Perceptions of Physical Activity Participation Among Adolescents with Autism Spectrum Disorders: A Conceptual Model of Conditional Participation

Virtual reality as a telerehabilitation strategy for people with autism spectrum disorder during the COVID-19 quarantine scenario: physical activity, motor performance and enjoyment

PURPOSE

People with autism spectrum disorder could benefit from physical activity during the pandemic and COVID-19 restrictions, mainly to maintain adequate physical activity. We aimed to evaluate the feasibility, enjoyment, and potential effect of telerehabilitation using a serious game named 'MoveHero'.

MATERIALS AND METHODS

Registered in Clinical Trials (NCT04402034). We adopted a remotely run Telerehabilitation research design with 44 participants recruited: 22 People with ASD people and 22 non-ASD individuals.

RESULTS

All participants safely participated, 100% adherence to sessions, ∼60% enjoying the task, and significantly improved performance, with better performance for the NA group at most practice moments.

CONCLUSIONS

Our findings support both how to implement a gaming intervention and the need to investigate the efficacy of serious games to motivate moderate intensity physical activity in people with ASD.

Motivation to participate in structured physical activity for autistic youth: A systematic scoping review

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.

Effects of physical activity and exercise-based interventions in young adults with autism spectrum disorder: A systematic review

LAY ABSTRACT

Young adults with autism spectrum disorder over 18 years of age are an underserved population, and there is presently limited evidence examining the effects of physical activity programs in this population. Our review synthesizes the evidence to date from studies that have assessed the effects of physical activity/exercise programs in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 studies that included a total of 763 young adults with autism spectrum disorder. There is the strongest evidence for improvements in physical fitness, followed by motor skills, psychological function, and quality of life following physical activity interventions in young adults with autism spectrum disorder. Specifically, aerobic and resistance training as well as programs focused on movement skill and sport-specific training lead to improved physical fitness and movement performance. Holistic interventions focusing on physical activity, dietary changes, and lifestyle modifications lead to improvements in body composition and quality of life of young adults with autism spectrum disorder. There is presently limited evidence to support the use of exercise/activity programs to improve physical activity levels and core autism symptoms in young adults with autism spectrum disorder. Based on our review results, we also provide practical recommendations for clinicians working with young adults with autism spectrum disorder.

Parents' perceptions: Participation patterns and desires for change for children and adolescents with autism spectrum disorder-A descriptive population-based study from Switzerland

BACKGROUND

Low participation in youth with autism spectrum disorder (ASD) has been reported, but age-related and contextual information is rare.

OBJECTIVE

This study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5-11) and adolescents (age: 12-17) with ASD in Switzerland.

METHOD

A cross-sectional design used the German version of the Participation and Environment Measure-Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change.

RESULTS

Participation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement.

CONCLUSIONS

This study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD.

Neurocognitive Test Performance and Concussion-Like Symptom Reporting Among Adolescent Athletes With Self-Reported Autism on Preseason Assessments

OBJECTIVE

To examine baseline neurocognitive functioning and symptom reporting among adolescents with self-reported autism.

METHOD

Participants in this cross-sectional, observational study were 60,751 adolescents who completed preseason testing. There were 425 students (0.7%) who self-reported an autism spectrum disorder (ASD) diagnosis. Cognitive functioning was measured by Immediate Post-Concussion Assessment and Cognitive Testing and symptom ratings were obtained from the Post-Concussion Symptom Scale.

RESULTS

Groups differed significantly across all neurocognitive composites (p values <.002); effect size magnitudes for most differences were small, though among boys a noteworthy difference on visual memory and among girls differences on verbal memory and visual motor speed composites were noted. Among boys, the ASD group endorsed 21 of the 22 symptoms at a greater rate. Among girls, the ASD group endorsed 11 of the 22 symptoms at a greater rate. Some examples of symptoms that were endorsed at a higher rate among adolescents with self-reported autism were sensitivity to noise (girls: odds ratio, OR = 4.38; boys: OR = 4.99), numbness or tingling (girls: OR = 3.67; boys: OR = 3.25), difficulty remembering (girls: OR = 2.01; boys: OR = 2.49), difficulty concentrating (girls: OR = 1.82; boys: OR = 2.40), sensitivity to light (girls: OR = 1.82; boys: OR = 1.76), sadness (girls: OR = 1.72; boys: OR = 2.56), nervousness (girls: OR = 1.80; boys: OR = 2.27), and feeling more emotional (girls: OR = 1.79; boys: OR = 2.84).

