Context: Focus on Social lntegration
Author: Marialice de Castro Vatavuk. Brazil
The main purpose of this presentation is to pinpoint some principies and practical considerations concerning the development and implementation of physical education and exercise programs for persons with autism, stressing the possibilities of social use of the abilities fostered, thus enhancement of quaiity of life. Firstly, is essential to know how is each student individually in the general context of autism. According to our experience the first two steps for the development of meaningful, good motor skill is is to know in details the actual motor skills interests and communicative skills, to ensure, the person will be almost absolutely successful in the tasks posed to build-up motivation, compliance, self-esteem and independent performance. Secondly, for "having fun", easily understanding of what is expected is crucial. Structural elements play an important role in this game. The teachers have to be good players maintaining a positive relationship with each student, students in couple, the group, the students and non-handicapped peers, brothers, sisters and the parents. Thirdly, we recommend activities compatible with the culture of each specific community, in our case Sáo Paulo-Brasil, to facilitase integration. Our institution opted for jogging, indoors and outdoors circuit training, skating, swimming, gym, imitation games, relaxation, massage and the use of music. Last but not least, frequency, duration, intensity and medication must be taken into account.
There is a great deal of concern in the field regarding the lack of data based research involving people with autism and the motor domain as well as a general claim that physical educators have generally had littie to say in regard to program suggestions,teaching principies or motor performance of people with autism and furthermore have been conspicuously silent conceming the role of movement activities for this "population" (Crovm, Auxter&Pyfer, 1981; Reid & Morin, 1981; Seaman & DePauw, 1982; Reid, Collier & Morin, 1983, Morin & Reid, 1985, Collier & Reid, 1987). Whoever dares to dive in a deep search for the genesis of autism would take the risk to be brought back to the primordium of mankind. Together with time in human phylogenesis and at an astonishing speed, runs a crescent demand for very specialised and adaptational abilities and skills Mose proficiency are fundamental for survival as a free representativa of the human specimen it is now 53 years since Leo Kanner in Baltimore published his first paper vath the original description of autism,and during this half center we've been vátnessing researchers and professionais of several fields struggling in the endeavour to grasp the very nature of autism, specially an almost desperate search for common markers. It'seems nowadays that the more we try to "round off' the circle overty broader tums out to be the syndrome of autism Under the wings of pervasive developmental disorders (Volkmar et cols, 1994) With trends to be viewed as a non-specific behaviour syndrome shading into other disorders of empathy (Giliberg, 1992), the "autistic continuum"(Wing, 1989) or "autism spectrum" (Giliberg & Giliberg, 1989) involves three classes of affected areas often referred to as a triad (Wing, 198la, Wing & Gould, 1979) of social, communication and behavioural impairments. To be more specific, the "common markers+ at this time is that there must be severe impairments in: 1) relating reciprocally to other people,2) verbal and/or non-verbal communication, communication, and 3) in adjusting the behavioural repertoire in a flexible way to the changing demands of new social situations (Giliberg, 1993). Therefore,the diagnosis per se involves not only non-specification but also does not provide conditions for the establishment of prognosis and adequate treatment strategies (Assungáo Jr., 1995). However comprehensive educational interventions at eariy age, remain the best documented approaches in the treatment of autism (HoWin &R utter,1987; Schopier, 1989; Lovaas et al.1989; HoWin & Yates l989). In our institution, a division of AMA - Association of Friends of People with Autism of Sáo Paulo,Brasil, after years of search for a treatment approach that would be flexible enough to meet this population and their families, we adopted a great deal of the philosophy and principies of TEACCH approach (Rutter, 1978; Schopier et ai.; 1980, 1984, TEACCH, 1991), of course With far less complex administrative structures. It is of great weight to bear in mind that those principies have to be constantiy re-examined in the light of current developments, the enduring cardinal ones are:
1. the view of autism as an organic disability: that they process information and understand the world quite differently that their non-handicapped peers, the main goal is the understanding the implications of their central impairments, thus to use this in bridging the gap between their perception and those shared by the rest of society;
2.parents-professional collaboration:this interaction is not only politically potent but crucial for assuring the valid programs for each individual child
3.people with autism and these families require a "continuum" of lifelong comprehensive services based on the demands of each particular community,4.individualization:is the key to establish specific strategies for individual skills, strengths interests and the single needs of the individual and the family,
5.an interactional model: where the optimisation of the treatment will depend on: the interactions (a two-way view) between parents and professionals, parents/professional and the individual with autism, and the evaluation of the educational/therapeutic intervention will be based on A x B, which A. for the person with autism - the best combinations to enhance his/her abilities and consequently promote adaptation and minimise behavioural problems and B.from the environment-the adaptations applied at school, home and community in acceptance and recognition to individual's special needs to promote integration (which cannot be taken at all as normalization),
