A chinese mind-body exercise improves self-control of children with autism: a randomized controlled trial

The effect of physical exercise therapy on autism spectrum disorder:a systematic review and meta-analysis

BACKGROUND

Physical Exercise Therapy (PET) is increasingly applied in the treatment of Autism Spectrum Disorders (ASD), yet the empirical evidence supporting its efficacy remains ambiguous. This systematic review and meta-analysis aimed to investigate the effectiveness of PET for individuals with ASD, providing evidence-based support for clinical and scientific research.

METHODS

We systematically searched four international databases (Medline via PubMed, Embase, Cochrane Libraries, and Web of Science) and three Chinese databases (CNKI, Wanfang, and VIP Libraries) up to July 31, 2023. The search was conducted in both English and Chinese for original research articles employing randomized-controlled-trial (RCT) designs to study PET's effects on individuals diagnosed with ASD according to DSM or other established criteria. Co-primary outcomes focused on the overall severity of autism, while secondary outcomes included measures of stereotyped behaviors, social deficits, social skills, and executive functioning. Data from the included studies were synthesized and analyzed using RevMan 5.4. This systematic review is registered with PROSPERO (CRD42023443951).

RESULTS

A total of 28 RCTs comprising 1081 participants were analyzed. Of these, only three studies met high-quality standards. Compared to control groups, PET showed improvement in at least one core symptom of autism, including Motor Performance (SMD=1.72, 95%CI[1.01, 2.44], I2=90%), Restricted Repetitive Behaviors (SMD=-0.81, 95%CI[-1.00, -0.62], I2=0%), Social Dysfunction (SMD=-0.76, 95%CI[-1.06, -0.46], I2=47%).

CONCLUSIONS

PET may offer benefits in reducing the overall severity and associated symptoms in individuals with ASD. However, given the high overall risk of bias in the included studies, these findings should be interpreted with caution.

Effects of aquatic exercise intervention on executive function and brain-derived neurotrophic factor of children with autism spectrum disorder

BACKGROUND

Limited knowledge exists regarding the effectiveness of aquatic exercise intervention for improving executive function (EF) in children with autism spectrum disorder (ASD). Additionally, the impact of aquatic exercise on brain-derived neurotrophic factor (BDNF) in children with ASD requires further investigation.

AIMS

This study aimed to explore the effects of a 12-week aquatic exercise intervention on core EF and BDNF levels in children with ASD.

METHODS AND PROCEDURES

Thirty children with ASD were assigned to an experimental or control group. The experimental group underwent a 12-week aquatic exercise intervention, while the control group engaged in supervised free activities. Pre- and post-intervention assessments measured EF and BDNF levels.

OUTCOMES AND RESULTS

The experimental group showed significant improvements (p < 0.05) in inhibition control, cognitive flexibility, and BDNF levels. However, working memory did not significantly improve. The control group exhibited no significant changes in EF or BDNF levels.

CONCLUSIONS AND IMPLICATIONS

Aquatic exercise appears to be a beneficial intervention for cognitive development in children with ASD, as it enhances inhibition control, cognitive flexibility, and BDNF levels in children with ASD. Furthermore, the observed improvements in EF following aquatic exercise intervention in children with ASD may be associated with increased BDNF levels.

Mechanisms Linking Physical Activity With Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review

INTRODUCTION

Physical activity (PA) is a promising way to improve mental health in children and adolescents with neurodevelopmental disorders (NDDs). However, the underlying mechanisms remain unclear. The current review aimed to explore the potential neurobiological, psychosocial, and behavioral mechanisms between PA interventions and mental health in children and adolescents with NDDs.

METHODS

Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC were searched from inception to June 2023. Randomized controlled trials/quasi-experimental designs applying PA interventions and reporting at least one mental health outcome and at least one potential mechanism in children and adolescents with NDDs were included. The best evidence synthesis rating system was adopted to determine the strength and consistency of potential mechanisms and was performed in 2024.