CONCLUSION

Students with self-reported autism participating in organized sports likely experience a low degree of functional impairment, on average. If they sustain a concussion, their clinical management should be more intensive to maximize the likelihood of swift and favorable recovery.

Evaluation of Skipping in College Students with and without Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) demonstrate motor skill deficits in comparison to their neurotypically developing peers. However, it is unknown whether these motor skill deficits persist into adulthood. We evaluated skipping kinematics and motor performance in college students with and without ASD. We collected kinematic data from 20 college students, 10 with ASD and 10 without ASD, using a 12-camera three-dimensional motion capture system while participants completed three skipping trials. We scored skipping performance using Everyone Can! and the Halverson Developmental Sequences for Skipping, and we processed data using Cortex, Visual 3D, and MATLAB. We extracted data for center of mass excursion, peak velocity of joint extension, and peak joint angles of the hip, knee, and ankle of the dominant leg. Independent t-tests and Mann-Whitney U tests were used to examine differences between groups with an alpha level of p ≤ 0.05. We found no statistically significant differences for peak sagittal plane joint angles, velocities, or vertical center of mass excursion. However, the ASD group demonstrated greater medio-lateral center of mass displacement (ASD M = .08, SD = .1 m; Control M = .03, S = .03 m; p = .026) and greater frontal plane knee excursion (ASD M = 11.49, SD = 6.23°; Control M = 5.29, SD = 2.44°; p = .01) than participants without ASD. Similarly, the ASD group performed less proficiently in skipping than the group without ASD, as assessed by the developmental scoring methods (Everyone Can! composite score medians [interquartile range]: ASD M = 10.5, SD = 8; Control M = 15.0, SD = 0, p = .008). Despite many similarities in skipping kinematics between groups, participants with ASD were less proficient in skip performance than participants without ASD. Interventions for individuals with ASD addressing skipping proficiency or the performance of other locomotor skills, such as running and jumping, may promote participation in activities that involve complex motor skills and help individuals with ASD lead more physically active lives.

A randomized cross-over trial investigating the neurocognitive effects of acute exercise on face recognition in children with autism spectrum disorder

Difficulties in face recognition contribute to social-cognitive problems in autistic children. Evidence on behavioral interventions targeting this cognitive domain is limited. In non-autistic individuals, a single exercise session is known to elicit temporary benefits for several cognitive functions. Our study investigates whether acute aerobic exercise influences face recognition in autistic children. In a randomized order, 29 participants completed a 20-min moderately-intense cycling bout on an ergometer and a control condition. Before and after each condition, participants categorized Mooney faces and instruments during a computerized cognitive task. Simultaneously, the N170 component of event-related potentials and pupil size were recorded using electroencephalography and eyetracking, respectively. As indicated by a greater increase of reaction time in the exercise compared to the control condition, the results revealed impaired face recognition following aerobic exercise. This effect was accompanied by a lower decrease of the positive N170 amplitude and a trend towards a greater constriction of the pupil size in the exercise compared to the control condition. Our findings highlight the interplay of the physiological state and face recognition in autistic children. Exercise-induced impairments in this social-cognitive ability may be due to an interference with the learning effect that is typically seen for the structural encoding of faces.

Investigating Strategies Used to Foster Quality Participation in Recreational Sport Programs for Children With Autism Spectrum Disorder and Their Perceived Importance

Quality experiences in sport programming for children with autism spectrum disorder (ASD) can promote physical and psychosocial benefits and long-term quality participation (QP). Unfortunately, children with ASD often experience sport participation barriers and, consequently, participate less in sport compared with children without disabilities. This study investigated QP priorities and strategies that could foster QP for children with ASD. Caregivers (n = 13), volunteers (n = 26), and staff (n = 14) involved in sport programming for children with ASD rated experiential elements of QP using the Measure of Experiential Aspects of Participation. In addition , a two-round Delphi survey with staff (Round 1: n = 11; Round 2: n = 13) generated 22 strategies for promoting QP-each rated highly with regard to importance (5.69-6.85 on a 7-point scale). Strategies were substantiated with published research evidence. Findings informed the development of a QP tool designed to help instructors implement identified strategies in hopes of improving sport experiences for children with ASD.

