VOLUME 01
ISSUE 03
Avoiding the Quarantine 15
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ON THE SPECTRUM IN
ADULTHOOD
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A NEWSLETTER PROVIDING RESOURCES FOR THE
ADULT AUTISM COMMUNITY
Brought to you by the
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A MESSAGE FROM
THE DIRECTOR
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Maintaining proper diet and exercise while respecting social distancing guidelines poses a challenge for us all. Research on proper diet and exercise for people on the autism spectrum indicates a pronounced concern related to health outcomes and overall wellness. Being home during the COVID-19 pandemic could result in the dreaded "quarantine 15." How do we avoid the temptation to mindlessly snack when you may not be able to go to the gym, or have access to healthy food options at the supermarket?
In this issue, we are happy to offer content from members of the Rutgers - GSAPP community on proper diet and exercise for adults on the autism spectrum. Here, we offer resources to help meal plan, motivate yourself, and track progress on your exercise and healthy diet plans.
Think about embedding exercise into your functional activity schedules! Remember
this exercise activity schedule
from our first e-newsletter? This may help get you thinking about how to plan your healthy lifestyle!
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Stay well,
James Maraventano, EdD, BCBA-D
Director, RCAAS-SCALE Program
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EAT RIGHT, FEEL RIGHT
Jacqueline Smith, PsyM
Clinical Psychology Doctoral Candidate, GSAPP
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The current COVID-19 pandemic has highlighted the importance of prioritizing physical and mental health. What we put in our bodies can have a profound impact on how we feel, behave, and function. Some of the many benefits of a healthy diet include a boosted immune system, reduced risk for physical illnesses and diseases like cancer and diabetes, as well as weight loss and management. Eating well may also have a positive effect on mood - something that may be negatively impacted by quarantine restrictions - and set up a person to be less emotionally reactive (“hangry” anyone?).
And while it’s now more important than ever to eat healthfully, it may also feel like current circumstances are making it increasingly challenging to maintain a proper diet. You are not alone. Days with less structure can result in over- or undereating, constant access to food in the home can lead a person to fill up on less nutritious snacks, and caregivers who are stretched thin may have fewer resources to encourage healthy eating habits. The sections that follow will give you tips and resources to overcome these hurdles.
But first, what is a ‘healthy diet’ anyway? Current dietary guidelines for adult Americans suggest maintaining a diet that is rich in fruits, vegetables, low-fat dairy, a range of proteins, healthy fats (found naturally in foods like nuts, seeds, and seafood), and grains (at least half of which should be whole grains). A proper diet also limits salt, saturated and trans fats (less than 10% of daily caloric intake), and added sugars (less than 10% of daily caloric intake). More information can be found at:
Dietary Guidelines for Americans.
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CREATE A BALANCED MEAL PLAN
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Choose My Plate provides resources to facilitate meal planning, prepping, and healthy eating education. This website can also calculate your ideal daily caloric intake and help you personalize a food plan. The following link also delivers examples of healthy balanced meals for adults:
Meal Plan Example. Once you know the right foods to eat, there are several strategies you can implement to encourage healthy eating for yourself or the adult on the autism spectrum in your life:
- Set an alarm to cue mealtimes and snacks. Keep away from the refrigerator in between alarms.
- Eat the less preferred items in a meal before the more preferred ones (“first salad, then sandwich”).
- Eat at a table and not in front of the TV. This is tough, but can result in less snacking on the couch, as the TV won’t be paired with eating (i.e., stimulus control) and more attention can be paid to feelings of fullness (i.e., mindful eating).
- Create a BINGO card with a mix of available healthy foods in your home for the day. Once eaten, cross off the picture of the food on the card. Build in a reward for doing so!
- From a food group chart like this one, make a list of available foods in your home and sort it by category (i.e., vegetables, grains, etc.). Pick one food from every category to include in each meal following suggested portion sizes.