6.a generalist model, instead of too much concentration on a single aspect of the child or narrowy to the eyes of an specific discipline it requires a broad view of autism,of the needs of the person and the family focusing on organizing information and treatment prescription on those central priorities. Coming back to the first issue posed: Are problems in the motor domain central in autism?; What information do we have concerning the motor performance of people with autism?; Would specific knowledge and concentration in the motor domain enough for developing meaningful physical education and exercise programs?and What could be the role of movement activities for people with autism? In his classical paper Kanner (1943) commented that motor development and co-ordination were normal in autism,that although clumsiness in gait and in gross motor performances,they vmre very skillful.This clinical observation remained for more than thirty years,Men researchers begun to question the belief of adequacy and developmental consistency Wth chronological age(Lotter, 1 966,
Wing, 1 976, Ornitz et. al 1977; Geddes, 1977). More systematic andlor specific studies of motor performance of people Wth autism(DeMyer 1976,1980; Singienton,1974Jones & Prior,1985;Maurer & Damasio,1982;Reid Collier & Morin,1983; Morin &Reid,1985), come to "disappointing" resuits:Men compared to retarded and nonretarded, subjects Wth autism revealed poorer scores on the follovfing fitness measures:body fat, grip-strength, abdominal strength and flexibiiity,specially in trunk flexion.They were below chronological age level on tasks requiring physical integration skílls, quite below the level of normal and subnormal children on body imitation tasks (dynamic and static movements),on qualitative motor skill performances : immature motor pattems in throwng,jumping and running, accompanied by inappropriate and non-functional arm movements.The subjects with autism despite demonstrating significantiy superior performance qualitatively on dynamic balance,virtually moved at a slower and more controlled speed. Minimal differences in performance on most tasks were found vvhen comparing older and younger groups of autistic individuais. lt was also found splinter skills,diminushed energy output,low functioning regarding body image, abnormalities on postural fixation and righting, bradynesia, aknesia, dystonia,hyertonia and hypotonia. Some of the researchers tend to attribute this low scores to autism in association to mental retardation (75% to 90%) On the other hand, others found that there are difriculties with complex co-ordinated motor tasks even in the high functioning seeming to indicate central nervous system dysfunction. In one of the studies that compared the performance of high, middie and low functioning people with autism to people Wth mild retardation, people Wth autism had lower scores except for stair tasks (climbing and descending)Anedoctically in this task, the middie functioning had the best performance of all for groups. According to some of the authors, from a developmental perspectiva the formula"normal development in slow motionndoes not apply,they progress at different rates and some motor behaviours are atypical at any stage of normal development. Reid(1 981 )suggested that "motor impairment might be a misnomer for what is really poor perceptual processing+. After this brief review of some research data on the motor domain of people with autism, is not unkward to come to the conclusion that the striking problems posed are mostly manifestations of the central deficits in autism and that individualization is the key for enhancement. In our opinion programs of physical education and exercise, must not concentrate on teaching movements as an end in itseif,but on the usefulness of its leaming
stressing the possibilities of gains in adaptation,social useof the abilities fostered and the enhancement of quaiity of life (Haracopos, 1 989). Without taking into account the context,in other words,the particular needs of each individual for more independent life in his/her community,it turns out to be an empty conception,vaiich would be transformad in one more source of displeasure in the life of people Wth autism. The first step is to know how is each person individually in the general context of autism,and the intrincate,creative interaction between autistic traits and other qualities of the individual, in this vmy : no two people Wth autism are the same (Sacks,1994). According to our experience for developing meaningfui, good motor skills,it is crucial to know in detaiis the actual motor skills,cognitive style, interests and communicate skills of each student.To tackie this issue we suggest the use of data from some instruments: careful analysis during the application or of the resuits in the CARS(Schopier et. a/,1988)items: relating to peopie,imitation,emotional response,body use,object use,adaptation to change, visual response, listening response, use of the proximal senses,fear or nervousness, the PEP-R(Schopier et aL,1990) or AAPEP( Mesibov et al,1987)for specific information conceming the development in different functional areas as vmil as behavioural characteristics, an evaluation of spontaneous communication skills in every day life(Lord,et al., 1 989). lts indispensable to taik to the famiiy for assessment of person's interests and experiences in leisure time,expectations and concemings of the famiíy about motor/feisure activities they wouid like to share Wth . Not less important is involving the vvhole family since the beginning as v,/ell as thinking together in activities would be compatible Wth the culture and the community in question.For scanning the actual motor skills, cognítive style and level of confidence in solving motor problems,structural level needed for seif-orientation, attention span without much help of the instructor Ievel of "concrete thinking",motivators and direct interests is very usefui to apply some sessions of informal evaluation in the settings where the activities váli be applied, in our case indoors and outdoors. Situations are purposefully created,with basis on the previous information gathered:
a) in form of circuits of obstacie courses,which beginning and ending are clearly indicated, where are posed some "real+ problems and "tricks",and may demand:changes of direction and plains,climbing, descending,balance,jumping, hanging,straddle, transporting objects, static and dynamic balanceabal kicking,shooting,throwng etc...
