Proprioception, Autism, Exercise and Sensory Issues – A Guest Post from PlayThroughAutism.Com

Autism Exercise Topics: Proprioception and Sensory

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 Proprioception and sensory are widely discussed topics in Autism literature, and understanding the implication on physical activity can be immediately actionable for getting our kids to exercise more effectively. Proprioception is essentially our body sensing and working with the world around us.

Let’s focus on proprioception in relation to our spatial senses. Spatial senses tell us where our arms and legs are as we move around. We use our proprioceptive senses when our mind tells our body how to physically and technically do the exercises we intend to perform.

However, propioceptive sense is more than that. It’s the feeling you get “in your gut” when you are falling, and how springboard divers and gymnasts know when they have done 2 twists instead of 3. Some kids love to experience this sense and jump off of things or rock back and forth. Controlling this sense can also be comforting for many kids with autism.

“The child with ASD will learn to roll, crawl, and walk, but the quality of their movements may be poor. As the child gets older, they may struggle to function at more sophisticated levels when they have not mastered these core skills. As a result of differences during development, children with ASD often have deficits in equilibrium and righting reactions (moving the body to maintain an upright position), protective reactions (putting a hand out to catch yourself when falling), and movement strategies (persistent w-sitting). These differences may present as clumsiness, lack of coordination, lack of attention, hyperactivity, gross motor skill delay, flat feet, toe-walking, postural instability, poor posture, decreased respiratory control, oral motor difficulty, and flexibility restrictions.” (Ghaziuddin & Butler, Gillberg, Kohen-Raz et al., Hallet et al., Vilensky et al.).


So what does proprioception and sensory mean for helping our kids with autism exercise?

It goes without saying that exercise is important for our kids’ physical health. However, exercise and play therapy have been shown to improve the lives of kids with autism by supporting self-image, integrating with peers in natural ways, decreasing unwanted behavior impulses, and exploring personal capabilities.

For instance, a therapist can use play observation to assess balance, protection reactions, and motor planning skills. The therapist can also assess the child’s posture in different positions, determining how posture changes the child’s motor control. The therapist can then analyze which muscle groups are being underused or overused, and help set a plan to correct that. For example, a child who is a “toe walker” may be overusing their calf muscles. Understanding how to incorporate more active utilization of the opposing muscle group, and stretches to loosen up the calf muscle may help somewhat. For a look at a quick assessment of posture using a simple squat, check out this post.

Next step – decide which actions specifically we are trying to motivate relating to fitness. Our list probably looks something like this:

  • Improve postural control to increase stability.
  • Improve balance to improve motor control.
  • Learn to perform the sequencing, timing, and execution of individual components of exercises.
  • Maximize sensory processing and organization skills to put into controlled motor skills.
  • Lay down the foundations of gross motor skills to support participation in community and peer activities.


Awareness of the Challenges of Proprioception for Kids with Autism

Sensory integration refers to the brain’s ability to receive and process sensory stimulations from the environment. This includes three basic senses – tactile, vestibular, and propioceptive.

The tactile system refers to the nerves under the skin’s surface that send information such as light touch, pain, temperature, and pressure to the brain. This is important for perceiving the environment, as well as protecting from dangers. Issues with this system could lead to hyper- or hyposensitivity (such as tactile defensiveness which makes a person extremely sensitive to light touch).

The vestibular system refers to senses and structures within the inner ear that detect movement and changes in the position of the head, such as when the head is up or down, even when the eyes are closed. Issues with this system may be on either extreme. One extreme is that they are fearful of even small normal changes in vestibular stimulation making it difficult to learn to walk on stairs and unstable surfaces. On the other extreme, the child may like these sensations and want to jump, spin, and roll excessively.

The proprioceptive system, what we want to focus on for our exercise purposes, refers to the muscles, joints, and tendons that provide awareness of body position. When proprioception is functioning properly, a person’s body position is integrated into their sensory awareness and can be automatically adjusted. For example, the propioceptive sense helps us to step down a stair smoothly, or to judge the necessary speed to sit in a chair. This sense also helps with using fine motor skills such as writing with a pencil, or buttering a piece of toast.

Issues with the propioceptive sense are evident through clumsiness, falling often with out being able to catch yourself, odd body postures, difficulty with dexterity and apprehensiveness with new motor skills.

Motor planning refers to a persons ability to plan and execute different motor tasks. This takes into account the following systems to accurately take in information, perceive it properly, and then executing on those senses with appropriate actions.

What Can This Tell Us?

The implications of dysfunctions in these sense areas can mean lowered activity levels and being easily fatigued or easily distracted. It can also mean that children with autism fluctuate between these extremes and can be hard to predict. Becoming frustrated, aggressive or sad, and withdrawing are all common.

The goal is to eliminate environmental senses and stressors that are not consistent with the desired exercise outcome and to increase the motivation techniques the help to support proper exercise. Read here for information about motivation.