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INCREASE YOUR MOTIVATION
Faris Kronfli, PhD, BCBA-D
Behavior Analyst, RCAAS-SCALE Program
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Recent research shows that people on the autism spectrum are more likely to have higher levels of obesity, develop metabolic syndrome and other chronic health problems, such as type 2 diabetes and cardiovascular disease, relative to neurotypical individuals (Barnard et al., 2002; Freedman et al., 1999; Jones et al., 2017; Ludwig et al., 1999). In general, this is due to lower levels of physical activity and higher levels of sedentary behavior, sleep disorders, restricted food interests, limited social skills, and prescription of atypical antipsychotics, which are more likely to be prevalent among individuals on the autism spectrum.
However, with dietary changes (Healy et al., 2018; Kronfli et al., 2019; Rafacz, 2019), an increase in physical activity (Galbraith & Normand, 2017; LaLonde et al., 2014; Nastasi et al., 2020; Nieto & Wiskow, 2020), and lifestyle modifications, these risks can be reduced. The biggest obstacle we face, however, may be ourselves. I am sure most of us have found exercise aversive at some point in our lives; so how do we increase our motivation? One way can be to use reinforcement or rewards.
True story: I recently went out for a run but learned the batteries to my wireless headphones were dead. I immediately turned around and went back home. There is nothing wrong with making exercise more enjoyable by using things like music, videos, or something special, such as a favorite food or beverage when you complete the activity. Make sure it is something chosen by the person who has earned it, and is not an assumed reward. This is something we often promise ourselves (e.g., I am going to eat dessert after I finish my work) or others in our life (e.g., You can eat dessert after you eat your vegetables). Placing a contingency on our own behavior (i.e., positive reinforcement) or adding something we enjoy to an ongoing, possibly aversive activity (i.e., noncontingent reinforcement) is a great way to increase the likelihood we will get something done.
Positive reinforcement is the delivery of a preferred item or activity contingent on a behavior, while noncontingent reinforcement is “free access” to the item or activity. For me, I prefer dessert to vegetables, so making dessert contingent on consumption of vegetables is an example of positive reinforcement. I also do not like running, but I enjoy listening to podcasts. So, listening to a podcast while running is an example of noncontingent reinforcement. Listening to the podcast reduces the overall aversiveness of running, which increases the likelihood that I will complete my run. Check out this
information offered by Autism Speaks. Here you can find resources to promote a healthier lifestyle for you and your family.
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GET GOING, KEEP GOING
Todd Frischmann, EdM, BCBA
Behavior Analyst, DDDC
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Numerous studies have shown the importance of exercise and physical activity for everyone with regard to improving overall intellectual functioning, emotional well-being, positive self-concept, and physical health and fitness. Research also links several health problems, including cardiovascular disease, insulin resistance syndrome, and obesity to a sedentary lifestyle. Further, individuals with disabilities, including those with autism spectrum disorders, engage in less physical activity and show relatively low levels of physical fitness overall compared to individuals without disabilities. This may increase the risk of developing a sedentary lifestyle in adolescence/adulthood.
Individuals on the autism spectrum may encounter a multitude of obstacles to engaging in exercise and physical activities. These challenges can include:
- low starting physical fitness levels
- poor motor coordination
- preferences/aversions to certain types of physical activities or environments (e.g., at home v. at a gym; alone v. with others)
- lack of motivation or sufficient reinforcement (a common difficulty for many people!)
- limited availability of or access to exercise equipment
In addition, effective instruction may need to be tailored to a specific activity for the individual. However, these obstacles are not insurmountable. Given the lifelong benefits of a physically active lifestyle, it is important for individuals on the autism spectrum to identify physical activities that match their particular interests and preferences, and to learn the necessary skills to engage in those activities. Remember, it may be necessary to consult a physician before starting any type of exercise or physical activity program.