b) the same situation together with his/her group(ex.in a row).
c) more free situations, with some hints displayed by the disposition of materials, with the teacher, for specific skills ex.imitation(dynamic and static), bailplaying(rolling, kickíng,dribling,catching),
d) other situations demanding proximity andlor co-operation, with the teacher or peer(s).
e) physical evaluation: height,weigh, skinfolds (if possible in this ínitial contact),heart rate and blood pressure at rest and after exercising.
During this situations the teacher has to be concentrated on observing:
1. how the student solve the problems, explore the environment;
2. which resources helshe relied on doing so: motor feedback (proprioception) , visual input, others;
3. what type of hints from the environment and teacher were more relevant;
4. if the student "asked" for heip somehow and how the student communicate (functions and semants categories used)-
5. which motor abilities are good, emerging or poor-
6. was he/she capable of moduíating rhythm accordingly,
7. what his/her resistance 'to frustration;
8. what was the level or style of interactions established between teacher, student and peer(s)
9. if the student demonstrated any kind of interest or pleasure during this sessions;
10. which type of stimulus distracted (or tended to)and attracted the student
11. was the student motivated by social praise(understood by any verbal or non-verbal modes of communication displayed by the teacher to praise the student)
The acquisition of a motor ability involves a teaching-learning process,the main goal is the solution of a posed motor proposition wfiich is demanded by the external environment(Tani,1989). To find a "solution" the individual must to process the information gathered from the external environment and of his/her own body (proprioceptive)and make the necessary adjustements.lt involves a vast array of very sophisticated interactions between the sensory receptors,perception mechanisms, feedback circuits, muscular system besides motivational factors.lt has a direct relationship to attention, integration and processing of information,sequencing and memory.Optimal gains in performance are obtained if the solution of the motor proposition once obtained is repeated for retention.in this process performance errors can be originated by three axis:1.the individual that transmits the information, 2.the environment and 3.the person vvhich receives process and apply the information for solving the problemón autism, together váth the Triad of impairments, independentiy of IQ,we have cognitive,sensory, organizational impairments as well as markedly uneven development betvmen and within the various developmental, functional areas.Thus, vte have actually a problem v,/ith +axis 3+ and had made alall the screening to obtain a "profiie" In this way the system for adequate leaming acquisition is disbalanced,or out of modulation.As a resuft the next step is to make triais to adjust axisland 2,respectively.lt demands for creativity of the teacher to make constant environmental manipulations,select flexible strategies and activities' organization. On top of this,if axis 3 changes its position,in other mrds students gain adaptation,axis 1 and 2 have to bring up date their acquisition.Thus,there is no place for "inactivityw.if people váth autism lack a Theory of Mind( Lesliel987,1988; Frith,1989),a chalienging start is to exercise our innate capacity of stepping in other people's shoes,and the striking enigma lo decipher wvuid be the boundaríes between lack of emphaty and capacity of linkage or attachment.The teacher shali be someone who shares his/her experiences with the students,not being a good person,but a gentie one;a facilitator adjusting his communication to each particular situation,being economiced and concrete vvhen using verbal language,giving priority to the modes of communication used by each student:instrumental gestures,corporal posture,facial expression... lnstruction will involve the use of a varied of prompts and cues in combination:a)completelpartial physical manipulation,manipulative prompting,minimal guidance,b) completelpartial skill model or demonstration, c)gestural cues,d)direct instructions or cues,e)indirect cues or f)no cues or prompts:imitative initiation andlor spontaneous initiation In some situations vvhere demonstration and imitation are used,some "acting spirif and concrete miming can help to stress clear-W definitions of main position(s) and movements and their nature(siight or powerful). Sounds can be smartly used lo hint the target goals: ciaps,counting,cueing by reproducing the sound of a bali dribling,the landing from a platform,etc.The teacher and instructors have to be good players building up in class a positive associative relationship with each student,students in couple,the group,the students and non- handicapped peers,brothers,sisters,parents and sympathizers.in our institution,a great deal of students benefit fiom sessions with brothers or sisters,non-handicapped peers,other members of the staff,relatives and parents,vve observed surprising gains in performance during this sessíons.Before participating all have to know the ruies for "getting the neck of the game".Axis 2,or the structural elements of the environment play its role by offering redundancy of relevant information.For having fun,easily understanding of vihat is expected of him/her is crucial.The main elements are:visual "division" of the space in areas,physical disposition of materials,ciass schedules,sequencies and routines, visual organization and hints, individualized tasks structures and communicative systems. Some ideas from an ecological framework are of great value in engineering the environment and structuring the tasks.lt emphasize the person~environment
