The Effect of Different Intervention Approaches on Gross Motor Outcomes of Children With Autism Spectrum Disorder: A Meta-Analysis

Have the Fundamental Movement Skills of U.S. Children Changed?

Purpose: By using four national data sets, this study aimed to examine the changes in U.S. children's fundamental movement skills (FMS) from 1985 to 2019. Method: Three Tests Gross of Motor Development (TGMD) normative studies, i.e. TGMD-1 (N = 909, male% = 50), TGMD-2 (N = 1143, male% = 50) and TGMD-3 (N = 864, male% = 51), and the TGMD-2 data of the 2012 NHANES National Youth Fitness Survey (NNYFS-2012; raw N = 352, national represented population = 12,509,706, male% = 51) were used for analyses. Each item in TGMD-2/NNYFS and TGMD-3 was carefully examined, and these that did not match to TGMD-1 were deleted. Cohen's D effect size (ES) was utilized for the difference among year-to-year comparisons. Result: From 1985 to 2000, FMS in US children of 3-7 years old (90% increase & 10% no change) increased temporarily, but remained stable (17% increase & 83% no change) among 8-10 years old. Between 2000 and 2019, however, U.S. children began to demonstrate a slight/stable drop in FMS among 3-5 years old (22% decrease & 78% no change), and a distinct decline among 6-10 years old (80% decrease & 20% no change). While children with normal BMI showed the highest FMS score, the direct cause of reduction in FMS is still unknown. Conclusion: An overall up-and-down change was observed in U.S. children's FMS between 1985 and 2019, and more longitudinal studies with FMS-related variables are needed.

Equine-assisted services for motor outcomes of autistic children: A systematic review

LAY ABSTRACT

Equine-assisted services use various aspects of horses, like their movement, warmth, and size, to enhance individuals' overall well-being. Many studies have underscored the positive impact of equine-assisted services on autistic children, affecting areas such as social interaction, communication, engagement, stereotypical behaviors, and motor functions. Given the growing recognition of motor functions as clinical specifiers in autism, it is imperative to specifically investigate how equine-assisted services influence these outcomes. To address this, we conducted a systematic review to synthesize existing literature on the effects of equine-assisted services on motor outcomes of autistic children. Our review encompassed study characteristics, features of equine-assisted service interventions, and major motor outcomes. We also evaluated the methodological quality of the equine-assisted service studies to offer insights for future research directions. Through thorough database searches and the use of the standardized procedure of conducting a systematic review (The Preferred Reporting Items for Systematic Reviews and Meta-analyses), 12 research studies were identified and included. These studies reported the effects of various equine-assisted service types (such as therapy, horsemanship, or learning) on motor outcomes of autistic children. Significant enhancements in coordination, strength, balance, posture, and overall motor skills indicate the effectiveness of equine-assisted services in improving motor outcomes of autistic children. Building on these findings, we provide recommendations for future research endeavors aimed at enhancing the reliability and validity of using equine-assisted services to improve motor outcomes of autistic children. This work contributes to a deeper understanding of how equine-assisted services can benefit this population and guides the development of more effective equine-assisted service interventions.

Physical Activity Interventions for Improving Cognitive Functions in Children With Autism Spectrum Disorder: Protocol for a Network Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects millions of children worldwide, with a current prevalence of approximately 1 in 54 children in the United States. Although the precise mechanisms underlying ASD remain unclear, research has shown that early intervention can have a significant impact on cognitive development and outcomes in children with ASD. Physical activity interventions have emerged as a promising intervention for children with ASD, but the efficacy of different types of interventions remains unclear.

OBJECTIVE

This study protocol aims to update the knowledge on extant literature and explore the efficacy of physical activity intervention strategies on cognitive functions in children with ASD.

