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The Impact of a Rock Climbing Program for Adolescents with Autism Spectrum Disorder: A Pilot Study
Abstract
It is often a challenge for adolescents with autism spectrum disorder (ASD), as it is for many individuals with disabilities, to participate in activities such as physical education class or community sports with typically developing peers. As such, activities that do not require high skill levels and team environments have been recommended for individuals with ASD. Rock climbing allows individuals of all abilities and skill levels to participate. The purpose of this pilot study was to: (a) explore the impact of a community-based rock climbing intervention on adolescents with ASD, and (b) examine the social validity of rock climbing as a community-based activity for adolescents with ASD. Ten adolescents participated in a 4-week rock climbing program (1x/week). During each session, the following were recorded: (a) a task analysis, (b) resting and working heart rates, and (c) pre/post cancellation test to assess attention. Parents participated in a focus group and completed a social validity scale (IRP-15) following the last session. Demographic and IRP-15 data were analyzed using descriptive statistics, exercise intensity was established for each participant using American College of Sports Medicine guidelines, and pre/post-test cancellation test scores were compared using a Wilcoxon Signed Ranks Test. The focus group session was transcribed and then reviewed to identify themes among responses. Results indicated that 6/10 participants were working at moderate aerobic capacity. No statistically significant differences were observed in attention test scores, although 6/10 participants improved. All of the parents strongly agreed/agreed that rock climbing was a good activity to address participation.
... Within this study, although the authors did report that climbers working at higher intensity levels demonstrated improved attention test scores, there were no statistically significant differences observed in attention tests with moderate exercise intensity. However, all the parents of participants in this study strongly agreed or agreed that rock climbing had a positive effect on their child [20,21]. The purpose of this pilot study was to explore the effects of rock climbing on attention in children with ADHD. ...
... The Trail Making Test (TMT) was used to track progress in attention, planning, and executive functioning. The TMT is one of the most popular neuropsychological tests and was chosen based on the ease of administration and correlation to prior research related to the dependent variable in this study [20]. Trail Making Test B (TMT-B), utilized in the study, required the participant to draw a line connecting numbers and letters in ascending order (1-A-2-B-3-C, etc.). ...
... Exercise intensity while climbing may vary based on the patient population. Oriel et al., found that children with ASD demonstrated higher levels of exertion while exclusively top roping [20], which is inconsistent with this study's findings. This inconsistency may be explained by the level of executive functioning and planning encouraged by participants with ADHD while top roping in this study. ...
Attention-Deficit/Hyperactivity Disorder impacts children’s participation in activities that require attention to instruction, sustained mental effort, and executive functioning. Physical activity has been correlated to improvement in attention in children with ADHD. Rock climbing challenges muscular endurance, attention, and route planning. Five participants, aged 8-13, participated in the climbing program. Attention was measured pre and post climbing intervention with Trail Making Test B (TMT-B) for time to complete. Exercise intensity was measured by heart rate. Parent feedback on behavior was collected with the Conner’s Parent Rating Scale (CPRS). The social validity of the intervention was measured by the IRP-15 measures. Statistically, significant intrasession attention improvements were noted in all 5 climbers (p=.43). Two climbers were consistently working at a moderate intensity (40-60% HRmax) while 3 climbers maintained a light level of intensity (20-40% HRmax). No statistically significant improvements were found on the CPRS, although improvements are noted with qualitative reports from parents. The IRP-15 showed 100% of parents believed rock climbing was an effective intervention for their children with ADHD. Rock climbing at a light to moderate intensity is associated with improvements in attention and behavior in children with ADHD.
... For example, Eckstein and Rüth (2015) found that activities such as rock-climbing have positive outcomes on attention and affect regulation for children and adolescent psychiatric inpatients. In addition to the 13 mentioned studies, we found 12 studies that solely included social outcomes, such as gender equality, network building, social inclusion and exclusion, interaction, and friendship (see, e.g., Müller and Mutz 2019;Sisjord 2012;Spencer-Cavaliere et al. 2017), and 13 studies that included only behavioral outcomes, such as identity, creativity, expressions of masculinity and/or femininity, knowledge development, risk taking, sporting behavior, and use of alcohol (see, e.g., Cheng and Tsaur 2012;Oriel et al. 2018;Säfvenbom and Stjernvang 2020). ...