relationship.According to Gibson(1977,1979) the environment is perceived in terms of its utiiity for the perceiver.FolloWng the same viewother authors suppose that movement co-ordination and control emerge from the mutual constraint of perception and action(Fitch,Tulier & Turugy,1982).If we are dealing Wth people that need central coherence,vaio have difficulty in making sense out of the worid(Frith,1989) irrelevant objects that are able lo be acted upon,should be removed,vvbile objects used in a given task should be modified to accentuate or increase their attraction to be acted upon(Burton, 1 987). By our side,vte have the concrete nature of movement, which provides an immediate indication of success or failure(Mosher,1981). The flexibiiity of motor tasks, organizad in chains,not sprayed or dispersad in the space, enables the teacher to set the goals making adjustments, even during its course,to give immediate feed-back and assure,specially in the beginning,that the person váli be almost absolutely successful.The repeated experience in successfui accomplishing a task provides not oniy an intrinsic reward,but also opportunity for the teacher to respond with approval to the student actions.The maintenance of motivation and compliance are positively related to success(O'Deil,Duniap &Koegel, 1983) and are essential to build up seif-esteem and for independent performance.in other studies, some authors, pointed out that the evident low level of motivation in children v,/ith autism,might inhibit the acquisition of new skills and maintenance of acquired skills, (Koegel & Mentis,1985),other suggested that motivation might be decreased, performance impaired and task avoidance increased by repeated experiences of failure(Clark,Rutter,1979;MacMillian,1971;Rodda,1977). In selecting the activities vm consider:adequacy to chronological age,total information from evaluations and its compatibiiity viith cultural and familiar factors,for giving people with autism the tools they need to keep fit and enhance quality of social life.Particular needs are fully considerated,one of our students is attending a normal school vvhere he is leaming to play soccer,although being very skillful,he has some utypical autistic difficulties": mhat side is supposed to be attacked and no matter v,here the goal keeper is,if he catches the bali, a goal is not obtained.The main program for him is a backing one,consisted of a series of practical motor tasks for helping him to learn the ruies.We opted for walking,jogging,circuit activities,circuit training,skating, skating,svvimming, gym,imitation games,relaxation games,massage and the use of appropriate music as much as possible.To organise and present the tasks ít is mainiy used a task specific approach(Auxter & Pyfer,1985) rather than a developmental approach.lt concentrases in teaching a specific skill or a chain of skills directiy,in as normal context as possible and moving dowi to work on general abilities or basic input/ output system oniy if it is necessary for a particular skill.lt is established a class structure followng the normal technical principies of physical education and training.The sequence of a basic class is:l.warn-up(articular, muscular and cardiovascular), 2.main activities(longer) and 3.cooi-dowm(relaxation, massage, specific exercises, stretching ... ).The length of time of each class is two hours and the main activities,for instance,circuit and svvimming, basketball and skating,are distributed to the week in a balanced form(enough exposition for learning) The initial indispensable action in a class is to present to the students a
"temporal sequence",to assure the communication of v.,hat is going lo happen,by schedules adapted to the individual needs:objectal,representationai,written or in combination.in my experience if you quarantee the communication of what is going to happen, constant changings in routine are weil accepted. Depending on the group that can be done individually, in pairs or the whole group, the schedule presentes ready or made by teacher and students.Schedules are a potent opportunity for teaching opportunism:to evaluate gains and introducing new chalienges, for instance,give opportunity for choices or posing a sequence of activities in the main
