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Adapting a Preschool Physical Activity Intervention to Be Inclusive of Children on the Autism Spectrum
Individuals whose educational needs differ for various reasons can benefit from appropriate educational services through early assessment and diagnosis practices. At-risk children who fail to achieve adequate development in general education classes need more intensive education. For these individuals to benefit effectively from the education process, it is important to organize it according to their characteristics. Identifying the children in the risk group is possible through teachers’ experience, observation, and assessment practices. In this context, if a class includes children who are considered to be in the risk group, the educational assessment process should be initiated. The aim of this study is to examine preschool teachers’ identification of risk groups in their classes and the intervention plans they implement. Fifteen preschool teachers from the central district of Konya province of Türkiye participated in the study, which was conducted as a case study, a qualitative research method. Data were collected through interviews. The findings obtained from the data indicate that the preschool teachers participating in the study think early intervention is mostly aimed at children with special needs. However, children may be in the risk group due to familial, environmental, and individual factors, and preschool teachers mostly use observation and information obtained from the family while identifying these groups. The teachers stated that most socioeconomically disadvantaged children were present in their classrooms. The teachers stated that they do not implement a systematic planning process for the risk groups in their classes, but they make some changes in the education process according to the needs of the children.
While there is wide consensus regarding the importance of early intervention, health is rarely considered within priorities. Twenty-five children on the autism spectrum (Mage = 4.67, SD = 0.82) participated in a 12-week physical activity intervention. Primary objective was to examine impact of a physical activity intervention on physical activity, fitness and motor competence. Secondary objective was to examine associations between motor behavior and ASD symptoms. Ball skills (p < .001) and isometric push-up performance (p = .02) improved. Autism symptoms were associated with motor skills (r > − .49, p < .05). Study outcomes provide new knowledge regarding design, delivery, and measures for early interventions targeting health disparities in young children on the autism spectrum.
Considering that parents are one of the key figures in their child’s participation in physical activity, it is extremely important to examine parents’ perceptions and experiences of physical activity in order to protect children with Autism Spectrum Disorders (ASD) from the inactive life during the novel Coronavirus (COVID-19) outbreak and to include them in physical activities in the home environment. Although it is still a new subject, there is no research that addresses parents’ physical activity knowledge, needs and recommendations for the physical activity experiences of children with ASD during the COVID-19 outbreak, and offers solutions accordingly. Considering this gap in the literature, the aim of this qualitative study is to explore parents’ perceptions on physical activity for their children with ASD. Participants of the study were 10 parents with children with ASD, who participated in one-to-one semi-structured phone calls. Interview data were analyzed thematically. The analysis of the data revealed three main themes: 1) Possible benefits of physical activity during the COVID-19 outbreak, 2) Physical activity barriers during the COVID-19 outbreak, and 3) Recommendations for physical activity during the COVID-19 outbreak. The results revealed that parents thought that physical activities had a positive effect on the development areas of their children with ASD. It was determined that parents want to involve their children in physical activities in the home environment, but they have barriers that they need to overcome.
Described as a global outbreak (pandemic) by the World Health Organization, Coronavirus disease (COVID-19) raises great concern with more than 2 million infected patients worldwide. A series of measures are taken by governments worldwide to prevent the spread of the outbreak. As new cases increase, people are asked to stay at home. Active living areas such as sports centers, parks and schools are closed in most countries. In this process, staying at home for a long time makes it difficult for individuals with special needs such as Autism Spectrum Disorders (ASD) to stay physically active as well as typically developing individuals. The education process of children with ASD is disrupted, especially due to closed special education schools and rehabilitation centers. Online learning environments are often not suitable for children with ASD. It is predicted that excessive weight, obesity and sedentary life, which are high in children with ASD, may increase even more due to COVID-19. This article outlines the benefits of physical activity for children with ASD and provides strategies and examples of physical activity for children with ASD during the COVID-19 outbreak. The article is thought to be a guide for encouraging children with ASD in the home environment to physical activity.
