Accelerating Motor Skill Acquisition for Bicycle Riding in Children with ASD: A Pilot Study

Exploring Adaptive Cycling Interventions for Young People with Disability: An Online Survey of Providers in Australia

Adapted cycles offer young people with disability a fun way to participate in over-ground cycling, but little is known about current practices to train and sustain cycling in this group. This study aimed to describe interventions used to introduce adaptive cycling to young people with disability and explore barriers and facilitators to adapted cycle use. A cross-sectional online survey was distributed among Australian allied health, education and recreation providers through targeted advertizing and snowball methods. Data were analysed using mixed methods and reporting was guided by the CHERRIES and CROSS checklists. There were 107 respondents with n = 90 (84.1%) who fully completed the survey. Respondents worked with riders who had cerebral palsy, neurodevelopmental disabilities and movement impairments. Adaptive cycling interventions were customized according to a rider's goals, needs and resourcing. The training of cycling skills included "an eclectic mix" of experiential learning, individual goals, task-specific training and holistic practice models. Diverse factors impacted cycling participation, with opportunities reliant on access to a supportive environment, including a suitable adapted cycle. This study found that providers viewed adaptive cycling as a therapeutic or active leisure experience within protected traffic-free environments. Strategies to extend adaptive cycling opportunities into the community are required.

Policy brief: adaptive cycling equipment for individuals with neurodevelopmental disabilities as durable medical equipment

- Durable medical equipment (DME) policies require that the equipment be medically necessary; however, adaptive cycling equipment (bicycles and tricycles) are usually not deemed medically necessary. - Individuals with neurodevelopmental disabilities (NDD) are at high risk for secondary conditions, both physical and mental, that can be mitigated by increasing physical activity. - Significant financial costs are associated with the management of secondary conditions. - Adaptive cycling can provide improved physical health of individuals with NDD potentially reducing costs of comorbidities. - Expanding DME policies to include adaptive cycling equipment for qualifying individuals with NDD can increase access to equipment. - Regulations to ensure eligibility, proper fitting, prescription, and training can optimize health and wellbeing. - Programs for recycling or repurposing of equipment are warranted to optimize resources.

Parent perceptions of cycle training for children with special education needs and disabilities: What drives intention to cycle?

Background

Young people with Special Educational Needs and Disabilities (SEND) are especially vulnerable to physical inactivity. Research has demonstrated the effectiveness of tailored cycle training for children with SEND, however, it is unclear whether this then results in a greater uptake of cycling.

Aims

To determine parent based perceptions of a SEND cycle training programme, factors which predict intention to cycle more and ongoing barriers to cycling.

Methods

A tailored questionnaire was distributed to parents of children who took part in the cycle training.

Results

Parents reported increased confidence in their child's ability to cycle independently with many also highlighting improvements in confidence and resilience. The outcome of the cycle training (level of enjoyment and change in cycling ability) had a positive influence on intention to cycle more while cycling frequency prior to training had a negative influence. Continuing barriers to cycling were identified which included difficulties accessing specialised equipment and a need for additional on-road cycle training.

Conclusions and implications

This study demonstrates the success of a specialised cycle training programme for children with SEND in terms of improvement to cycling and influences on the intention to cycle more.

Impact of adapted bicycle riding on outcomes for children and adolescents with disabilities: A systematic review

AIM

To review the evidence for the effects of adapted bicycle riding on body structures and functions, activity, participation, and quality of life outcomes in children with disabilities, along with family-level participation outcomes.

METHOD

A systematic review with searches of nine electronic databases to identify studies involving participants with a developmental disability aged 4 to 18 years who used a dynamic adapted bicycle was completed in August 2021. Risk of bias was assessed based on individual study designs. A narrative synthesis integrated the findings of the included studies. Certainty of evidence was synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

Ten studies were included with 234 participants. Five studies reported outcomes at the body structures and functions level, ten reported activity-level outcomes, two reported participation-related outcomes, and none assessed quality of life or family participation in social and recreational activities.

INTERPRETATION

Adapted bicycle riding interventions may improve gross motor function, enhance lower-limb muscle strength, and promote physical activity; however, certainty of evidence of effects was rated very low using GRADE. Further research is required to understand the impact of adapted bicycle riding on the participation outcomes of children and adolescents with disabilities and on family-level participation in social and recreational activities.

WHAT THIS PAPER ADDS

Adapted bicycle riding interventions may improve motor functions and physical activity. Evidence about participation outcomes after adapted bicycle riding is limited. Research on adapted bicycle riding interventions in natural settings is needed.

Strategies to Support Learning of Gross Motor Tasks in Children with Autism Spectrum Disorder: A Scoping Review

AIMS

Children with autism spectrum disorder (ASD) display motor difficulties that may impact social and communication interactions and participation in everyday activities. These difficulties may be related to a difference in the way they learn new skills. Therefore, strategies to support motor learning to optimize skill acquisition and retention may be beneficial. This scoping review described current motor learning strategies used to optimize acquisition, retention, transfer, and generalizability of motor tasks in children with ASD.

METHODS

Three databases were searched from inception through 2021. Studies were included if they involved participants with ASD ≤ 18 years old, evaluated learning of a novel gross motor task, manipulated a motor learning variable, and were written in English.

RESULTS

Twenty-two articles met eligibility criteria. Most articles examined strategies that manipulated the instruction of task, with few articles examining feedback or practice. Skill acquisition was the most represented motor learning outcome, with fewer studies examining retention, transfer, or generalizability.