part of the class that the last of them Wil be done only if there wouid be time for(to negotiate the rigidness of a high functioning student).There are many reasons to present tasks in form of circuits v.,ith varied goals:l.it offers instantaneous opportunity for seif-oriented performance,2.poses a concrete situation váth clear beginning and ending, 3.student may have immediate feedback of performance and opportunity to make many triais and to usolve the problem+ in its owm manner,3.gives a multitude of possibilities for combination of varied categories of skills,so offering relevant and dynamic motor experiences,4 physically or visually connecting isolated pieces of equipment increases the number of possibilities conceming spatial disposition, variation of courses,combination of emergent and mastered skills, combination of each student tastes , interests and level of abilities,5.provide chances for both group wvrk at many leveis and individual adaptations using the same materials, posing different tasks according to individual abiiity.The level of udensity+ of the materias and its disposition must be proporcional to the symbolic and representational impairment of the person Wth autism:so one can use dense materias with real connection (stairs,benches,car tyres,bicycle tyres, balance beans ropes ... ), materias not so dense and visually connected(foot prints,taplines ... ), graphic indications(arrows,numbers ... ),pictures, dravvings,written hints,etc.For developing flexibiiity and helping generalization the teacher has to try both the use of the same materias for different proposais and different materias for the same proposal.Circuits can be used for teaching fundamental skills and developmental activities,for leaming new skills and for training what they had already mastered.it can be'open'(one route),in stations or continuous Continuous circuits are ciosed so the teacher must to propose or establish the number of tums the students are supposed to do,and find a meaningfui way to make it clear,one vmy to do so is having a small box for each student(,Mth photo or name) over a table "in circuir Wth a number of tickets or checkers corresponding to the number of tums.Each time the students passes the table helshe gets a checker and insert in a coin keeper,Wlen the box is out of checkers, game's out. It gives chance for students asking for more checkers or giving some back to the teacher. In continuous circuits specific for training the measure may not the number of turns but the length of time(use timer). Station circuits are displayed in sequential stations where the students(normally in couples) stay making the same movement or a smali sequence of movements for some time or number of times.Ex., for adolescents :a.Bicycling(2 ergometric bicycles),b.infra-abdominais(specific apparatus),c.jumping(2 rebounders) and d. strength -training :trunk(2 pack-decks).For developing the initial abilities,obtaining gains in performance and using meaningfully skills leamed, this leaming process is follomed;the student needs to leam:l. the necessary movements,2.combine in the situation proposed, 3.repeating for retention,fixation, 4. repeating, in optimal timing for the situation, 5. repeating in optimal timing and length of time for the situation( Le Boulch,1984). ls of great weight to apply systematical sabotage to negotiate their rigidness,to bring up date their acquisitions of adaptation, aiways posing new chalienges,as it's hard to foresee their limits and it should not be given chance for losing such priceless opportunities.The priorities are: aerobic exercise training for adolescents/adults and functionalldevelopmental motor activities for the younger. Studies employing a variety of antecedent exercises have documented that a Wde range of clinical populations had associated reductions in negative behavioural and affective symptoms.Other studies have shomn improvements in social skills through structured exercise programs even though the activity was not aerobically stressfui (Elliot, Dobbin, Rose & Soper, 1 994;Andel & Austin, 1 984). Similar resuits vmre found in studies conceming mainly children with autism(Watters & Watters,1980,Kem et al.,1982,1984).The only that used adults (n=6) suggested that vigorous aerobic
exercise might be a usefui tool in reducing maladaptative behaviour,thus facilitating community integration. Last but not least, considerations conceming training variables '7 and medication must be taken into account for each modality.The most obvious lmplication wvuid be to become familiar váth physical fitness training techniques.Since vigorous training in the aerobic modaiity is designed to stress the cardiovascular system to approximately 70% of the maximum function for a minimum of 15-20 minutes(Cooper,1978)and in general the intensity ranges from 60% to 70% of maximal functional capacity(American College of Sports Medicine,1986), it is important to have an in-depth understanding of exercise physiology,prevention and treatment of sports injuries,and emergency procedures. Periodízation of training have to be planned Wth maximum measures for security as they can not tell wtiat they feei:fiequency, duration,intensity,graded exercise programs prescriptions, nutritional concealing, knovviedge of eariy signs of overtraining,systematic screening and supervision Physical exercise increases the production of norepinephrine Wth similar resuits so that of using amphetamines and there are several reports of " negative addiction to exercise" or symptoms similar to chemical dependency (Morgan,1979b).Vigorous exercise resuits in increased level of plasma oendorphin(Borttz et al. 1 981),airding to Sahiey and Panksepp(1 987), this wouid be beneficial lo reduce stereotypy in people with autism. Studies have shomn that vigorous exercise may heighten the person's sensitivity to pharmacological agents,thus supervision of specialized medical professionais is highly recommended.
