Bridging the Gap: Occupational Therapy’s Role in Exercise for Autism & IDD
By Emilee Moore, OTD
Houston, We have a Problem
Exercise is shown to be one of the most impactful interventions for an individual's health and wellness. With that being said, only 27% of adults worldwide meet daily physical activity standards (WHO, 2022). These statistics are even more alarming for the community of people with disabilities, rising to 47% (CDC, 2019). Individuals with disabilities are frequently marginalized from community-based physical activities. Among individuals with disabilities, 81% state that they do not feel welcome in fitness spaces (Geslak, 2023). This is due to “discriminatory and oppressive attitudes'', lack of accessible gym spaces, and lack of collaborative practices (Bethancourt et al., 2014; Moreno-Peral et al., 2015; Sharon-David et al., 2021). These discrepancies in health management routines have put individuals with disabilities at a significantly greater chance of developing obesity and secondary related conditions such as diabetes and heart disease (WHO, 2023). As healthcare practitioners we have a responsibility to change this narrative. Our healthcare system can be more successful in promoting healthy, physically active lifestyles. The World Health Organization (WHO) has recognized that Occupational Therapists (OT’s) can pave the way in preventive healthcare.
We’ve Always Done it This Way
The current system takes a reactive approach where healthcare professionals and therapists intervene with patients after an illness or injury. Occupational therapists, whether in the outpatient or in the hospital setting, have a limited number of sessions to progress towards desired outcomes. Once the outcome is achieved, or progress is no longer being made, the patients are discharged from services. The symptoms have been treated, but the underlying alignment, an unhealthy & physically inactive lifestyle, has not been addressed - especially for those with disabilities.
Due to Covid-19, preventative healthcare screenings have decreased, resulting in fewer people attending annual or biannual exams to screen for health conditions (Alba et al., 2024). The patients that are attending these appointments are typically recommended to implement lifestyle changes such as diet and exercise, but physicians rarely equip patients with the strategies and tools to actually make these activities routine. Most medical schools are not adequately educating or preparing doctors on nutritional and physical activity guidelines (Aggarwal et al., 2019). Patients leave these appointments and search the internet to find “miracle cures”, social media exercise influencers, and misinformation. These individuals often return to their doctor to find they have the same or worse health condition.
“Discrepancies in health management routines have put individuals with disabilities at a significantly greater chance of developing obesity and secondary related conditions. As healthcare practitioners we have a responsibility to change this narrative.”
Physicians cannot cultivate these health routines alone. Collaboration with exercise physiologists and qualified fitness professionals, who receive extensive and accredited training on how to promote physical activity, will make a profound impact. Within the fitness industry, there are practitioners and organizations that are dedicated to providing evidence-based exercise opportunities for those with disabilities. The ACSM/Exercise Connection Autism Exercise Specialist Certificate, and the ACSM/NCHPAD Inclusive Fitness Trainer Certification are educating professionals on evidence-based support to make exercise more accessible and inclusive for those with disabilities. Many healthcare professionals, individuals or caretakers of individuals with disabilities are unaware that qualified professionals like this are in their communities. The gap in communication between healthcare professionals and qualified fitness professionals is where there is a tremendous opportunity to make a difference (Bethancourt et al., 2014). Occupational Therapists can bridge this gap to create a continuum of care that enhances preventative wellness. The WHO has named Occupational Therapists the champion of Preventative Healthcare in the Healthy People 2030 Initiative (AOTA, 2022).
A Collaborative Approach
Occupational Therapy is the therapeutic use of everyday activities for the purpose of enhancing or enabling participation (AOTA, 2020). OT’s diverse training equips them with the tools and knowledge to aid in the development of health and wellness routines. Health Management routines, including physical activity, diet, health literacy, and sleep hygiene, are directly listed as areas of intervention that Occupational Therapists are qualified to address (AOTA, 2020). Including Occupational Therapists on the collaborative team aids in better communication. Physicians can recommend their patients to OTs for assistance in implementing lifestyle changes. OT’s can assist in assessing areas of interest, conducting motivational interviewing, and connect their clients with qualified fitness professionals that fit their needs.