Feasibility of Using Q-Sort to Map Conditional Participation in Physical Activity in Adolescents With Autism Spectrum Disorder

BACKGROUND

Participation in physical activity among adolescents with autism is often conditional. However, there is a lack of methods for identifying these specific conditions. Therefore, the purpose of this study was to develop and investigate the feasibility of a Q-sort tool to map individual-specific conditions for participation in physical activity among adolescents with autism and to identify different viewpoints regarding conditions for such participation.

METHOD

An exploratory mixed-methods design was employed to investigate the feasibility of using Q methodology and the Q-sort procedure to identify what individual-specific conditions are important for participation in physical activity for adolescents with autism.

RESULTS

The adolescents ranked the statements with varying levels of ease. Two viewpoints were identified: Autonomous participation without surprises and Enjoyment of activity in a safe social context.

CONCLUSION

Q-sort is a feasible method for mapping conditions for participation, which can guide the development of tailored physical activity interventions.

Facilitators and Barriers to Physical Activity Involvement as Described by Autistic Youth with Mild Intellectual Disability

Objectives

Physical activity involvement among autistic youth and youth with an intellectual disability is significantly lower than the general population. Few studies have included youth with comorbid diagnoses of ASD and intellectual disability. Fewer studies collect information from the youth themselves. This study examined barriers and facilitators to physical activity in autistic youth with mild intellectual disability using semi-structured interviews with youth and through caregiver reports.

Methods

Fourteen caregivers and their children ages 8 to 16 years old participated. Caregivers completed a questionnaire about their thoughts on their child's physical activity while their children completed the semi-structured interview. A descriptive phenomenological approach was followed.

Results

Four themes were inductively identified: intrapersonal barriers (factors that are within the person which impede physical activity involvement, such as exhibiting challenging behaviors that inhibit engagement), interpersonal barriers (factors external to the person, such as lack of community support), intrapersonal facilitators (factors within the person that enhance physical activity involvement, such as being intrinsically motivated to improve skills), and interpersonal facilitators (external factors such as supports from caregivers).

Conclusions

Interviewing youth is important to capture a holistic picture of factors influencing physical activity. Future research may focus on implementing and assessing the efficacy of strategies to address the barriers facing youth diagnosed with ASD and intellectual disability.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41252-022-00310-5.

Effect of Longitudinal Practice in Real and Virtual Environments on Motor Performance, Physical Activity and Enjoyment in People with Autism Spectrum Disorder: A Prospective Randomized Crossover Controlled Trial

(1) Background: People with ASD commonly present difficulty performing motor skills and a decline in physical activity (PA) level and low enjoyment of PA. We aimed to evaluate whether longitudinal practice of an activity in virtual and real environments improves motor performance and whether this improvement is transferred to a subsequent practice when changing the environment, promoting PA and providing enjoyment; (2) Methods: People with ASD, aged between 10 and 16 years, were included and distributed randomly into two opposite sequences. The participants performed a 10 session protocol, with five sessions practicing in each environment (virtual or real). Heart rate measurement was carried out and an enjoyment scale was applied; (3) Results: 22 participants concluded the protocol. Sequence A (virtual first) presented an improvement in accuracy and precision and transferred this when changing environment; they also had a greater change in heart rate reserve. The majority of participants reported "fun" and "great fun" levels for enjoyment; (4) Conclusions: The virtual reality activity presented a higher level of difficulty, with greater gains in terms of transference to the real environment. Considering PA, our task provided very light to light activity and the majority of participants enjoyed the task.

Physical activity correlates in children and adolescents with autism spectrum disorder: a systematic review

PURPOSE

This systematic review examined correlates of physical activity (PA) at all levels of the socio-ecological model (i.e., intrapersonal, interpersonal, environmental and policy level) in children and adolescents with autism spectrum disorder (ASD).