This study tested the Wellness Enhancing Physical Activity in Young Children (WE PLAY) program, a 4-week online preschool teacher training, on children's moderate-to-vigorous physical activity (MVPA). In this cluster RCT, six Head Start preschools were randomized to an intervention and comparison group. Children's MVPA was measured using accelerometers at pre- and posttest. The magnitude of the difference in MVPA between groups at posttest was small, but in the expected direction: Δ min/hour = 1.60, 95% CI [-0.97, 4.18], p = .22, Cohen's d = 0.32. We observed a pre/post within group increase in average minutes per hour of MVPA in school with a medium effect size for the intervention group: Δ mean min/hour = 2.09, 95% CI [0.51, 3.67], p = .0096, Cohen's d = 0.42. An increase was not seen for the comparison group: Δ mean min/hour = 0.44, 95% CI [-0.70, 1.59], p = .45, Cohen's d = 0.07. WE PLAY children in 6 hr/day programs gained 63 min of MVPA per week in school, providing preliminary evidence of the benefits of WE PLAY on children's physical activity levels. WE PLAY deserves further testing with larger groups of children and teachers. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Primary-school-aged children and adolescents with autism spectrum disorder (ASD) are reported to engage in lower levels of moderate-to-vigorous physical activity (MVPA) compared to typically developing (TD) children (Jones et al. in PLoS ONE, 12(2):1–23, 2017). Levels of MVPA in young children with ASD remain unclear. This study aimed to investigate MVPA in 4-to-7-year-old children with (n = 37) and without (n = 40) ASD, to determine if MVPA is related to ASD diagnosis; and examine correlates to better inform interventions. Results indicated children with ASD engage in the same levels of MVPA as TD children. Future studies need to further explore MVPA in children with ASD over time to uncover when the divergence in MVPA levels occur and what factors may be associated.
This article describes the Wellness Enhancing Physical Activity in Young Children (WE PLAY) teacher training, which was designed to assist early childhood educators to promote physical activity among preschoolers in child care. We describe the WE PLAY intervention and its grounding in constructs from theories of health behavior and an implementation science framework. Fidelity, feasibility, and acceptability data from the WE PLAY pilot study, a cluster randomized controlled trial (RCT) with six Head Start programs in Massachusetts. Data, collected between October 2017–May 2018, are from teachers and supervisors at 3 preschool programs who participated in the WE PLAY (intervention) group. To understand program feasibility and acceptability, we used the Usage Rating Profile-Intervention (URP-I; n = 13) and key informant interviews (n = 5). The URP-I is a validated teacher survey with 6 subscales (Acceptability, Understanding, Feasibility, Family-School Collaboration, Systems Climate, and Systems Support). It was administered twice; immediately after users completed the first component, an online training (week 2), and after implementation of all program components (week 4). WE PLAY was implemented as it was intended, and it was considered acceptable and feasible to users. There was an increase in users’ understanding of how to implement the program between weeks 2 and 4, and a concomitant decrease in the amount of additional systems-level supports users thought they would need to implement WE PLAY between weeks 2 and 4. WE PLAY was easily understandable and feasible to implement in real world settings, it was highly acceptable to users, and it deserves further testing.
Individuals with autism spectrum disorder (ASD) are generally less physically active than individuals without disability due to factors such as lack of motor coordination and inadequate transportation resources that can result in various barriers to participation. This affects their independence and may interfere with expectations (e.g., employment) during adulthood. It is essential to explore ways to teach physical activity so people with ASD can generalize skills in community settings. This study examined the effect of a multicomponent behavioral intervention that included (a) the Exercise Buddy application, (b) a system of least prompts, (c) an incremental increase of criteria, and (d) reinforcement to teach three adolescents with ASD functional movement exercises (e.g., squat). All participants increased their mastery of performing these exercises compared to baseline and generalized these skills across two community settings.
Background:
This study aimed to evaluate the effectiveness of a selected group exercise known as Sports, Play and Active Recreation for Kids (SPARK) on the motor and behavioral skills of children with autism spectrum disorder (ASD) using a quasi-experimental design with repeated measures.
Methods:
Twenty-eight children with ASD (age range of 5e12 years) participated in this study. The participants were examined at baseline, pre-test, and post-test using Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), Autism treatment evaluation checklist (ATEC), and Gilliam Autism Rating Scale-second edition (GARS-2).
Results:
The results showed that the SPARK program significantly improved balance (static and dynamic), bilateral coordination and social interaction (p < 0.05) in children with ASD.
Conclusion:
The results of this study suggest that the SPARK's training can be considered as a therapeutic option not only for motor enhancement but also for improving social skills in children with ASD.