METHODS

A systematic review and network meta-analysis (NMA) will be conducted following the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols for Network Meta-Analyses) statement. A total of 9 bibliographic databases (APA PsycInfo, CENTRAL, Dimensions, ERIC, MEDLINE Complete, PubMed, Scopus, SPORTDiscus, and Web of Science) will be systematically searched to screen eligible articles based on a series of inclusion and exclusion criteria. A study will be considered for inclusion if it is not classified as a systematic review with or without meta-analysis, was published from inception to present, includes children aged 0 to 12 years with ASD, quantitively measures cognitive outcomes, and examines treatment comprising at least 1 physical activity intervention strategy. The internal validity and quality of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework. Statistical analyses will be performed in the RStudio software (version 3.6; RStudio Inc) with the BUGSnet package and the Comprehensive Meta-Analysis software (version 3.3; Biostat Inc). The results of our NMA will be illustrated through network diagrams accompanied by geometry and league tables. Further, to rank the interventions based on their efficacy, we will use the surface under the cumulative ranking curve.

RESULTS

Our preliminary search identified 3778 potentially relevant studies. The screening of the studies based on the inclusion and exclusion criteria is ongoing, and we anticipate that the final number of eligible studies will be in the range of 30 to 50.

CONCLUSIONS

This study will provide a comprehensive review of the literature on physical activity interventions for children with ASD and will use NMA to compare the efficacy of different types of interventions on cognitive outcomes. Our findings will have important implications for clinical practice and future research in this area and will contribute to the growing body of evidence supporting the use of physical activity interventions as a key component of early intervention for children with ASD.

TRIAL REGISTRATION

PROSPERO CRD42021279054; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279054.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40383.

Effectiveness of exercise intervention on improving fundamental motor skills in children with autism spectrum disorder: a systematic review and meta-analysis

Background

Autism spectrum disorder (ASD) is a severe public health concern, and most of the children with ASD experience a substantial delay in FMS. This study aimed to investigate the effectiveness of exercise interventions in improving FMS in children with ASD, and provide evidence to support the scientific use of exercise interventions in practice.

Methods

We searched seven online databases (PubMed, Scopus, Web of Science, Embase, EBSCO, Clinical Trials, and The Cochrane Library) from inception to May 20, 2022. We included randomized control trials of exercise interventions for FMS in children with ASD. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database Scale. Stata 14.0 software was used for meta-analysis, forest plotting, subgroup analysis, heterogeneity analysis, and meta-regression.

Results

Thirteen studies underwent systematic review (541 participants), of which 10 underwent meta-analysis (297 participants). Overall, exercise interventions significantly improved overall FMS in children with ASD. Regarding the three categories of FMS, exercise interventions significantly improved LMS (SMD = 1.07; 95% CI 0.73 to 1.41, p < 0.001), OCS (SMD = 0.79; 95% CI 0.32 to 1.26, p = 0.001), and SS (SMD = 0.72; 95% CI 0.45 to 0.98, p < 0.0001).

Conclusion

exercise interventions can effectively improve the FMS of children with ASD. The effects on LMS are considered as large effect sizes, while the effects on OCS and SS are considered as moderate effect sizes. These findings can inform clinical practice.

Systematic review registration

https://inplasy.com/inplasy-2022-12-0013/.

Non-pharmacological interventions for autistic children: An umbrella review

LAY ABSTRACT

What is already known about the topic?The delivery of evidence-based interventions is an important part of the clinical pathway for many autistic children and their families. However, parents, practitioners, and policymakers face challenges making evidence informed decisions, due to the wide variety of interventions available and the large, and often inconsistent, body of evidence regarding their effectiveness.What this paper adds?This is a comprehensive umbrella review, also known as a 'review of reviews', which examined the range of interventions available, the evidence for their effectiveness, and whether effects were influenced by factors relating to individual children (e.g. chronological age, core autism characteristics, and related skills) or the ways interventions were delivered (by whom and in what setting, format, mode, and amount). There was evidence for positive therapeutic effects for some, but not all, interventions. No single intervention had a positive effect for all child and family outcomes of interest. The influence of child and delivery characteristics on effects was unclear.Implications for practice, research, and policyThe findings provide parents, practitioners, and policymakers with a synthesis of the research evidence to inform decision-making and highlight the importance of individualised approaches in the absence of clear and consistent evidence. The findings also highlight the need to improve consistency and completeness in reporting of research studies, so that the same questions may be answered more comprehensively in the future.