References:
American College of Sports Medicine:Guidefines for Exercise Testing and Prescription,
Phiiadelphia,Lea & Febiger,1986.
Andel, G., & Austin, D. Physical fitness and mental health: a review of the 1 iterature.
Adapted Physical Research Quarteriy,1,207-220,1984.
Arnheim,D.D,Auxter,D., & Crowe,W.C.A review of schizophrenia in chilhood,Canadian
Psychiatric Journal, 1 1,276-285,1966.
Assungáo Jr,F.B.In Conceito e Classificagáo das Síndromes Autísticas ln:Schwartzman.,
J.S:Assungáo JR,F.B et al.Autismo lnfantii:3-16, Sáo Paulo,SP, Memnon,1995. Auxter,D. & Pyfer,J.Principles and Methods in Adapted Physical Education and Recreation.St Louis,Times Mirror,Mosby,1985.
Borts,W.M,Angivin,P.Mefford,P.in:Boarder,M.R,Noyce,N. & Barchai,J.Cathecholamines,
dopamine and endorphin leveis during extreme exercise.New England Joumal of Medicine,305,466- 467,1981.
Burton,A.W.Confronting the interaction between perception and movement in adapted physical education.Adapted Physical Research Quarteriy,4,257- 267,1987. Ciar@k,P. & Rutter,M.Task difficulty and task performance in autistic children. Journal of Child Psychology and Psychiatry,20,271-285, London, Pergamon Press, 1 979. Collier,D., & Reid.G comparison of two modeis designed to teach autistic children a motor task.Adapted Physical Research Quartely,4,226-236,1987.
Cooper, K. H. The Aerobics Way. New York, NY, Bantam Books, 1 978.
Crovm,W.C., Auxter,D., & Pyfer,J.Principles and Methods in Adapted Physical Education
and Recreation.St Louis,Times Mirror,Mosby,1985.
DeMyer,M.K Motor,Perceptual Motor and lntellectual Disabilities of Autistic Children. In:
Wing, L. Early Chilhood Autism, 1 5-65, New York, Pergamon Press, 1 976.
DeMyer,M.K. Motor,Perceptual Motor and Intelectual Disabilities of Autistic Children.in:
Wing, L. Early Chilhood Autism, 1 69-189, New York, Pergamon Press, 1 980.
Elliot Jr,R.O.,Dodbin,A.R.,Rose,G.P., & Soper,H.V.Vigorous aerobic exercise versus
general motor training abilities:effects on maladaptative and stereotypic behaviours of adults with both autism and mental retardation. Joumal of Autism and Developmental Dísorders,24,5,565-586,1994.
Fitch,H.L;Tulier,B. & Turvey,M.T.The Bernstein Perspective:lli,Tuning of Coordinative Structures víith Special Reference to Perception. ln:Keiso,J.A.S.Human Motor Behaviour: An lntroduction,271-281,Hilisdale,NJ, Eribaum,1982. Frith,U.Explaining the Emigma.Cambridge,Massachusetts,Axel Scheffier,1989. Geddes, D. Motor development of autistic monozygotic tvlins: a case study. Perceptual and Motor Skills,45,179- 186,1977.
Gibson,J.J.The theory of affordances.in:Chaw,R., & Brandsford,J.Perceiving, Acting and
KnoWng: Towards an Ecological Psychology.Hilisdale,NJ, Eribaum,1977.
Gibson,J.J.The Ecological Approach to Visual Perception.Baston,Houghton,Mifflin,1979.
Giliberg, C.The Ematuel Miller Memorial Lecturel 991:Autism and autistic- like conditions:
subciasses among disorders of emphaty.Joumal of Child Psychology and Psychiatry, 33,813-42,1992.
Giliberg,C.Autism and related behaviours.Joumal of Intelectual Disability Research 37,
343-372,1993.
Giliberg,C., & Giliberg,I.C.Asperger syndrome-some epidemiological considerations:a research note. Joumal of Child Psychology and Psychiatry,30,631-638,1989.