Background
The ToyBox-intervention is a theory- and evidence-based intervention delivered in kindergartens to improve four- to six-year-old children’s energy balance-related behaviours and prevent obesity. The current study aimed to (1) examine the effect of the ToyBox-intervention on increasing European four- to six-year-old children’ steps per day, and (2) examine if a higher process evaluation score from teachers and parents was related to a more favourable effect on steps per day.
Methods
A sample of 2438 four- to six-year-old children (51.9% boys, mean age 4.75 ± 0.43 years) from 6 European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) wore a motion sensor (pedometer or accelerometer) for a minimum of two weekdays and one weekend day both at baseline and follow-up to objectively measure their steps per day. Kindergarten teachers implemented the physical activity component of the ToyBox-intervention for 6 weeks in total, with a focus on (1) environmental changes in the classroom, (2) the child performing the actual behaviour and (3) classroom activities. Children’s parents received newsletters, tip cards and posters. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and the six intervention countries separately. In addition, process evaluation questionnaires were used to calculate a total process evaluation score (with implementation and satisfaction as a part of the overall score) for teachers and parents which was then linked with the physical activity outcomes.
Results
No significant intervention effects on four- to six-year-old children’ steps per weekday, steps per weekend day and steps per average day were found, both in the total sample and in the country-specific samples (all p > 0.05). In general, the intervention effects on steps per day were least favourable in four- to six-year-old children with a low teachers process evaluation score and most favourable in four- to six-year-old children with a high teachers process evaluation score. No differences in intervention effects were found for a low, medium or high parents’ process evaluation score.
Conclusion
The physical activity component of the ToyBox-intervention had no overall effect on four- to six-year-old children’ steps per day. However, the process evaluation scores showed that kindergarten teachers that implemented the physical activity component of the ToyBox-intervention as planned and were satisfied with the physical activity component led to favourable effects on children’s steps per day. Strategies to motivate, actively involve and engage the kindergarten teachers and parents/caregivers are needed to induce larger effects.
Electronic supplementary material
The online version of this article (10.1186/s12966-017-0574-z) contains supplementary material, which is available to authorized users.
Positive activity behaviours (i.e. higher physical activity [PA]/lower sedentary behaviour [SB]) are beneficial from infancy, yet evidence suggests that young children (0- to 6-year-olds) are relatively inactive. To better understand the perceived influences on these behaviours and to aid intervention development, this paper systematically synthesizes the extensive qualitative literature regarding perceived barriers and facilitators to PA and SB in young children (0-6 years old). A search of eight electronic databases (July 2016) identified 43 papers for inclusion. Data extraction and evidence synthesis were conducted using thematic content analysis, underpinned by the socio-ecological model (i.e. individual, interpersonal, community, organizational and policy levels). Parents, childcare providers and children perceived seven broad themes to be important for PA and SB, including the child; the home; out-of-home childcare; parent-childcare provider interactions; environmental factors; safety; and weather. Each theme mapped onto between one and five levels of the socio-ecological model; barriers and facilitators at the interpersonal level (e.g. parents, care providers and family) were most frequently cited, reflecting the important (perceived) role adults/peers play in shaping young children's behaviours. We provide an overarching framework to explain PA and SB in early childhood. We also highlight where gaps in the current literature exist (e.g. from male carers; in developing countries; and barriers and facilitators in the environmental and policy domains) and where future quantitative work may focus to provide novel insights about children's activity behaviours (e.g. safety and weather).
Autism spectrum disorder is the fastest growing developmental disability in the United States. As such, there is an unprecedented need for research examining factors contributing to the health disparities in this population. This research suggests a relationship between the levels of physical activity and health outcomes. In fact, excessive sedentary behavior during early childhood is associated with a number of negative health outcomes. A total of 53 children participated in this study, including typically developing children (mean age = 42.5 ± 10.78 months, n = 19) and children with autism spectrum disorder (mean age = 47.42 ± 12.81 months, n = 34). The t-test results reveal that children with autism spectrum disorder spent significantly less time per day in sedentary behavior when compared to the typically developing group (t(52) = 4.57, p < 0.001). Furthermore, the results from the general linear model reveal that there is no relationship between motor skills and the levels of physical activity. The ongoing need for objective measurement of physical activity in young children with autism spectrum disorder is of critical importance as it may shed light on an often overlooked need for early community-based interventions to increase physical activity early on in development.
