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Eric Chessen 1

When To Pass “Go”: Criteria for Baseline Mastery and Coaching The Neuroadaptive Population

“So every few weeks you change things up, right?”

A common question asked by parents when I begin working with a new athlete in my program. 

“I change the exercises once we see independent mastery. Variety is just variety without pre-requisite skills being developed. So yes, I’ll add some new exercises…when it makes sense.”

If there’s one thing I can’t do it might be avoiding long-winded sentences. 

For the autism and other neuroadaptive populations, developing strength and enhancing motor skills does not come easily. Pre-existing deficits in motor control and stability can present a challenge for engaging in a variety of physical activities. Many individuals with ASD often find physical activity aversive due to myriad factors. Among these are;

  • New/novel tasks and environments
  • Instructions that may be unclear
  • Elevated anxiety and uncertainty 

The pathology behind movement limitations is a combination, mostly a feedback loop, of muscular and neurological impediments. Differentiation in neuronal firing for those with autism causes a delay in neuromuscular performance, often resulting in movement that can be described as “clunky,” “inhibited,” and compensatory patterns are often observed.

Given the importance of fitness, particularly the development of strength and stability for neuroadaptive populations, it is critical to implement programming that addresses strength deficits and contraindicated movement patterns. An effective approach progresses or regresses exercises based on current level of ability.

Criteria for Baseline Mastery (CfBM) is a protocol borrowed from the practice of Applied Behavior Analysis (ABA). CfBM provides us a clear description of when a skill is mastered and what the requirements are for that goal. Mastery, in this definition, means that the skill can be performed to a particular level independently. 

In our Autism Fitness™ programs, we use CfBM to set goals, track progress, and provide appropriate progressions and regressions for each athlete with every exercise. With squats, we very often reduce range of motion (ROM) by having the athlete squat to a box or similar stable platform. Depending on trunk stability, an upper body support may also be required. Having the athlete hold onto a band (held lengthwise by the coach), provides additional support. What we’re after is the athlete’s best performance of the squat with a complete reduction of compensatory movement.

Establishing a standard for performance enables us to set both general and specific goals for each athlete. For squats, as with most of our strength-focused exercises, we use 3 sets of 10 reps as our goal. Within those sets and repetitions, we are looking for stability and control throughout the entire range of motion (hips below parallel). While 3 x 10 may initially read like a standard-issue hypertrophy protocol (not necessarily bad, either), there is further reason to embrace this scheme. Three sets provides enough stimulus for the athlete and enough observational opportunity for the coach for integrity or technical breakdown of the movement. If and when the athlete is able to maintain technical control of the squat for 3 sets of 10 reps, it will be abundantly clear that they have mastered the skill, at least to the current level of challenge. 

We use 10 repetitions because it takes us far enough away from maximal loading to be safe (especially for detrained athletes) and an excellent range for improving general strength and muscular development. If an athlete can perform 10 consecutive squats below parallel maintaining rooted foot position and spinal integrity, we have valid claim to progressing the exercise.

For those with neurodevelopmental challenges, it may take months to improve on a particular exercise. Strength and stability aside, proprioception (the real-world “mind/body” relationship) often presents as a particular obstacle. Our athlete may confuse squatting with bouncing or sitting, intentionally or unintentionally rushing through the exercise. 

We have to be careful in assessing the underlying reason for the bounce and/or sit squat. When we consider through the lens of the PAC Profile™, we ask whether this is a physical, adaptive, and/or cognitive concern. For each possibility, we can apply particular questions.

Physical: Is the squat progressed beyond the current capability of the athlete and are they compensating as a result?

Adaptive: Is the athlete sufficiently motivated to complete the exercise at their current level of ability?

Cognitive: Does the athlete understand the expectation for performance of the squat? Are we certain it is clear for them? 

Our goal for each athlete, strictly from the physical perspective, is safe and effective performance of each exercise or movement pattern before adding variety. Building a foundation of strength, stability, and motor planning can have restorative and preventative benefits and enhance quality of life at any age.

Eric Chessen, M.S. is the Founder of Autism Fitness. An Exercise Physiologist with an extensive background in Applied Behavior Analysis (ABA), Eric has coached successful fitness and adapted PE programs for the neurodiverse population over 18 years. Eric is the creator of the Autism Fitness™ Certification and PAC Profile™ Method. He is also Director of Neuroadaptive Programming for Inclusive Fitness. He resides in Charlotte, NC. Go to AutismFitness.com for more information. 


The Pharmacologics of Exercise: Yes, Exercise Is Medicine!