MATERIALS AND METHODS

Major electronic databases were searched from inception until March 23^rd, 2021. A summary coding was used to analyze the data for children (3-12 years) and adolescents (13-18 years) with ASD separately.

RESULTS

Out of the 79 potential PA correlates, retrieved from 32 studies (991 657 children; 3857 adolescents), only five correlates were consistently examined as a PA correlate (i.e., examined in four or more studies) in children and adolescents with ASD. Only age was inversely associated with PA in children and adolescents with ASD. Data on gender, body mass index, autism severity level and day of the week being physically active in children with ASD were mixed.

CONCLUSIONS

We only found consistent evidence for age being inversely related to PA. Our review indicates that more research is needed to explore intrapersonal, interpersonal, environmental and policy-related correlates of PA in children and adolescents with ASD.IMPLICATIONS FOR REHABILITATIONRehabilitation programs should take into account that in particular older children and adolescents with autism spectrum disorder are at risk for physical inactivity.Boys and girls with autism spectrum disorder need the same care when motivating them to be more physically active.

Instructors' Perspectives of Social and Motor Influences on Participation in Children With Autism Spectrum Disorder

Participation is key to childhood development and is essential for health and well-being; yet children with Autism Spectrum Disorder (ASD) participate less in social and physical activities compared to their typically developing peers and little is known about how social and motor challenges impact participation patterns. Purpose: The current research garnered experiential insights of the quality and quantity of participation, through the lens of instructors (N = 9) working with a child or children with ASD. Method: Semi-structured qualitative interviews were conducted to capture a comprehensive and informative profile of how social and motor functioning of children with ASD influence involvement in social and physical activities. Results: Thematic analysis revealed consistent viewpoints in four main areas: (1) Viewpoints extend beyond the World Health Organization definition of participation; (2) Participation depends on who is involved; (3) Although motivation, confidence, and competence in social/motor domains underlie participation, social challenges were perceived as the greatest barrier; (4) While acknowledging the benefits of participation, it is necessary to be cognizant of the required supports. Throughout these themes, the notion of heterogeneity was made very clear. Conclusion: Collectively, perspectives offer descriptive insight which may be useful when designing opportunities for participation in social and physical activities among children with ASD.

A Systematic Review and Meta-Analysis of Moderate-to-Vigorous Physical Activity Levels in Children and Adolescents With and Without ASD in Inclusive Schools

Background: The health benefits of physical activity (PA) participation are well-documented. Little was known about the PA levels of students with autism spectrum disorder (ASD) and their typically developing (TD) peers in inclusive schools. This study aimed to synthesize available studies examining PA levels of children and adolescents with and without ASD and its associated factors that affected their PA participation during inclusive schools applying the social-relational model of disability (SRMD). Methods: Eight databases were searched including CINAHL Complete, SPORTDiscus with Full Text, PubMed, Embase, Web of Science, Eric, APA PsycINFO, and Scopus from inception through May 2021 to identify related studies. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. The McMaster Critical Reviewer Form for quantitative studies was used to evaluate the methodological quality of the included articles. Results: A total of seven articles were included in this systematic review. Overall, meta-analysis results indicated that children and adolescents with ASD had a moderately decreased PA levels compared with their TD peers [SMD = -0.585, 95% CI (-0.774, -0.425), p < 0.01]. Individual-, social-, and environmental-level factors that influence PA levels in children and adolescents with ASD were identified from the perspective of SRMD. Conclusion: This review indicates that children and adolescents with ASD have lower PA levels than their TD peers in inclusive schools and multilevel factors affect their PA.

The Impact of Anxiety on the Participation of Children on the Autism Spectrum

Anxiety is common in children on the autism spectrum, however its impacts are not fully understood. Participation is an important outcome, linked to the health and wellbeing of children. This study examined the relationship between anxiety and participation using parent reports for 131 children on the autism spectrum, aged 6-13 years. Hierarchical multiple regressions explored child and family factors in relation to participation in Home and Community settings. Anxiety was a unique, significant predictor of the frequency of children's participation (but not involvement in activities) in both settings, when controlling for autism characteristics, communication skills and family income. Anxiety symptomatology may contribute to the less frequent participation of children on the autism spectrum in home and community activities.