Despite evidence suggesting one of the earliest indicators of an eventual autism spectrum disorder diagnoses is an early motor delay, there remain very few interventions targeting motor behavior as the primary outcome for young children with autism spectrum disorder. The aim of this pilot study was to measure the efficacy of an intensive motor skill intervention on motor skills (Test of Gross Motor Development-2), physical activity (accelerometers), and socialization (Playground Observation of Peer Engagement) in young children with autism spectrum disorder. A total of 20 children with autism spectrum disorder aged 4–6 years participated. The experimental group (n = 11) participated in an 8-week intervention consisting of motor skill instruction for 4 h/day, 5 days/week. The control group (n = 9) did not receive the intervention. A repeated-measures analysis of covariance revealed statistically significant differences between groups in all three motor outcomes, locomotor (F(1, 14) = 10.07, p < 0.001, partial η² = 0.42), object control (F(1, 14) = 12.90, p < 0.001, partial η² = 0.48), and gross quotient (F(1, 14) = 15.61, p < 0.01, partial η² = 0.53). Findings shed light on the importance of including motor programming as part of the early intervention services delivered to young children with autism spectrum disorder.
Context:
The review describes the effectiveness of physical activity interventions implemented in centre-based childcare services and (i) examines characteristics of interventions that may influence intervention effects; (ii) describes the effects of pragmatic interventions and non-pragmatic interventions; (iii) assesses adverse effects; and (iv) describes cost-effectiveness of interventions METHODS: Data sources were Cochrane Central Register of Controlled trials, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, SCOPUS and SPORTDISCUS. Studies selected included randomized controlled trials conducted in centre-based childcare including an intervention to increase objectively measured physical activity in children aged less than 6 years. Data were converted into standardized mean difference (SMD) and analysed using a random effects model.
Results:
Overall interventions significantly improved child physical activity (SMD 0.44; 95% confidence interval [CI]: 0.12-0.76). Significant effects were found for interventions that included structured activity (SMD 0.53; 95% CI: 0.12-0.94), delivery by experts (SMD 1.26; 95% CI: 0.20-2.32) and used theory (SMD 0.76; 95% CI: 0.08-1.44). Non-pragmatic (SMD 0.80; 95% CI: 0.12-1.48) but not pragmatic interventions (SMD 0.10; 95% CI:-0.13-0.33) improved child physical activity. One trial reported adverse events, and no trials reported cost data.
Conclusions:
Intervention effectiveness varied according to intervention and trial design characteristics. Pragmatic trials were not effective, and information on cost and adverse effects was lacking. Evidence gaps remain for policymakers and practitioners regarding the effectiveness and feasibility of childcare-based physical activity interventions.
The purpose of this pilot study was to demonstrate the impact of a fundamental-motor-skill (FMS) intervention on the motor skills of 3- to 7-year-old children with autism-like characteristics in an early intervention classroom. A secondary purpose was to qualitatively assess the impact of the program as described by the classroom's special education teacher. All children in the classroom (N = 5) took part in an FMS intervention for two 6-wk blocks (fall 2013 and winter 2014). Motor-skill proficiency and social skills were assessed at 3 times: baseline, after Block 1 of the intervention, and after Block 2 of the intervention. In addition, an interview was conducted with the classroom teacher after Assessment 3 to draw further insights into the relative success and impact of the program. Results were analyzed through a visual analysis and presented individually. They indicated improvements in the participants' individual FMS and social-skill scores, possible improvements in declarative knowledge, and an increase in the special education teacher's readiness to teach FMS; further research with larger, controlled samples is warranted.
This article provides a discussion on the question of validity in qualitative evaluation. Although validity in qualitative inquiry has been widely reflected upon in the methodological literature (and is still often subject of debate), the link with evaluation research is underexplored. Elaborating on epistemological and theoretical conceptualizations by Guba and Lincoln and Creswell and Miller, the article explores aspects of validity of qualitative research with the explicit objective of connecting them with aspects of evaluation in social policy. It argues that different purposes of qualitative evaluations can be linked with different scientific paradigms and perspectives, thus transcending unproductive paradigmatic divisions as well as providing a flexible yet rigorous validity framework for researchers and reviewers of qualitative evaluations.
Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985,
1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is
found to be well supported by empirical evidence. Intentions to perform behaviors of different
kinds can be predicted with high accuracy from attitudes toward the behavior, subjective
norms, and perceived behavioral control; and these intentions, together with perceptions of
behavioral control, account for considerable variance in actual behavior. Attitudes, subjective
norms, and perceived behavioral control are shown to be related to appropriate sets of salient
behavioral, normative, and control beliefs about the behavior, but the exact nature of these
relations is still uncertain. Expectancy value formulations are found to be only partly
successful in dealing with these relations. Optimal rescaling of expectancy and value
measures is offered as a means of dealing with measurement limitations. Finally, inclusion of
past behavior in the prediction equation is shown to provide a means of testing the theory*s
sufficiency, another issue that remains unresolved. The limited available evidence concerning
this question shows that the theory is predicting behavior quite well in comparison to the
ceiling imposed by behavioral reliability.
A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n = 5, control n = 4); the impact of intervention intensity was also explored. The experimental group significantly improved their object manipulation and overall motor scores from pre- to post-intervention. The wait-list control design revealed no group-by-time interactions; however, with the groups combined time was a significant factor for all motor variables. There were no significant changes in adaptive behavior and social skills. These preliminary findings suggest that a fundamental motor skill intervention may benefit young children with autism spectrum disorder. Future research with larger samples is warranted.
The use of manual‐based interventions tends to improve client outcomes and promote replicability. With an increasingly strong link between funding and the use of empirically supported prevention and intervention programs, manual development and adaptation have become research priorities. As a result, researchers and scholars have generated guidelines for developing manuals from scratch, but there are no extant guidelines for adapting empirically supported, manualized prevention and intervention programs for use with new populations. Thus, this article proposes step‐by‐step guidelines for the manual adaptation process. It also describes two adaptations of an extensively researched anger management intervention to exemplify how an empirically supported program was systematically and efficiently adapted to achieve similar outcomes with vastly different populations in unique settings.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
Implementation science is growing in importance among funders, researchers, and practitioners as an approach to bridging the gap between science and practice. We addressed three goals to contribute to the understanding of the complex and dynamic nature of implementation. Our first goal was to provide a conceptual overview of the process of implementation by synthesizing information from 25 implementation frameworks. The synthesis extends prior work by focusing on specific actions (i.e., the “how to”) that can be employed to foster high quality implementation. The synthesis identified 14 critical steps that were used to construct the Quality Implementation Framework (QIF). These steps comprise four QIF phases: Initial Considerations Regarding the Host Setting, Creating a Structure for Implementation, Ongoing Structure Once Implementation Begins, and Improving Future Applications. Our second goal was to summarize research support for each of the 14 QIF steps and to offer suggestions to direct future research efforts. Our third goal was to outline practical implications of our findings for improving future implementation efforts in the world of practice. The QIF's critical steps can serve as a useful blueprint for future research and practice. Applying the collective guidance synthesized by the QIF to the Interactive Systems Framework for Dissemination and Implementation (ISF) emphasizes that accountability for quality implementation does not rest with the practitioner Delivery System alone. Instead, all three ISF systems are mutually accountable for quality implementation.
Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith
Wellness Enhancing Physical Activity for Young Children (WE PLAY) is an intervention intended to promote physical activity (PA) among typically-developing preschool children in child care settings. It was adapted for use by teachers who educate children with Autism Spectrum Disorders (ASD). This study used a multiple baseline design across participants to evaluate the impact of WE PLAY-Autism on teachers' PA facilitating behaviors and on the PA levels of children with ASD. Visual analysis and effect size estimates indicated that two of the three teachers increased their PA facilitating behavior, although this was insufficient to demonstrate a functional relation. Children's (n = 5) PA was measured daily during school hours using accelerometry. Visual analysis, which was further supported by effect size calculations, indicated higher average levels of moderate-to-vigorous PA (MVPA) among preschoolers with ASD in the intervention phase (Tau-UA vs. B = 0.53, p < .001, Hedges' g = 0.99, 95% CI [0.56, 1.43]) and post-training phase (Tau-UA vs. B = 0.55, p < .001, Hedges' g = 1.17, 95% CI [0.73, 1.60]) in comparison to the baseline phase. WE PLAY-Autism is an intervention deserving of further investigation given its meaningful impact on the MVPA of preschoolers with ASD paired with its potential for broad implementation in preschools.
