Recreational Therapy (RT) Modalities for Individuals with Autism

Autism

Disabling Condition Description

Autism is a mental condition which starts in your early childhood years and causes difficulty in communicating, forming relationships with other people and in using language and abstract concepts. Autism is considered to have a broad range of conditions with social skills, repetitive behaviors, speech and nonverbal communication (Autism Speaks, 2018). People with autism have difficulties such as behavior, responding and reacting to their environment, social interaction, communication and sensory sensitivities. These characteristics are common among some people on the autism spectrum.

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  Individuals with autism have difficulty creating and maintaining relationships with others. They do not respond to many of the non-verbal forms of communication like facial expressions, physical gestures and eye contact. People on the autism spectrum autism will sometimes not understand nor express their needs just as they are unable to comprehend the needs of others which causes them to not share their interests with other individuals. They are often delayed in their speech so that is why they avoid interactions and struggle to make sense using non-verbal forms of communication. Some people with autism speak fluently while others are unable to speak at all. The people who can speak will only use a certain level of language. For example, they will repeat your words, sentences, questions back to you, instead of responding. “People with autism will usually only talk about topics that are of interest to them which makes the give and take in communication, difficult (Autism Spectrum Australia, 2018).”

There are three different types of Autism Spectrum Disorders. The first one is Autistic Disorder which is a more intense level than the rest. People with autistic disorder have social, communication and behavioral challenges. The second type is Asperger Syndrome which is on the milder end of the autism spectrum.  They are intelligent and can depend on themselves and handle their daily life but still have a hard time socially. The third autism spectrum disorder is Pervasive Developmental Disorder and those are people whose autism is more severe than Asperger Syndrome but not as much as Autistic Disorder (CDC 2014, Autism Society of America, 2014).

There’s three functional levels of autism, the first one is requiring support and that’s when they have difficulty initiating social interactions. The second level is “Requiring Substantial Support” which is difficulty when utilizing verbal and nonverbal social communication skills and lack of social interaction with one another. The third level of autism is “Requiring Very Substantial Support” and that is when one truly has difficulty in verbal and nonverbal social communication skills (About, Inc. (Dot dash), 2018). Autism is caused by abnormalities in the brain but there isn’t a single cause that’s known for autism spectrum disorder. Establishing a routine and keeping it consistent to a daily schedule as well as allowing time between transitions controls their behaviors and helps the needs of an individual with autism. Many individuals with autism have strong passions and deep interests.

“Prevalence of Autism is autism statistics from the U.S. Centers for Disease Control and Prevention which is identified around 1in 68 American children as on the autism spectrum.” “Research shows that this increase is only partly explained by improved diagnosis and awareness (CDC 2014, Autism Society of America 2014).” Autism is more common in boys than in girls. “An estimated 1 out of 48 boys and 1 in 252 girls are diagnosed with autism in the United States (CDC 2014, Autism Society of America 2014).” People with autism may have physical health issues such as difficulty sleeping, gastritis, chronic constipation, etc. Epilepsy which is a seizure disorder affects a large amount of people with autism. Another secondary condition that results from autism is gastrointestinal disorders which happens to be more common in individuals with autism than any other individual.

Recreational Therapy (RT) Modalities

  The different types of RT modalities that are provided for individuals with autism are Exercise, Music/Therapy, Storytelling, Arts and Crafts, and Social Skills Training. Exercise is one of the most effective treatments for autistic people. It can help reduce stress and anxiety but at the same time improve your sleep, reaction time and memory. Music therapy helps individuals improve their ability to function using cognitive and emotional skills (Rudy 2018). Storytelling helps children with autism spectrum disorder improve language and listening skills, increase attention span, develop curiosity and creativity, and better understand nonverbal communication. Art offers a way for people to express themselves without using any words especially people with autism that are highly to be visual thinkers. “Expressing feelings and ideas through images is very natural for such people and can be a welcome relief from the daily struggle to use words effectively (The art of autism, 2011-2020).”

It has been over 40 years that the history of social skills training is one of the most studied approaches to psychiatric rehabilitation. Social skills are what we use to communicate and interact with each other both verbally and non-verbally through gestures, body language and our appearance. “Social skills development for people with autism involves, direct or explicit instruction with practice in realistic settings, focus on timing and attention, support for enhancing communication and sensory integration, learning behaviors that predict important social outcomes like friendship and happiness, and a way to build up cognitive and language skills (2018 Autism Speaks Inc.).”

Social skills training involves the systematic teaching of interpersonal skills through the process of breaking complex behaviors into their constituent elements, demonstrating those skills in role plays, engaging clients in role plays to practice those skills, providing positive and corrective feedback to improve performance, additional role play practice, and developing assignments to practice those skills in naturally occurring interactions in clients lives.

“The purpose of social skills training is teaching people who may or may not have emotional problems about the verbal as well as nonverbal behaviors involved in social interactions (Advameg, Inc., 2018).” Social skills play a huge part of our everyday lives. For example, the social skills we use daily are making eye contact with others during a conversation, smiling when greeting people, shaking hands when meeting someone and expressing opinions to others. People with autism often have difficulties interpreting others causing misunderstandings. Social skills are essential for lifelong success but children with special needs often struggle with this skill. Successful social skills require you to read and understand the nonverbal cues of others and to express thoughts, feelings, and intentions through facial expressions, gestures, and body language.