Some strategies for anyone thinking about incorporating exercise and physical activity into his or her lifestyle are:
- Try a variety of different activities to identify what is preferred or disliked (and why). Not sure where to start? Check out this Fitness Assessment offered by WebMD. It may help you figure out your fitness type and how to overcome any obstacles to getting started.
- Start an activity with small goals (a few repetitions, a brief amount a time, a short distance, etc.). Gradually set higher goals that encourage continued participation.
- Use prompts that are effective for the individual (in-person or video modeling, verbal prompts, gestures, visual cues, physical guidance, etc.). Revisit this reference from last week's e-newsletter for more info on prompts.
- Include reinforcement for participating during and/or after the activity (music or videos while exercising, a preferred beverage or relaxing activity when finished).
- Make exercise and physical activities part of a daily or weekly routine. Think about how to add exercise to your functional activity schedules.
- Use a money jar, token system, or other method to reward (or reinforce) exercising.
- Track progress using one of the following methods:
- Use a spreadsheet (my personal preference), such as Excel by Microsoft. Not familiar with Excel or graphing? Check out this beginner’s tutorial on how to get started using Excel.
- A wall chart is another good way to outline the schedule and intensity of your workouts.
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Are you concerned you will not be able to maintain a healthy lifestyle while respecting social distancing guidelines? Don't worry, you are not alone!
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Here is an article by Dr. Melina Jampolis offering ways to avoid falling off the healthy-lifestyle bandwagon. From food shopping tips to guidelines for proper sleep, this article can help you think about your food choices and your schedules for maintaining a healthy lifestyle.
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Many people, including adults on the autism spectrum, benefit from visual guidance as they develop healthy eating habits and functional skills in the kitchen.
For recipe inspiration and meal instruction with visual elements,
check out this resource from the Center for Autism and Related Disabilities (CARD) at the University of South Florida. CARD compiled a list of cookbooks written to promote healthy eating and meal preparation skills for people on the autism spectrum.
Accessible Chef
offers a collection of free visual recipes and other resources, for you or the person on the autism spectrum in your life to teach or learn cooking skills.
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Smart eating starts with smart shopping. When shopping for groceries, keep this in mind - if it’s not in your house, you can’t eat it! Here are a few tips and resources to help you think about how to shop for healthy foods:
Limit the soda, chips, and other processed foods available to you and others in your home. The
Mealtime app can help you plan meals, has a built-in shopping list function to streamline grocery runs, and more.
Stock up on canned or frozen fruits and vegetables if the fresh ones are too expensive or spoil faster than you can eat them. More budget-friendly tips can be found on the
USDA's ChooseMyPlate page.
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Not sure where to start with your exercise routine? Below are some resources we found to help you hit the ground running.
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The Autism Society offers a resource to help create an exercise program that is appropriate for you or the adult on the autism spectrum in your life. Click
here
to learn more.
Need some motivation to get started? This article in
Science Daily details how praise can motivate young adults on the autism spectrum to exercise more. Read more
here.
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You're probably spending a lot of time at home on your phone. Look at these apps to help get your exercise routine kickstarted and keep you motivated for the long run (pun intended).
Exercise Buddy is an app made specifically for individuals on the autism spectrum. It uses social narratives, visual supports, video models, and technology-aided instruction to make exercise more accessible and understandable.
Looking to use media as motivation? There are many free applications for Android and iOS devices to access music, news, podcasts, and more. Some popular apps to consider:
Pandora,
Spotify, and
TuneIn.
MapMyRun is a
free runner's tracking app that includes metrics such as distance, pace, and calories burned. This app is designed for new and expert runners alike.
The free
Apple Health App
for iOS devices helps organize your important health information and offers a multitude of detailed metrics for tracking your health.
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"Take care of your body. It’s the only place you have to live."
- Jim Rohn
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WE HOPE YOU ENJOYED THIS ISSUE OF THE RCAAS E-NEWSLETTER
AND FOUND IT USEFUL. PLEASE DON’T HESITATE TO SEND
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