How Nintendo's Exercise Experiment Is Helping Autistic Children Move

Ring Fit Adventure is finding new life in some unexpected spaces.

Anjana Bhat does not consider herself a “gamer,” but recently, this professor of physical therapy at University of Delaware has found herself spending a lot of time in front of and around a Switch. Within Bhat’s Move 2 Learn Innovation lab, she works with a team focused on finding ways for autistic children to move and exercise, and they’ve found success with Nintendo’s gaming and exercise hybrid, Ring Fit Adventure.

“My lab is focused on how to make therapy meaningful and engaging for children with autism and other disabilities,” said Bhat in an interview. “In the past, my lab has studied the effects of music and movement, dance, yoga, robotics, etc. Gaming seemed to be an obvious avenue given children’s predilection to technologies and gaming.”

Bhat pointed to a study by SPARK (Simons Powering Autism Research) that showed 87-percent of autistic children deal with motor challenges, yet only 32-percent of those impacted actually engage in meaningful physical or recreational therapy to address it, with a disappropriate emphasis placed on “promoting communication, fine motor, and academic performance.” This split becomes more meaningful at autistic children age, and become at higher risk for obesity, diabetes, etc.

“Exercise is hard for everyone!” said Bhat. “For autistic children there are other barriers. They may have sensory, motor, cognitive, and social challenges that makes it hard to participate in after school, community-based, group physical activity like karate or dance.”

You can watch examples of Ring Fit Adventure in action with these kids below:

When the lab started investigating games, they went down a few rabbit holes, including Xbox’s old Kinect technology (which had a number of examples of exercise gaming), Wii Sports, and others. What’s unique to Ring Fit Adventure is the gamified design. Wii Sports, for example, is a game where you might get some exercise. Ring Fit Adventure, however, is exercise where you also play a game. The dynamic is flipped.

“Parents have explicitly said that Nintendo exergaming works well because the child can do it on their own and not feel put on the spot or be teased by their peers,” said Bhat. “There are other advantages: a) the ability to form sets/picture [a] schedule of activities, b) the timely feedback and points scored to motivate the child, and c) the visually engaging nature of the game. Together, this makes the Switch exergames much more compelling to the autistic child.”

There aren’t that many exercise games, Bhat discovered, believing there is “a lot of room for further development.” Beyond Ring Fit Adventure, they have seen encouraging results from both Switch Sports and Bandai Namco’s Active Life Outdoor Challenge, a 2021 mini-game collection featuring squats, jumps, and other moves. The latter is “better for younger children” because players can accomplish the motions by moving around, rather than manipulating the circle controller used in Ring Fit Adventure.

No great shock: Active Life Outdoor Challenge was previously released on the Wii.

It’s also, frankly, cool to play a video game. It doesn’t feel as much like work. 

“Autistic children have [a] predilection to technologies and like the structured environment it offers,” she said. “Nintendo has the feature of developing sets/picture schedules of activities for each session. We developed sets/routines that were a mix of stretches, rhythmic timing games, exercises that are incentivized by points and encouragement, and endurance games that are scored for performance and improvement over time. Autistic children are used to receiving encouragement and feedback and the Switch games have nicely incorporated those within the game. The visualization and authenticity of the environment is also very engaging for the child.”

Ring Fit Adventure was my game of the year in 2019, because of the unique feedback loop. I’m a runner, so I’m not new to exercise, but Ring Fit Adventure helped me look at my body, and the parts of it that I still find embarrassing or shameful, differently:

“When we say games can be transformative experiences, what do we mean? Transformative to whom and to what? But I can safely say playing Ring Fit Adventure for the last several months has been precisely that: transformative. When we think of exercise and fitness, what comes to mind? The Rock? Every schlubby dude who magically transforms for a new Marvel movie? It’s unhealthy. Despite being skinny, I’ve harbored shame and embarrassment about my body, feeling weak and powerless. I’ve always wanted to improve, but never known how to go about it, or who to ask for help. Ring Fit Adventure gave me what I’d been missing: control. It handed over the keys to improvement without judgement or disappointment, suggesting that altering your body doesn’t have to come from a place of despair. It can be done with a smile, alongside the hard work. Ring Fit Adventure is a game that understands bodies, and specifically, that most of us don’t understand ours. It’s a game that offers a set of tools that’ll outlast whatever time I spend with Ring Fit Adventure itself. For that, I’m grateful.”

Most modern exercise services are reactive and ongoing. When I load up Apple Fitness every week, there are new routines for me to follow from my favorite instructors. I could do the same videos over and over again, like a VHS tape from the 80s, but part of the joy is an ongoing and shifting relationship. Sadly, Ring Fit Adventure has fallen into a grand tradition of Nintendo games that the company has completely forgotten about since launch. No expansions, no updates, nothing at all.

Still, years later, Ring Fit Adventure is finding new audiences. Nintendo was truly onto something. If we’re lucky, a sequel is around the corner for everyone in the future.

Have a story idea? Want to share a tip? Got a funny parenting story? Drop Patrick an email.

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Also:

• Writing about this got me upset (again) about the lack of support for Ring Fit Adventure, when then got me upset about the lack of support for Mario Maker 2.

• I’ve been meaning to write about my journey with exercise over at Remap, because these days I have a video game boss-like relationship with my Apple Fitness trainers, and I choose which trainer I want based on my mood that day.

• I fell off Ring Fit Adventure when I signed up for Apple Fitness, because I found the HIIT workouts were scratching the same itch and gave me more flexibility.