It’s been said: “If all the benefits of exercise could be placed in a single pill, it would be the most widely prescribed medication in the world.” Scientific evidence continues to mount supporting the numerous medicinal benefits of exercise. In fact, there’s hardly a disease that I can think of that exercise won’t help in one way or another, be it prevention, treatment, or even cure in some instances.

middle aged stretching outdoors

Yoga for Mental Health

Since yoga has been found to help those with diseases and illnesses like Alzheimers, Arthritis, it’s a given that it can help ease mental health issues and disorders. A new review on the health benefits of yoga, published in Frontiers in Psychiatry, with help from researchers at Duke University School of Medicine, found that yoga could be a promising treatment for some mental illnesses.

Walk Park

Natural Prescription – An Alternative Approach

One of the best things we can do for our bodies is to “get out of the way”! Believe it or not, our body can actually do a great job of healing itself, or functioning quite optimally when it’s allowed to do so. The body does this by reacting to what “stresses” are put upon it and finding homeostasis through temporary changes or more permanent adaptations. Even the brain will make quick reactions to things in the form of neurotransmitters and neural firing or long term adaptations in adopting new ways of perceiving things or hard-wiring changes.

A statement capturing the above sentiment is from Goodheart (1989) on healing, “People are healed by many different kinds of healers and systems because the real healer is within. The various healing modalities are merely different ways of activating the inner healer.” 1

Are you of the Mechanist (Rationalist) or Vitalist (Empirical) Approach?

The standard or “orthodox” medical practice in the U.S. follows a mechanist approach, where symptoms are perceived as bad and should be minimized or suppressed through surgical or pharmaceutical means. This seems great at the surface level. If something is causing me pain or discomfort let me do something to relieve or eliminate that pain. If I am having nausea or diarrhea because of something in my gut, let me take something to stop the vomiting or diarrhea. Underlying this “quick fix” of symptom alleviation is THE PROBLEM.  The body is trying to rid itself of the “problem” by expelling if forwards or backwards!  There are many medical conditions for which it is okay to consider treating symptoms, and for some this is vital.  However, it is preferable for this to be done in conjunction with identifying the source of the problem, so a long-term fix can be explored.

ChirocopractorA Vitalist approach views symptoms as part of the healing process, not a problem that should be hidden. Many branches of health care use this philosophy including: chiropractors, osteopaths, naturopaths, and practitioners of Chinese or Indian medicine advocate this Vitalist approach. By suppressing the symptoms, the practitioner may actually be extending the illness or exacerbating the problem. Researchers at the University of Maryland found taking aspirin for the flu may prolong the illness up to 3 days. Acetaminophen (Tylenol) or aspirin interferes with the normal fever response that fights the infection (Burke, 2000).

Listening to the Symptoms tell you Where the Problem Lies

Rather than reducing or eliminating the symptoms, what if we tried to increase our sensitivity to it. For example, if we took antibiotics to fight a bacteria, are we enhancing the body’s immune response to this foreign agent or “giving it” something to help, much like a crutch. A quote from unknown origin:

Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.

This is at the heart of the Vitalist approach. The body is great at adaptation but we have to let it “learn” to adapt- not “feed” it some drug that forces it to do something. A quote from the Nobel Prize winner, Rene Dubos, Ph.D. remarks, “Good health is a process of continuous adaptation to the myriad of microbes, irritants, pressures and problems which daily challenge man.” This is also at the heart of exercise training. You must “overload” a system in order to get an improvement in function. You literally must stress it, and let it endure that strain in order to get the adaptation. Likewise, by putting your body in destabilized environments, you will gain a better sense of balance, in order to stabilize yourself.  Recent evidence has found that anti-inflammatory agents actually weaken the endurance training effect.

Fortunately, medical advances have allowed us to treat many illnesses effectively and safely, and it is always advisable to follow the advice of your doctor.  Allowing your body to adapt to certain stresses can be very positive in certain scenarios, but it is important to recognize when this doesn’t come at a risk of increasing morbidity, mortality, or increasing the likelihood of illness complications.

To Drug or Not to Drug: that is the Question

Prescription drugsNo one likes being depressed. About one in 10 Americans takes some sort of antidepressant medication. It is the most commonly prescribed drug in the U.S. according to a report published in the Archives of General Psychiatry (2009).  While the U.S. may not be a Prozac Nation, as popularized in 1994 by the author Elizabeth Wurtzel, the rates almost doubled from 1996 to 2005 (5.84% to 10.12%). A report in the Journal of the American Medical Association found it to work best in only severe cases of depression and exercise had similar effects in the short term treatment and better effects in long term treatment! The difficulty lies in getting someone to exercise when they are depressed. Thus, an integrated approach is often the best, and this includes psychological counseling as well.