Program evaluation of a virtual physical activity program for individuals with disabilities

Introduction

Regular physical activity is important for positive health outcomes yet, most individuals do not meet physical activity guidelines. Recent studies show that one in five Canadians aged 15 or older have one or more disabilities, yet as a population, individuals with disabilities are 16%-62% less likely to meet physical activity guidelines. The COVID-19 pandemic created additional barriers to physical activity participation as lockdowns prevented in-person programming. In response to the pandemic, the Acadia University Sensory Motor Instructional Leadership Experience (S.M.I.L.E.) Program shifted its programming to a virtual platform; however, there was little research to guide its creation, implementation, or expected outcomes. Thus, this program evaluation explored program feasibility and impact on physical activity and physical literacy.

Method

A mixed methods case study approach was used for this project. Virtual S.M.I.L.E. took place over eight weeks in the fall of 2020. Programming consisted of three live Zoom sessions facilitated by trained program leaders, and eight weeks of at-home activity guides for participants to complete on their own time. Demographic data, physical literacy (PLAYself), and physical activity (IPAQ-A) data were collected using caregiver pre-and post-programming surveys. Throughout programming, weekly check-in surveys were sent to reflect on the previous week of programming. After the eight weeks of programming were complete, caregiver and leader interviews were conducted to understand both program implementation and performance perspectives.

Results

Results indicated that participants' (N = 15, M_age= 20.4 years) overall physical literacy and physical activity did not change; however, there was a decrease in the cognitive domain of physical literacy (p = 0.03). Caregiver and leader interviews highlighted five main themes following the virtual programming: (a) Virtual impact on programming; (b) Programming impact on social and motor goals; (c) Impact of program design; (d) Impact on physical activity; and (e) Program feasibility for families.

Discussion

Results from this program evaluation suggest that physical literacy and physical activity levels were generally maintained throughout programming and caregivers indicated several social and activity benefits. Future work includes program modifications and further evaluation of virtual adapted physical activity programming to improve the physical literacy of individuals with disabilities.

Physical Educators' Qualifications and Instructional Practices Toward Students With Disabilities

The purposes of this study were (a) to investigate the prevalence of physical educators who report delivering high-quality instructional practices to students with disabilities and (b) to examine the relationships between teachers' qualifications and the delivery of high-quality instructional practices. A secondary analysis using data from the School Health Policy and Practice Study 2014 data set was employed. The analytic sample included 256 physical educators who taught students with disabilities. Prevalence estimates of physical educators who reported using high-quality instructional practices were calculated. Two separate binary logistic regressions using weighted data were conducted to evaluate the relative contribution of (a) teacher qualifications and (b) educational degrees in accounting for differences in the use of high-quality instructional practices. Less than half of the sample reported using high-quality instructional practices. Considering the increasing prevalence of students with disabilities in general education classrooms, teacher education programs should prioritize providing teacher candidates with coursework that aligns with the expectations of physical educators who teach students with disabilities.

A Review of Motor Skill Development in State-Level Early Learning Standards for Preschoolers in the United States

The purpose of this study was to examine state-level early learning standards specific to physical development, including fundamental motor skills and gross motor development for preschool-aged children in the United States. All standards related to motor development and specific to children ages 3–5 years were extracted from publicly available online documents from all 50 states. Upon initial review, 961 standards were extracted from all documents. Through aggregation of similar skills and elimination of duplicates across states, 48 unique skills were identified. Frequencies and proportions of states that included each skill in their standards were calculated. Descriptive results indicate that none of the 48 skills were included as a standard across all 50 states. Only three skills, running, jumping, and throwing a ball overhand were a standard in over 75% of states. Most of the skills were standards in less than 50% of states. Trends from these data show that a wide range of motor skills are included within preschool physical development standards within the United States, with large variability among states. Considering this variability, and currently low levels of motor competence among young children, additional evaluation, and future creation of best practice preschool physical development standards are warranted.

