002; Todd & Reid, 2006). In
come lifelong learners and movers and will ultimately affect
general, students with disabilities have faced more barriers
their health and well-being in the present and in the future.
(e.g., less motor coordination, lower levels of physical fitness)
To effectively introduce functional fitness activities to
to actively engage in physical activity than students without
students with ASD, teachers must consider the ability of the
disabilities. Thus, students with disabilities, inclusive of those
students to complete the activities. Furthermore, additional
with ASD, have engaged in less physical activity and shown
modifications may be necessary. As is the case with all stu-
a relatively low level of physical fitness (Bandini et al., 2013;
dents, it is important for teachers to consider the delivery
Frey, Stanish, & Temple, 2008; Pan, 2014).

Vol. 32, No. 1  | 2018 |  PALAESTRA   51

of instruction. Some students with ASD may have difficulty
with auditory instructions alone; thus, visual cues may be
necessary (Grandin, 1995). For example, Breslin and Rudisill
(2011) examined the effects of visual supports on the motor
performance of children with ASD and found that children
with ASD performed better with the picture task card proto-
col than with traditional and picture activity schedule pro-
tocols. Beyond visual supports, teachers must consider the
needs of the individuals, as no two students will respond to
stimuli in the same way. Teachers must consider multiple
strategies to communicate with students with ASD and ease
them into new activities to limit challenging behaviors. Lee
and Haegele (2016) suggest that it is important for teachers
to introduce students to new stimuli slowly, limit the sur-
rounding distractions, and allow students time to touch new
objects, among other methods.
The following functional fitness activities are meant to
improve activities of daily living that require strength, en-
durance, flexibility, or stability. These activities are meant to
be stimulating and purposeful.
1. Water Bottle Shake-Up: This exercise requires stu-
dents with ASD to shake water bottles in various body
planes and positions. The act of shaking the water
bottle requires a coordinated contraction of agonist
and antagonist muscles for students to successfully
perform the task smoothly. Instead of performing
traditional strengthening or muscular endurance ex-
ercises, students with ASD will focus on the changing
color of the water–oil mixture. Additionally, they can
move their upper extremities through various body
planes and positions, as is required in many activities
of daily living. Furthermore, shaking the water bot-
tles for a prolonged period may also act as a form of
cardiovascular fitness exercise for students with ASD.
a. Equipment/Materials: Various sized water bot-
tles that are filled a third of the way with water,
a few drops of food coloring, and the rest of the
way with oil.
b. Activity: Students extend the water bottles (one
or two) away from their bodies and shake them
in the frontal plane, in the sagittal plane, in the
transverse plane, or through a diagonal range of
motion, based on the teacher’s directions. The
visual stimulation of the oil and food coloring
allows students to focus on the bottle while in-
creasing muscular and cardiovascular endurance
(see Figures 1 and 2).
c. Progressions: The teacher may modify the activi-
ty in new and challenging ways, depending on the
comfort level of the students with ASD. The stu-
dents may hold one or two water bottles at a time.
An increase in the weight of the bottle may allow
for a focus on muscular strength as opposed to
muscular endurance or cardiovascular fitness. In
addition, the teacher may request small and fast
movements, large and slow movements, or may
ask the students to extend the bottles in front of
them to create specific shapes, which are shown
on task cards. Stability, another component of
functional fitness, may also be incorporated with
52  PALAESTRA  |  2018  |  Vol. 32, No. 1
Figure 1. (Left) Shake the bottle in the sagittal plane.
Figure 2. (Right) Shake the bottle in the frontal plane.
this exercise with the teacher asking students to
balance on a small trampoline or balance pads
while moving the bottles.
2. Color-Changing Chair Sit-to-Stands: The ability to
transfer from a seated to standing position is func-
tional for many activities of daily living such as sitting
on a toilet, transferring into or out of a car, and sit-
ting on a chair. It requires a coordinated contraction
of the muscles in the quadriceps, glutes, and ham-
strings; furthermore, mobility in the ankle (e.g., dor-
siflexion) and the hip (e.g., hip flexion) are necessary
for someone to perform this functional task effec-
tively. This exercise mimics this activity of daily liv-
ing and promotes lower extremity mobility, strength,
muscular endurance, and even cardiovascular fitness
if done consecutively as part of a walking and sit-to-
stand circuit.
a. Equipment/Materials: Chairs, plyometric
boxes, or medicine balls as a surface to sit on.
Color-changing paper (paper that changes color
on contact), which provides a visual stimulus,
and two-sided tape, which holds the paper in
place on the sitting surface.
b. Activity: Students sit on a surface of the teacher’s
choosing that is covered with the color-changing
paper. Be sure to tape the paper down to prevent
sliding. Visual stimulation will be provided when
students are asked to stand back up and view
the paper, because the paper changes color upon
making contact with the student’s body (see Fig-
ures 3 and 4).
c. Progressions: Students can sit on items of vari-
ous heights, which increases the distance from
the starting position (standing) to their resting
position (sitting). To focus on cardiovascular en-
durance, students can repeatedly jump or hop
from one piece of paper to another. This can be
organized in multiple patterns, which extends
the difficulty of the task.

