Pilates for the Special Needs Community

My interest in teaching Pilates for the Special Needs Community developed because I am a caregiver for my daughter with Special Needs, Solana, who is 10 years old. I use my body to manage unconventional body movement from my daughter. She is unstable in her walking and requires constant handholding or guidance on the shoulder or under the arm. She is visually impaired and legally blind but has access to a vision field 30% of a typical person. She was diagnosed with Williams Syndrome at 4 months. An individual with Williams Syndrome tends to be a fun loving individual with cardiac complications. As each of us is unique, so is each person with Williams Syndrome. Solana is not a typical person with Williams Syndrome, but she is her unique self with gifts and challenges. After finding better symmetry and eliminating pain in my body through Pilates, I followed the path and joined the BASI family. I have completed the Foundation and Graduate Program.

The special needs community is varied: it covers individuals with physical limitations, medical complications, intellectual disability, and emotional disability. Some individuals can have one or global delays. When a person is born with limitations and it is diagnosed, a family or the individual begins to work with various therapists. Therapists can include physical therapists, speech therapists, occupational therapists, and vision therapists. Numerous medical professionals are also part of the team for an individual with Special Needs.

I have gradually begun to use some modified exercises with Solana. The progress is remarkable. Her base line was hunched over, low and high muscle tone, elbow and knee joints very tight, and toe walking. Solana is developmentally between 18 and 24 months old and non-verbal. She communicates pleasure with smiles, coos, and jumping, while displeasure is displayed in grunts, cries, or jerks. Solana would not allow herself to work in the Pilates Studio, as she does not like to lie on firm surfaces. Adding mats or towels won’t work for her. I started doing modified work on her home bed mattress.

The first exercise introduced was pelvic curl. She does lie on a bed for diaper changes. As I was lifting her body for the changes, I thought this could help her participate in the change and alleviate me from lifting her legs. I started by placing her feet behind the sit bones and placing both hands on the hips to lift as I showed her and verbally said lift. She began with incremental lifts. She is now able to lift and understands the verbal cue, pelvic curl. Now that she is more proficient with the movement, I hold her knees together to show that all the leg should be active. As she is gaining better understanding of her body, we are working on introducing spinal articulation. This process is done with me running my hands along her back to lift and to release back to the bed.

Second exercise introduced: Leg Circles. These are completely done by me. We started with 2 to the inside and 2 to the outside. I hold the foot and support the knee as I make circles. Cuing of the breath is made. Solana does not demonstrate an awareness of the cueing for breath, but as she always surprises me with comprehension using a communication device, I speak as if she understands everything we are working on to achieve.   We are now up to 8 inside 8 outside on both legs.

Third exercise introduced: Spine Twist Supine. This is completely supported by me. I hold legs as I move them from one side to the next. As she is ready to bring legs back to center, I gently touch the opposite side abdominals and say, “Pull from here.” We have 4 on each side.

Fourth exercise introduced: Leg lifts. This exercise is completely supported by me. The intention is to maintain a consistent knee angle and work at a pleasant pace while maintaining hip disassociation. We do 4 on each side.

Fifth exercise introduced: Chest lift. This is a fun exercise because she thinks I am bringing her into a sit position and I say, “Ok,” and release her back. She thinks it’s a game and giggles as she falls back onto the bed.

Solana’s repertoire is greater than the 5 exercises. These are the ones she has been doing the longest. She will continue to add to her daily regiment. As you can see from the last picture, Solana’s posture has improved. I see less tightness in the knee and elbow region. She is navigating uneven pavement surfaces better. It is important to maintain a schedule of practice because regression begins quickly and the gains seen are lost as the muscles go back to low and high tone. Working with a person who has different abilities requires patience, modifications, and gentle cuing. The benefits for both teacher/parent and student are helpful as the teacher/parent releases some work and the individual gains independence. Pilates is for every Body.

By Lisa Holmes