Fundamental Motor Skill Delays in Preschool Children With Disabilities: 2012 National Youth Fitness Survey

Delays in fundamental motor skill (FMS) competency have been observed in a variety of children with disabilities. However, evidence of FMS delays is largely limited to small, geographically specific, limitedly diverse, and non-representative samples. The purpose of this study was to examine the association between FMS competency and reported disability status among pre-school children, ages 3–5 years, using the 2012 National Youth Fitness Survey (NYFS). In total, 329 preschool children (49% female; 4.00 ± 0.04 years of age) from the 2012 NYFS completed the Test of Gross Motor Development−2, including 43 preschoolers identified with a disability based on parental report (44% female; 4.20 ± 0.16 years). Associations were examined with logistic regression using sampling weights. Poor FMS competency, defined as gross motor quotient scores ≤ 79, was observed in significantly more children with disabilities (29%) than children without disabilities (10%, OR = 3.5, p = 0.04). While not statistically significant, there was a growing disparity in FMS competency at age 5 (41 vs. 11%) compared to age 3 (15 vs. 9%, OR = 1.80, p = 0.30). The results provide additional evidence for poor FMS competency among pre-school children with disabilities. FMS should be an early part of comprehensive assessments for all children suspected of disability or development delay as it is critical to identify and intervene upon FMS delays before discrepancies can widen.

Promoting Adapted Physical Activity Regardless of Language Ability in Young Children With Autism Spectrum Disorder

Purpose: There is a relationship between motor and language skills in children with Autism Spectrum Disorder (ASD), but little work addresses the ramifications of this relationship for professionals who teach motor skills to this population. Within a motor skills intervention, this study probed the importance of language skills for motor intervention. We examined the relationship between motor and language skills at baseline, and then the relationship between baseline language skills and motor improvements resulting from the intervention. Method: Twenty children aged 4-6 years with ASD participated. Eleven children received 20 hr per week of motor intervention for 8 weeks. Nine children did not receive motor intervention. Language skills (Mullen Scales of Early Learning) and motor skills (Test of Gross Motor Development - 2) were assessed at baseline and post-intervention. Spearman correlations tested the associations between baseline language and baseline motor skills. This analysis was repeated in the intervention sample to test the association between baseline language level and response to intervention (motor skill changes from baseline to post-intervention). Results: Prior to intervention, locomotor skills are positively correlated (p < .001) with both receptive (rs = 0.827) and expressive (rs = 0.722) language skills. Similarly, object-control skills are positively correlated (rs < .001) with receptive (rs = 0.779) and expressive (rs = 0.729) language skills. However, those baseline language skills do not relate to motor change in the experimental group. Conclusion: These results suggest that motor programs may improve motor skills in children with ASD when language is supported, regardless of pre-program language ability.

An evidence-based framework for determining the optimal amount of intervention for autistic children

The provision of timely, effective, and socially valid non-pharmacological intervention is at the core of efforts to support the development of young autistic children. These efforts are intended to support children to develop skills, empower their caregivers, and lay the foundation for optimal choice, independence, and quality of life into adulthood. But what is the optimal amount of intervention? In this Viewpoint, we review current guidelines and consider evidence from an umbrella review of non-pharmacological interventions for autistic children aged up to 12 years. We show the lack of consensus on the issue, identify factors that might be relevant to consider, and present an evidence-based framework for determining the optimal amount of intervention for each child, along with recommendations for future research.

Baseline behaviour moderates movement skill intervention outcomes among young children with autism spectrum disorder

LAY ABSTRACT

It is common for children with autism spectrum disorder to experience delays in their movement skills. These skills are important for participation in play and physical activity. Previous research has found that movement skills can be improved with movement skill interventions. This study explored the behavioural factors of young children with autism spectrum disorder that make them most likely to improve their movement skills following a 12-week intervention. The study found that children with higher levels of adaptive behaviour and lower levels of emotional and behavioural challenges at the start of the intervention were more likely to have greater improvements in their movement skills following the intervention. These findings may help clinicians and caregivers plan which types of interventions are best suited for individual children with autism spectrum disorder.