Health Factors, Sociability, and Academic Outcomes of Typically Developing Youth and Youth with Autism Spectrum Disorder: A Latent Class Analysis Approach

To identify profiles of both typically developing (TD) children and children with autism spectrum disorder (ASD) based on health indicators, and academic/social engagement. Latent class analysis was conducted to identify profiles of children from the 2016 National Survey of Children's Health, based on physical activity, screen time, sleep, and academic/social engagement. A three-profile solution was the best fitting model, with children in profile 3 characterized as having excellent health, and academic/social outcomes, compared to profiles 1 and 2. Compared to TD youth, a greater percentage of youth with ASD fit into the poorer health profiles. Studies should examine whether health interventions for youth with ASD can improve factors, such as academic engagement and social interaction.

Experiences of stakeholder collaboration when promoting participation in physical activity among adolescents with autism spectrum disorder

PURPOSE

Various stakeholders contribute to the development of healthy physical activity habits in adolescents with autism spectrum disorder (ASD). Parents and stakeholders seek collaborative actions but little is still known about such efforts. The purpose of this study was thus to explore how professionals from different services experience stakeholder collaboration when promoting participation in physical activity for these adolescents.

METHOD

Five focus group discussions were held with 17 professionals from education, health care, community, and sports organizations, engaged in the promotion of physical activity in adolescents with ASD. The data were analyzed with qualitative content analysis.

RESULTS

The discussions revolved around a central theme: Collaboration is needed to promote physical literacy among adolescents with ASD. The professionals though experienced that this collaboration was hampered by the low priority given to physical activity issues within different organizations, by limited resources, lack of knowledge, and unclear roles.

CONCLUSIONS

Notwithstanding the professionals' different roles, all agreed that physical activity issues need to be prioritized and that each stakeholder needs to acknowledge the shared responsibility of collaboration. However, more clear routines for collaboration that include joined efforts but also highlight the organization-specific responsibilities might enhance the collaborative efforts.IMPLICATIONS FOR REHABILITATIONIn-depth understanding of both the adolescents' needs and the environments in which physical activity is promoted is required if participation in physical activity among adolescents with ASD is to be enhanced.Families and professionals within different organizations need to be supported to collaborate when mapping and meeting the adolescents' physical activity needs.Issues regarding developing physical activity habits need to be prioritized.Professionals, such as education, health, and community professionals who are important for the promotion of healthy physical activity habits need to be included in multi-stakeholder meetings.

Evaluation of Overhand Throwing Among College Students With and Without Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) typically demonstrate deficits in gross motor skills such as the overhand throw. It has not been determined whether such deficits persist into adulthood. Therefore, the purpose of this study was to examine the kinematics and developmental level of overhand throws among young adults with and without ASD. Three-dimensional motion-capture data were collected during overhand throwing trials performed by 20 college students (10 students with ASD). Individuals with ASD demonstrated similar throw duration, stride length, and step width but a longer acceleration phase and slower ball velocity than individuals without ASD. Young adults with ASD also performed the overhand throw with less developmental proficiency than those without ASD. Specifically, individuals with ASD exhibited developmental deficits in the backswing and composite throwing score. Motor skill interventions for individuals with ASD should address throwing skills, with a particular focus on the preparatory phase of the overhand throw.

Parents' perceptions and concerns about physical activity participation among adolescents with autism spectrum disorder

The parents of adolescents with autism spectrum disorder have a vital and proactive role in encouraging healthy physical activity habits, and they possess important knowledge about the adolescents’ needs when it comes to enhancing participation in physical activity. But promoting healthy physical activity habits in adolescents can be difficult. The purpose of this study was thus to describe parents’ perceptions of their adolescent child’s participation in physical activity and to describe the parental role in promoting such participation. Twenty-eight parents of adolescents aged 12–16 years with autism spectrum disorder were interviewed. The interviews were analyzed using an inductive content analysis approach. The parents described how challenging participation in physical activities could be for their adolescents. Despite this, they wanted to see their children participate more in physical activity but found the promotion of physical activity to be an overwhelming task that was difficult to cope with on their own. The results reveal a need for support and collaborative efforts among different actors to give these issues increased priority in order to promote the adolescents’ physical activity participation.