RESULTS

In total, 45 studies were included, 29 of which were randomized controlled trials and 16 were quasi-experimental, with a total of 1,751 participants. According to the best evidence synthesis rating system, neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms were the frequently examined and consistent mechanisms through which PA affected mental health in children and adolescents with NDDs. However, evidence regarding P3 latency, beta activity, and physical self-concept was insufficient.

DISCUSSION

Future PA interventions could consider neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms. Alternatively, PA can be developed as an adjunctive approach with interventions that specifically focus on these mechanisms to enhance mental health in children and adolescents with NDDs.

A network meta-analysis of the effect of physical exercise on core symptoms in patients with autism spectrum disorders

Objective

To compare the effects of various sports exercise programs on the core symptoms of patients with autism spectrum disorder (ASD).

Methods

We searched the China National Knowledge Infrastructure, VIP databases, Wanfang databases, Cochrane Library, PubMed, EMBASE, and Web of Science databases from their inception to February 2023 for randomized controlled trial that investigated the effect of sports exercise on the core symptoms of ASD. The overall risk of bias in the included literature was summarized using the revised Cochrane Randomized Trial Risk of Bias Tool (ROB2), and network meta-analysis was used to compare the intervention effects.

Results

A total of 30 studies involving 1,375 participants were included. The results showed that sports exercise programs, including 8-12 weeks of ball sports (SMD = -5.35, 95%CI: -7.57, -3.23), horse riding (SMD = -3.71, 95%CI: -6.18, -1.13), 8-12 weeks of comprehensive sports exercise (SMD = -2.17, 95%CI: -3.99, -0.44), and more than 12 weeks of comprehensive sports exercise (SMD = -3.75, 95%CI: -6.33, -1.24), significantly improved social interaction disorders. Furthermore, 8-12 weeks of ball sports (SMD = -4.36, 95%CI: 2.04, 6.73) and more than 12 weeks of comprehensive sports exercise (SMD = 3.65, 95%CI: 1.40, 6.08) significantly improved repetitive behaviors and restricted interests.

Conclusion

Sports exercise can improve the core symptoms of ASD patients, and different symptoms show a selective response to different exercise elements.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42023455806.

Meta-analysis of Psychotherapy for Autistic Youth

In order to provide more individualized support, it is imperative to further understand the effectiveness of different types of psychotherapy on the clinical areas of need common in autistic youth (Wood et al. in Behav Ther 46:83-95, 2015). Randomized controlled trials of psychotherapy for autistic youth were included if published in English, included random assignment to treatment or control group, required a previous diagnosis of autism, had a mean age of 6-17 years, and provided outcome measure data from both intervention and control groups. A total of 133 measures were coded across 29 studies and included 1464 participants with a mean age of 10.39 years (1.89). A small mean effect size (0.38,95% CI [0.26, 0.47]) was found overall, with the largest effects for cognitive behavioral therapies on autism-related clinical needs (0.81) and overall mental health (0.78). The results show the significant impact of psychotherapy interventions for autistic youth. Additional research should further assess the details of the most effective psychotherapies for each area of clinical need.

Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis

Importance

Children and adolescents with neurodevelopmental disorders experience mental health issues and are encouraged to be brought together in real-life treatment. However, physical activity, which is a promising method for boosting mental health, has only been examined in children and adolescents with certain types of neurodevelopmental disorders.

Objective

To examine the association of physical activity interventions with mental health (ie, cognitive function, psychological well-being, internalizing, and externalizing problems) in children and adolescents with neurodevelopmental disorders and to identify possible moderators.

Data Sources

Studies were searched from inception to May 2023 through Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC.

Study Selection

Randomized clinical trials or nonrandomized designs applying physical activity interventions and reporting at least 1 mental health outcome in children and adolescents aged 5 to 17 years with neurodevelopmental disorders were included. Two independent reviewers selected and assessed the studies.

Data Extraction and Synthesis

Random multilevel meta-analysis using Hedges g was performed. Data extraction and risk-of-bias assessment were conducted by multiple reviewers. Heterogeneity, publication bias, sensitivity analysis, and moderator analysis were examined to substantiate the results.