The purpose of our study was to determine the effect of music (music with lyrics versus music with lyrics plus instruction) relative to on-task behaviors in preschool children with autism spectrum disorder (ASD) in a gross motor setting. Five preschool children (4 boys, 1 girl) diagnosed with ASD served as participants. A multiple baseline across participants in conjunction with an alternating-treatment design was used. For all participants, music with lyrics plus instruction increased on-task behaviors to a greater extent than did music with lyrics. The results of our study provide a better understanding of the role of music with regard to the behaviors of young children with ASD.
Recently the Institute of Medicine (Early childhood obesity prevention policies, Washington, DC, 2011) established a US guideline for preschool children and recommended 15 min or more of total physical activity (i.e., total accumulated light, moderate, and vigorous activity) per hour or 3 h per day assuming 12 h of wake time. Nevertheless, researchers have found that many young children do not meet the proposed guideline in early care and education programs.
In spite of the extensive interests in preschoolers’ physical activity and emerging descriptive and intervention investigations, much remains to be learned about young children’s physical activity. Our purpose for this chapter is to selectively review the evidence of what we know about young children’s physical activity and based on that emerging informational base make reasonable recommendations for practitioners who are interested in enhancing preschool children’s salubrious activity in community-based early care and education programs.
Objectives:
Educator-led programs for physical activity and motor skill development show potential but few have been implemented and evaluated using a randomized controlled design. Furthermore, few educator-led programs have evaluated both gross motor skills and physical activity. Therefore, the aim of this study was to evaluate a gross motor skill and physical activity program for preschool children which was facilitated solely by childcare educators.
Design:
A six-month 2-arm randomized controlled trial was implemented between April and September 2012 in four early childhood centers in Tasmania, Australia.
Methods:
Educators participated in ongoing professional development sessions and children participated in structured physical activity lessons and unstructured physical activity sessions.
Results:
In total, 150 children were recruited from four centers which were randomized to intervention or wait-list control group. Six early childhood educators from the intervention centers were trained to deliver the intervention. Gross motor skills were assessed using the Test of Gross Motor Development (2nd edition) and physical activity was measured objectively using GT3X+ Actigraph accelerometers. No statistically significant differences were identified. However, small to medium effect sizes, in favor of the intervention group, were evident for four of the five gross motor skills and the total gross motor skill score and small to medium effect sizes were reported for all physical activity outcomes.
Conclusions:
This study highlights the potential of educator-led physical activity interventions and supports the need for further translational trials within the early childhood sector.
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.
Children with autism have deficits in social communication and may engage in less moderate-to-vigorous physical activity (MVPA) than children without disabilities. In this study, a classroom teacher implemented two interventions in the context of an alternating treatments design. Physical activity, engagement, and social behaviors were monitored for two young children with autism spectrum disorders. Data show that engagement and social behaviors increased during a structured choice (SC) intervention condition. MVPA was variable within and across conditions, but appropriate physical activity (e.g., physical activity that was associated with engagement) was highest during the SC condition. A final condition during which the teacher prompted movement showed minimally higher physical activity with sustained social and engagement behaviors.
AimThis study aims to investigate the association between daytime physical activity (PA) and sleep in pre-schoolers with or without autism spectrum disorders (ASDs).Method
Thirty-one pre-school children with ASD and 16 age-matched controls were recruited. Sleep and PA patterns were measured with an Actiwatch for 7 days. After average PA values were calculated for three periods (morning, afternoon and evening) of each day for each child, the days with maximum (active) and minimum (inactive) PA values for these three periods were determined. The Wilcoxon signed-rank test was used to compare sleep following active mornings, afternoons and evenings with that following inactive time periods.ResultsIn control children, sleep onset time following active mornings/afternoons did not differ from that following inactive mornings/afternoons. In contrast, sleep onset following the most inactive morning (median sleep onset time: 9:57 pm) and the most inactive afternoon (median sleep onset time: 10:24 pm) began significantly later than that following the most active mornings (median sleep onset time: 9:21 pm) and the most active afternoons (median sleep onset time: 9:39 pm) in children with ASD. The percentage of sleep for control children following active mornings was significantly higher (median: 93.2%) than that following inactive ones (median: 91.7%). Significant associations were not found between evening PA and sleep in either ASD or control children.ConclusionsA high level of morning and afternoon PA can advance the sleep phase in children with ASD.
Background:
Overweight and obesity are major pediatric public health problems in the United States; however, limited data exist on the prevalence and correlates of overnutrition in children with autism.
