Anna Woods by Anna Woods

Autism spectrum disorder (ASD) is the fastest-growing developmental disorder in the United States, with about 2.2% of the population having received a diagnosis. Although the incidence is increasing as a result of improvements in early ASD identification, there has, fortunately, been an increase in acceptability, accommodations and specializations for people with ASD in all areas of life, including the fitness community.

Autism Spectrum Disorder: A Review 

While there are specific ways to facilitate quality training programs for people with ASD, to best understand how to meet the needs of this group of people, it is crucial to understand how their brains work. In addition to often being highly intelligent and observant of certain interests, individuals with autism may exhibit the following behaviors and challenges: 

  • Difficulty understanding or expressing themselves with spoken words or body language 

  • A lack of eye contact 

  • Challenges understanding social cues 

  • Difficulty with transitioning or changes in plans and routines 

  • Sensory overstimulation related to sounds, lights and smells 

  • Anxiety 

  • Special interests of a greater degree than typical hobbies or interests

  • Tendency toward repetitive or restrictive behaviors 

Exercise can be highly effective for addressing many of these challenges, including reducing deficits in social interaction, aggressive behavior and stereotypical ASD behaviors, while also improving restricted and repetitive patterns of behavior and physical motor deficits. 

Implementing Safe Exercise 

Because people with ASD have different tendencies and needs, you need to exercise your creativity, flexibility and perception to successfully train this population. The ability to change plans, adapt the program and think on the fly are key. From minute to minute, a person with autism can become overstimulated, irritated or non-compliant for various reasons—some of which they can communicate and some of which they cannot. You need to be able to read the client, recognize their behaviors, read a change in body language or observe rising irritability to best interpret how a training session should proceed, and possibly scale back any overstimulating activity or high-energy movements that will serve to exacerbate a behavior to anger or outbursts.  

Overstimulating activities may include dancing, boxing, jumping, throwing, swinging or high-intensity interval training (HIIT). It also is essential to avoid any type of equipment that could be dangerous for you or the client should an outburst occur. Dumbbells, kettlebells, plates, heavy medicine balls and bands can become dangerous during a moment of anger or frustration expressed by a client with autism. Activities that are better suited for days like these include yoga, tai chi chuan, foam rolling, stretching, breathing activities, swimming, weighted vest walking and heavy sled pushing and pulling. These activities are generally more calming and have been shown to have calming effects on people with developmental delays.

Creating a Plan 

A person with ASD typically follows a strict schedule and routine; therefore, try to maintain the same training times from week to week with each client’s sessions. The personal-training session should follow a plan that is written out for the client to see and follow. In addition, the reasons for the exercises and reps and sets should be explained. Take the time to communicate regularly with the client, particularly when you first start working together. Ask them about goals and dreams, or even about the celebrities they want to train and look like. This information will give you a clearer idea of how to motivate the client and devise a plan. Because people with autism generally lack social understanding and cues, they are more likely to be honest with you about what they want and why, which should come as a great help to you when designing their programs.

Consider incorporating the following three elements when designing programs for clients with autism: play, breath and core control, and brain-challenging exercises.


When creating a program for a client with autism, keep in mind that ASD is a group of developmental brain disorders. It affects how information processing in the brain occurs by altering how nerve cells collect and use information. Play therapy has been shown to help encourage brain development in people with autism, as it can help improve social and emotional skills, as well as challenge the client to think in different ways. One easy way a trainer can introduce play therapy into a training session is to get on the floor and play a game.  

The video below shows how a game of Candy Land can be adapted for use with children who have developmental disabilities such as ASD and Down syndrome. The rules were changed to apply exercises and reps to each colored square. The clients had to work their way through the squares to Candy Land by doing each of the designated exercises they landed on. 


Breath and Core Control 

Research suggests that diaphragmatic breathing can be an effective tool in reducing anxiety and should be used as a therapeutic protocol. Additionally, research has shown that diaphragmatic breathing paired with Dynamic Neuromuscular Stability exercises involving aligning the head, neck, spine and pelvis help improve respiration and core function even further. Adding breathing and core-aligning positions into the client’s warm-up can be a great way to reduce anxiety before a workout session, while also improving core strength.

Brain-challenging Exercises 

Finally, you may consider incorporating brain-challenging exercises for your clients, depending on their level of function. We know that for developmental disorders such as autism, left-right brain communication and optimal balance between hemispheres is vital. Contralateral exercises, such as crawling, bird dogs, alternating supermans, marching in place with arm swings and dead bug variations, are a great way to implement use of both hemispheres of the brain. Incorporating these movements into a dynamic warm-up, applying load with bands or a weighted vest or using them to create a circuit at the end of a workout are creative ways to help enhance a client’s brain health during a workout session.

To learn more from author Anna Woods, check out these two ACE continuing education courses: 

  • Adaptive Fitness Exercise Programming (worth 0.4 ACE CECs): In this course, you’ll learn how to effectively work with clients with Down syndrome and autism spectrum disorder, as well as non-ambulatory individuals. The focus is on communication, individualized programs and motivating both clients and caregivers. 

  • Adaptive Fitness for Clients with Special Needs (worth 0.1 ACE CECs): In this course, you’ll learn how to modify exercises and programs for clients with various diagnoses, behaviors and physical limitations, as well as communication strategies that encourage client compliance and motivation to learn.