Main Outcomes and Measures

The main outcomes were mental health related to cognitive function, psychological well-being, internalizing, or externalizing problems measured by neurocognitive tasks or subjective questionnaires.

Results

A total of 76 studies involving 3007 participants were included in systematic review, 59 of which were used for meta-analysis. The findings indicated that physical activity interventions were associated with significant benefits for overall mental health (g, 0.67; 95% CI, 0.50-0.85), cognitive function (g, 0.74; 95% CI, 0.53-0.95), psychological well-being (g, 0.56; 95% CI, 0.16-0.96), internalizing (g, 0.72; 95% CI, 0.34-1.10), and externalizing problems (g, 0.58; 95% CI, 0.28-0.89). Moderators were also identified: frequency, total sessions, and total duration for overall mental health; total sessions, and total duration for cognitive function; session duration and frequency for psychological well-being; physical activity type for internalizing problems; and session duration for externalizing problems. Moderator analyses showed that type of neurodevelopmental disorder did not modify the associations between physical activity and overall mental health or its subgroups.

Conclusions and Relevance

The findings in this study suggest that children and adolescents with different types of neurodevelopmental disorders may be grouped together when performing physical activity interventions, which were confirmed to be beneficial to overall mental health and its subgroups in this new diagnostic population, but that physical activity interventions should be tailored when targeting different mental health domains.

Effect of Yoga Intervention on Problem Behavior and Motor Coordination in Children with Autism

Children with autism exhibit more pronounced symptoms of both problem behaviors and motor coordination difficulties. Yoga, recognized as an effective intervention modality, can be valuable after assessing its efficacy in addressing problem behaviors and motor coordination challenges, ultimately contributing to symptom alleviation in autism. The randomized controlled trial (RCT) was used to divide 17 children with autism into an intervention group (n = 9) and a control group (n = 8). The intervention group participated in an 8-week yoga intervention training (three sessions/week, 45-50 min/session), and the control group did not participate in yoga training but only in daily program activities. Pre-test, mid-test, post-test, and after delayed test, teachers assessed the effect of yoga intervention on problem behaviors of children with autism through the Aberrant Behavior Checklist (ABC) and the effect of yoga intervention on motor coordination through the Movement Assessment Battery for Children-Second Edition (MABC2). Results show that the yoga intervention is effective in reducing problem behaviors and improving motor coordination in children with autism. Yoga intervention significantly reduces irritability and social withdrawal in children with autism. Yoga intervention had the most significant improvement in ball skills and static and dynamic balance.

Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment

The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI.

Exploring the effects of physical exercise on inferiority feeling in children and adolescents with disabilities: a test of chain mediated effects of self-depletion and self-efficacy

Objective

The purpose of this study was to investigate the effects of physical exercise on inferiority feeling of children and adolescents with disabilities and its mechanism of action, as well as the mediating role of self depletion and self-efficacy.

Methods

The following scales were administered to 546 children and adolescents with disabilities (mean age 15.6 years): The Feelings of Inadequacy Scale, (FIS), the Self-Regulation Fatigue Scale (S-RFS), the General Self-Efficacy Scale (GSES), and the Physical Exercise Rating Scale.

Results

(1) Physical exercise can directly and negatively predict inferiority feeling, self-depletion, and can directly and positively predict self-efficacy; self-depletion can directly and negatively predict self-efficacy. Similarly, self-depletion positively predicts inferiority feeling; physical exercise and self-efficacy can also directly and negatively predict inferiority feeling. (2) The indirect effect of the path with self-depletion as the mediating variable was - 0.05, the indirect effect of the path with self-efficacy as the mediating variable was - 0.09, and the indirect effect of the path with self-depletion and self-efficacy as the mediating variables was - 0.04. (3) The sum of all indirect effects was - 0.18, and the three indirect effects accounted for 15.6%, 28.1%, and 12.5% of the total effect, with mediating effect was 56.2%.

