Tennis As Therapy With Love Serving Autism

Podcast Episode 48. Tennis, because of its repetitive nature, is an excellent therapeutic tool which can develop not only physical skills but also builds language and social skills, according to this week’s podcast guest Lisa Pugliese, from Love Serving Autism.

Lisa is the founder and CEO of Lover Serving Autism and has combined her skills as an ex-professional tennis player and Speech-Language Pathologist to develop an innovative program that uses tennis to help young people on the autism spectrum develop skills. These can include the physical skills around increased fine and gross motor coordination and hand-eye coordination. In addition, other benefits include providing aerobic and cardiovascular exercise, as well as improving speed, flexibility, and agility. Playing tennis also helps to increase visual and auditory processing skills.

Lisa explains how the program is also useful in developing the language and social skills of young people. Many of them are reluctant to try anything new because they prefer to know what’s coming. Some struggle to transition to a new sport, which is why Love Serving Autism uses “Social Stories” to help participants learn what to expect from a tennis class. This helps to prepare them and familiarise them with the classes in advance.

As Lisa explains the classes are very structured so, at the beginning of class, the students meet and greet one another, which helps to improve their language and communication skills. The organization also encourages them to partake in different group activities, such as practicing tracking with the ball by rolling it back and forth with a partner as well as practice catching and throwing the ball. Lisa explains how tennis has helped many of the young people become more independent as they progress, and their individual skills develop.

Lisa talks about the challenges of running an organization like this. They are reliant on volunteers, but fortunately, they have plenty of people offering to help out. She talks very honestly about how challenging some volunteers find it to work with the young people on the program. Although the volunteers are all excited about helping, they aren’t sure how to help. They often wait on the sidelines for instruction from the program director and one of the main issues is that they just aren’t sure how to speak to autistic children. It can take time build their confidence so that they feel more comfortable helping and being part of the team.

This applies equally to the tennis professionals Lisa uses on the program. They quickly find they need a different set of skills and have to think of new ways to teach the sport. But, as Lisa notes, what they learn on this program will make them so much more effective as they go on to teach other young people who have additional needs. In a sense, they will serve as ambassadors for tennis as sport and tennis as a therapy.

Like many similar organizations Lisa has had to navigate the world of funding. She talks about the approaches they use, which include organizing events to raise money and to also promote autism awareness. She also talks about the long-term goals of Love Serving Autism which are to expand the program to more locations across the USA.

Lisa has been able to very effectively combine her passions to change the lives of many young people, impact on the volunteers and tennis professional she trains, and show just how tennis can be used as a therapy in a way which is fun but also meets the long-term objective of building the self-worth of the young people she serves.

 

Show Full Transcript
Podcast Transcript
DEBRA: Welcome to episode 48 of the Journey Skills podcast. I think this episode is best described as a combo of a story and a solution. Lisa Pugliese founded Love Serving Autism which is an organization that uses tennis as a therapy tool for people with autism. And Lisa shares a story of going from tennis professional to speech and language professional and then finding the perfect way to combine both of those professions. And it’s a solution because Lisa talks about the therapeutic value of tennis and what exactly a programme like the one that she’s developed can achieve. Not a big fan of tennis but never really thought of it as something that can help my daughter until I talked to Lisa. It’s just a really great job of explaining why tennis, in particular, is a really useful therapeutic tool because it’s a sport-infective repetition. It obviously works well for many people on the autism spectrum but I suspect a lot of young people with additional needs, my own daughter included, would find the repetitive nature tennis comforting if that’s the right word. Because although Lisa focuses on helping young people with autism, the kind of idea she talks about could be used to help any young person I believe. We all know sports provides plenty of health benefits so even just for that reason the sort of programme that this was developed is one to be applauded. But actually what she explains is that this is much more than just a place to learn tennis, it also takes quite a few of the boxes in terms of developing hand-eye coordination as well as the obvious ones of developing social and communication skills. I really enjoyed talking to Lisa partly because her passion is obvious but also because I think this is another great example of what’s possible when we think differently about how we can help our children develop the skills that make their chances of living more independently a realistic option. So let’s hear it from Lisa.