The aim of this study is to review the literature on lifestyle sports and lifestyle sport contexts with regard to the developmental potential they may represent in young people’s everyday lives. The review applies a relational developmental systems approach to youth development. The eligibility criteria are based on the phenomenon of interest and outcomes. Hence, we include studies examining the associations between young people performing lifestyle sports and potential developmental outcomes: mental, biological, social, and behavioral. The present study shows that the volume of research on informal lifestyle sport is rather extensive and that studies on the way these activity contexts may affect developmental processes in youth are diverse and wide ranging. The studies suggest that performing lifestyle sports may have several beneficial health and skills outcomes. Furthermore, positive associations are suggested between involvement in lifestyle sport contexts such as climbing, snowboarding, parkour, tricking, kiting, and surfing and (a) mental outcomes such joy, happiness, freedom, euphoria, motivation, self-efficacy, and well-being; (b) social outcomes such as gender equality, network building, social inclusion, interaction, friendship; and (c) behavioral outcomes such as identity, creativity, and expressions of masculinity and/or femininity. The review performed indicates that lifestyle sport contexts are flexible according to needs and desires that exist among the practitioners and that the human and democratic origins of these contexts make them supportive for positive movement experiences and for positive youth development. The findings have implications for PE teachers, social workers, policymakers, sport organizations, and urban architecture, in that providing lifestyle sport opportunities in the everyday lives of young people will foster a holistic development in a positive way.
Autistic youth participate in less mainstream physical activity than their neurotypical peers. A scoping review was conducted to explore motivational factors influencing participation in structured physical activity for autistic youth. Relevant databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses with the inclusion of stakeholder consultation, to synthesise existing literature describing the participation and motivations of autistic youth in structured physical activities. Eighteen publications met the eligibility criteria. Qualitative data were extracted and analysed using directed content analysis and then mapped to the motivational constructs of the self-determination theory. Autism-specific themes falling outside of the self-determination theory were coded inductively. Competence was the most reported psychological need ( k = 14), with intrinsic motivation being the most common motivational regulator ( k = 12). Inductive analysis revealed one additional theme, which was the impact of the sensory environment on autistic youths’ motivation to participate. Findings indicate that meeting the psychological needs of autistic youth support self-determined motivation to participate in structured physical activities, although fulfilling these needs may differ from their neurotypical peers. Additional autism-specific factors may also influence motivation to participate in structured physical activities. Future research should examine motivational factors that support engagement in structured physical activities through the lens of autistic youth and their experiences.
Lay abstract
Autistic youth participate less in physical education classes and organised sport than their neurotypical peers. We conducted a review of existing studies to investigate what is known about what motivates (and does not motivate) autistic youth to take part in structured physical activities. We systematically searched electronic databases and found 18 publications that met the criteria to be included in this review. Data from these studies were extracted and mapped to the self-determination theory to identify factors that support (or undermine) motivation for autistic youth. We also discussed the findings with autistic individuals and other relevant stakeholders to discover how the review related to their experiences. Our results found competence (youth feeling competent in their athletic and social skills and abilities) to be the most reported psychological need impacting motivation for autistic youth. Intrinsic motivation (participating for enjoyment and satisfaction) was the most common facilitator of motivation. Autism-specific themes outside of the self-determination theory were mapped inductively, and we found that the sensory environment was a prominent theme reported to influence the motivation of autistic youth not covered by the self-determination theory. The findings of this review suggest that supporting the psychological needs of autistic youth can foster motivation to engage in physical activity, although how these needs are met can differ from their neurotypical peers. Future research should examine motivational factors that support engagement in structured physical activities through the lens of autistic youth and their experiences.
This study aimed to describe barriers to and opportunities for integrating climbing, as a form of adventure education, in Austrian school physical education (PE). Guided by the theoretical framework of self-determination theory and the pedagogical model of Outdoor Adventure Education, fourteen teachers with and without experience in integrating climbing in PE were interviewed using a semi-structured interview approach. Teachers reported positive impacts of climbing in the pedagogical areas of sociological competencies and adventure experience, as well as physiological and psychological benefits. Potential barriers referred to organizational aspects including time, group size and infrastructure. They stated that the integration of climbing in PE depended solely on the willingness of the PE teacher to integrate it. Advanced training courses for PE teachers may foster implications of adventure education in PE and its integration into the school curriculum in order to address the youth culture and provide a meaningful experience in PE.
There is growing evidence to suggest the physical and mental health benefits of lifestyle sports (LS) in disabled people. However, disabled people are less likely to participate in sports than those without disabilities and the evidence base is sporadic. We conducted a scoping review to explore the range and quality of this evidence base. Methods: Eligible studies consisted of participants participating in LS with a physical, intellectual, mental or sensory disability and included both adults and children. Descriptive, thematic and quality assessment techniques were used to provide a comprehensive summary of all evidence. Results: We identified 57 studies, across seven different sports, with numerous physical and mental health benefits to disabled people, including improved strength, fitness and balance as well as confidence, self-esteem and overall psychological wellbeing. Key emergent themes were that participation in LS promoted the development of social skills and building of community. Conclusions: Our scoping review was the first to explore this field of research, revealing a unanimously positive association between lifestyle sports and physical and mental health. Future research could focus on understanding the relationship and mechanisms between the sport, being in nature, or participating as part of a group that creates health benefits; and identifying appropriate duration, intensity and quantity of participation needed for long-term improvements.
