Expert Q&A: Tips for an active and healthy lifestyleJanuary 24, 2023
Research shows that people with autism are at especially high risk of a range of physical and mental health issues as they age. While some of these health problems have genetic roots, many can be tied to sedentary lifestyles and poor nutrition, both of which have been found to be more common among autistic people.
A healthy diet and regular exercise can help avoid these health risks and improve physical and mental health among autistic children, adolescents and adults alike. In this Q&A, Dr. Jean Gehricke, a clinician and researcher at the University of California, Irvine (UCI), an Autism Speaks-supported Autism Care Network site, shares some tips for encouraging a healthy lifestyle among autistic youth.
Dr. Jean Gehricke is a licensed clinical psychologist and an associate professor at The Center for Autism and Neurodevelopmental Disorders at UCI. His clinical expertise is in the assessment and treatment of ASD, ADHD and co-occurring conditions such as depression, anxiety disorders and drug abuse.
How do physical activity and nutrition affect well-being?
Physical activity has been shown to have a positive effect on general health and well-being. There’s very clear literature that even mild to moderate amounts of physical activity can be preventative for cancer. There is also evidence that physical activity helps with longevity and prevention of chronic disease, including cardiovascular disease, diabetes and obesity. It even has some positive effects on seizures.
We also know that physical activity has a positive effect on mental health. Studies have shown that exercise helps with executive function, anxiety, stress management and mood. In general, people who have an active lifestyle are much more emotionally resilient and focused. There also seems to be some evidence that physical exercise helps people with depression and ADHD, which are commonly co-occurring conditions with autism.
But physical exercise is only one piece of a healthy lifestyle. Another equally significant piece is diet and nutrition. For example, when it comes to cancer prevention and heart disease, the so-called Mediterranean diet seems to be more beneficial than the standard American diet. There’s a clear-cut effect on longevity.
Do you have any tips for families who are trying to get their autistic kids to be more active?
There’s not a one-size-fits-all approach. It’s really important to get children, adolescents and young adults engaged in physical activity as a hobby. It should be something they feel connected with—that they feel is interesting. We want to help kids develop an appreciation and a motivation to be physically active, and it doesn’t have to be part of a physical exercise program. We don’t need them to become competitive—that might be way too much. It’s more important to go out, take a walk, or run and chase each other, always keeping in mind the playful aspect—whatever the child reacts to positively. That’s a very important part of reinforcement.
I recommend being very vigilant about observing what the child enjoys and what kind of activity the child feels naturally inclined to do. Sometimes, parents think that their children like certain activities and it turns out that’s not the case. Watch what the child does when they’re relaxed in their natural environment. Do they get up? Do they start running around? Do they bounce up and down? It may be helpful to bring in an Applied Behavior Analysis (ABA) therapist who can help you see what activities the child is interested in and then extrapolate what they like doing and might be good at.
Are there specific physical activities you recommend?
It depends on the age. In general, team sports are challenging for kids on the spectrum. Sometimes, autistic kids cannot communicate well and have trouble with coordination and timing in a team sport situation, so they begin to feel isolated and lonely, and it becomes painful. And that is what we want to avoid. It’s better to participate in an activity where they feel included. And sometimes, you have to do it as a whole family, which is actually a good thing because parents of autistic children need exercise too.
Interestingly, you may find the child enjoys an activity and when they hit pre-puberty or puberty, they lose interest. But once they go into young adulthood, they may pick it back up again. That is why it is so important to encourage physical activity as a hobby. If you do that, the individual will have enough motivation to maintain the activity throughout their life even though it challenges them physically.
How can families encourage their kids to eat a nutritious diet?
A lot of autistic kids are very picky eaters. Expanding their palette and bringing in heterogeneous foods that are healthier is a challenge for any parent. It’s hard to explain nutrition to a younger child, so behavioral strategies that reinforce trying different foods are the go-to techniques with younger kids. It requires persistence—you have to keep on trying. Let the child have their favorite meal but encourage them to have a spoon of peas or one piece of broccoli before they eat. It takes an observing and persisting parent to gently push and remind them how important it is to eat other things.
As they grow older, oftentimes their tastebuds change, so naturally they become more willing to try different things. For older kids, explaining the value of healthy foods is important. You can talk about the nutrients and vitamins a person needs and make an activity where you identify which foods have those ingredients.
What has your research revealed about the link between physical activity and well-being in people with autism?
We recently did a study that looked at the effects of physical exercise on 143 children with autism between the ages of 6 and 12. The kids came in twice a week for 8 weeks and participated in a physical exercise intervention that used ABA principles to offer positive reinforcement. We compared that to an 8-week sedentary intervention where the kids played LEGO and Minecraft with a therapist.
Our focus was really on the effect of physical activity on anxiety, because there’s a lot of research that shows physical exercise helps with stress reduction. We looked at parent-rated anxiety, self-reports of anxiety and cortisol levels. We found that self-reported and parent-reported anxiety levels were reduced in both groups. While we expected physical activity to have a greater effect, we learned that simply doing something that makes you feel good can in itself help reduce stress and anxiety.
However, even though both physical and sedentary intervention activities were shown to be effective in relieving stress, active exercise plays a crucial role in a person’s general health and well-being. Families should instill the importance of a healthy lifestyle and give their autistic children the tools to stay active throughout their lives.