Sometimes Less is More

A take away from this article should not be that standard medical care is bad. Far from it. Many M.D.s are very knowledgeable in areas outside of their standard practice and advocate expressive, rather than suppressive therapies. The take away should be to not rush for a drug to hide or mask your symptoms, but focus on what is the root of the cause, and take action to address this. The term iatrogenic is used for the inadvertent problem caused by a medical treatment. In fact, reports estimate it to be the third leading cause of death in the U.S. with 225,000 to 250,000 dying from iatrogenic diseases annually! While it is hard to say how many of these deaths could have been avoided, it is quite obvious that minimizing invasive treatments until they are necessary is the best plan of action.

Complementary or Integrated medicine can possibly have the answer to a majority of the health issues presented. The Medical Fitness Network believes those professionals are the future of health care.

Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.


The Benefits of Adding Tai Chi to Your Exercise Regimen

Tai Chi is better than a glass of wine!”

The above quote is an actual proclamation from one of my students at the end of class one night. Let’s take some time to look through all the things that you can expect from learning this relaxing, slow martial art.

Because Tai Chi offers a slow, meditative approach to movement, some people question it as an exercise modality since the aerobic component is not high. You should not dismiss it, however, simply because you might not break a sweat doing it! The intensity of this form of exercise can be increased or decreased depending on the depth of the postures and the duration of practice.  It is certainly a low-impact form of exercise which is beneficial to people with existing joint issues and to people who want to avoid joint issues.

Let’s take a look at both the scientifically proven benefits and the anecdotal benefits that occur with the regular practice of Tai Chi.

Physical benefits

As you would expect, there are many physical benefits when one practices any form of exercise over a period of time.  The benefits that research has proven with the regular practice of Tai Chi are surprisingly far-reaching, especially in our current climate of anti-aging remedies.  The Mayo Clinic lists some of the benefits of Tai Chi as:

  • Improved aerobic capacity
  • Increased energy and stamina
  • Improved flexibility, balance and agility
  • Improved muscle strength and definition
  • Enhanced quality of sleep
  • Enhanced functioning of the immune system
  • Reduction in blood pressure
  • Reduction in joint pain
  • Improved symptoms of congestive heart failure
  • Reduction in the risk of falls in older adults

That list is impressive just by itself!  There are other studies that have proven improvement for those who live with chronic conditions such as fibromyalgia, Parkinson’s disease, osteoarthritis, COPD and others.  It has also been proven to improve bone mineral density in elderly women. One study (Tai Chi Chuan: an ancient wisdom on exercise and health promotion) even stated that, “The long-term practice of Tai Chi Chuan can attenuate the age decline in physical function . . . .”  It’s no secret that we are living longer now due in part to medical advances.  It can be argued that we are not necessarily living better, however.  The practice of Tai Chi can possibly be one of the ways we are able to increase the enjoyment of our later years because of the improvements it provides in physical function.

One of the biggest concerns of aging is falling.  Obviously, the physical detriment of broken bones or concussions or even just severe bruising are difficult for the aging population to deal with.  The mental effect of being scared it will happen again is even worse, however.  There are many studies that show a rapid decline in independence after just one fall.  Clearly, working on balance is an important concept to help prevent falls.  In a meta-study, authors Wong and Lan wrote in “Tai Chi and Balance Control” that, “recent studies substantiate that Tai Chi is effective in balance function enhancement and falls prevention.”  They also concluded that, “Tai Chi improves static and dynamic balance, especially in more challenging sensory perturbed condition.”  A different study on the effect of 4-and 8-week intensive Tai Chi training on balance control in the elderly concluded that, “even 4 weeks of intensive Tai Chi training are sufficient to improve balance control.”  Anecdotally, I have witnessed this in the classes I teach.  Many of my students comment on the marked improvement in their balance.  One student in particular related the story of how she and her husband were hiking and she was getting frustrated because she felt unstable going over the rocks.  Then she remembered her Tai Chi training and started to incorporate some of the principles of columns and weight shift, and she immediately felt more balanced and in control on their hike!

One of the other anecdotal effects that I have seen in my classes is weight loss with Tai Chi.  It is not something that people express as a goal when they start Tai Chi, however, I have had several students who have admitted that beneficial weight loss has been a side effect of their training.

Mental benefits 

The benefits of Tai Chi are not only substantiated as physical benefits.  There are important mental and emotional benefits as well.  Let’s return to the list of benefits from the Mayo Clinic. They also list the following as resulting from practicing Tai Chi:

  • Decreased stress, anxiety and depression
  • Improved mood
  • Improved overall well-being

And I would add the following to that list:

  • Increased mental focus
  • Improvement in working memory/executive function
  • Social enjoyment and interaction