Debra: Today I’m talking Lisa Pugliese, founder of Love Serving Autism which is based in Florida in the US. Welcome, Lisa.

Lisa: Thank you, Debra, for having me.

Debra: You tell me a little bit about Love Serving Autism, really, the journey from how it got started and also about yourself?

Lisa: I began playing tennis at the age of 5 years old and I quickly fell in love with the sport and I began competing for the tournaments at a young age. I competed in junior tennis all the way up until I was 18 years old. And I received a college scholarship to DeVry University and so I started my freshman year at DeVry University playing tennis and decided that would be my focus for my career and I had aspirations to make the best in me. I ended up transferring from Devry University to the University of Florida.I wanted to be closer to home. And our team did really well. We won the national championships and most of our team members played professionally once we graduated. So I started playing on a tour, then had a little bit of a sideline the moment I had an injury at my back and received back surgery. So at that point in my life, I was in my mid-’20s. And I had to make a decision of whether I wanted to go back on a tour or teach tennis full-time or do something else in my life. And so I took a few courses in Communication Sciences and Disorders because my undergrad was in Linguistics and I entered graduate school. So I took a break from tennis altogether. Long story short, 3 years later, I received a master’s degree in Speech and Language with my specialization on Speech and Language Pathology. So I was in my late ’20s at that point, early ’30s and still really was not that involved in tennis but I was focusing more on the Speech and Language Pathology career.

[Talks about her career history] My first job interview was at a public school here in Florida and they had an autism unit. And I knew nothing about autism at that time because we really didn’t have any training at graduate school about the disorder and at that point, I said, “Well I may as well try this new job in a classroom for children with autism and I quickly fell in love with it. I did the Speech and Language job at that 1 school for 10 years. Really, still wasn’t that involved in tennis but switched careers completely. In 2011, I write an article about a national non-profit that teaches tennis to children for- across the United States- teaches tennis to children with autism. And I contacted the founder and his wife and it turns out actually I’ve met them from when I was younger. And they started the programme in Boston and moved it to LA. So he spoke with me and said, “Why don’t you start the first programme in Florida for our organization. So for the next five years, I was the board of programme director for that national nonprofit in addition to my Speech and Language job. And I ran all the programmes there for 5 years as a board of regional director. In 2016, I decided “You know I really wanna to do more” and I had a new vision because I work with children in the classroom as well and I wanted to combine my careers of the speech and language therapy and the tennis. So, I told the national nonprofit that it was a wonderful experience and I’m very appreciative but I’m going to start a new tennis programme, the organization. And at that time, I did not know the name at all. I was working at a charter school for autism which is a large school for children who have a diagnosis of autism spectrum disorders.

[Talks about how she jumpstart into doing what she’s now doing] So I’m currently working there as a speech and language therapist. And I spoke to the executive director and I told her that I would like to start an after-school tennis programme for the children there. She was really excited. So in January 2017, I piloted the first tennis programme at the school. We had 40 children registered. So long story short, you know, that’s how I transitioned from when I was young to becoming a speech and language pathologist into starting a new organization. I feel that Love Serving Autism was something that I’ve always wanted to do, I just really didn’t know how to get started. I knew nothing about nonprofits or 501(c)(3)s at the time and there was a wonderful woman in Chicago who have helped me walk through the steps online. You know, you have to get a board of directors, start with that, I have 4 wonderful board of directors here who are passionate about autism and have children themselves on the spectrum. Started Love Serving Autism, like I said, the promised school for autism and we have now branched out to 8 charter schools for autism and community-based tennis centers in a year and a half. So there’s a large need for this programme because it provides structure for the children after school and we also have Saturday programmes at the public tennis center as well. So to get more into the organization itself, the programme, obviously you need to have a diagnosis of autism to attend the class, but we also invite siblings as well. And they are great role models for the children for social skills. So a large component of our classes is based on increasing language and social skills. Since we are quite new, our goal is to develop a therapeutic model for these children. It’s documented on how well they’re doing with their language skills. We have, say, 30-40 percent of the children in the classrooms are non-verbal, so they use communication devices in the classroom which is voice output devices and apps on their ipads to speak. And we encouraged the families to bring the ipads to the tennis classes so that the children have a way to communicate with us. And they really do a great job whether it’s in the classroom, on the tennis court, requesting/telling us when they need a break, when they need to go to the bathroom, when they need water. We do sometimes experience behavioral challenges and our transitions from the classroom to the tennis court and thankfully we have a few behavior therapists who come out to the tennis classes as well to support the children.