Figure 3. (Left) Ready position for squat to box.
Figure 4. (Right) End position for squat to box.
3. Medicine Ball Toss: The medicine ball toss requires a
coordinated sequential segmental movement pattern
starting from the lower extremities, through the core,
and into the upper extremities. The momentum ini-
tiated by the lower extremities must be transferred
into the upper extremities for students to toss the ball
successfully. Furthermore, the activity requires the
ability to control the amount of force generated, with
targets set up at various distances from the student.
This exercise may help in activities of daily living
such as carrying and lifting bags, groceries, or boxes.
a. Equipment/Materials: Medicine balls of various
sizes (e.g., that can be handled with one or two
hands) and weight (e.g., ranging from 1 t0 15
pounds), depending on the ability of the student.
Furthermore, the teacher may set up various tar-
gets either on the wall or on the ground (e.g., tape
target on the wall, Hula Hoops, sand-filled water
bottles, cones on the ground).
b. Activity: Students hold the medicine ball at their
chest with elbows bent and push it toward the
target (i.e., basketball chest pass). Visual stim-
ulation is provided in the various high and low
targets that are impacted by contact with the
medicine ball. This activity focuses on muscular
strength and transfer of force from the legs to the
upper extremities, requiring students to exert
enough force to reach the target.
c. Progressions: Students who are ready for a more
difficult variation of the activity can hold the
medicine ball behind their head with elbows bent
and swing the ball forward (i.e., soccer throw-in;
see Figures 5 and 6). This progression requires
students to focus on balance while managing a
perturbation to their stability and may help in
preventing falls. To increase or decrease the dif-
ficulty, the teacher can move the targets closer or
farther away from the student. In addition, the
teacher may adjust the size or number of tar-
gets to fit the needs of the students. The teacher
may give different point values to the targets,
to challenge the students. The teacher may also
have students adjust their base of support. This
may include a wide base (shoulder width), a nar-
row base (feet together), a tandem stance (one
foot in front of the other), or a one-foot stance.
Figure 5. (Left) Medicine ball overhead throw – Prep
phase.
Figure 6. (Right) Medicine ball overhead throw –
Follow-through phase.
4. Resistance Band Walk: This exercise challenges the
core, upper body, lower body strength, and balance.
The resistance band provides a form of variable re-
sistance that increases as the student moves farther
away and decreases as the student gets closer to the
anchor point of the band. The variable resistance
causes students to consistently increase or decrease
the force that they apply in order to move forward,
backward, or side to side. It is functional in nature in
that it requires a concerted coordination of the whole
body for it to move in various directions with varying
degrees of effort.
a. Equipment/Materials: Resistance bands and
an anchor for the resistance bands. Optional
heat-activated color-changing paper or a tape
line may also be used as targets that cue the stu-
dents of how far they need to move.
b. Activity: Students hold a resistance band that is
anchored to an immovable object (i.e., a basket-
ball pole) with both hands. They laterally shuffle
(feet never crossing) a few steps away from the
anchor and then back. Color-changing paper or
a tape line may be provided as a target to reach.
Students should take turns moving to their right
and to their left. Another modification may be for
students to walk backwards and forwards while
holding the resistance band over their head (see
Figures 7 and 8).
c. Progression: Students may use resistance bands
of increasing resistance, based on the individu-
al’s strength. Students may also walk out faster
Vol. 32, No. 1  | 2018 |  PALAESTRA   53
 or slower to make the exercise more challenging.
Enjoyment is necessary, so teachers must pay
attention to students who are becoming discour-
aged and decrease the resistance if necessary.
Figure 7. (Top) Resistance band lateral shuffle.
Figure 8. (Bottom) Overhead grip resistance band
walk.
Summary
Students with ASD can improve their motor skills and
fitness levels by participating in physical activity interven-
tion programs (Pan, 2014). Physical educators who focus
on teaching motor skills and physical fitness to students
with ASD may encourage students to lead a more active
life. Furthermore, functional fitness activities may help stu-
dents with ASD to engage in their daily activities more inde-
pendently; these functional fitness activities that prepare the
body for the demands of everyday life require the coordinat-
ed use of multiple muscles and joints. To truly be effective in
implementing functional fitness activities for students with
ASD, both adapted physical education and general physical
education teachers have to realize that strong management
and content are necessary to allow for student achievement.
All activities should be modified to meet student outcomes.
Teachers may be able to meet all four domains (i.e., psy-
chomotor, cognitive, affective, social) with these activities
(Bailey et al., 2009). For instance, students may be asked
to repeat basic cues (cognitive), respect the equipment (af-
fective), or share the equipment with others (social). It is
important for teachers to consider the individual needs and
capabilities of their students. No two students are alike, so
activities that are enjoyable or appropriate for some will not
be for others.
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Hyun-Kyoung Oh is an associate professor at California
State University, San Bernardino. She coordinates
adapted physical education specialist credential
program and her research interests are challenging
behavior of students with disabilities, teacher self-
efficacy, and pre-service PE and APE teacher training.
Guillermo Escalante is an assistant professor at California
State University, San Bernardino. His research interests
are sports injury prevention, sports supplementation,
sports performance enhancement, and biomechanics.
Christopher Gentry is an assistant professor at California
State University, San Bernardino. His research interests
are elementary physical education, teacher career
cycle, physical education teacher perceptions, and
group dynamics in physical education.