Bikes and colors

By Alex Piazza
apiazza@umich.edu

Dean Smith waves to his friends as he proudly pedals through the subdivision.

His smile is contagious and it hardly ever leaves his face when the 12-year-old is on his bicycle.

Forty miles south, Ara Ahlquist twists and turns her body through narrow crevices in a textile environment. As imaginary birds appear on the stretchy white surface, the 6-year-old waves her arms with excitement.

The two children have never met, but they share a common bond as their behavior is partly influenced by innovative research being conducted at the University of Michigan.

Dean and Ara are among the 1 in 68 children in the U.S. who are diagnosed with autism spectrum disorder (ASD). The Centers for Disease Control and Prevention describe ASD as a group of developmental disabilities that can cause significant social, communication and behavioral challenges, but its severity varies greatly.

As researchers worldwide investigate risk factors associated with ASD, U-M professors Dale Ulrich and Sean Ahlquist focus their efforts on improving the lives of children with autism.

Pedal, brake and turn

Lori Smith and her husband had tried everything, yet nothing seemed to work.

Their son, Dean, was diagnosed with moderate to severe autism. He struggled with routine tasks like tying his shoes and buttoning shirts.

Riding a bike was no different.

Dean struggled to abandon training wheels and none of the YouTube instructional videos worked.

A coworker then told Lori about a bike camp in Ann Arbor specifically designed for adolescents with autism.

“I felt like riding a bike was a very necessary life skill for Dean to have because I don’t know that he’ll ever be able to drive,” she said.

Dale Ulrich, professor of movement science at U-M’s School of Kinesiology, helped organize the camp to study how bicycling influences the physical and behavioral skills of youth with autism.

Children and adolescents are paired with trainers, many of whom are U-M kinesiology students, throughout the 5-day program in which they are taught how to properly pedal, brake and turn.

“Just like anyone who’s fearful, they start out with a death grip,” Ulrich said. “But you can see by the end of that first day that their arms start to relax because, guess what, they haven’t fallen.”

That’s because trainers use a bike engineered with a back tire that resembles a rolling pin. As participants get more comfortable on their bike, trainers reduce the size of the back tire until it’s equal to the front.

After five days, a majority of participants are able to independently ride a two-wheeled bicycle. Dean was not one of them.

“It wasn’t because Dean and his trainers didn’t give their best effort,” his mother said. “It’s just that everything with Dean is a process.”

Lori and her husband would not give up, though. They purchased the same bike used at Ulrich’s camp and practiced with Dean every night for four weeks.

One night, Lori let go of the handle on the back of Dean’s bike. She continued to run alongside him, but Dean sped off without help.

“It was a pretty amazing feeling—one of the proudest moments of my life,” she said.

Since Dean learned to independently ride a two-wheeled bike, his confidence has increased, he interacts more with kids in the neighborhood and he’s embraced other forms of physical activity like soccer.

Based on Ulrich’s research, these behavioral changes are not unique to Dean.

One year after youth with autism completed a five-day camp in Ann Arbor, Ulrich followed up to study how biking influenced their physical and behavioral skills.

In a study soon to be published, Ulrich found that participants experienced a 21 percent decrease in their body mass index. They increased their leg strength and also vastly improved their ability to balance.

A majority of autism research focuses on social and communication deficits, but Ulrich’s recent study is one of the first trials to examine the long-term benefits of a motor skill intervention for adolescents.

“If you reflect back on your life, when you acquired certain motor skills, it provided you with a lot more opportunities to play with other kids,” Ulrich said. “My work looks at how physical activity and motor skills play a role in improving social and behavioral skills.”

His research has generated interest from many community groups who want to organize similar bike camps for children with developmental disabilities in their area.

“Given the number of times that we’ve interacted with some of our participants, you see how they’re changing,” he said. “You see how their families change, too. I’ve had people contact me and say, ‘Dale, this is the first time we’ve been able to take our bicycles up to Mackinac Island with Jimmy.’ That’s pretty great to hear.”

Power of touch

Ara Ahlquist plugs away on her iPad as her father Sean looks on.

The more Ara plays with the device, the stronger she taps the screen.

“She really hammers away at this iPad and hits it much harder than she needs to,” said Sean Ahlquist, assistant professor of architecture at U-M’s Taubman College of Architecture and Urban Planning. “The iPad is not going to tell my daughter how hard to hit the screen. If she touches it in the right spot, the device doesn’t care. It just takes her to a different screen.”

Ara was diagnosed with ASD when she was 2 years old. Among her many issues are disruptions between the sensory input at her fingertips and the relaying of information to her brain. As a result, Ara has difficulty both deciding upon and controlling the amount of pressure she uses when interacting with her iPad.

But what if Ara had a much larger screen to work with, and instead of an impenetrable surface, she could press her fingers against a stretchable textile material?

Ahlquist has worked with textiles for years, so he started to pursue the question even further.

“It was pretty exciting when I first realized that all of my research I am doing here at the university could actually translate to my daughter,” he said.

Ahlquist teamed up with colleagues from across campus, including David Chesney (electrical engineering and computer science lecturer) and Sile O’Modhrain (associate professor of music and information), to create the StretchIColor project—a tool designed to help youth with autism improve their fine and gross motor control.

The project addresses Ara’s sensory issues because, if she pushes against the textile screen, color appears, and she gets an increased sensory experience through the texture and springiness of the textile. As she exerts more pressure, the textile expands and the color changes.

The colors provide Ara visual feedback as to the amount of pressure she is applying to the textile screen, compensating for the limitations in her sensory system..

As part of a new Mcubed project, the technology soon will be housed at Spectrum Therapy in Ann Arbor, where Ahlquist and U-M colleagues Costanza Colombi (research assistant professor of psychiatry) and Leah Ketcheson (kinesiology research fellow) will capture when and where children touch the textile surface. They also will measure the amount of pressure children exert on the surface and how that changes over time.

This data will help them determine how the project impacts development of fine motor skills among youth with autism.

Ahlquist also developed the StretchIPlay project, which was designed to help improve social interaction skills for children with ASD. Like the Color project, youth with autism can witness visual displays on stretchable textile surfaces.

But the Play project is much larger and it engages children on a multisensory level, which is one of the reasons why Ara enjoys maneuvering through the textile environment with her father.

“As a parent, we are always striving for that type of positive social feedback and physical interaction, especially considering Ara is nonverbal,” he said. “For everything we do with our daughter, we understand it’s just trial and error. But watching kids like Ara interact with these projects is so important because it gives us a glimpse of what unique sensory environments help foster successes in behavior, communication and social interaction.”