[Talks about why tennis and its positive impact to children with additional needs] Tennis is a great sport because- for multiple reasons, to name a few, tennis increases the prime modern gross motor skills. So children with autism tend to have gross motor deficits as well as apraxia so their body might want to do one thing and they might not be able to do that actions. So the repetition of tennis is great for them because it programs their body to do the same, over and over again. Obviously, it increases their fitness level on their health, and a lot of the parents don’t want their children to just go home and sit on the couch and watch TV. They want them running around or doing something physical. It’s healthy for them and increases their self-esteem and their confidence so the families are happy and it’s obviously a therapeutic benefit for tennis. Tennis also increases their auditory and visual processing skills. Many of the children do have difficulty processing information. They need extra time, so for instance, even some of our children who are higher level or higher functioning with Asperger syndrome or verbal, you might ask them a question and they look at you but they’re not responding yet. And they might need extra time to process the information, so it’s important to give them that extra time. We have a huge volunteer programme and we’re building it currently. We provide community service credits for high school students and college students. We’re beginning to develop online as well as on-court trainings about autism and working with children and adults who may need additional supports in tennis. There is a definite interest for the high school students and the college students to learn more about it. I think they wanna help and they wanna make a difference. And sometimes, they don’t know how so when the volunteers come to the tennis programme, they’re often paired with a child. They might work one-on-one with that child. We also have tennis professionals who attend the classes who don’t really have a lot of experience teaching tennis to the children and adults on the spectrum. And once again, we’re on the process of developing training, curriculum, and tools for them to learn on how to work with these children and adults because they’re used to teaching their private lessons and there’s a lot more involved.

[Talks about the challenges in incorporating tennis in what they do] When you teach tennis to children and adults too, you know, maybe more challenge. And we have a few funny stories on pros, tennis professionals coming out and working on their skills in the forehand, in the backhand and the volleys and we’re trying to tell them, “There’s a bigger picture than that working with these children”. It’s not just about technique, it’s about engaging them with social skill, making sure that they’re following their routine and providing water breaks and whatever the child may need. Usually, the pros come back, they love it, they wanna do more to help. I tried to tell the tennis professional, even if you don’t come to our Love Serving Autism programme, you will at some point in your career meet a child or an adult who has, you know, developmental challenges and autism in your lessons or in your classes. And it’s important to learn how to integrate them into your programmes. Another thing we focused on is inclusion because we don’t just wanna group the children together and have them model each other especially for children who don’t enroll nonverbals so we do our best to provide – you know, like I said the volunteers, with their social engagement for them so that they have neuro-typical peers to model because I think that’s the best way for them to learn how to communicate, how to behave, or how to follow directions. And it’s usually a very positive relationship between the volunteers and the children. We did start 2 adult programmes in 2018 and they’re small and we have 30-40-50- year olds who are now learning to play tennis for the first time. At first, there was a little bit of a struggle on the challenge because its a completely new routine for them and they’re older. Thankfully though, with repetition and practice and encouragement that they even return to the classes and they’re doing better in time. We also provide something called stories which we have on our web on the Love Serving Autism website, it’s a story about what to expect during a tennis class. And I encouraged the families for the children and adults to read the is social stories so that when they get to tennis they know a little more about what they’re doing. As great as many of the classes are, we do have difficult moments where children may struggle to transition to a new sport. It’s important for us to alleviate that internally help them, prepare them before they come to the classes so that they feel more comfortable with the new routine.

