Basic Body Awareness Therapy for Persons With Autism. A Pragmatic Randomized Controlled Study

Introduction Movement quality is a concept that describes how movements are performed in space, time and amount of energy. When the quality is good, the movement is perceived as unrestricted and gives a sense of freedom, physically and mentally. Movement quality and body awareness are dependent on each other. Body awareness is the ability to be consciously present and interpret signals from your own body. A physiotherapeutic treatment method that describes how movement quality and body awareness interact on a deeper level is Basic Body Awareness Therapy (BBAT).

The purpose of BBAT is to raise physical and mental awareness by strengthening the interplay between sensory impressions and motor ability, gaining knowledge of movement patterns and habits that are not functional. Man's ability to perceive, take care of, control and use the body in a functional manner affects the quality and expression of the movements. According to the theory behind BBAT, movement quality and body awareness are both important abilities to develop bodily self-consciousness.

In order to distinguish between oneself and others, ability to gather and make conscious sensory impressions through the body is demanded. In order to understand the impressions and the world around us, one need to be able to integrate sensory impressions to each other into an information with deeper meaning, the creation of perceptual coherence. The perceptual coherence is the basis for knowledge of one's own body and movement quality. Body awareness increases with more experience of movement. based on the physiotherapeutic bodyself, the subjective ("I as my body") and objective ("I in my body") identity we use to meet and understand the world. The bodyself comes to expression through the degree of movement quality and can as such be observed.

When people with autism grow up, their development differs from typically developed peers. They may find it difficult to understand that other people have their own thoughts and feelings, so-called theory of mind and to understand their own feelings and inner states. They may lack central coherence, being able to merge details to the whole. They may also react differently to smells, flavors, sounds or materials carried on the body, having difficulty imitating others, have less flexibility to achieve motion targets, have poorer motor skills and/or sensorimotor function. In autism, the ability for multi-sensory integration is often inadequate. In this way, context and meaning can become less comprehensible and meaningful. This can lead to changes in the bodyself.

As children with autism exhibit worse body awareness and movement quality than children with typical development, it may be likely that body and movement experiences are reduced through upbringing. This can affect physical and mental health, as seen in autism. A study from 1991 examined how young adults with autism describe how movement quality from a body function perspective affects their ability to maintain daily activities and participation. The attention it required of the individual to attempt to master stereotyped movements to be considered "normal", resulted in increased mental energy utilization as they constantly watched their own behavior, also creating anxiety. In a previous study we interviewed eleven young adults with autism about their experiences about body and movement, as well as examined them with one motor and one body awareness instrument. The results showed conflicting feelings about their bodies and movements, but also how movement quality was related to the way the individual had access to functional strategies to handle everyday situations or not. There is little knowledge about the effects of various interventions that focus on body awareness and movement quality in this group.