Conclusion

Physical exercise can indirectly predict inferiority feeling in children and adolescents with disabilities through the independent mediation of self-depletion and self-efficacy, as well as through the chain mediation of both. This study supports that moderate physical exercise has a positive effect on the mental health of children and adolescents with disabilities, and that reducing self-depletion and improving self-efficacy are important ways to prevent inferiority feeling among children and adolescents with disabilities. It reveals the relationship between physical exercise and inferiority feeling and its mechanism of action, and further improves the research on the effect of physical exercise on inferiority feeling of children and adolescents with disabilities.

Effectiveness of physical activity interventions for core symptoms of autism spectrum disorder: A systematic review and meta-analysis

In this paper, systematic review and meta-analysis were used to demonstrate the effectiveness of physical activity intervention on core symptoms of autism spectrum disorder (ASD). Physical activity intervention for core symptoms of ASD were retrieved by computer from the PubMed Cochrane Library, Web of Science, APA PsycNet, and CNKI database during December 1, 2022. Two researchers evaluated the quality of the included literature and extracted the data. Sixteen studies were eventually included, with a total of 587 patients with ASD. Meta-analysis showed that the core symptoms of ASD patients decreased after physical activity intervention, ES(g) = 0.681(95% CI: 0.380-0.982, p = 0.000), specifically, physical activity improved the reduction of social disorder ES(g) = 0.749(95% CI: 0.524-0.973) and repeated rigid behavior ES(g) = 0.553 (95% CI: -0.079 to 1.186). Subgroup analysis showed that preschool children with ASD who were 3-6 years old, exercised for more than 12 weeks, more than 3 times a week, and exercised for more than 90 min per session had better improvement in core symptoms after participating in physical activity. The conclusion of this paper is that physical activity intervention can improve the core symptoms of ASD, especially the reduction of social disorders and repetitive behaviors.

The neurobiological effects of mind-body exercise: a systematic review and meta-analysis of neuroimaging studies

The neurobiological effects of mind-body exercise on brain activation, functional neural connections and structural changes in the brain remain elusive. This systematic review and coordinate-based meta-analysis investigated the changes in resting-state and task-based brain activation, as well as structural brain changes before and after mind-body exercise compared to waitlist or active controls based on published structural or functional magnetic resonance imaging randomized controlled trials or cross-sectional studies. Electronic database search and manual search in relevant publications yielded 34 empirical studies with low-to-moderate risk of bias (assessed by Cochrane risk-of-bias tool for randomized trials or Joanna Briggs Institute's critical appraisal checklist for analytical cross-sectional studies) that fulfilled the inclusion criteria, with 26 studies included in the narrative synthesis and 8 studies included in the meta-analysis. Coordinate-based meta-analysis showed that, while mind-body exercise enhanced the activation of the left anterior cingulate cortex within the default mode network (DMN), it induced more deactivation in the left supramarginal gyrus within the ventral attention network (uncorrected ps < 0.05). Meta-regression with duration of mind-body practice as a factor showed that, the activation of right inferior parietal gyrus within the DMN showed a positive association with increasing years of practice (voxel-corrected p < 0.005). Although mind-body exercise is shown to selectively modulate brain functional networks supporting attentional control and self-awareness, the overall certainty of evidence is limited by small number of studies. Further investigations are needed to understand the effects of both short-term and long-term mind-body exercise on structural changes in the brain.PROSPERO registration number: CRD42021248984.

Effect of yoga on the social responsiveness and problem behaviors of children with ASD in special schools: A randomized controlled trial

CONTEXT

Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder and is increasingly reported among school-age children in India. Many children with ASD attend special schools which extend support for learning basic functional and academic skills. Problem behaviors and lack of social responsiveness are frequently associated with children with ASD in a school environment. Many evidence-based studies have explored various interventions in mitigating the lack of social responsiveness and problem behaviors in children. Few studies have examined the impact of yoga on social responsiveness and problem behaviors in special schools.

OBJECTIVE

The objective of the study was to highlight the effect of school-based yoga on the social responsiveness and problem behaviors of children with ASD in special schools. Forty-three children with ASD from four special schools participated in the study.