Debra: Do you break into abilities or do you just have a sort of process that everyone goes through?

Lisa: The Saturday classes, when they come out to the community, at the public tennis center, so break it down to ages. So we have a 10 and older class and then 11 and older class. Within those specific classes though, there’s a wide range of children who have different communication levels, different skill levels, so within those classes, we then create small groups. And we typically pair children of equal ability with each other. The children who are more challenged or who maybe are nonverbal or need one-on-one support, you know, they may be in their own group with one of the volunteers specifically helping them the physical problem. At the charter school programmes, it’s a little more difficult with scheduling to base it on age so we usually do it based on their schedule. A lot of the children who are there, speech therapy, occupational, physical therapy after school, and then the family speak them up so we try to base it more on their schedule than the ability levels. I think it works because I, like myself, working at a charter school for autism, I know the children quite well so when they come out to the class, I know their different ability levels so if there’s a new programme director who doesn’t know the children, it takes time to recognise their skill levels and their communication and to understand who would pair well together in which small group. It’s a great question because during our classes, we do rotations.

[Talks about how exactly they do it in class] So we when start our classes, children all meet together in the beginning. All the children, let’s just say we have 10 in a group, we do warm-ups and stretches, and we do greetings so they have to stand and greet each other and use whether their verbalization or device to communicate and then after that they do an obstacle course which works on their footwork, following directions and after that we go into hand-eye coordination drills which they practice throwing and catching. There are different prompt levels so for instance, it’s physical prompting, there is verbal prompting and then gestures. So physical prompting is more when you have to walk with the child and basically hold their hands. some of the children, we need to hold their hand because they might run, so we do have a few children who try to run out of the tennis court. A child who may need more physical support, the volunteer will stay with them the entire class. And we don’t progress right into, you know, the higher level drills with them. We might do, we might practice the hand-eye coordination at catching and throwing or practice tracking the ball which we roll the ball back and forth with a partner. We also might do like hand over hand with them, so for instance, if we wanna practice the ball with someone is standing behind that child and helping swing with them so the mat independently during the drill by themselves because at that point they’re not capable of it. But we have seen some children progress where they might be moderate to severely autistic maybe and they come out to tennis and they’re not independent but with 5 or 6 sessions, we could see they’re becoming more independent and they know the routine. But it just depends on their level, like I said if their gross motor skills and what they’re capable of doing at that time.

Debra: Because tennis is quite repetitive, is that why it works so well?

Lisa: Yes. Tennis is an extremely repetitive sport. In fact, I contacted a company in London called the Regal Wall which is a portable wall and they build inflatable and concrete walls for children to practice hitting that wall. So it provides that constant repetition and so we’re ordering one so that we could bring to our programmes because the more repetition the children have, and even in the classroom, you know, they might fix their favorite toy or their favorite video game and it’s the same with tennis where they can do the same motion over over over again, they tend to enjoy it. If children have different levels of sensory challenges so some of the children are hypersensitive, meaning that they don’t like to be touched, they don’t like to be hugged, they don’t like to be around anyone. And other children are hypo-sensitive, meaning they need additional sensory input so might have to help them swing or you know, give them high-fives to help regulate them. And like I said, as long as they know the routine, you’d be surprised if you attend in one of our programmes, the first class are not the most successful but after week 6, we usually go in 6 week increments for the classes, and then we take up a 2 week break and start again and by week 6, you could see that the children are smiling and laughing and engaged and they know what to expect.

Debra: In terms of running the organization, what’s been some of the biggest challenges for you?