Haracopos,D.Comprehensive treatment programs for autistic children and adults in Denmark. In: Gillberg, C. Diagnosis and Treatment of Autism,251-261, Pienum, 1 989 HoWin, P. & Rutter,M.Treatment of Autistic Children.Tiptree,Essex, Anchor Brendon Ltd, 1 987.
Jones,V., & Prior,M.Motor imitation abilities and neurologícal signs in autistic children.
Joumal of Autism and Developmental Disorders, 1 5,1,37-46,1985.
Kanner,L.Autistic disturbances of affective contact.Nervous Child,2,217-250,1943.
Kem,L..,Koegel,R.L., & Duniap,G.The influence of vigorous versus mild exercise on
autistic stereotyped behaviours.Joumal of Autism and Developmental Disorders,14,5767,1984.
Kern, L ... Koegel,R.L..,Dyer,K..,BiewP.A.., & Fenton,L.R.The effect of physical exercise on self estimulation and appropriate responding in autistic children. Joumal of Autism and Developmental Disorders,12,399- 419,1982.
Koegel, R. L., & Mentis, M. Motivation in chiidhood autism: Can't they or wvn't they.? Joumal of Child Psychology and Psychiatry,26,2,185-191,1985.
LeBoulch,J.L'Education Psychomotrice á L'Ecole Elémentaire-La Psychocinétique á L'Age
Escolaire,Paris, de Les Editions ESF,1984.
Leslie,A.M.Pretence and representation:the origins of "theory of mind".Psychological Review,94,412- 426,1987.
Leslie,A.M.Autistic children's understandíng of seeing knowng,and belíeving.British Joumal of Developmental Psychology,6,315-324,1988.
Lord,C.,Rutter,M.,Goode,S.,Heemsbergen,J.,Jordan,H.,Mavvhood,L., & Schopier,E. Autísm diagnostic observation schedule: a standardized observation of communicative and social behaviour.Joumal of Autism and Developmental Disorders,19,185-212,1989. Lotter,V.Services for a Group of Autistic Children in Middlesex.in:Wing,J.KEarly Chiidhood Autism, London, Pergamon Press, 1 966
Lovaas,I.,Calouri,K.,& Jada,J.The nature of behavioural treatment and research vlith young autistic persons.in: Gillberg,C.Diagnosis and Treatment in Autism, 285-305, NewYork, NY, Pienum Press,1989.
Maurer, R. G., & Damasio,A. R. Chiidhood autism from the poínt if view of behavioural neurology, Joumal of Autism and Developmental Disorders,12,2,195-205,1982.
McMillian, D. L.the problem of motivation in the education of the mentally retarded.
Exceptional Childrem,37,549-586,1971.
Mesibov,G., Schopier,E.,Schaffer,B., & Landrus,R. lndividualized Assessment for Autistic and Developmentally Disabied Children: Vol.4.Adolescent and Adult Psychoeducational Profile(AAPEP).Austin,Texas,TX PRO-ED lnc,1988. Morgan, W.P.Negative addiction in runners.Physician and Sports,7,2,59-69,1979,b. Morin,B., & Reíd,G.A quantitative and qualitative assessment of autistic individuas on selected motor tasks.Adapted Physical Research Quartely,2,43-55,1985. Mosher,R.The hole of motor programs in the development of autistic children. Canadian Association of Health Physical Education & Recreation Joumai,29-33,1981. O'Dell,M.C;Duniap,G. & Koegel,R.L.The importance in reinforcing verbal attempts during speech trainingmth non-verbal childrem.Paper presentes at the American Psychological Association Annual Conventíon, Loa Angeles, CA, 1 983. Omitz,E.M.,Guthrie,D., & Fariey,A.J.The eariy development of autistic children. Joumal of Autísm and Chiidhood Schizophrenia,7,208-229,1977 Journal of Autism and Developmental Disorders,15,1,37-46,1977.
Reid,G.,Collier,D., & Morin,B.The motor performance of autistic individuais.in: R.L.Eason,
T. L, Smith& F. Caron(Eds),Adapted Physical Activity: From Theory to Application,201 218, Champaign,IL,Human Kinectics, 1983.
Reid, G & Morin,B.Physical education for autistic children.Canadian Association of Health
Physical Education & Recreation Joumal,48,25-29,1981.
Reid,G.Perceptual motor training:has the term lost its utiiity?Journal of Health,Physical
Education,Recreation and Dance,92,38-39,1981.
