Training clients with neurodivergent behaviors or cognitive impairment, which includes those with attention-deficit/hyperactivity disorder, autism spectrum disorder, Down syndrome, dyslexia, aphasia and/or brain injury, requires personal trainers to take their creativity and empathy to another level beyond what the job typically demands. 

“Intuition should be your guide,” says Anna Woods, an ACE-certified personal trainer and founder of the sheSTRENGTH Movement and App. “Every client, from session to session, minute to minute, can change — and it is the trainer’s greatest asset to see and feel this change happening, be able to address it, adjust the plan and continue moving forward with the session.” 

Ahead, we walk through a few simple steps personal trainers can take to ensure clients with neurodivergent behaviors or cognitive impairment have the best experience possible while training with you. 

Training clients with neurodivergent behaviors or cognitive impairment

It’s common for clients with cognitive impairment or neurodivergent behavior to have difficulty transitioning from one activity to the next, causing them to experience anxiety, panic, discouragement and/or fear, which can lead to frustration and sensory overload. 

So, it’s essential that personal trainers understand and anticipate what triggers each client. In fact, this should be a primary topic of discussion in your initial interview with the client and their parent or guardian. 

Start by asking questions about the client’s fears and anxieties. These can include medication changes, staffing or schedule changes, weather changes, sensory overload, illness, pain, fatigue or stress, among countless others. It would be impossible for you to narrow this list without a thorough interview prior to the onset of training. You should also do your best to get to know each client’s emotional, physical, and mental needs.

“A trainer can anticipate unexpected behaviors by learning to read the room,” explains Woods. “In-the-moment signs that a client has been triggered include a change in tone of voice, arm/hand flapping (which is known as stimming), humming, pacing, lying down on the floor, or suddenly leaving the room without permission.” 

Understanding a client’s usual behavior and mannerisms will help you recognize these shifts as they begin rather than when it’s too late to respond proactively. If left unaddressed, the results may include an outburst, aggression, hiding, non-compliance, irritability, anger, and frustration. 

To avoid these scenarios, it’s crucial to understand the coping mechanisms a client may use and help the client employ them. If the behavior is already taking place, the goal then becomes to negotiate or redirect the client to something more positive. 

One strategy is to remind distracted clients of their workout routine by writing out the session, which can help them stay focused. You can also dim the lights, turn off music, or move to a quieter area of the facility. Finally, if you are working with a group, assign a distracted or anxious client a task like timing exercises or counting reps as this can give them a sense of purpose and focus.

“Training clients with neurodivergent behaviors can be overwhelming or scary at first,” admits Woods, “but the rewards, the friendships and endearing relationships developed with these clients will far outweigh any initial fears.”

Continuing education

As you might expect, training clients with neurodivergent behaviors or cognitive impairment requires specific education. You should never take on these clients — or any clients, for that matter — without fully understanding the special considerations involved and being sure you have the training and expertise necessary to serve the client safely and effectively.

Woods has created two courses for the American Council on Exercise (ACE): Adaptive Fitness Exercise Programming and Adaptive Fitness for Clients with Special Needs. These courses are part of ACE’s efforts in the area of equity, diversity and inclusion (EDI), which includes offering continuing education covering size inclusivity, recognizing racial microaggressions, creating an inclusive health and fitness space, and practicing EDI as a business owner, facility manager, or exercise professional.

The goal of this coursework is to make movement and physical activity accessible to everyone who wants to take part — and that includes clients with neurodivergent behaviors or cognitive impairment.