Methods:
Through a large integrated health care system's patient database, we identified 6672 children ages 2 to 20 years with an assigned ICD-9 code of autism (299.0), Asperger syndrome (299.8), and control subjects from 2008 to 2011 who had at least 1 weight and height recorded in the same visit. We calculated age-adjusted, sex-adjusted body mass index and classified children as overweight (body mass index 85th to 95th percentile) or obese (≥ 95th percentile). We used multinomial logistic regression to compare the odds of overweight and obesity between groups. We then used logistic regression to evaluate factors associated with overweight and obesity in children with autism, including demographic and clinical characteristics.
Results:
Compared to control subjects, children with autism and Asperger syndrome had significantly higher odds of overweight (odds ratio, 95% confidence interval: autism 2.24, 1.74-2.88; Asperger syndrome 1.49, 1.12-1.97) and obesity (autism 4.83, 3.85-6.06; Asperger syndrome 5.69, 4.50-7.21). Among children with autism, we found a higher odds of obesity in older children (aged 12-15 years 1.87, 1.33-2.63; aged 16-20 years 1.94, 1.39-2.71) compared to children aged 6 to 11 years. We also found higher odds of overweight and obesity in those with public insurance (overweight 1.54, 1.25-1.89; obese 1.16, 1.02-1.40) and with co-occurring sleep disorder (obese 1.23, 1.00-1.53).
Conclusions:
Children with autism and Asperger syndrome had significantly higher odds of overweight and obesity than control subjects. Older age, public insurance, and co-occurring sleep disorder were associated with overweight or obesity in this population.
Despite evidence that preschoolers spend the majority of their time in sedentary activities, few physical activity interventions
have focused on preschool-age children. Health promotion interventions that can be integrated into the daily routines of a
school or other setting are more likely to be implemented. The Study of Health and Activity in Preschool Environments employed
a flexible approach to increasing physical activity opportunities in preschools’ daily schedules through recess, indoor physical
activity and physical activity integrated into academic lessons. Eight preschools were randomly assigned to receive the study’s
physical activity intervention. Teachers in these schools partnered with university-based interventionists across 3 years
to design and implement a flexible and adaptive intervention. The intervention approach included trainings and workshops,
site visits and feedback from intervention personnel, newsletters, and physical activity equipment and materials. Teachers
reported a high acceptability of the intervention. The purpose of this article is to describe the evolution of a multi-component
physical activity intervention in preschools, including (i) a description of the intervention components, (ii) an explanation
of the intervention process and approach, and (iii) a report of teachers’ perceptions of barriers to implementation.
Context:
To date, no reviews have investigated the evidence of tracking of physical activity and sedentary behavior specifically during early childhood (aged 0-5.9 years) or from early childhood to middle childhood (aged 6-12 years). It is important to review the evidence of tracking of these behaviors to determine their stability during the foundational early years of life.
Evidence acquisition:
A literature search of studies was conducted in seven electronic databases (January 1980 to April 2012). Studies were compared on methodologic quality and evidence of tracking of physical activity or sedentary behavior. Tracking was defined as the stability (or relative ranking within a cohort) of behaviors, such as physical activity and sedentary behavior, over time.
Evidence synthesis:
Eleven studies met the inclusion criteria. All studies reporting physical activity outcomes had high methodologic quality; 71% of studies reporting sedentary behavior outcomes had high methodologic quality. Of the tracking coefficients for physical activity, 4% were large, 60% were moderate, and 36% were small. Of the tracking coefficients for sedentary behavior, 33% were large, 50% were moderate, and 17% were small. Overall, there was evidence of moderate tracking of physical activity during early childhood, and from early childhood to middle childhood, and of moderate-to-large tracking of sedentary behavior during early childhood and from early childhood to middle childhood.
Conclusions:
This review highlights the importance of establishing recommended levels of physical activity and sedentary behavior during the early years of life. Based on this review, the following recommendations are made: (1) early childhood should be targeted as a critical time to promote healthy lifestyle behaviors through methodologically sound prevention studies; and (2) future tracking studies should assess a broad range of sedentary behaviors using objective measures.