The purpose of this scoping review was to examine how mixed methods research (MMR) has been applied in adapted physical activity (APA) research about children and adolescents age 5–18 years with a disability. Six electronic databases were searched to retrieve relevant studies published between 2003 and 2020. Sixty-four studies were identified and analyzed. The findings were organized into five categories of interest: publication information, study objectives, mixed methods research design, participants’ information, and data integration. Challenges related to the design and publication of MMR in APA were uncovered, and suggestions for improvement are provided. This study adds to the knowledge of MMR design, and it provides an understanding of the underlying processes and methodological strategies that have guided this approach in APA research. This article will encourage APA researchers to engage in MMR while also aligning future studies with contemporary MMR literature and publication standards.
This paper is aimed at depicting the quality of functions of some of the aspects of attention in children with mild intellectual disabilities and their influence on the mastering of arithmetic operations, including addition and subtraction. The sample used in this study encompasses 60 pupils, both males and females. The criteria used in the selection of examinees included the IQ level of the students which ranged from 50 - 69, calendar age from 12 to 14 years, school age which involved the inclusion of pupils attending grades five to seven of primary school in Serbia. To evaluate the quality of attention in our study we used the Trail Making Test form A and the Double Letter Cancellation Test, whilst a Criterion-referenced test was used to evaluate how well the specified body of knowledge, in this case arithmetic operations i.e. addition and subtraction were learned by the pupils. The implications of the study pertain to the proposal of implementing specific, creative activities and exercise during play, concrete contents, demonstration, experiments and teaching resources susceptible for teaching arithmetic.
[Purpose] The purpose of this study was to evaluate the effect of therapeutic climbing activities on the brain waves and attention of a child with attention deficit hyperactivity disorder. [Subject and Methods] The subject of this case study was a 7 year 6-month old child diagnosed with attention deficit hyperactivity disorder. This study was based on evidence gathered at 3 distinct stages: a pre-intervention period, 10 intervention periods (2 weeks), and one post-intervention period. The intervention involved therapeutic climbing activities wearing a weighted vest over the course of 4 weeks. The clinical outcome measures were electroencephalography and the Star Cancellation Test. [Results] The mean activation of alpha waves was improved by the therapeutic intervention. During the intervention, the mean activation of alpha waves was the highest at the F3 cortical locus and the lowest at the T4 cortical locus. The average Star Cancellation Test scores were 43 at pre-intervention, 50 during the therapeutic intervention, and 52 at post-intervention. The performance time of the Star Cancellation Test was 240.1 seconds at pre-intervention, 90.2 seconds during the therapeutic intervention, and 60.0 seconds at post-intervention. [Conclusion] The results of this study suggest that therapeutic climbing activities performed wearing a weighted vest had positive effects on the brain waves and the attention span of a child with attention deficit hyperactivity disorder.
Research demonstrates substantial health benefits of physical activity (PA), especially moderate to vigorous physical activity (MVPA). Several studies suggest that MVPA may be especially beneficial to children with autism spectrum disorders (ASD) including improved physiological, cognitive, psychological and behavioral functioning. However, few PA-based interventions have targeted adolescents with ASD, when PA rates are shown to decline significantly, primarily focusing instead on children with ASD. Further, these studies have varied significantly in methodological rigor, making it difficult to disentangle consistent findings of effective intervention. Given a majority of adolescents with ASD fail to meet national recommendations for daily PA and demonstrate lower rates of PA relative to their non-disabled peers, identifying effective interventions for this population is needed. The purpose of this systematic review was to collect and synthesize evidence from studies of PA-based interventions for adolescents with ASD (N=19) to identify benefits of PA and effective strategies for increasing PA in adolescents with ASD. The strongest empirical support for the benefits of PA was identified for self-regulation, health, and motor skills, while evidence remains limited or absent for benefits related to improvements to cognitive, language, and sensorimotor functioning. Highly effective intervention mechanisms identified included prompting, modeling, praise, and structured teaching.