The studies concerned with the effect of Tai Chi on psychological well-being are not as conclusive as the studies on the physical benefits due in part to the obvious reliance on subjective measures.  In general, however, the studies do demonstrate beneficial effects in regard to practicing Tai Chi for depression, anxiety, stress management and mood disturbance.  One study on the therapeutic benefits of Tai Chi exercise (Kuramoto AM) states that, “Tai Chi can influence older individuals’ functioning and well being . . . and the positive effects of Tai Chi may be due solely to its relaxing, meditative aspects.”   Just the other day, I had a student comment to me after class that, “It always seems that whatever I’m dealing with on a particular day just eases back into the proper perspective when I’m done with Tai Chi.  It obviously doesn’t make the problem go away, but it feels like I can approach it with a better mindset and a healthier attitude.”  That’s really the beauty of Tai Chi.  It’s not some mystical, magical force or religion.  In one study that measured heart rate, adrenaline, cortisol and mood during Tai Chi (Jin P), “Relative to baseline levels, subjects reported less tension, depression, anger, fatigue confusion and state-anxiety. They felt more vigorous and in general, they had less total mood disturbance.”  In another meta-analysis regarding Tai Chi exercise and the improvement of health and well-being in older adults (Yau MK), “There is considerable evidence that Tai Chi has positive health benefits; physical, psychosocial and therapeutic.  Furthermore, Tai Chi does not only consist of a physical component, but also sociocultural, meditative components that are believed to contribute to overall well-being.” This same study concluded that, “It is recommended as a strategy to promote successful aging.”  That’s quite an endorsement!  You might say that Tai Chi comes close to being a fountain of youth for those that practice it!

In my own experience, I have seen the improvement in mental focus and working memory.  If you are not “in the moment” and really thinking about your movements and how to apply the principles of Tai Chi . . . you will get lost!  You can’t think about what’s for dinner that night, or the fight that you had with your spouse the night before.  You must focus your mind on the task at hand and that actually causes a relaxation and meditative effect.  Because many of the movements force you to cross the midline, you are also forcing your brain to function in a different pattern by making the left side talk with right side.  Jean Blaydes Madigan, a neurokinesiologist states that, “Crossing the midline integrates brain hemispheres to enable the brain to organize itself. When students perform cross-lateral activities, blood flow is increased in all parts of the brain, making it more alert and energized for stronger, more cohesive learning. Movements that cross the midline unify the cognitive and motor regions of the brain.”  Wow!  You are actually making your brain function better on all levels with the simple practice of Tai Chi!

In two different meta-studies concerned with the cognitive performance in healthy adults (Zheng, G, et. al and Wayne PM, et.al), they both concluded that “Tai Chi shows potential protective effects on healthy adults’ cognitive ability.  Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning.”  Executive function is defined on WebMD as “ a set of mental stills that help you get things done.”  Who doesn’t need to get more things done in their life??  And unfortunately, if we don’t work at it, executive function declines as we age.

The last point I want to mention about the benefits of practicing Tai Chi is the most subtle, but certainly a very important point, especially as we age.  I see a community develop in my classes that is so strong, it supports each member and provides a social interaction that is rare in our society. Many studies have shown that for successful aging, people need to be involved and to interact with each other.  My students come to class to enjoy the benefits of Tai Chi . . . but they also come to class to enjoy the social interaction and support from their classmates.  This kind of support and interaction can happen in any number of different venues, of course.  I think the combination of the relaxing atmosphere, a non-intimidating, simple to move kind of exercise and the joint experience of learning something new that has a calming influence on your mood is un-paralleled in the exercise world.  Tai Chi brings together your physical well-being with your mental and social well-being in a unique experience that can be practiced for years. Better than a glass of wine, indeed!

Dianne Bailey has been providing professional weight management and sports conditioning training for individuals since 2002 and opened The Conditioning Classroom, a private personal training studio, in 2006. She earned the prestigious designation of Certified Sports Conditioning Specialist from the National Sports Conditioning Association in 2007. In addition, Dianne is a Certified Tai Chi Instructor (level 1) through the American Tai Chi and Qigong Association and leads the Tai Chi program here at the studio.


Simple Breathing Exercises for Stress and Anxiety

Breathing is one of the bodily functions that you can control on your own with very little effort. You can regulate your breathing with a little bit of practice in order to calm your mind and body to relieve stress and anxiety when they inevitably arise. If you’re a naturally high-strung person, this may take some practice but, luckily, these breathing exercises for stress and anxiety can help you.


Sleep and Your Health

In the world of exercise and fitness, we constantly talk about nutrition. We are in the stages of making resolutions for 2017. Here is one I implore every person to mindfully add to their 2017 commitments – getting restorative sleep. We are going to talk about quality sleep, because the truth is quantity can vary greatly.

Woman Receiving Massage

Invest in Your Health with Therapeutic Massage. If You Don’t, Who Will?

Massage, Reiki and CST allow me to work deeply into the muscles of my clients but without the pain often associated with “deep tissue massage.” Sore points are gently held until they release, and restrictions in the central nervous system are removed, allowing circulation to flow through the muscle fibers again, restoring movement and flexibility.