“The first step in social skills training programs should consist of conducting a thorough evaluation of the child’s current level of social functioning (Bellini, S. 2009).” The purpose of the social skills assessment is to identify skills that will be the direct target of the intervention and to monitor the outcomes of the social skills program. The evaluation details both the strengths and needs of the individual related to social functioning. The assessment often involves a combination of observation both naturalistic and structured, interview, and social skill rating forms (parent, teacher, and self-reports). Social skills assessment involves the direct assessment of social skills and the evaluation of social competence. Information gathered from the assessment allows us to develop quality Individualized Educational Plan (IEP) and treatment objectives. Direct observation of social behaviors should follow the interviews and administration of rating scales. Two traditional methods of observation may be used to assess the social functioning of children with ASD, naturalistic and structured. The purpose of both is to observe the child’s social performance across settings, persons, and social contexts. Naturalistic observation involves observing and recording the child’s behavior in real-life social settings, such as school playgrounds and cafeterias, or in various social settings at or near the child’s home. Structured observations involve observing social behavior in a structured play group or structured social group.

Board games are one of the best ways to work on social skills. Playing a board game requires patience, wait and take turns, negotiation about who goes first, agreeing to and sticking to the rules. A great game to encourage conversation is Q’s Race to the Top. This game has question cards with conversation prompts on them and the fun part of this game are the “DO” cards that break up the game play and engage kids in easy movement and flexibility (Encourage Play, LLC 2013-2017). Playing basketball can help you learn the value of teamwork, organization, leadership, motivation, and fitness. All these qualities are great for character-building and for improving socialization skills. Painting is much more than a simple activity, it is a way for different types of children to express themselves in their own special way. Painting helps children use their senses, express emotion, explore color and create experiences. Emotion Charades can help open communication with and among students about their feelings. It also helps build students vocabulary, and their confidence in using their full vocabulary range. Role play can be an effective learning tool for breaking down or rehearsing a diverse range of social situations or social standards and makes it a powerful learning tool for teaching social skills.

Activity Description and Activity Analysis Form & Summary

Basketball is a team sport, where you can play with a minimum of two players and a maximum of ten players. There are different ways to play the game of basketball but the main way to play is on a court with two basketball hoops that are ten feet tall. The objective of the whole game is to put the ball into the hoop, if there are ten players playing then it is a five against five. One team brings the ball up the court and must maintain their dribble alive, if they pick up the ball and stop dribbling they just either shoot it or pass it to another teammate, if you take more than three steps without dribbling it is called a traveling violation, and the other team gets the ball. If you are dribbling the ball and then stop dribbling and dribble again, it is called double dribble violation, and the other team gets the ball.

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In a basketball court there are lines and marks, so you can’t step out of bounds, if you step on the out-of-bounds line or throw the ball out of bounds, the other team gets the basketball. There is also a mid-court line where the line separates the court in half and each team gets their basket to shoot on, once you cross that half court line with the basketball you can’t go behind the line or else it will be a back-court violation and the other team gets the basketball. If a player is going up for a shot or in the process of taking a shot, and you hit him, it is a shooting foul and the player who was fouled will shoot two free throws. If the player is fouled while shooting and he makes the shot, then the basket counts, and he will go to the free throw line and shoot one free throw. If you foul a player when he doesn’t have the ball or when he is dribbling, it is a regular foul and the team keeps possession of the ball.

 Another important thing to make note of is that when you are playing at the professional level such as the NBA, college, league or in a school team, there is a time clock with referees and you have a certain amount of time to shoot the ball into the hoop. The time and length of the game really depends on where you are playing but in professional basketball there are four quarters each being twelve minutes long and you have twenty-four seconds each possession to shoot the ball. You can call timeouts and the clock only stops for timeouts, free throws and when the ball goes out of bounds or whenever the referee blows the whistle. It is important to know and understand these rules when playing basketball because it is a team sport that has plenty of different rules. “Sports are competitive physical activities that are performed for pleasure, require physical effort and are played according to fixed rules (Mckenny and Wolfe, 2016. P.145)”

In this activity analysis form the physical aspects in the activity basketball you need to be standing. The body parts that are required are arms, hands, legs, feet, neck, head, upper torso and lower torso. You need to have much movement between body parts and much hand – eye coordination. The social aspect of this activity is multilateral which is action of a competitive nature among three or more persons with no person as an antagonist.

Activity Adaptation

The skills taught in the activity can help those with disabilities to stay active and hopefully become stronger through an enjoyable activity. With correct instruction and adaptations all students can take part in basketball activities. Students with different fitness levels can push themselves to their highest performance levels with the help of their peers and the teacher. For children with autism, basketball may help lessen the negative effects of autism. For the autistic child, participation in organized sports offers opportunities to coordinate and connect with others, and to develop relationships with peers. For parents of autistic children, investing in an adjustable in-ground basketball hoop can be a great way to spend quality time bonding with your child while combating the symptoms of autism. Adjustable basketball goals mean that the backboard can be raised and lowered to a height that is best for your child. Players of all ability levels can engage in activities that teach the fundamentals of basketball. Activities and drills target emotional regulation, communication, following game rules and team work.