IMPROVEMENT OF THE HEALTH OF PEOPLE WITH AUTISM SPECTRUM DISORDER BY EXERCISE

ABSTRACT Introduction Autism Spectrum Disorder (ASD) is a typical neurological development disorder of the brain, exhibiting social communication and communication disorders, narrow interests, and repetitive, stereotyped behaviors. Movement development is an important evaluation index for the development of early motor function in children, so exercise intervention in children with ASD is of great significance. Objective This article conducts exercise intervention on children with ASD to stimulate their exercise ability and improve their self-care ability. Methods The article randomly grouped 24 children with an autism spectrum disorder. The experimental group received exercise intervention, and the control group had regular classes. After the experiment is completed, the influence of exercise intervention on children with autism is analyzed. Results The motor skills of the two groups of children were different after the intervention. The motor skills of the experimental group improved more significantly. Conclusion Exercise intervention can significantly improve the motor skills of children with an autism spectrum disorder. To evaluate whether the large-muscle motor skill learning of children with ASD and its influence on basic motor skills can be transferred to provide a reference for related motor intervention. Level of evidence II; Therapeutic studies - investigation of treatment results.

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.

Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review

In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children.

The Effects of Motor Skill Interventions on Motor Skills in Children with Developmental Disabilities: A Literature Review

OBJECTIVES Children with developmental disabilities experience motor skill deficits from childhood. Participation in motor skill intervention may be a promising way to promote their motor skills. The purpose of this study was to review the effectiveness of motor skill interventions on motor skills in children with disabilities.METHODS To select relevant articles about motor skill interventions for children with developmental disabilities, a search of a database with pre-determined search terms and a manual search were implemented. After screening 476 articles, 21 studies were included in the current study. The studies were systematically summarized, and theories of motor development were discussed.RESULTS Participation in motor skill intervention may be a way to promote motor skills in children with developmental disabilities. Dynamic system theory, Newell’s model and Stodden’s model can be used as a framework for motor skill interventions.CONCLUSIONS Ample evidence exist indicating motor skill interventions are effective to promote motor skills in children with developmental disabilities. The motor skill interventions should be provided to children with developmental disabilities.

A meta-analysis of the effect of adapted physical activity service-learning programs on college student attitudes toward people with disabilities

Aim: The purposes of this study were to examine the effect of service learning on changes in college student attitudes toward disability and identify potential factors to improve the quality of service learning using meta-analysis.Method: A total of 1984 potential studies were identified through 6 different databases and 14 studies met the necessary criteria for quantitative analysis. Effect sizes were estimated as Hedges' g using random effects, and heterogeneity among effect sizes was assessed with Q and I² statistics.Results: The overall effect size was positive but small (δ = .41, SE = .05, 95% CI [.33, .50], p < 0.05). Additionally, the results confirmed that different programs have different levels of impact on the student attitudes toward disability (Q = 25.71, p < 0.05, I² = 45.54). Service-learning programs that were part of a course requirement, on-campus, included a lecture component, and emphasized teacher-centered goals had smaller impacts than programs that were voluntary, off-campus, did not include lecture, and emphasized the achievement of common goals.Conclusion: The present analysis suggests that different service-learning programs have different effects, and factors like requirement status and type of involvement may lead to greater changes in attitudes toward disability.IMPLICATIONS FOR REHABILITATIONAdapted physical activity service learning has positive, yet small, effects on college student attitudes toward disability.Service-learning practitioners should aim to increase autonomy within service learning by providing multiple choices and opportunities to college students, such as a variety of practicum types, locations, and disability populations to choose from.Service-learning practitioners should encourage the development of common goals between college students and people with disabilities and integrate shared activities that are familiar to both groups in order to promote optimal contact conditions and enhance attitude change.Programs that intend to change attitudes toward people with disabilities should incorporate strategies specifically designed to target attitude change.