CONCLUSIONS

Positive results in 95% of the articles suggest that the use of support strategies to optimize motor learning is feasible and beneficial for children with ASD, and that modifications to instruction, feedback, and practice schedules should be considered in motor interventions.

It’s Not Just about Bicycle Riding: Sensory-Motor, Social and Emotional Benefits for Children with and without Developmental Disabilities

Background: A developing area for therapy is teaching children to ride a bicycle. Little has been written about the effectiveness of these programs. This study explored outcomes from participation in a novel bicycle riding program for children with a wide array of developmental challenges. Method: Two studies were conducted; a nonconcurrent, multiple baseline design with four participants and a pretest–posttest single group with 15 children. Results: Study 1 participants improved on broad jump. Balance positions showed variable responses. Study 2 participants showed significant improvement on broad jump, and a trend toward significance walking forwards and backwards. Parents reported improvement in following rules, participating in daily routines, interacting with peers, and feeling good about him/herself and a change in child’s participation in community and extracurricular activities. All children improved in glide time or achieved independent riding. Conclusions: Preliminary evidence was found for the effectiveness of one approach for developing motor and social skills within the context of learning to ride a bicycle. Children over the age of 6 years were able to ride a two-wheeled bicycle at the end of the program. Participation suggested improvement in motor coordination and dynamic balance as well as changes in measures of social interaction and self-esteem.

Improving Executive Function of Children with Autism Spectrum Disorder through Cycling Skill Acquisition

PURPOSE

Executive dysfunction has been widely reported in children with autism spectrum disorder (ASD). Although studies have clearly documented the cognitive benefits of physical exercise on cognition in children, similar studies in children with ASD are scarce. The purpose of this study was to compare the effect of cognitively engaging exercise and noncognitively engaging exercise on executive function in children with ASD.

METHODS

Sixty-two children diagnosed with ASD (50 males and 12 females, Mage = 9.89 ± 1.53 yr, Mheight = 1.43 ± 0.15 m, and Mweight = 44.69 ± 11.96 kg) were randomly assigned into three groups: learning to ride a bicycle (n = 22), stationary cycling (n = 20), and control (n = 20). Four executive function components (planning, working memory, flexibility, and inhibition) were assessed.

RESULTS

Results revealed significant improvements in all executive function components in the learning to ride a bicycle group (Ps < 0.05) but not in the other two groups after controlling for age and IQ.

CONCLUSION

Our findings highlight the value of cognitive engagement in exercise programs designed to improve cognition in children with ASD.

Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review

PURPOSE OF REVIEW

This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD).

RECENT FINDINGS

Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.

Can a Community-Based Football Program Benefit Motor Ability in Children with Autism Spectrum Disorder? A Pilot Evaluation Considering the Role of Social Impairments

This non-randomised pilot study evaluated the impact of a community football program on motor ability in children aged 5-12 years with autism spectrum disorder. Sixteen children were evaluated at baseline-and-post attendance in a football program for a varied number of weeks and compared to 19 children engaging in treatment-as-usual. Primary analyses indicated a statistically significant increase in total MABC-2, aiming and catching, and balance scores for the intervention group, with no changes in scores in the comparison group. There were no changes in manual dexterity across either group. At a between group level, the changes in aiming and catching scores were significantly greater for the intervention group. Further analyses highlighted the potential importance of social impairments regarding aiming and catching.

Efficacy of Lower Extremity Cycling Interventions for Youth with Intellectual Disabilities: A Systematic Review

PURPOSE

To systematically examine the efficacy of lower extremity cycling interventions for youth with intellectual disability (ID).

METHODS

Seven databases were searched from March 2000 to October 2019 for English-language articles on cycling interventions for youth with ID. The American Academy of Cerebral Palsy and Developmental Medicine guidelines were used for assigning levels of evidence and grading study quality.

RESULTS

Eight articles met inclusion criteria. Children and young adults, 7-26 years (n = 229), with diagnoses of Down syndrome, autism spectrum disorder, or unspecified ID participated in the studies. Moderate evidence (one level II single subject design study) suggests that a specific cycling intervention can improve two-wheeled cycling skills in youth with ID. Weak evidence (level II group studies) supports stationary cycling for short-term improvements in cognitive skills and two-wheeled riding intervention for increasing physical activity one-year after intervention.

CONCLUSIONS

Moderate to weak evidence exists to support two-wheeled cycling instructional programs or stationary cycling interventions for children and young adults with intellectual disabilities. Therapists can use this information when discussing cycling interventions for individuals with ID. Further research is needed to inform therapists in clinical decision-making related to dosing cycling interventions.

Social Skill Outcomes Following Physical Activity-Based Interventions for Individuals on the Autism Spectrum: A Scoping Review Spanning Young Childhood Through Young Adulthood

Researchers posit that physical activity (PA) settings may provide an increased opportunity for social interaction. However, little consensus exists regarding the construct of social skills. Moreover, little is known about what type or amount of PA is necessary for individuals on the autism spectrum to benefit from this increased interaction. Thus, this scoping review synthesized the components (e.g., design, participants, independent and dependent variables, etc.) and findings of PA-based interventions that included social skill components to identify how interventions have incorporated these skills in different settings. Based on a review of 25 articles, this review revealed a great deal of variability in the types of PA, social skills, and instruments studied, as well as the intensity of intervention delivery in the published findings. No longitudinal studies were identified as a part of the search. These results provide a foundation for the design of effective PA-based interventions that may have an increased impact on the social skills of individuals on the autism spectrum. Future research should employ longitudinal designs to capture the relationship between social skills and PA, as well as to increase the likelihood of capturing change.