The purpose of this study was to measure oxygen uptake and energy expenditure in children during rock climbing activity. 29 children (age = 10.9 ± 1.7 yr) participated in the study. A commercially available rock climbing structure with ample features for submaximal effort climbing provided continuous terrain. Participants were instructed to climb at a comfortable pace. Following an initial 5-min rest, each child climbed one sustained 5-min bout followed by 5-min sitting recovery for a total of 10 min (SUS). This was immediately followed by five 1-min climbing + 1-min recovery intervals for a second total of 10 min (INT). Expired air was analyzed continuously. Energy expenditure (EE) was determined via the Weir method for 10-s intervals throughout the full protocol. The total energy expenditure in kilocalories during the 10-min SUS period was 34.3 ± 11.3 kcal. Energy expenditure during the 10-min INT period averaged 39.3 ± 13.1 kcal and was significantly higher than during SUS (p < .05). The mean total EE for SUS + INT was 73.7 ± 24.2 kcal. EE was correlated with body mass; r = .86. The rock climbing tasks employed in this study produced EE levels similar to what have been reported in children for stair climbing, sports/games activities, and easy jogging.
Investigated the influence of behavior problem severity, interventionist, and modality of case presentation on teacher's judgments of school-based interventions. 54 regular and special education teachers attending a university summer course used an intervention scale and the Semantic Differential to rate all possible combinations of 2 interventions (principal or teacher implemented) applied to 2 behavior problems (daydreaming and destruction of others' property). Ss read about or viewed a videotape of a 5th-grade boy engaging in 1 of the 2 problem behaviors. An ANOVA of Ss' ratings of intervention acceptability showed that behavior problem severity and interventionist significantly affected Ss' judgments of intervention acceptability. Findings show that interventions that could be implemented by the teacher were more acceptable. In addition, Ss rated interventions as more acceptable when applied to behavior problems of greater severity. (16 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study used Photovoice methodology to assess barriers to and facilitators of after-school participation in moderate to
vigorous physical activity as perceived by children with ASD and determine if physical activity patterns exist in relation
to these barriers. Participants were a convenience sample of 12 boys and two girls with autism spectrum disorders (ASD), ages
8–14years. Participants wore an accelerometer and completed an activity log for 7days. Data were analyzed using qualitative
techniques and fitted in a socio-ecological model. Participants reported 143 (44%) barriers and 181 (56%) facilitators. The
most frequently cited barriers were intrapersonal, followed by interpersonal, physical, community, and institutional. The
most frequent facilitators were physical, followed by intrapersonal and interpersonal, community, and institutional. The study
gives support to the use of a multipronged approach when designing physical activity interventions for children and adolescents
with ASD.
KeywordsAutism spectrum disorders–Physical activity–Photovoice–Barriers–Ecological model
The study assessed parental perceptions of the benefits of physical activity (PA) and the factors that influence participation of children with autism spectrum disorder in PA after school. Data were collected from 103 parents using an online open-ended questionnaire and focus-group interviews. Data were analyzed using a socioecological model. Parents provided 225 responses that were coded as advantages, 106 as disadvantages, 225 as facilitators, and 250 as barriers of PA. The most frequently reported advantages were physical, followed by psychosocial, and cognitive. Disadvantages were psychosocial and physical. The most frequently reported barriers were intrapersonal, followed by interpersonal, physical, community, and institutional. Facilitators were intrapersonal, followed by physical, interpersonal, community, and institutional. Public policy factors were elicited in the interviews.
ABSTRACT:
Although motor deficits are gaining attention in autism research much less attention has been paid to the physical activity patterns in this group of children. The participants in this study were a group of children with autism spectrum disorder (N = 72) between the ages of 9-18 years. This cross-sectional study explored the physical activity patterns of seventy-two children with autism spectrum disorder as they aged.
Results indicated significant differences between the mean time spent in moderate to vigorous physical activity and the mean time spent in sedentary activity. Older children with autism spectrum disorder are significantly more physically inactive, compared to younger children.
Physical activity programs and interventions need to address this deficit, in physical activity. Children with autism have a similar trend in physical activity patterns compared to their peers without autism; associated benefits and future research will be discussed.
To establish the norms for the letter-cancellation task-a psychomotor performance task.
Eight hundred nineteen school students were selected in the present study in an age range between nine and 16 years (M = 12.14; SD = 1.78 years). Subjects were assessed once for the cancellation task.
Both age and sex influenced performance on the SLCT; therefore, correction scores were obtained on the basis of these factors.
The availability of Indian normative data for the SLCT will allow wider application of this test in clinical practice.