Rodda,M.Language and language disordered children.Bulletin of the British Psychological
Society,30,139-142,1977.
Rutter, M., & Schopier, E.Autism:A Reappraisal of Concepts and Treatment. New York , NY, Pienum Press,1978.
Sacks,O.A neurologist's notebook:an anthropologist on Mars.The New Yorker, 1 994. Sahiey,T.L... & Panksepp,J.Brain opioids and autism:an updated analysis of possible linkages. Joumal of Autism and Developmental Disorders,17,2,201-216,1987. Schopier,E.,Mesiboy,G.B., Shígley,R.H., & Bashford,A.Helping Autistic Children Through Their Parents: The TEACCH Model.in:Schopier,E & Mesibov,G.B.The Effects of Autism in The Famiiy,65-81.NewYork,NY,Pienum Press, 1984
Schopier,E.Principles for directing both educational treatment and research.ln: Giliberg,C.
Diagnosis and Treatment of Autism(ed.C.Giliberg),167-183,New York,NY,Pienum Press, 1 989.
Schopier,E., Reíchier,J.R., Bashford,A.,; Lansing,M., & Marcus,L.. M.Individualized Assessment for Autistic and Developmentally Disabied Children: Vol. 1.
Psychoeducational Profile Revised(PEP-R).Austin,Texas,TX,PRO-ED Inc.,1990. Schopier, E., Reichier, J. R., & Lansing, M. 1 ndividual ized Assessment and Treatment for Autistic and Developmentally Disabled Children:Vol.2.Teaching Strategies for Parents and Professionais. Austin,TexasTX, PRO-ED lnc,1980.
Schopler,E.,Reichier,J.R., & Renner,B.The Childhood Autism Rating Scale(CARS),
Westem Psychological Services, 1 988.
Seaman,J.A., & DePauw.The NewAdapted Physical Education:a Developmental Approach Palo Alto,CA, Maryfield, 1982.
Singienton,D.A.A Physical Education Program for the Autistic Child:Paper presentes at The National Conference on Physical Activity Program and Practices for the Exceptional lndividual,Long Beach,1974.
Tani,G.Significado,detwMo e corregáo do erro de performance no processo ensinoaprendizagem de habilidades motoras.Revista Brasileira de Ciéncia e Movimento, 3(2),50-58,FEC do ABC e CELAFISCS,1989.
TEACCH Annual Report, 1991-1992.
Voikmar, F. R.et al. Field trial for autistic disorder in DSM-IV.American Joumal of Psychiatry,
151:9,1361-1367,1994.
Watters,R.G.,& Watters,W.E.Decreasing seif-stimulatory behaviour v.,ith physical exercise in a group of autistic boys.Journal of Autism and Developmental Disorders, 1 0,379-387, 1980.
Wing,L.Diagnosis,Clinical Description and Prognosis.in:Wing,L.Early Chilhood Autism,
1 5-65, New York, Pergamon Press, 1 976.
Wing,L.Language,social and cognitive impairments in autism and severe mental retardation. Joumal of Autism an Developmental Disorders, 1 1, 31 -44,1981 a. Wing,L., & Gould,J.Severe impairments of social interaction and associated abnormalities in children:epidemiology and classification. Joumal of Autism and Developmental Disorders,9,11-29,1979.
Wing,L.The Diagnosis of Autism.in:Diagnosis and Treatment of Autism (ed-C.Giliberg),
5-22. New York, NY, Pienum Press, 1 989.
Curriculum vitae
Physical Educator, student and researcher of the Center of Studies from the Physical Fitness Laboratory of Sáo Caetano do Sur, for 3 years; invited teacher in the post-degree course of the faculty of P.E, in the discipline "Adapted Physical Education".Diretor af a physical fitness center during 4 years. Professional in the school of the Association Of Parents and Friends of The Autistic in Sáo Paulo,since 1991, working at the general project of implementation of the TEACCH Program, had mrked in the followng areas: initial programs for workshop and classrooms,study and application of the PEP-R,coordination of PE and exercise programs as a teacher in internal training and seminars for students and professionais.Nowadays working in a project of exercise programs for residents and students of the mrkshop.Transiator of the PEP-R in Portuguese. Attended together with staff, training and consultation Wth Thomas E.whates, from the Wilmington TEACCH enter,Mogens K.Ilpsen,Klaus Olsen, Lisbeth Hove from Sofieskoien, Denmark and June Philiips and Judi Bailey, from the Orange GroveCenter.