1. Community Piece It Together An Exercise Program for Teenagers & Young Adults with ASD
Lily Gullion, OTS, Caitlin Keller, SPT, Julia Levin-Rector, BSN, RN
Patty Coker- Bolt, PhD, OTR/L, FAOTA; Jennifer Pitassi, PT, PCS; Carrie Cormack, DNP, CPNP; Carrie Papa, Eve Spratt, MD, MSCR
Introduction
Components of an Effective Physical Activity Program
Summary
The body of research related to individuals with Autism Spectrum Disorder (ASD) and their participation in physical activity continues to grow, but there is still a lack of evidence determining the most effective strategies to engage individuals with autism in physical activity throughout their lifespan.1
Recent evidence suggests a motor component to ASD, though it is not a diagnostic criteria. Children with ASD may have difficulty with motor imitation and motor planning and decreased postural control, which all may lead to decreased physical activity.2
Piece It Together (PIT) is an exercise program developed by a team of multidisciplinary professionals created for teens with ASD and other neurodevelopmental disorders. Goals of PIT include increasing physical activity, improving body composition, promoting healthy food choices and broadening social skills.3
The purpose of this Leadership and Education in Neurodevelopmental Disorders (LEND) project was to introduce Piece It Together, an existing program created by the Medical University of South Carolina (MUSC), to the surrounding Charleston community.
Regular exercise can lead to improvements in social, behavioral, cognitive, and motor impairments in individuals with ASD. 4
An interprofessional team can play a pivotal role in developing, implementing, and providing support to sustain participation in health and fitness programs for youth with disabilities.
A survey was conducted at the end of our two sessions which revealed that the majority of participants in the Community Piece It Together program agreed that PIT was beneficial on both physical and social levels, and they would enjoy PIT returning to respite night.
Even after the leadership project concluded, there has been a continuation of the partnership between Piece It Together and the respite night at the local church.
Enthusiastic, patient, and knowledgeable volunteers at a 1:3 volunteer to participant ratio
Opportunities for participants to make decisions during the session and take lead (ex. allow for participants to demonstrate a stretch)
Organized and structured routines and transitions which allow for predictability and reduce sensory overload
Effective Physical Activity Program
Mark off a specific area for each participant to stay in
Create and utilize a visual schedule
Create an environment based on the sensory needs of the participants
(ex. avoid loud music, bright lights, distractions)
Give sufficient breaks to avoid overwhelming the participants
Use adaptive equipment and provide manual guidance of motor activities as needed
Planning Our Physical Activity Program
Objectives of the Project
Literature Review- Focused on exercises and activities that are effective, how to integrate sensory components into exercise programs, and ways to address barriers individuals with ASD have to completing regular physical activity.
Outreach- Collaborated with a local church that holds a respite night once per month for individuals with disabilities. Two nights were scheduled to hold a modified PIT physical activity and education program for teenagers and young adults with autism. Our leaders included a student physical therapist, a student occupational therapist, and a nurse who all have experience with teens with ASD and/or exercise planning.
Planning- Planned two exercise/education sessions for the respite nights, taking into consideration common sensory patterns for individuals with ASD. A visual schedule of exercises and water breaks was hung in the room and music was kept upbeat but quiet. Exercise and nutrition education was provided through dynamic conversations, which also allowed for practice of appropriate social skills.
Following completion of the leadership project:
MUSC’s Piece It Together will be introduced to other locations within the surrounding Charleston community
Community locations will understand how to adapt and implement a cost-effective physical activity program to promote fitness and wellness in individuals with ASD
These locations will determine whether a physical activity program is effective and make adaptations as necessary
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number T73MC22233, Leadership Education in Neurodevelopmental and Related Disorders Training Program.  This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
References
Curtin C, Anderson SE, Must A, Bandini L. The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children's Health. BMC Pediatr Feb 23;10:11.
Downey R, Rapport MJ. Motor activity in children with autism: a review of current literature. Pediatr Phys Ther Spring;24(1):2-20.
Piece It Together. (2017, August 10). Retrieved October 18, 2017, from
Mieres AC, Kirby RS, Armstrong KH, Murphy TK, Grossman L. Autism spectrum disorder: an emerging opportunity for physical therapy. Pediatr Phys Ther Spring;24(1):31-7.