Studies that examine the effects of exercise on children's intelligence, cognition, or academic achievement were reviewed and results were discussed in light of (a) contemporary cognitive theory development directed toward exercise, (b) recent research demonstrating the salutary effects of exercise on adults' cognitive functioning, and (c) studies conducted with animals that have linked physical activity to changes in neurological development and behavior. Similar to adults, exercise facilitates children's executive function (i.e., processes required to select, organize, and properly initiate goal-directed actions). Exercise may prove to be a simple, yet important, method of enhancing those aspects of children's mental functioning central to cognitive development.
Autism represents an unusual pattern of development beginning in the infant and toddler years.
To examine the stability of autism spectrum diagnoses made at ages 2 through 9 years and identify features that predicted later diagnosis.
Prospective study of diagnostic classifications from standardized instruments including a parent interview (Autism Diagnostic Interview-Revised [ADI-R]), an observational scale (Pre-Linguistic Autism Diagnostic Observation Schedule/Autism Diagnostic Observation Schedule [ADOS]), and independent clinical diagnoses made at ages 2 and 9 years compared with a clinical research team's criterion standard diagnoses.
Three inception cohorts: consecutive referrals for autism assessment to (1) state-funded community autism centers, (2) a private university autism clinic, and (3) case controls with developmental delay from community clinics.
At 2 years of age, 192 autism referrals and 22 developmentally delayed case controls; 172 children seen at 9 years of age.
Consensus best-estimate diagnoses at 9 years of age.
Percentage agreement between best-estimate diagnoses at 2 and 9 years of age was 67, with a weighted kappa of 0.72. Diagnostic change was primarily accounted for by movement from pervasive developmental disorder not otherwise specified to autism. Each measure at age 2 years was strongly prognostic for autism at age 9 years, with odds ratios of 6.6 for parent interview, 6.8 for observation, and 12.8 for clinical judgment. Once verbal IQ (P = .001) was taken into account at age 2 years, the ADI-R repetitive domain (P = .02) and the ADOS social (P = .05) and repetitive domains (P = .005) significantly predicted autism at age 9 years.
Diagnostic stability at age 9 years was very high for autism at age 2 years and less strong for pervasive developmental disorder not otherwise specified. Judgment of experienced clinicians, trained on standard instruments, consistently added to information available from parent interview and standardized observation.
A wide range of abilities was assessed in 56 high-functioning children with autism and 56 age- and IQ-matched controls. Stepwise discriminant analyses produced good group discrimination for sensory-perceptual, motor, complex language, and complex memory domains but lower agreement for the reasoning domain than previously obtained for adults. Group discrimination did not occur for attention, simple language, simple memory, and visuospatial domains. Findings provide additional support for a complex information-processing model for autism, previously based on adult data, demonstrating a pattern across domains of selective impairments on measures with high demands for integration of information and sparing when demands were low. Children as compared to adults with autism exhibited more prominent sensory-perceptual symptoms and less pronounced reasoning deficits reflecting brain maturation.
The objective of this research was to explore the effects of risperidone on cognitive processes in children with autism and irritable behavior.
Thirty-eight children, ages 5-17 years with autism and severe behavioral disturbance, were randomly assigned to risperidone (0.5 to 3.5 mg/day) or placebo for 8 weeks. This sample of 38 was a subset of 101 subjects who participated in the clinical trial; 63 were unable to perform the cognitive tasks. A double-blind placebo-controlled parallel groups design was used. Dependent measures included tests of sustained attention, verbal learning, hand-eye coordination, and spatial memory assessed before, during, and after the 8-week treatment. Changes in performance were compared by repeated measures ANOVA.
Twenty-nine boys and 9 girls with autism and severe behavioral disturbance and a mental age >or=18 months completed the cognitive part of the study. No decline in performance occurred with risperidone. Performance on a cancellation task (number of correct detections) and a verbal learning task (word recognition) was better on risperidone than on placebo (without correction for multiplicity). Equivocal improvement also occurred on a spatial memory task. There were no significant differences between treatment conditions on the Purdue Pegboard (hand-eye coordination) task or the Analog Classroom Task (timed math test).
Risperidone given to children with autism at doses up to 3.5 mg for up to 8 weeks appears to have no detrimental effect on cognitive performance.
Background:
Participation in social and physical activities has a number of benefits for children with or without disabilities. However, individuals with disabilities are often excluded from taking part in social activities. Most of the research on activity participation has focused on adults or youth with milder disabilities. However, children and adolescents with severe and complex needs, including those with autism, are often excluded from this type of research because of their complexities and level of functioning. Thus, we examined the social participation and friendships of children and adolescents with severe developmental disabilities, with and without autism, compared with peers without developmental disabilities.
