Addressing the needs of adults on the autism spectrum would be remiss if it failed to include the adoption of a healthy lifestyle. The United States is faced with an obesity epidemic that affects people of all ethnic backgrounds and types of disabilities. Currently 2/3 of the population of the United States is either overweight or obese (CDC, 2009). People on the autism spectrum may even be more susceptible to obesity than their neurotypical counter parts due to a number of factors. First, many people on the autism spectrum take medications to deal with co-morbid disorders. One side effect of some of these medications is weight gain. Second, some individuals on the spectrum have very restrictive self-imposed diets that are high in fat and have little nutritional value. In fact, anecdotal stories of individuals with ASDs eating only “white foods” such as breads and plain pasta suggest that they have a diet replete with carbohydrates that are associated with weight gain. Third, there is some research to suggest that individuals with Asperger Syndrome may have coordination problems (Siapras, Holland, & Ring, 2008) or difficulties with proprioception (Weimer, Schatz, Lincoln, & Ballantyne, 2001), which might discourage an individual from participating in sports requiring a high degree of coordination or a good sense of where their body is in space. And finally, many forms of exercise are team sports oriented. Many team sports require a high degree of sociability and the ability to anticipate the intension of others (e.g. whether a runner in baseball intends to steal a base). The stressors associated with team sports would discourage many adults with ASDs from participating in team sports and enjoying the benefits of exercise. A lack of regular exercise is associated with obesity, diabetes, orthopedic problems, loss of bone density and heart disease (Pangrazi, Beighle, & Sidman, 2007).
A positive relationship exists between exercise and longevity. Individuals who exercise regularly have reduced mortality from all causes (Paffenbarger, Hyde, Wing, & Hsieh, 1986; Blair & Brodney, 1999). One form of exercise that is available to the majority of individuals on the autism spectrum is walking. Walking requires no training, little equipment, and can be done almost anywhere. Walking 10,000 steps a day is associated with better cardiac health, reduced stress, better moods, reduced risk of diabetes, lower blood pressure, and improvements in sleep quality. A sedentary person walks between 1,000 and 3,000 steps a day (www.walkingsite.com). Walking 10,000 steps is equivalent to almost 5 miles a day.
Aside from having a comfortable pair of walking or running shoes, a person wishing to begin a walking program should purchase a pedometer. Pedometers can range in price from $24 for one pedometer to as low as $8-$12 a pedometer if you buy in bulk. The more features a pedometer has, the more the costly the pedometer will be. For individuals on the autism spectrum, the functions should be kept to a minimum to avoid frustration and confusion. The pedometer should have a belt clip as the primary way to secure the device to the hip area of the walker and a back up alligator clip that will prevent the device from getting lost in the event it becomes dislodged. Two other features to look for are a cover and a simple one touch reset button. The cover will prevent the individual from accidentally resetting the pedometer and “losing “all of the steps the individual has accumulated. The loss of the data can easily frustrate a new walker and discourage him or her from exercising. A simple one touch reset button, likewise helps prevent frustration.
A second important piece of “equipment” for adults on the autism spectrum is graph paper. The graph paper is used to document and monitor the progress the walker has made to date. In group settings, the graph paper can be used to compare walkers side by side to instill a little healthy competition. It is important to reward the daily wearing of the pedometer early and often so the person gets into the habit of wearing the pedometer. Then rewards should be set up based upon reaching certain milestones. In the beginning of the pedometer program these rewards so come more frequently than in the later stages of the pedometer program. Weekly updates and award ceremonies are key to maintaining motivation.
The pedometers can be incorporated in other activities such as using a tread mill or other exercise equipment. Even video games such as Wii games, Wii Fit and Dance, Dance, Revolution can be used to motivate pedometer users to exercise in a fun way. In inclement weather, stair climbing contests can be used not only to get the pedometer numbers up, but also the heart rates of the participants.
At New York Institute of Technology Vocational Independence Program we began a pedometer program this academic year. The students were involved in the planning and selection of incentives. Each class, (Freshmen, Sophomores, and Juniors), were competing against each other and the staff as well as competing individually. Class prizes included parties and trips. Individual prizes included t-shirts, sweatshirts, free movie passes, and I- Tune gift cards. The grand prize for the student body upon reaching their ultimate goal was the opportunity to shave the head of the dean of the program. In less than two semesters the students and staff walked over 48 million steps which was approximately 21,000 miles. This was the equivalent of walking due east from our Central Islip campus to Australia for a rest stop and then proceeding to Los Angeles, CA. Participants in the program were in better shape and lost weight as a result walking 10,000 steps a day.
Dr. Ernst VanBergeijk, is the Associate Dean and Executive Director of New York Institute of Technology’s Vocational Independence Program. He is also a research associate at the Yale Child Study Center’s Developmental Disabilities Clinic and is assigned to the autism unit. The publication of this article was made possible by a grant from the National Institute of Health, LRP grant (Number, L30HD053966-01).