Finding Quick Fixes for Frequent Sense Issues During Exercise:

Sight: Sensitivity to bright and flashing lights or other people or objects moving quickly in the exercise area can cause too much stimulation to be able to focus on the requested exercise. Try to move toward an area of the gym or exercise room where other people are not running or throwing things. Ask that flash photography is not allowed in during your training times. If it’s possible, try to dim the lights a little during your exercise times or seek out natural lighting. If these options aren’t available, try to move toward a corner of the exercise area and face the corner eliminating other distractions.

Hearing: Loud music is a staple of most people’s workouts. However, loud and/or fast paced music may cause too much distraction and simulation. The person may not be able to filter multiple sounds at once and might make it hard to focus. First try eliminating extra noise, such as turning off the music. However, the silence may also be distracting so try to find music to add with a slower beat and less percussion. Find the right music may be a good way associate exercise with something the kids already like. For instance, one of our athletes loves High School Musical. Associating the High School Musical soundtrack as a reward for exercising well has proven to be a big help in keeping him focused.

Touch: This can be a make or break point for many of our athletes with autism. The feel of our cross-stitched trampoline mat can be a great sensation on our kids’ feet and the feel of the foam in our foam pit can become fascinating. However, the chalk on the mats, or the instructors hands on their sides as they attempt to use the bar, can be completely devastating. Find the sources of distress and see if they can be removed. However, often the sources of pleasure can be just as distracting. See if there is a way to turn these into awards associated with exercising. Using a foam block the kids loves to touch as a target on the floor when we are doing bend and reach exercises has proven to be a big help.

Smell: It’s not embarrassing, people smell sometimes when they exercise and gym’s or other exercise areas often try to mask it with worse smelling air fresheners. Sweat is natural, lilacs mixed with aerosol and rubbing alcohol is not. Ask to have ventilation and better airflow as a means to control scent, and to eliminate any artificial air fresheners. If this isn’t possible, try to open a nearby window or door yourself to get the scent as neutralized as possible.

Finally, let’s focus on internal and external feedback. Internal feedback is when the child feels his or her body in space and can adjust as necessary. External feedback is when the child is told to change his or her body position or is somehow guided to make the correction. We have seen a lot of progress with trying to incorporate both internal and external feedback, by using mirrors to allow our athletes to see themselves make the corrections that either they feel are best internally, or we are asking them to make verbally or guiding them to make through contact.

Thank you for reading and I hope that you can use this information to help create a healthy and physically active lifestyle for your child with autism. For more exercise ideas, get the e-book below!

*Much of this research comes from this article: Dr. Joni Redlich, DPT, Autism Spectrum Disorders and Physical Therapy: The Motor Connection. January 2010

Please feel free to ask any questions or share any ideas in the comments box below.

How easy was it to get your child diagnosed with autism? Please share your story at our discussion blog!

How easy was it to get your child diagnosed with autism?

How easy was it to get your child diagnosed with autism?

I think at the outset I should mention that I’m not neutral on the subject of the diagnosis of autism i a young child.  On 1st of September 2009 (yes I can remember without looking it up) my now six year old son was diagnosed with Autistic Spectrum Disorder or ASD.

The process of getting our son diagnosed took around six (rather traumatic) months.  The reason it was so fast was two-fold.  One was that a diagnosis would provide our son with access to vitally needed interventions as early as possible.  The second was that the London based service providing the diagnosis felt we would accept it.

As I run a Facebook Page called AutismTalk ( I realise that there is no one” best way” to get and accept an autism diagnosis.  On the AutismTalk  page there are a wide variety of different reactions to an autism diagnosis.  It is this that I want to explore on today’s blog.

In March of 2009 we were informed by our son’s nursery that they though he had a sharp delay in speech development as well as raising concerns over his gross and fine motor skills.  (No he had not been potty trained by that stage).

Once referred to an “Early Years Centre” in South London our case worker was blunt about telling us that speech delay was highly indicative of autism and that early intervention was vital.    Brilliantly, for all of us, she suggested we move him from his old nursery to a band new specialist autism nursery based in a local primary school.  He started there even before receiving his diagnosis.  The team in this nursery (or Resource Base as it is sometimes referred to) included Occupation Therapists, Speech and Language Therapists as well as conventional teachers.  Its objective was, and is, to enable autistic children to enter mainstream schooling.  This our son achieved.  Though the story of his misadventures in mainstream schooling is perhaps for another post!

I would like to pay tribute to the support of all those professionals who helped our son so much.  By seeming him develop, though sometimes, ever so slowly was the way I came to terms with my sons diagnosis.  While tough I realised there was future with a full life for him rather than the long night of pain I’d expected when I first heard the term autism in relation to our son.

So what is the point of this blog?  Apart from, I suppose, the eternal struggle to get ones “thoughts in order”.  Really I’d just like to ignite a conversation with fellow parents and carers of autistic people about both the process of diagnosis and how they came to terms with that diagnosis.  I’d love it if you could use the comments box below to share your thoughts.  You might like to think about some of the following questions?

a)      What actually was your child’s diagnosis?  At what age were they diagnosed?

b)      What process did your child go through to get diagnosed and how long did it take?

c)      How did you react to the diagnosis?  How did your feelings change over time?

d)      And finally what words of advice would you give to somebody who has just been warned that their child may have autism?