DESIGN

A randomized controlled trial (RCT) design was employed for the study. Children with ASD (n = 43) from four special schools were assessed by their teachers for social responsiveness and problem behaviors with the Social Responsiveness Scale-2 (SRS-2) and Aberrant Behavior Checklist-2 (ABC-2) at the baseline and after the yoga intervention.

INTERVENTION

Structured yoga of 45 min for 12 weeks was conducted across four special schools with simple yoga practices conducive to children with ASD.

RESULTS

Significant changes were observed post-intervention in the mean scores of the social communication aspect in social responsiveness (p = .021), irritability (p = .041), and social withdrawal (p = .047) aspects of problem behaviors.

The effect of physical exercise on disordered social communication in individuals with autism Spectrum disorder: a systematic review and meta-analysis of randomized controlled trials

Objective

The aim of this systematic review and meta-analysis was to systematically investigate the intervention effect of physical exercise on disordered social communication in patients with autism spectrum disorders.

Methods

This systematic review and meta-analysis used the PubMed, Web of Science, the Cochrane Library, and Embase electronic databases to conduct a systematic search of literature describing randomized controlled trials (RCTs) on the effect of physical exercise on disordered social communication in autistic patients from the first year of inclusion to 21 January 2023.

Results

A total of 14 RCTs including 460 autistic patients were analyzed. A meta-analysis showed that physical exercise had a positive effect on social communication disorder (SMD = 0.45, 95% CI: 0.15, 0.74, p < 0.05) in autistic patients. Subgroup analysis showed that exercise programs with multiple components (SMD = 0.73, 95% CI: 0.39, 1.06, P < 0.001), a moderate duration (SMD = 0.73, 95% CI: 0.38, 1.08, P < 0.001), a moderate-high frequency (SMD = 0.84, 95% CI: 0.53, 1.14, P < 0.001), and a long duration (SMD = 0.77, 95% CI: 0.36, 1.18, P < 0.001) led to significant improvement.

Conclusion

Physical exercise can improve disordered social communication in patients with autism spectrum disorders. Specifically, early intervention, multi-component exercise, a moderate period, moderate and high frequency, long duration, and multi-participant programs were most effective.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/ RecordID= CRD42023422482.

The efficacy of mindfulness-based therapy for anxiety, social skills, and aggressive behaviors in children and young people with Autism Spectrum Disorder: A systematic review

Introduction

The purpose of this systematic review was to examine the efficacy of mindfulness-based interventions for improving anxiety, social skills, and aggressive behaviors in children and young people (CYP) with Autism Spectrum Disorder (ASD); summarize the results across clinic, home, and school contexts; and evaluate the quality of these interventions for clinical practice.

Methods

A search of the PsycINFO, Medline (Ovid), Web of Science, and Scopus databases was conducted in June 2021, and no date restrictions were applied. Inclusion criteria were quantitative or qualitative research implementing a mindfulness-based intervention for CYP aged 6–25 years with a diagnosis of ASD, Pervasive Development Disorder, or Asperger’s Syndrome.

Results

We identified 23 articles for inclusion including within subject pre- and post-testing, multiple baselines, and randomized control trials, among other research designs. Of these, a quality analysis conducted using an ASD research-specific risk of bias tool found over half (14) were of weak methodological quality, whereas only four and five were found to be of strong and adequate quality, respectively.

Discussion

While the results of this systematic review suggest promising evidence for the use of mindfulness-based interventions to improve anxiety, social skills, and aggressive behaviors in CYP with ASD, results should be interpreted with caution due to the limitations resulting from the overall weak quality of the studies.

