The Perfect Match - Rugby and ADHD?
The Perfect Match
Whether it is driven by an extreme need to win, a leisurely past time, a way to feel part of a team, or even simply a desire to shred a few pounds or narrow your waistline, there’s no denying that sport offers a range of beneﬁts.
From health to social, to physical and mental, the diverse and wonderful world of sport probably has a place for you or your client.
One OT that has recognised the power of sport is Australian paediatric occupational therapist Carlien Parahi, who found the perfect way to marry sport with OT, co-founding Sense Rugby with Rio 2016 Olympian and Glasgow 2014 Rugby Sevens medallist husband Jesse Parahi.
You set up the programme with your husband, can you talk me through how it all came about and to be?
Sure! We still have a friendly debate sometimes about how it actually started! I’m a paediatric OT and my husband plays rugby for the Australian Sevens Team.
For Jesse, he always felt that working with kids would be his ideal job and for a while we thought about him running rugby clinics for kids after he retires. Around the same time, I asked him to come into some of my sessions as I felt that some of the kids could really beneﬁt from his increased physicality. A few months later, we went to a local sevens tournament and met a family whose son with Asperger’s beneﬁted signiﬁcantly from being part of a rugby team. This started the conversation about the sensory and social beneﬁts of rugby for kids and we haven’t looked back.
Can you talk our readers through why rugby is an ideal sport for OT – the sensory beneﬁts and such?
Rugby tends to have a bit of a bad reputation in the medical world. It’s associated with injuries seen to be quite dangerous, but not many people have actually stopped to think of the beneﬁts. Besides the myriad of beneﬁts of team sport, there are a few things about rugby that we as OTs may be more inclined to think about.
Rugby allows for appropriate physical contact. Physical contact and risk-taking is increasingly discouraged. OTs know the value of experiencing and exploring your body around objects and others in order to develop the body and spatial awareness that is so often missing. Rugby allows for that, without kids getting into trouble for it.
Rugby is an incredible mix of tactile, vestibular and proprioceptive input. In its natural form, it involves rolling on the grass, falling and getting back up, pushing, pulling, squeezing, running, jumping, diving, crashing, wrestling and so much more. You use excessive force but it also requires you to plan more controlled movements and put the two together.
Three words - projected action sequences. I had this great chat with OT Teresa May-Benson when she was in Sydney recently and it was great to see her passion for, not only rugby, but the motor planning it requires. When you pass a ball down the line in rugby, you have no choice but to develop your timing and planning skills. This is one of our kids’ biggest challenges, but also their greatest achievement.
It’s motivating and it has a shared purpose. For children who are usually hesitant with movement, it’s encouraging to see other kids safely tackle a tackle bag and fall without getting hurt. For kids who usually struggle with limits, it’s a safe and motivating way to practice the skill of motor control.
Social skills, including how to manage yourself when you lose, wait your turn, follow instructions and structured activity.
You run the service for young children, do you think the principals or process can be adapted to suit adults?
For sure! We just need to ﬁnd some extra time somewhere.
What has it done for the kids involved?
Gosh, I would ﬁnd it hard to narrow it down as it’s so broad. Our ﬁrst group we ever ran helped a six-year-old boy with ASD who had never successfully engaged with his friends, play rugby with friends at school after a couple of sessions. Some are enjoying and playing sport successfully for the ﬁrst time, sharing with friends more and others are ﬁnally coping with being on the grass. Some have showed signiﬁcant improvements in their motor planning abilities and others are now happy to be in the same space with others without meltdowns. We have girls who realised that just because they don’t like craft or dance, it doesn’t mean that they can’t be part of a team or group.
Also for us though, we have families who have a community to belong to and a new interest and can come and just relax because they know the other parents ‘get it’.
Do you think that sport and OT have a lot of similarities? In terms of things like roles, development or aims and objectives?
Yes. Firstly, I think sport is an occupation that most kids are required to participate in at one point. It can be very challenging for some kids with signiﬁcant effects on their conﬁdence. It’s very important that OTs help kids succeed in this occupation because the impact it has on social and physical success is monumental. In terms of objectives of sport at a young age, it aligns so well with our goals of helping kids successfully be part of the community. Team work, ﬂexibility, accepting another person’s strengths and weaknesses as well as your own is fundamental to most occupations.
Do you think enough OTs consider sport as an option for their clients – not even just for rehab purposes, but to provide support in the areas you specialise in?
In my experience, I have deﬁnitely seen some wonderful OTs recommend sport that could be beneﬁcial. I think we tend to focus on clinical settings or school settings because, perhaps, sometimes it’s easier logistically to reach our goals this way. There comes a time when a child needs to practice their skills in a community setting. In saying that, it’s not for everyone and some kids are simply not ready to be challenged on so many levels at the same time.
It’s celebrating its ﬁrst birthday. How has the ﬁrst year been and what’s in store next for Sense Rugby?
This year has been by far the craziest one of our lives! We got married, started Sense Rugby and Jesse went to the Olympics after a code switch to and back from Rugby League! We are very fortunate to have a great team around us. The Australian Rugby Sevens family, our team of therapists and students as well as their families, have been so supportive of the programme. This has allowed us to grow from occasional school groups to running seven weekly groups in ﬁve locations. Next year, we’re aiming to add at least ten regular locations and grow our amazing team. We are also working on continuing to improve the programme in preparation for a research project midway through next year.
I’ve read that you wish you’d had these kinds of opportunities when you were young, how does it feel to be a part of this?
Growing up, I found it pretty difﬁcult to focus and learn. I didn’t have any particular diagnosis and awareness of the OT role in learning was pretty low. I assumed that studying wasn’t for me and I found rugby and sport to be the only things I was good at. As a result – that’s all I did! When I met Carlien and learnt more about the foundations to attention and sequencing, I couldn’t help but start thinking about my own experiences and the different ways there are to learn. Thinking back, I wish this sort of information was more readily available back then as I feel I really would’ve beneﬁted from it. To be able to now use what I have achieved to make a difference is just incredible. It’s the most rewarding thing I’ve ever done. It’s also really great to be able to help raise the proﬁle and awareness of OT in environments where it’s usually not considered. Of course, I also see my own OT to help me focus on the ﬁeld.
What is your role in the sessions and what do you think of the OT side of it?
I still play rugby full time and travel around the world every year to do so. It’s pretty full on, but I try and get to every session I can. When I’m home, I usually lead the sessions. The kids tend to get pretty involved in tackling me at the end of the sessions so that’s always a highlight – for them!
My wife jokes that I’m a stand-in OT as we talk about the OT side of the groups all the time. I have developed a pretty good understanding of sensory processing and ﬂoortime-techiques and do all the courses I can. I ﬁnd it absolutely fascinating and love seeing it in action during the sessions.
You have had a career in rugby and are obviously now helping the next generation get involved. Do you think enough is done in sports, like rugby, to make it accessible and inclusive enough for kids?
I don’t think that there’s an inclusion issue as much as an understanding issue. I don’t think clubs are purposely exclusive, but I think there’s not enough training on how to make groups inclusive to kids who have different needs. I feel that most coaches just don’t know how to help kids be successful in some settings and as a result they may feel at a loss. We are working on helping clubs to understand how to integrate kids,which is great!