Methods:
We compared the activity participation and friendships of typically developing children (n = 210), children with an intellectual disability (ID only; n = 186), and children with autism spectrum disorder plus intellectual disability (ID + ASD; n = 232) between the ages of 3 and 19 years. Parents of these children completed a survey, which included questions about their children's participation in six activities, and the number and quality of their children's friendships.
Results:
Children and adolescents with ID only and ID + ASD were reported to participate in significantly fewer activities and to participate much less frequently than typically developing peers. Those with ID only and ID + ASD were reported to have fewer friends and poorer quality of friendships. In addition, those with ID + ASD participated even less frequently in some activities and had fewer friends relative to those with ID only.
Conclusion:
It is important to find ways to increase the social and activity participation of children and adolescents with ID only and ID + ASD. Future research should examine the barriers to such participation and factors that impact social participation in this population.
The authors compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy between adolescents with autism spectrum disorder (ASD) and typically developing (TD) adolescents. A questionnaire was verbally administered to 35 adolescents with ASD and 60 TD adolescents. Compared with TD adolescents, fewer adolescents with ASD enjoyed team sports (65% vs. 95%, p < .001) and physical education (84% vs. 98%, p = .02). A greater proportion of adolescents with ASD perceived that physical activities were too hard to learn (16% vs. 0%, p < .01), and fewer believed that physical activity was a way to make friends (68% vs. 97%, p < .001). Fewer adolescents with ASD preferred to do physical activity in their free time (25% vs. 58%, p < .01). Most adolescents with ASD felt that physical activity is fun (84%), but the proportion was lower than in TD adolescents (98%, p = .03). Some perceptions about physical activity were similar between the 2 groups, but differences identified may inform program development.
The underlying factors affecting physical activity (PA) participation of children with high-functioning autism spectrum disorders (HFASDs) and their family members were investigated using a mixed method research design. Six families with children with HFASD aged 4 through 13 participated in the study. Findings revealed that levels of moderate to vigorous physical activity (MVPA) in children with HFASD varied between 85min and 405min for seven days. Parents of children with HFASD in this study were inactive (levels of MVPA varied between 6min and 53min) during this period. Qualitative data from parents highlighted many essential issues. Those issues are categorized under three main themes: (a) understanding PA in children with HFASD, (b) living with a child with HFASD, and (c) awareness of autism spectrum disorders (ASD) at school and community settings. Social skills, issues related to bullying, fear of injury to the child, as well as support from family members and lack of understanding of the disability emerged as subthemes extracted from these data.
Many students with autism spectrum disorder (ASD) fall short of the recommended physical activity levels and experience challenges in physical activity and physical education settings. This article reviews factors that can improve the physical activity statistics of students with ASD, outlines the researched benefits of physical activity for students with ASD, and summarizes previously published strategies for success in physical education. It serves as a tool for teachers who wish to promote best practices and advocate for quality movement programs for these students.
Individual, social, and community barriers to physical activity (PA) experienced by children with autism spectrum disorder (ASD) make PA participation more difficult and may contribute to increased screen time.
We compared the prevalence of parent-reported barriers to PA among 58 typically developing (TD) children and 53 children with an ASD, 3-11 years, and assessed the association between barriers and PA participation and screen time among children with ASD.
Parents of children with ASD reported significantly more barriers than parents of TD children. Based on parent-report, 60% of children with ASD required too much supervision compared to no TD children (p<0.001). Parents of children with ASD were more likely to report that adults lack skills needed to include their child (58%), that their child has few friends (45%), and that other children exclude their child (23%). The number of parent-reported barriers to PA was inversely correlated with the hours spent in PA per year (r=-0.27, p=0.05) and positively related to total screen time (r=0.32, p<0.03).
These findings underscore the need for community-based PA programs designed to meet the special requirements of this population and policies that compel schools and other government-supported organizations for inclusion and/or targeted programming.
The present study evaluated an intervention package for teaching route following to two children with autism at an indoor rock-climbing gym. The intervention consisted of multiple within-stimulus fading procedures in combination with errorless learning procedures, positive reinforcement, an error correction procedure, and conditional discrimination training technologies. The results demonstrated that both participants learned to climb at least 10 ft/3 m on specified routes. Furthermore, both participants learned to climb an entire 22-ft/6.7-m wall for at least one of three different routes without any errors in a regular rock-climbing gym setting. The acquisition of this skill provides children with autism with an additional option for leisure participation with others. Copyright © 2010 John Wiley & Sons, Ltd.