The review protocol was pre-registered on PROSPERO (CRD42021259125) and can be viewed at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259125

The Effect of a Single Bout of Chinese Archery on Core Executive Functions in Preadolescent Children in Shanghai

BACKGROUND

Recent literature has demonstrated that acute physical activity benefits the transfer of executive functions. However, further studies indicated the type of variability in the effect of physical activity on executive functions. Therefore, this study initially explored the effect of a single bout of Chinese archery on subdomains of core EFs in preadolescent children; Method: Eligible participants were allocated either an intervention group (n = 36) or a control group (n = 36). The subjects in the intervention group received a 45-min Chinese archery session. The primary outcomes were the performance of core EFs (inhibition control, working memory, and cognitive flexibility) in preadolescent children, assessed with psychological paradigms (Fish Flanker Task, N-Back Task, and DCCS (Border version), respectively). Paired t-test and ANCOVA were used to analyze the mean difference in the performance of core EFs within and between subjects, respectively; Results: Considering reaction time and accuracy, we explored the impressive performance in three cognitive tasks with acute Chinese archery; Conclusion: The finding suggests that a single bout of Chinese archery benefited three subdomains of core EFs in healthy preadolescent children.

Inclusive physical education program of schoolchildren with autism spectrum disorders

Purpose: The purpose was to develop an inclusive physical education program for schoolchildren with ASD and experimentally test its effectiveness. Materials and methods: An inclusive physical education curriculum for children with ASD was made up and incorporated into the process of physical education in secondary schools. At the beginning and the end of the pedagogical experiment, 12-year-old children were tested in the experimental (involved in the author's program, n=9) and control groups (involved in the traditional curriculum, n=11). The indicators of psychophysical fitness of children were determined according to the results of 19 test exercises. The reliability of the differences was determined by the Mann-Whitney U test.  Results: Under the influence of the author's program, physical fitness of children of the experimental group improved significantly. Whereas the trend towards improving almost all indicators of the physical fitness of children with ASD in the traditional program has not been confirmed statistically. The traditional physical education program was most effective in promoting flexibility (inclinations forward) and coordination (passing and catching a ball against a wall) in children with ASD. Conclusions: The author's program was proven to be significantly more effective than the traditional ones in the formation of the strength of shoulder extensors and hand flexors, fine coordination of hand muscles, the speed-strength of leg muscles, and balance. This allows us to recommend it for use in physical education lessons in institutions of general secondary education.

Scoping Review of Yoga in Schools: Mental Health and Cognitive Outcomes in Both Neurotypical and Neurodiverse Youth Populations

Yoga is used widely as a therapeutic tool for physical and mental well-being. The mind-body activity could be an inclusive and cost-effective intervention used within schools to help tackle the mental health crisis in youth populations. To date, research has focused on mainly neurotypical youth populations. However, greater acknowledgement of the impact for neurodiverse youth populations is warranted. Therefore, the aim of this scoping review is to understand what is known about the relationships between yoga in schools and mental health and cognition in neurotypical and neurodiverse youth populations. Methods: This review followed O’Malley and Arskey’s methodological framework. A comprehensive database search using fundamental keywords and index terms was conducted. Screening was carried out in CovidenceTM software. Results: Substantial evidence to support the use of school-based yoga programmes for the improvement of anxiety, self-concept, resilience, depression, self-esteem, subjective and psychological well-being, executive function, inhibition, working memory, attention and academic performance in neurotypical populations was found. Evidence to support school-based yoga programmes in neurodiverse populations with improvements in self-concept, subjective well-being, executive function, academic performance and attention was also found. Conclusions: The findings support the provision of yoga in schools to improve mental health and cognition whilst also creating clear pathways for future research and school-based yoga intervention development.

Effect of Yoga on the Motor Proficiency of Children with Autism Spectrum Disorder and the Feasibility of its Inclusion in Special School Environments

Yoga as a movement-based intervention is increasingly considered to improve the motor skills of children with autism spectrum disorder (ASD). However, there is little evidence of the effect of yoga on their motor skills. The current study aims to explore the effect of group yoga program on motor proficiency of children with ASD and feasibility of its inclusion in special schools. Forty-three children with ASD from four special schools were randomized into yoga (n = 23) and control (n = 20) group. A structured yoga program of 45 min for 12 weeks was delivered by trained yoga teachers who also tracked their daily responses. The Bruininks-Oseretsky Test of Motor Proficiency. Second Edition was used to assess both the groups pre- and postintervention. In conclusion, the study highlighted that yoga appears to have a positive impact on the gross motor rather than fine motor proficiency of children with ASD and is feasible to be delivered as group intervention in special schools.

Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities-A Systematic Review

Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.

Kindergarten-Based Progressive Muscle Relaxation Training Enhances Attention and Executive Functioning in 5-6-year-old Children: A Randomized Controlled Trial

In the present study we assessed the impact of kindergarten-based progressive muscle relaxation (PMR) on attention and executive functioning of 5-6-year-old children. In this randomized-controlled trial, 52 children (26 female; 26 male; M age = 5.4, SD = 0.2 years) from two private Tunisian kindergartens were randomly assigned to experimental and control groups. Over 12 weeks, 18 children performed PMR in two 30-minute sessions/week, another 17 children performed generic physical education (PE) for two 30-minute sessions/week, and 17 children in a control group (CG) had no systematically guided physical activity and engaged in usual self-chosen activities like free play or artisanal activities during Kindergarten hours. Prior to (T0) and after (T1) the 12-week PMR intervention, all participants completed the Visuomotor Precision and Statue subtests of the Neuropsychological Evaluation Battery (NEPSY-2), the Teddy Bear Cancellation Test, and the Rey Simple Figure Test. While there were no significant group differences at T0, repeated measures analysis of variance revealed higher scores for the PMR group relative to both the PE and CG groups on measures of attention, visuomotor precision, memory, and motor inhibition. PMR provided an effective relaxation technique and enhanced attention and executive functioning of these 5-6-year-old children, with important implications for assisting learning and academic achievement among young children.

Mind–Body Exercises for PTSD Symptoms, Depression, and Anxiety in Patients With PTSD: A Systematic Review and Meta-Analysis

Objectives

This study aims to systematically analyze the effects of mind–body exercises on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in patients with PTSD. Furthermore, it intends to provide scientific evidence-based exercise prescriptions.

Methods

Chinese (i.e., China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, and Wanfang) and English (i.e., Web of Science, PubMed, the Cochrane Library, and EMBASE) databases were used as data sources to search for studies on the effects of mind–body exercises on symptoms associated with patients with PTSD from January 1980 to November 2020. After a rigorous screening, 16 eligible randomized controlled trials (RCTs) were included in the meta-analysis.

Results

Mind–body exercises exerted a significant effect on PTSD symptoms [standard mean difference (SMD) = −0.41, 95% confidence interval (CI) −0.64 to −0.19, p < 0.001], depression (SMD = −0.35, 95% CI: −0.55 to −0.15, p < 0.001), and anxiety (SMD = −0.31, 95% CI: −0.74 to −0.12, p < 0.001) among patients with PTSD. Subgroup analysis demonstrated that 60–150 min per session for 8–16 weeks of mindfulness was more effective in improving symptoms in patients with PTSD under 45 years of age compared with other subgroups. For depression, 150–180 min of yoga exercises once per week was effective. For anxiety, the frequency, timing, duration, and type of mind–body exercises that are most effective in relieving anxiety in patients with PTSD cannot be determined at this time due to the limited number of eligible RCTs.

Conclusions

Mind–body exercises were found to be significantly effective in improving PTSD symptoms, depression, and anxiety in patients with PTSD. Therefore, they can be used as an adjunct to intervention for symptoms of patients with PTSD. However, this conclusion requires further confirmation through additional scientific and objective RCTs.

Systematic Review Registration:

Unique Identifier: INPLASY2020120072.

Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.

The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

BACKGROUND

Both chronic and acute exercise interventions have reported positive effects on executive functions (EFs) in general populations. However, data on changes in EFs in children and adolescents with autism spectrum disorder (ASD) in response to exercise interventions are still unclear.

OBJECTIVE

This systematic review and meta-analysis aimed to synthesize available empirical studies concerning the effects of exercise interventions on EFs in children and adolescents with ASD.