Thanks very much in advance.

PS  I did cry on receiving the diagnosis by the way.  Didn’t you?

Spread Autism Awareness with your Prepaid Card

Welcome to a new guest post about raising autism awareness from  Arianna Armstrong!

Autism Awareness
Autism Awareness


All packed for a trip to France. A suitcase filled with outfits destined for immortalization in snapshots by the Eiffel Tower, a carry-on with French translation dictionaries and language guides, and maps to take you from Aast to Zoteux. Then an announcement from the captain of the plane, alerting everyone that your arrival time in Rome is a brief twenty minutes away.

This is how one of my long-ago professors described parenting a child with autism. She said it’s like preparing for a trip to France, only to discover that you’ve unboarded in Italy. No judgments, no crises – just a completely different trip than the one you were expecting.

If you’ve spent months (or years) prepping yourself for one path – or if you were born into the situation – winding up on a different journey is going to take a little getting used to, especially if, to continue the metaphor, everyone in your group speaks anything but Italian.

In terms of autism, let’s stop promoting the long-held belief that autism is something bad – a burden people bear with quiet grace and strength while staring longingly at the pages of other people’s “normal” lives. This April, let’s appreciate that different does not equal wrong. As Matt Young beautifully described in his piece, “Acceptance”: “[we] have recast April as ‘Autism Acceptance Month,’ a time to celebrate the unique, complex, sublime individuals that we are, to accept our strengths and our challenges, our struggles and our triumphs.”

This month, let’s acknowledge that on our individual journeys, we’re frequently surprised about where we end up and are often grateful for the destination. Awareness is important – but let’s begin to move past awareness toward an acceptance of the traits, characteristics and vantage points that make up the individual. An unexpected trip to Italy is just as spectacular as a planned trip to France – if you’re willing to free yourself of preconceived ideas and appreciate everything there is to offer about where you’re headed.

To help further the cause, has launched the Autism Awareness Card. No matter where you’re going, the card is welcome everywhere Visa is accepted. Withdraw funds at thousands of ATMs, conveniently load money with Western Union, PayPal, bank transfers, MoneyPak, direct deposit of wages or federal benefits payments. You can spread the word while enjoying perks like:

• No late fees

• No overdraft fees

• No check cashing fees

• Spending tracking

• Online bill pay

• 24/7/365 live support by phone and web

The Autism Awareness prepaid card offers many of the perks of a credit card, it’s just different – different in a good way. Different in ways you can accept, and appreciate.

Autism Health FAQ: What Makes Exercise Different for Kids with Autism?


Autism-Exercise-E-book-Sample-Cover-300x292Hello to the readers of PatientTalk, and thank you for reading! This post comes from Seth McNew at Play Through Autism, a resource for kids with autism and their families, to develop better health and fitness habits.  Please like our Facebook page and join our emailing list for an autism exercise e-book. 
The honest answer is that youth fitness has the same end goals across the board:
1.) Give kids the tools, resources, and knowledge to understand their own fitness needs.
2.) Develop healthy life-long habits.
3.) Get kids moving – exercise begets exercise, and sitting begets more sitting.
4.) Finally, keep records of what the child liked and what they excelled at.

Now, if you are the parent of a child with autism, you will understand that the list is easier said than done for your child. That is why exercise is different for kids with autism. While the general population may have team sports, athletic motivations, and natural social play groups, we don’t always have those same amenities and possibilities in the youth population with autism.

This is one reason why the population of kids with autism has a 7% higher rate of obesity than the general population. While the end goals are the same for both sets of kids, the approach needed to get there may be very different. The same goals, as applied to our kids with autism may read something more like this:

1.) Make the learning process easier to provide better understanding.
2.) Use different prompts that promote habit formation, instead of just following commands.
3.) Find the right motivation that will get your child started, and help them to keep going.
4.) Finally, measure progress so that you know where you started, and where to go from that point on.
Sound familiar? That’s Applied Behavioral Analysis, as applied to exercise.

ABA Simplified for Autism Exercise
Applied Behavioral Analysis, ABA, is the practice of using rewards and consequences as behavioral reinforcement to encourage specific actions. ABA therapy goes much more in depth than that, but following basic principles can be important tools when planning exercise routines for children with autism. Here are the basic elements of ABA, as applied to exercise:
1. Making the learning process easier: ABA breaks actions down into basic building blocks and as the child masters a skill or motion, the action is made more difficult.

2. Different and Better Prompts: Physical and verbal prompts can both be used to help the young athlete work through new skills.

Autism-Exercise-PTA-Main-Background3. Finding the Right Motivation: Positive Reinforcement (rewarding good actions, instead of punishing bad actions) is used to encourage activities the young athlete likes that are also beneficial to his or her health.

4. Progress is Measured: Another important step is to measure the progress your child is making in his or her skill level and change the plan according to fitness goals.

5 Exercises for Everyday Fitness

We’ve developed a special, free e-book with 5 examples of appropriate exercises for kids with autism. You can get that instantly here.

Good luck with these exercises and get creative with making the exercises a little more complicated as they become too easy.