Exploring Caregiver Perspectives of Social and Motor Skills in Children With Autism Spectrum Disorder and the Impact on Participation

Participation is a key aspect of quality of life and is essential for children's well-being, yet children with disabilities are at risk for lower participation in social activities. For children with autism spectrum disorder (ASD), social skills may present a significant obstacle for participation in activities of daily life; however, motor skill development may also serve an important contributing factor. Nevertheless, the link between social and motor skills in children with ASD is not fully understood. The current research implemented semistructured interviews to garner descriptive insights from caregivers (N = 17) into the social and motor skills of 5- to 9-year-old children with ASD and the impact on participation in social activities. A constant comparative method was used to generate a coherent and thematic representation of caregivers' experiences. Thematic analysis revealed core consistencies in three areas: (1) caregivers viewed participation differently than their children; (2) participation levels of children with ASD are context specific; (3) challenges with social skills were perceived to present a greater obstacle to participation than motor skills. Overall, the notion that ASD is a heterogeneous disorder was made very apparent. Although caregivers believe there to be immense value in current treatment and intervention options, the availability and access to such options was a major barrier. The effectiveness of intervention programming designed to increase participation is contingent on understanding factors that affect participation. Implications concerning caregivers' perspectives are discussed.

Accelerometer-measured physical activity levels in children and adolescents with autism spectrum disorder: A systematic review

Associations between physical activity (PA) and health benefits are well documented. Evidence indicates that children and adolescents with autism spectrum disorder (ASD) are less physically active than their typically developing peers. The purpose of this systematic review is to provide a comprehensive summary of the PA levels of children and adolescents with ASD and the associated factors that affect their PA levels by applying a socio-ecological model (SEM). Seven databases (PubMed, CINAHL, SPORTDiscus with Full Text, MEDLINE, EMBASE, ERIC, and PsychINFO) were searched in June 2019 to identify studies examining accelerometer-measured PA and factors affecting the PA levels of children and adolescents with ASD, aged 6-17 years. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. Twenty-one studies were included in the detailed review. Only 42% of the participants met the PA guidelines (i.e., children and adolescents aged 5-17 years should do at least 60 min of moderate to vigorous PA daily). By applying the SEM, multi-level factors ranging from intrapersonal to community levels that positively or negatively influenced PA levels in children and adolescents with ASD were identified. This review indicates that children and adolescents with ASD have low PA levels, and that there are multi-level factors that affect their PA. There is a pressing need to design effective PA interventions that promote activity accrual in the school, family, and community settings for children and adolescents with ASD.

Adaptive Behavior Moderates Health-Related Pathways in Children with Autism Spectrum Disorder

The purpose of this study was to examine the moderating role of adaptive behavior on the pathways connecting motor competence, physical activity, and health-related fitness in 7-12 year old children with ASD (N = 27). Results demonstrate that motor competence and health-related fitness were positively related (r = .42, p < .05), and this relationship was moderated by adaptive behavior. Specifically, we found that motor competence and health-related fitness were significantly related for those participants scoring approximately one or more standard deviations below the mean on adaptive behavior. No other significant pathways were present. Implications of these associations and directions for future research are discussed.

Physiotherapists' experiences of the meaning of movement quality in autism: a descriptive phenomenological study

Introduction: Movement quality, represented in unrestricted movements, flow and pleasure, is often lacking in people with autism. One aspect is the non-verbal expression of the present emotional and psychological state of an individual.Purpose: To describe the meaning of movement quality in autism, as experienced by specialized physiotherapists.Method: Ten physiotherapists were interviewed. The data were recorded, transcribed verbatim, and analyzed using Giorgi᾽s descriptive phenomenological method.Findings: The general structure of movement quality in people with autism included eight key constituents: 1) reduced postural control; 2) deviant muscle tone and tension; 3) deviant sensory processing; 4) a lack of conscious awareness; 5) difficulties with body boundaries; 6) coordinating movements (including breathing); 7) lack of anticipatory preparations of movements; and 8) need of cognitive thoughts to control movements.Conclusions: This study provide an understanding of how movement quality in people with autism is expressed. Their lived bodies constantly need to protect themselves from sensory impressions from within or the surroundings, causing emotional distress and obscuring the meaning of their movements. Their bodily expression becomes restrained, fragmented, and hesitant. Understanding movement patterns and emotional reactions following their struggle with movements may facilitate constructive interaction and communication, which give important implications when designing physiotherapy interventions.