It is generally agreed that regular physical exercise promotes physical and mental health, but what are the benefits in people with Autism Spectrum Disorders (ASD)? This meta-analysis evaluates 16 behavioural studies reporting on a total of 133 children and adults with various variants of the syndrome who were offered structured physical activities either in an individual or a group context. The effects on social and motor deficiencies, two of the three primary symptom clusters of ASD, were normalized to afford a quantitative evaluation. Results pertaining to communication deficits were insufficient to permit classification. All activity programmes yielded significant progress on the measures assessed, but the individual programmes elicited significantly more improvement than the group interventions in the motor and, more surprisingly, also in the social domain. Although overall sample sizes were small, the combined results do permit the tentative conclusion that in terms of motor performance and social skills children and adults with ASD benefit most from individual exercise interventions. Further research of the impact of individual and group interventions on communication deficits in particular as well as studies gauging the extent to which exercise effects depend on ASD symptom severity are warranted.
Oromotor, manual and gross motor skills were assessed in an unselected group of 33 children attending a special school for children with autism. Children were assessed by staff with whom they were familiar, in conditions with which they were familiar, and with repeated testing where appropriate, thus maximizing the chances of children demonstrating their skills. Negative ratings were given only for responses or behaviour deemed to be markedly and clinically abnormal. Seventy-nine per cent of the children received negative ratings on over half of the 25 (or in some cases 21) measures, all affected children having oromotor impairments; 55% having additional manual impairments; and 18% having additional gross motor impairments. The findings are discussed in terms of possible causal factors, and in particular the likelihood that oral and manual dyspraxia contribute to impaired speech and signing in many children with autism.
Fifty-two people with developmental disabilities were interviewed using the Individual Supports Identification System (ISIS). This study reports on persons with developmental disabilities, served by the State of Washington Division of Developmental Disabilities, and includes persons whose onset of disability was prior to 18. To be eligible for services, an individual must have a disability that falls within one of the following categories: (1) mental retardation; (2) cerebral palsy; (3) epilepsy; (4) autism; and (5) other types of central nervous system impairment closely related to mental retardation. Interviews were conducted with two groups. The first comprised individuals with developmental disabilities and the second, significant persons in the life of each participant in the first group. A significant person was considered to be someone known by the individual with disabilities for more than 6 months, spending more time with him or her than others. In addition, the significant person must like the individual with disabilities, and have his or her best interests in mind. Seventy-five per cent of significant persons interviewed were parents. Significant persons also responded to a series of ISIS questions. Responses from the individual with disabilities and from the significant person in his or her life were compared in order to determine similarities and differences in perspective. Comparisons focus on issues pertaining to friends and relationships, living environment and daily care needs.
This study was designed to examine the services received by 3- to 9-year-old children with autism and pervasive developmental disabilities. Four questions were addressed: (1) What services are received? (2) How are families involved in their services? (3) How do providers ensure that their services have continuity or are organized around a common set of child needs? and (4) What problems do families report? These questions were addressed by conducting a telephone interview with 25 families in western Pennsylvania. Results indicated that families interacted with a host of different agencies and professionals. Several problems also became apparent, as many families reported difficulty accessing needed services and minimal involvement in planning or implementing these interventions.
Compared the motor impairment levels of Asperger syndrome and high functioning autistic children using a standardized test, the Test of Motor Impairment-Henderson Revision. The two groups did not differ on either total or subscale impairment scores. Intelligence level was negatively correlated with motor impairment although the relationship was mostly accounted for by the Asperger children. There was considerable variability within both clinical groups but 50% of Asperger children and 67% of autistic children showed a clinically significant level of motor impairment. Results offer no support for clumsiness as a diagnostically differentiating feature of these disorders.
Studies involving physical exercise and individuals with autism spectrum disorders (ASD) were reviewed. Systematic search procedures identified 18 studies meeting predetermined inclusion criteria. These studies were evaluated in terms of: (a) participant characteristics, (b) type of exercise, (c) procedures used to increase exercise, (d) outcomes, and (e) research methodology. Across the corpus of studies, exercise was implemented with 64 participants with ASD aged 3–41 years. A variety of exercise activities were employed (e.g., jogging, weight training, bike riding). Following the exercise interventions decreases in stereotypy, aggression, off-task behavior and elopement were reported. Fatigue was not likely the cause of decreases in maladaptive behavior because on-task behavior, academic responding, and appropriate motor behavior (e.g., playing catch) increased following physical exercise. Results suggest that programs for individuals with ASD may benefit from including components designed to incorporate regular and specific types of physical activity. Areas in need of further research are discussed.
The construct validity of the Behavior Intervention Rating Scale (BIRS) was investigated to develop an instrument to measure teachers' perceptions of treatment acceptability and percieved effectiveness of classroom interventions. An obligue factor analysis was utilized, and three factors, Acceptability, Effectiveness, and Time of Effect, were determined. Correlational analysis demonstrated moderate to strong relations among the three factors. The BIRS was shown to be a valid measure of two general constructs important to treatment evaluation, acceptability and effectiveness.
