In this blog post, physical therapists Bert Richards, PTA and Gin Utermohlen, PT give tips for bike riding help for children with autism.
“Let’s all go for a bike ride” …a simple suggestion you are not likely to hear in Jesse’s family. Jesse, who has low muscle tone and poor balance, is not yet independent on a bike. He is embarrassed to be seen riding with training wheels, yet a bad experience in previous bike riding attempts makes him afraid to try again without them.
A group called “Spinning Wheels,” developed by The Abilities Center in West Bloomfield, Michigan, helps children like Jesse to become good bikers. The six-week class is open to children over age seven who are motivated to ride a two-wheeler. The only prerequisite is that they be able to ride a bike with training wheels. In the two years since its inception, the group has taught children with diagnoses of Down syndrome, low tone, autism, and many who are “clumsy kids” with no diagnosis. Possibly your child or student could learn to ride a bike following this program.
Firm Foundation
The unique element in “Spinning Wheels” is the firm foundation of balance it establishes before the children get on their bikes. Our groups spend the first two class sessions in proximal balance activities sitting and standing, without even using a bike.
Focus is on activities which mimic the weight shift and steering components of bike riding. Participants use therapeutic balls to increase tone and stimulate righting reactions. Balance beams from 7″ to 4″ wide, level, inclined and elevated, provide the “just right” challenge to the balance system. Cadence stepping exercises on foam steps promote dissociation of left and right sides, while mimicking the rhythmic up and down of pedaling.
Parents receive weekly hand-outs describing ways to implement the class exercises at home without special equipment. For example, grapevine stepping and single leg stance with eyes closed adapt easily to a home program.
Bonding with the Bike
Week three is an exciting session. The children bring their bikes (sans training wheels) to the clinic – not for riding, but for “bonding”. Wearing helmets, they practice mounting, dismounting, walking along beside the bike pushing it, and turning the bike around – all skills which require a “feel.” The children also practice falling off their bikes onto the forgiving surface of soft mats.
The fit of the bike is important too. The child must be able to sit on the bike with both feet flat on the floor, increasing both gravitational security and confidence. This learning bike may be smaller than the one the child ultimately chooses once he or she has become a successful rider.
Taking the Bike Outside
Weeks four, five and six take place outdoors at a carefully selected community site on a gently sloping grassy area for the first outdoor lesson. Why grass? To alleviate the fear of falling on asphalt or cement. Why a slope? To make pedaling easier. And why an open area? To require less steering so the child can concentrate on balancing.
The therapist runs along beside, providing balance assistance at the bike seat as needed, while the child steers independently. Parents are welcome to be runners if the child invites them, or they can be cheering spectators.
In the final two weeks of class, some children advance to bike trail riding as their steering improves. Independent starting and stopping are refining skills usually gained during these weeks.
Success
We measure biking achievement as follows:
- Downhill on grass with assist
- Independent downhill on grass
- On bike path with assist
- On bike path with assist for start/stop only
- Independent rider
Thirty-seven children, ages 7 – 14, have been through the “Spinning Wheels” program. Twenty-five students (68%) achieved either a Level 4 or 5 after a single 6-week course. Ten students (27%) achieved Level 2 or 3.
Two significantly impaired students attained only Level 1 rating. One of those with Down syndrome, whose balance was severely compromised, was able to mount and dismount her bike independently after six weeks. And the other with cerebral palsy, was able to ride his bike with assistance on grass but was unable to remove his foot from the pedal strap for a controlled stop. Parents report that with continued home practice following the six-week course many more students advanced to higher levels.
“Spinning Wheels” teaches far more than bike riding. The successful student comes away with improved balance, coordination, and confidence – fundamentals which transfer into the social, physical and emotional arenas. Now, let’s all go for a bike ride.
Bert Richards, PTA and Gin Utermohlen, PT and Physical Therapy Department Supervisor, co-developed and co-teach “Spinning Wheels” at The Abilities Center, a pediatric OT, PT, and Speech clinic in West Bloomfield, Michigan.
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