Serving Autism On and Off The Tennis Court

Since childhood, Lisa Pugliese had set her sights on becoming a professional tennis player. She played at Duke University and the University of Florida. “I never really knew anything other than tennis,” she says. Following back surgery after a few years on the tennis tour, Pugliese questioned her next career step.

She changed course, instead carving out a career as a speech-language pathologist. After receiving her master’s from Florida Atlantic University in 2002, she focused on children with autism spectrum disorder (ASD)—first in a self-contained autism program in the Palm Beach County School District, then at the Palm Beach School for Autism, a charter school.

Over the years, the former athlete saw her students excluded from participating in sports because of struggles with concentration, motor coordination and social integration—and something clicked.

Sports should be a way to help these students with the exact challenges that keep them from participating, she thought. And she knew just the sport to introduce them to: tennis. “When you have a life change, you have to find a new purpose,” she says. “For me, that purpose was bringing my ASD insights to the tennis court.”

After gaining some experience in the area, Pugliese floated an idea to her administrators at the Palm Beach School for Autism: What did they think of her starting an after-school tennis program? They leaped at the idea.

When she launched the program in January 2017, she was overwhelmed at the turnout—40 students registered for the first six-week session. And it has only grown since then, expanding into multiple charter schools and community-based tennis programs. Today, Pugliese has even bigger dreams of morphing the program into an interprofessional therapeutic recreational center serving children and adults with ASD. More on that later.

Approach shot
Pugliese first connected tennis with ASD through the national nonprofit group, ACEing Autism. In 2010 she became the organization’s Florida program director, teaching basic tennis skills to children on the spectrum and recruiting other tennis instructors to do the same. The instructors used a visual schedule to familiarize children with what to expect during lessons, from warming up, to tennis drills and games, to picking up balls afterward.

Pugliese noticed how the visual and repetitive nature of tennis—keeping your eye on the ball and constantly hitting it back to your opponent—well suits children with ASD. The clear rules and structure of the game appeal to their need for predictability, while the exercise builds their motor skills, she says.

However, Pugliese also saw how challenging it could be to manage students’ off-task behaviors. “Some children may show up for a lesson and just sit down and cry,” she says. “Or they might become self-injurious or disengage—walk off and start plucking petals off a flower. Or stare up at an airplane flying overhead.”

Pugliese wanted to try using clinical engagement techniques to handle such situations. More generally, she was motivated to teach her tennis students about communication and social interaction. “I saw avenues for implementing speech-language and social skills strategies through tennis,” she says. “I had a new vision for what I wanted to do.”

Game on
Once Pugliese garnered support for her vision with the Palm Beach School for Autism, she started her own 501(c)(3) nonprofit organization, Love Serving Autism. Through it, she solicits grants (mostly from the U.S. Tennis Association) to finance equipment such as racquets, balls and modified equipment. Tennis instructors donate their time to the program, and Pugliese trains additional adult, college and high school volunteers to support students during the tennis lessons. The adult-to-student ratio is typically 1:3, with a maximum of 15 children in an hour-long class.

Aside from visual schedules and social stories, elements Pugliese adapts from her communication expertise include:

Reinforcers. The instructors and volunteers use first/then boards. When children disengage from the tennis activity, adults show them that “first” they participate, “then” they can engage with a motivating reinforcer—such as an iPad game. The goal is to wean them off those reinforcers over time.

Picture exchange. Adults and students wear Boardmaker visuals on lanyards to accommodate yes/no requesting and to help children learn new tennis vocabulary words. For instance, the instructor might say, “Ready, set….” and have the child say or point to the Boardmaker visual for “Go!”

Mobile devices. Pugliese plans to introduce portable electronics, such as iPod Touches (also worn around the neck), into lessons. Using them, nonverbal students could, for example, request water breaks via voice-output apps.

Pugliese finds that adult volunteers tend to bond with particular students in the tennis classes. Volunteers are often surprised at how strong students’ receptive language skills are, even if they can’t speak well—or at all. “Many students quickly learn to follow one-step directions,” says Pugliese. “You should always assume competency with these children, because if you think that they can’t do something, they will absolutely surprise you.”

Down the line
Pugliese sees other program benefits on the court, including a reduction in stereotypical behaviors—a decline she says teachers and parents also report seeing. “The tennis keeps students so busy that they don’t have as much time to spend on, for example, rocking or flapping their hands,” she says. “They have a tennis racquet in their hand, and they’re moving, running and communicating.”

Pugliese has even encouraged some tennis students into “inclusive” junior tennis classes in the community. Building on such successes, she’s expanded Love Serving Autism to 12 schools and two weekend adult programs in the community. Next up, she’s looking to raise funds to build a therapeutic center where children and adults with autism—and their families—can play tennis and receive speech-language, occupational therapy and physical therapy services.

“It’s been a blessing to me to be able to connect tennis to the children and adults I work with,” Pugliese says. “I just want this work to continue and grow, so I may make a difference in their lives.”

Author Notes
Bridget Murray Law is editor-in-chief of The ASHA Leader. bmurraylaw@asha. org

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