Entering into my career as an occupational therapist, I have put my doctoral research into action. With a background in fitness training and a yearning to advocate for those on the Autism Spectrum, I started an exercise program to promote physical activity and social skills for the kids who have been left wandering and wondering. Guided by the evidence-based practices of Autism Exercise Specialist Certificate, and rooted in occupational therapy theory, this multidisciplinary approach promotes client-centered holistic care that helps clients make the exercise connection.
Healthcare and fitness professionals share the same goal of improved health and wellness. Collaboration of these professionals with Occupational Therapists will support individuals with disabilities in making routines that are informed, attainable, and life-changing! I hope you will join me in leading the charge and change in preventive healthcare.
Earn the ACSM/EC Autism Exercise Specialist Certificate®
The American College of Sports Medicine & Exercise Connection partnered to create the Autism Exercise Specialist Certificate®. This newly updated course provides professionals with evidence-based strategies, practical exercises and individual/group protocols for inclusive exercise programs for those with autism and related conditions.
Course Details:
14-hour, self-paced online format
Earn Continuing Education Credits
Interactive case-based scenarios for a richer learning experience
Videos of actual clients with autism applying fitness techniques
Who Qualifies:
Exercise professionals
Healthcare professionals
Therapeutic Professionals
PE/ APE teachers
Special education professionals
Students in the above respective majors
New Course Launched August 1, 2024!
Learn more at exerciseconnection.com/autism-exercise-specialist-certificate.
About the Author
Dr. Emilee Moore, OTD , a rising star in Occupational Therapy, hails from central Nebraska and
is on the cusp of achieving her lifelong dream. She earned her undergraduate degree at the
University of Nebraska-Kearney in 2017 and recently graduated with a doctorate in Occupational
Therapy from St. Ambrose University in May 2024.
Emilee's current journey has taken her to Exercise Connection in La Grange, Illinois, where she
now serves as their resident Occupational Therapist. Here, she passionately advocates for
inclusive and accessible physical activity for individuals with autism and other disabilities,
drawing from her extensive five-year background as a fitness instructor and personal trainer.
Emilee firmly believes that everyone deserves the transformative benefits of exercise.
What sets Emilee apart is her ambition to bridge the gap between fitness and healthcare
professionals. Her groundbreaking research focuses on establishing collaborative partnerships
between these two fields to enhance the health and well-being of individuals with disabilities.
Emilee's journey is an inspiring tale of determination and commitment, as she strives to create a
more inclusive and healthier world for those with disabilities.
References
Aggarwal, M., Singh Ospina, N., Kazory, A., Joseph, I., Zaidi, Z., Ataya, A., Agito, M., Bubb, M., Hahn, P., & Sattari, M. (2019). The Mismatch of Nutrition and Lifestyle Beliefs and Actions Among Physicians: A Wake-Up Call. American journal of lifestyle medicine, 14(3), 304–315. https://doi.org/10.1177/1559827619883603
Alba, C., Zheng, Z., & Wadhera, R. K. (2024). Changes in Health Care Access and Preventive Health Screenings by Race and Ethnicity. JAMA health forum, 5(2), e235058. https://doi.org/10.1001/jamahealthforum.2023.5058
American Occupational Therapy Association [AOTA]. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), https://doi.org/10.5014/ajot.2020.74S2001
American Occupational Therapy Association (2022). AOTA is a Healthy People 2030 Champion! Aota.org. https://www.aota.org/practice/practice-essentials/quality/healthy-people-2030
Bethancourt, H., Rosenberg, D., Beatty, T., & Arterburn, D.(2014). Barriers to and facilitators of physical activity program use among older adults. Clinical Medicine & Research, 12(1-2), 10–20. https://doi.org/10.3121/cmr.2013.1171
Geslak, D. (2023, April 27). People with disabilities in fitness - idea health & fitness. IDEA Health & Fitness Association. https://www.ideafit.com/personal-training/training-people-with-disabilities-in-fitness/
Welcome to IDEA Health & Fitness Association. IDEA Health & Fitness Association. (2024a, April 25). https://www.ideafit.com/
World Health Organization. (2022). Global status report on physical activity 2022. World Health Organization. https://www.who.int/publications/i/item/9789240059153
World Health Organization. (2023). Disability. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/disability-and-health