The purpose of this systematic review was to synthesize evidence from studies examining the effect of exercise interventions on stereotypic behaviours in children with autism spectrum disorder (ASD).
Only exercise-related physical therapy (PT) interventions were included. A multifaceted search strategy identified studies published between 1980 and 2007. Quality was assessed using the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale, the Clinical Relevance Tool for Case Studies, and the Quality, Rigour or Evaluative Criteria tool.
Seven studies (1982-2003) met our inclusion criteria; four of these used single-subject research designs, two were group studies, and one was a case study. Ages and behavioural characteristics of the children (N = 25) varied among the studies. Levels of evidence ranged from II to V (of a possible I-V). Study quality scores ranged from 2 to 5 (range: 0 to 7); mean = 3.9, mode = 5. Few studies in this area of PT practice have been published, and those identified scored low levels of rigour on the AACPDM criteria.
Research suggests that exercise provides short-term reductions of stereotypic behaviours in children with ASD. Future research with stronger evidence levels, greater rigour, and longer-term outcome assessment is required to determine specific exercise parameters.
The impact of a six-week indoor wall climbing on the perceptions of self for children with special needs aged 6-12 years was explored. Participants (n = 46) were randomly assigned to the intervention (girls, n = 4; boys, n = 19) and control groups (girls, n = 5; boys, n = 18). Belayers' and children's perceptions of efficacy were measured using specifically designed questionnaires and perceptions of competence and global self-worth were measured using Harter's (1985) Self-Perception Profile for Children for participants with an adaptive age of 8 years or higher. Children's self-efficacy and belayers' ratings of children's efficacy improved significantly, t(21) = 3.9, p = .001, d= .84 and F(2, 44) = 30.03, p < .001, respectively. The children's judgments of their athletic and social competence and global self-worth, however, did not change over time or differ from the wait-listed control group (p > .05). These results suggest that it is likely that many experiences that enhance self-efficacy may be needed to improve self-perceptions.
Twenty-three children with autism and two control groups completed an attention battery comprising three versions of the continuous performance test (CPT), a digit cancellation task, the Wisconsin Card Sorting Test (WCST), and two novel, computerized tests of shifting attention (i.e., the Same-Different Computerized Task and the Computerized Matching Task). Children with autism could focus on a particular stimulus and sustain this focus as indicated by their performance on the digit cancellation task and the CPT. Their performance on the WCST suggested problems in some aspects of shifting attention (i.e., disengaging attention). The autism group performed as well as controls on the Same-Different Computerized Task, however, that required successive comparisons between stimuli. This implies that they could, in fact, shift their attention continuously. In addition, they did not differ from controls on the Computerized Matching Task, an analog of the WCST, suggesting that they do not have a general deficit in shifting attention.
To determine if abnormalities exist in postural control in autism and if they are related to age.
Dynamic posturography was performed in 79 autistic individuals without mental retardation and 61 healthy volunteers between ages 5 and 52 years. Both the sensory organization and the movement coordination portions of the test were performed.
The autistic subjects had reduced postural stability (p = 0.002). Examination of age effects revealed that the development of postural stability was delayed in the autistic subjects (p < 0.001) and failed to achieve adult levels (p = 0.004). Postural stability was reduced under all conditions but was clinically significant only when somatosensory input was disrupted alone or in combination with other sensory challenges (mean reduction in stability of 2.6 +/- 1.0 for the first three conditions without somatosensory disruption vs 6.7 +/- 2.7 for the last three conditions with somatosensory disruption), indicating problems with multimodality sensory integration.
The evidence from this and studies of the motor system suggests more general involvement of neural circuitry beyond the neural systems for social behavior, communication, and reasoning, all of which share a high demand on neural integration of information.
While many studies of motor control in autism have focused on specific motor signs, there has been a lack of research examining the complete range of subtle neuromotor signs. This study compared performance on a neurologic examination standardized for children (PANESS, Physical and Neurological Exam for Subtle Signs, Denckla [1974
Developmental Medicine and Child Neurology, 16(6), 729–741]) between a group of 40 boys aged 6–17 with autism and average range IQs and a group of 55 typically developing boys. The Autism group was shown to have significant impairment on several measures of motor control compared to the Control group. Regression analyses revealed that a model including four PANESS variables offered a high level of discrimination in distinguishing boys with high-functioning autism from controls.
Test of motor impairment: Manual
- D H Stott
- F Moyes
- S E Henderson