Although treatment acceptability was originally proposed as a critical factor in determining the likelihood that a treatment will be used with integrity, more contemporary findings suggest that whether something is likely to be adopted into routine practice is dependent on the complex interplay among a number of different factors. The Usage Rating Profile-Intervention (URP-I; Chafouleas, Briesch, Riley-Tillman, & McCoach, 2009) was recently developed to assess these additional factors, conceptualized as potentially contributing to the quality of intervention use and maintenance over time. The purpose of the current study was to improve upon the URP-I by expanding and strengthening each of the original four subscales. Participants included 1005 elementary teachers who completed the instrument in response to a vignette depicting a common behavior intervention. Results of exploratory and confirmatory factor analyses, as well as reliability analyses, supported a measure containing 29 items and yielding 6 subscales: Acceptability, Understanding, Feasibility, Family-School Collaboration, System Climate, and System Support. Collectively, these items provide information about potential facilitators and barriers to usage that exist at the level of the individual, intervention, and environment. Information gleaned from the instrument is therefore likely to aid consultants in both the planning and evaluation of intervention efforts.
Background: The literature on theoretically-based programs targeting healthy nutrition and physical activity in preschools is scarce. Purpose: To pilot test CATCH Early Childhood (CEC), a preschool-based nutrition and physical activity program among children ages three to five in Head Start. Methods: The study was conducted in two Head Start centers (N=75 children, their parents; 9 teachers). CEC was implemented by trained teachers over six weeks in fall 2008. Qualitative data on feasibility and acceptability was collected using post-intervention parent and teacher focus groups and lesson plan evaluation forms. Pre-to-post intervention changes in children's fruit and vegetable intake and physical activity at school were evaluated. Results: Results showed good feasibility and acceptability for the classroom curriculum, activity box and parent tip-sheets. There was a trend towards an increase in children's fruit, 100% fruit juice and vegetable intake and mean minutes of physical activity at school pre-to-post intervention. However, this increase was not significant. Discussion: The CEC program showed good feasibility and acceptability in the study population. Further evaluation of behavioral outcomes using a larger sample and a prospective design is needed. Translation to Health Education Practice: These results provide information important for developing and implementing evidence-based programs in preschools.
To review the published prospective observational studies of the relationship of physical activity and sedentary behavior with the development of overweight and adiposity, with an emphasis on methodologic issues.
Sample size, population studied, length of follow-up, assessment of exposure (physical activity, inactivity, or sedentary behavior), assessment of outcome (relative weight, overweight, % body fatness, adiposity), statistical approach, and main findings were extracted, summarized, and key methodological issues highlighted.
In total, 17 studies of physical activity and 15 studies of inactivity/sedentary behavior were identified; as these were not mutually exclusive, 20 unique studies were reviewed. Results were mixed, with most studies showing an inverse association of physical activity with weight or fatness outcomes and/or a direct association of inactivity/sedentary behavior with weight or fatness outcomes. The effects identified were generally of small magnitude. Imprecise measurement of activity exposures likely weakens the observed relationships. Most studies used a pre-post design and had limited duration of follow-up (< or = 2y). Studies with longer and more frequent follow-up did not always use the most advantageous statistical approach.
On balance, the available evidence from prospective observational studies suggests that increased physical activity and decreased sedentary behavior are protective against relative weight and fatness gains over childhood and adolescence. In addition to improved measurement methods, longer and more frequent follow-up as well as truly longitudinal analysis methods would help establish these important prevention and intervention targets, and identify subgroups or development periods where interventions would likely be effective.
The Interactive Systems Framework (ISF) for Dissemination and Implementation (Wandersman et al. 2008) elaborates the functions and structures that move evidence-based programs (EBPs) from research to practice. Inherent in that process is the tension between implementing programs with fidelity and the need to tailor programs to fit the target population. We propose Planned Adaptation as one approach to resolve this tension, with the goal of guiding practitioners in adapting EBPs so that they maintain core components of program theory while taking into account the needs of particular populations. Planned Adaptation is a form of capacity building within the Prevention Support System that provides a framework to guide practitioners in adapting programs while encouraging researchers to provide information relevant to adaptation as a critical aspect of dissemination research, with the goal of promoting wider dissemination and better implementation of EBPs. We illustrate Planned Adaptation using the JOBS Program (Caplan et al. 1989), which was developed for recently laid-off, working- and middle-class workers and subsequently implemented with welfare recipients.
Physical activity and children with disabilities
- A Fedewa
- H Erwin
- D J Young
- A Alumbaugh
- Fedewa A.