Moderating effect of social interaction on enjoyment and perception of physical activity in young adults with autism spectrum disorders

Background: Young adults with autism spectrum disorder (ASD) are at increased risk for a sedentary lifestyle and its associated health problems. In neurotypical (NT) individuals, social participation and enjoyment are related to physical activity engagement. Exergaming has been shown to increase energy expenditure compared to traditional video games and is an effective option for community-based recreation. Methods: We measured physiological and psychological responses of young adults with ASD to exergaming under varying conditions and sought to determine whether playing alone versus with a partner influenced physical activity level and/or experience in NT young adults (n = 18) and those with ASD (n = 18). Results: Both ASD and NT groups experienced high enjoyment and perceived exertion while exergaming. Perceived exertion was moderated by enjoyment when young adults with ASD played with a partner, reporting less effort despite actually expending more energy. Conclusion: Social interaction may lead to increased intensity and duration of physical activity for individuals with ASD. Exergaming is a socially acceptable and age-appropriate exercise modality for this group and likely represents a cost-effective and accessible way to incorporate physical activity and social interaction into their daily lives.

Participation profiles and the barriers and facilitators that impact on participation of children with Autism Spectrum Disorders living in regional and remote Western Australia

BACKGROUND

Autism Spectrum Disorder (ASD) is a heterogeneous condition, influencing participation in activity and occupation. Approximately, 1% of Australian children have an ASD diagnosis, with many of these families living in remote and regional areas. Given the environments role in facilitating or hindering participation, there is a need to understand how geographical location impacts the participation profiles of children with ASD.

OBJECTIVE

This study aims to describe the participation profiles, and environmental barriers and facilitators to participation for children with ASD living in regional or remote Western Australia.

METHODS

A total of 32 families completed a questionnaire pack including a socio-demographic questionnaire and the Participation and Environment Measure - Children and Youth.

RESULTS

Children with ASD had reduced participation in community activities. Within the home, children most commonly participated in computer and video games, and in school settings, children participated rarely in non-classroom and extracurricular activities. Parents reported a desire for their children to decrease time spent engaging in video games and increase time spent in the community, socializing, engaging in extracurricular activities, and completing chores. Parents reported a number of barriers to participation across community, home, and school settings.

CONCLUSION

Children with ASD living in regional areas had restricted participation profiles and a number of barriers to participation as reported by their parents. There is a need for additional support and services in non-metropolitan areas for families of children with ASD to increase participation. This study also highlights the need to expand the definition of participation in the International Classification of Functioning, Disability and Health to include aspects of involvement.

Supporting and hindering environments for participation of adolescents diagnosed with autism spectrum disorder: A scoping review

The influence of a person's environment and its modifying potential on participation is well recognized for most childhood disabilities, but scarcely studied for adolescents with autism spectrum disorder (ASD). A scoping review was conducted, the aim of which was to map the existing literature about supporting and hindering environments for the participation of adolescents with ASD. Sources of scientific evidence were searched for in four databases. Inclusion criteria were the perspectives of adolescents between 12 and 21, families, peers, or significant others; ecologic validity; and a clear connection between environment and participation. The publication dates ranged from 2001 to 2014 and partly up to 2018. The International Classification of Functioning, Disability and Health (ICF) served as the guiding framework for inclusion/exclusion during the selection process. Thematic analysis was performed by five independent reviewers. Results were additionally validated by stakeholders. This scoping review identified 5528 articles, and finally included 31 studies. Two main themes were found: "providing security" indicates how the environment, and specifically the parental, physical, and informational environments, have a securing or intimidating effect. The second theme, "helping to connect", indicates which environments support or hinder social relationships or social activities, and hence participation. An additional third main theme, "tension in participation", relates to ambiguities that seem essential to understand participation or isolation of adolescents with ASD. Results show that participation is a value-laden concept. This research widens the field of dealing with adolescents with ASD, as it directs attention towards the responsibility of the environment regarding participation.