Basketball also helps children work on coordination, core strength, balance and endurance. Even a simple game like “Horse” offers plenty of benefits.  This game teaches lessons like listening, following directions and waiting for your turn. The game horse is where you move around the goal, taking turns to make shots at the hoop. Each time they handle the basketball, even if they are chasing after it, their muscles are developing and strengthening. They gain the ability to better work with their own body and become more coordinated. You are also helping your child to develop confidence. They are learning about a game and you are bragging on them every time they take a try, whether they make a basket or not. Basketball helps improve an autistic child’s development and lessen the severity of the autistic symptoms. Basketball has many great benefits for people with autism. Other sports can be challenging for kids with autism that’s why it is important to help the individual choose a sport that they enjoy and will achieve in. Evaluate each student’s present level of basketball skill for probability of success. Assess previous experience, fitness level, motor functioning, attitude toward his/her disability, and willingness to participate. Observe your child’s social needs and guide him toward a better understanding of how to successfully play a game with other children.

Second Disabling Condition and Activity Adaptation

Hearing impairment is when you lose part or all your ability to hear. The sternness of the hearing impairment is impacted due to the lowest sound that can be heard with your better ear. The degree of hearing impairment can vary widely from person to person. Some people have partial hearing loss, meaning that the ear can pick up some sounds while others have complete hearing loss, meaning that the ear cannot hear at all. In some types of hearing loss, a person can have much more trouble when there is background noise. One or both ears can be affected, and the impairment may be worse in one ear than in the other ear. “The most common cause of hearing loss in individuals is “otitis media”, which is an ear infection that affects the middle ear (Morlet 2016).” A buildup of fluid or pus behind the eardrum is due to ear infections which cause to block the transmission of sound to travel. Even if the infection gets better, fluid might still stay in the middle ear for weeks or months, causing difficulty in hearing. When ossicles, ear canal, eardrum and certain parts of the ear are harmed it causes hearing loss. Treatment for hearing loss varies depending upon the cause of the hearing impairment. Treatment may involve removing wax or dirt from the ear or treating an underlying infection (Morlet 2016).

 New technologies are making it possible for more hearing-impaired individuals to attend school and participate in activities with their hearing peers. These technologies include programmable hearing aids (can be adjusted for different environments), cochlear implants, real-time captioning of videos, and voice-recognition software, which can help with note taking. Basketball is loved all over the world by millions of people from all different backgrounds. “All basketball players and players with hearing impairments face these same challenges, for example, not being tall enough, not strong enough, not fast enough and/or not skilled enough (Page 2014).” In basketball, the hearing impaired need to be able to communicate on the court during a fast-paced, chaotic game without hearing.

People with hearing impairments communicate just like how hearing players communicate. “Each team has their own defense and sets on offense and different words or signs that represent their defense and offensive sets to inform them which ones to run (Wilken, 2012).” Body language and signing is what the hearing impaired mostly rely on to keep the game going. The player with the ball needs to make sure everyone knows what plays, offense or defense to carry out. For all basketball players and teammates, the more they play together the more they learn, become familiarized with and expect certain styles and habits.

Teammates who work together and communicate will pick up on their teammates style quickly. For the hearing-impaired basketball player, their senses in picking up on these body language habits are usually quick to understand. “It is essential to know their teammates styles, so they know what to expect when the quickness of verbal communication is not an option (USA Deaf Sports Federation, 1996-2015).” For the hearing-impaired basketball players, it is important in understanding your teammate’s strengths and weaknesses. Specific adaptations for hearing impairments are lights to signal a whistle, give written outlines of events or notes, brighter balls will help to make up for a player calling your name to pass you the ball and making hand signal plays instead of verbal.

Works Cited

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• Rudy, L. J., & Forman, J. (n.d.). What Are the 3 Levels of Autism? Retrieved from https://www.verywellhealth.com/what-are-the-three-levels-of-autism-260233
• Admin. (2018, October 01). The value of art therapy for those on the autism spectrum. Retrieved from https://the-art-of-autism.com/the-value-of-art-therapy-for-those-on-the-autism-spectrum/
• Social Skills and Autism. (n.d.). Retrieved from https://www.autismspeaks.org/social-skills-and-autism
• Indiana University Bloomington. (n.d.). Retrieved from https://www.iidc.indiana.edu/pages/Making-and-Keeping-Friends-A-Model-for-Social-Skills-Instruction
• Morlet, T. (Ed.). (2016, March). Hearing Impairment. Retrieved from https://kidshealth.org/en/teens/hearing-impairment.html
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• Mamo, S. K., Chisolm, T. H., & Lin, F. R. (2017). Hearing impairments and their treatments. Oxford Medicine Online. doi:10.1093/med/9780198701590.003.0152