Lisa: As popular as the sport as tennis is, I think that there’s still is a lack of knowledge and understanding about how to work in tennis with children and adults on the autism spectrum. So one of the biggest challenges I would feel is the training levels of knowledge and understanding whether it’s tennis professionals or volunteers. How do we take what skills they’re learning of tennis to generalize into a classroom and to the home and to the community because I don’t really just wanna teach a tennis programme, I want it to be a therapeutic vehicle for these children and adults to excel in their life and then become more independent. So, you know, there’s a bigger picture. There has to be a pathway. And so that’s what Love Serving Autism is. It’s developing as a pathway so that tennis is a therapy for the children. If they’re learning to socialize in tennis, maybe they come in to socialize, use the same language skills at home, and someday, some of our children are now working at the public place. There’s such a wide range of children but one of the individuals said to me yesterday that he is now working in public such as a grocery store and that he is in the bag groceries, and he’s communicating with about what he learned in tennis class. And then I said, “What do you say to the cashier or do you say to the customers when they check out?”. So they don’t really know a lot of this information so we have to help them with this. You know, and to learn how to develop the skills in tennis that they can use across all environments.

Number 2, I’d say, another big challenge is volunteers. Some of the volunteers, people are excited to help out but they don’t know how and I think that when they attend the programmes, sometimes they stand, they wait for instruction from the programme director. I am the programme director right now for all the programmes until more training professionals are certified and trained at this moment. But a lot of volunteers come out and they mean well and they wanna help, but they don’t know how to calm the children. They may not know how to speak with them or they may not know, “Should I physically guide them? Or do I not?” And so it takes time to develop, you know, working with the volunteers and building confidence in them that they can help the children.

Funding is another difficult aspect of a nonprofit. We are now doing tennis fundraisers so every 3 months, we are organizing a tennis event in the community to raise money for the organization. Not only does it promotes autism awareness but it also helps us with the start-up cost of a new programme. Our goal is eventually to have sponsors and donors to help us so that we can build a programme and develop it. Someday, we would love to build a therapeutic tennis center so that the children and adults can come and play tennis and also receive therapies in one place. Since January 2017, there are 8 programmes here in South Florida, but we’re only in one place. One of the reasons is because we’re still developing their curriculum and we’re now training potential programme directors on how to run their own programme. You know, it’s important to find someone who not only is passionate about working in the industry but also who is very committed and organized and really wants to make a difference. I don’t think they have to be tennis professionals to teach the class. They have to know the basic skills which we can help them with. It’s more about knowing how to work with children, how to communicate with them. The families, a lot of times, are nervous to start something new. You know, what if their child does not succeed, what if they have a meltdown, or what if they, you know, not able to sustain tennis class. Someone who wants to start a new programme needs to understand that these children are not always going to react or to respond in a typical way. And you don’t really know what to expect until they’re exposed to it. And then we have to give them, you know, strategies and teach them how to learn something new. Another important tool we use in our programme is a visual schedule and it’s on a poster board so that the children know the order of the routine so that they can go to the poster board and say, “Now, we’re doing this and then we’re doing this” and they understand what the routine is. We have to really implement those strategies during our classes in order to be successful.

Debra: So would you say then that tennis is almost a conjoint to the therapy that you wanna give?

Lisa: When I was younger playing tennis, Debra, I don’t think I understood the bigger picture of tennis. I just knew I love, I, myself, love playing tennis. I used to head on a backcourt for hours a day. I love the repetition myself on tennis and it was almost comforting to me you know “Wow! I can just go out and play tennis!”. And still, as an adult, I feel that way. It’s a stress relief for me and it’s also a great exercise. But I do, when I was younger, I obviously did not know I would start an organization for tennis and for the children and adults with autism, but I do feel that as I progress this organization that I 100% agree that it is a therapeutic tool because it’s no longer than just a sport with a racket and a ball. It’s how we can use this sport to increase social skills and increase fitness levels and increase confidence. And you know, some of the children now are becoming friends with each other. You know, they go to birthday parties and they do activities, and their parents are meeting each other for the first time which is a support network for the parents as well. But you know, when you have a child with challenges and it’s not easy for the families so the fact that they could go somewhere on the weekends and bring their child to a sport and you know, they get to socialize with each other is very important.

Debra: Thank you so much for your time, Lisa.

Lisa: Thank you, Debra.

Debra: Key takeaways? Well for me it was to be a bit more open about the value of a sports like tennis and helping to develop life skills. I never really thought about how some sports can have much more therapeutic value.

Resources
Love Serving Autism

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