METHODS

In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the electronic databases CINAHL Complete (via EBSCOhost), SPORTDiscus with Full Text (via EBSCOhost), MEDLINE (via EBSCOhost), Web of Science, ProQuest, and Education Resources Information Center (ERIC; via EBSCOhost) were searched from inception to January 2021. Two authors independently extracted data and conducted a risk-of-bias analysis using the Physiotherapy Evidence Database scale. Randomized controlled trials/quasi-experimental designs that used acute or chronic exercise interventions and assessed EFs through neurocognitive tasks or questionnaires among children and adolescents with ASD were included. In total, 259 articles were identified, of which 15 full texts were independently assessed for eligibility by two authors. In total, 14 articles underwent systematic review, and seven were selected for meta-analysis.

RESULTS

Overall, chronic exercise interventions had a small to moderate positive effect on overall EFs in children and adolescents with ASD (g = 0.342; 95% confidence interval [CI] 0.084-0.600; p < 0.01). Regarding domain-specific EFs, chronic exercise interventions had a small to moderate positive effect on cognitive flexibility (g = 0.312; 95% CI 0.053-0.570; p < 0.01) and inhibitory control (g = 0.492; 95% CI 0.188-0.796; p < 0.01). However, our review found a non-significant effect size (g = 0.212; 95% CI - 0.088 to 0.512) on working memory.

CONCLUSIONS

Chronic exercise interventions appear to have beneficial effects on overall EFs in children and adolescents with ASD, particularly in relation to cognitive flexibility and inhibitory control.

Effects of Physical Exercise Interventions on Stereotyped Motor Behaviours in Children with ASD: A Meta-Analysis

Studies have reported that physical exercise reduces maladaptive stereotyped motor behaviours (SMB) in children with ASD, but these intervention studies vary in design and outcome. The present systematic review and meta-analysis included 22 studies, involving 274 children with ASD, to quantify the effect of exercise on SMB and its potential moderators. Multi-level modelling revealed a large overall effect, Hedges' g = 1.16, with significant heterogeneity across participant, treatment, and study levels. Further, a more appropriate model using between-case estimation for within-subject effects to improve comparability between single-case and group-design studies, yielded a smaller but still significant effect, g = 0.51. Lastly, higher exercise intensity, but not age, exercise duration or settings, reliably predicted treatment effectiveness. Implications for clinical practice and research are discussed.

Chanwuyi Lifestyle Medicine Program Alleviates Immunological Deviation and Improves Behaviors in Autism

Given the association between deviated inflammatory chemokines, the pathogenesis of autism spectrum disorders (ASD), and our previous findings of the Chanwuyi Lifestyle Medicine Program regarding improved cognitive and behavioral problems in ASD, the present study aims to explore if this intervention can alter pro-inflammatory chemokines concentration. Thirty-two boys with ASD were assigned to the experimental group receiving the Chanwuyi Lifestyle Medicine Program for 7 months or the control group without a change in their lifestyle. The experimental group, but not the control group, demonstrated significantly reduced CCL2 and CXCL8, a trend of reduction in CCL5, and elevation of CXCL9. The experimental group also demonstrated significantly reduced social communication problems, repetitive/stereotypic behaviors, and hyperactive behaviors. The present findings support the potential efficacy and applicability of the Chanwuyi Lifestyle Medicine Program for reducing both behavioral problems and immunological dysfunction in ASD. Further studies are warranted to verify its treatment effect and its association with brain functions.

The Effect of Tai Chi Chuan Training on Stereotypic Behavior of Children with Autism Spectrum Disorder

This quasi-experimental study investigated effects of Tai Chi Chuan training on stereotypic behavior of children with autism spectrum disorder. Twenty-three participants (mean age = 9.60 ± 1.40 years) were assigned to experimental (N = 12) and control (N = 11) groups. The experimental group received 12 weeks of Tai Chi training and all participants had pre, post, and one-month follow-up assessments. Stereotypic behavior measured using Gilliam Autism Rating Scale 2 Scores, was significantly altered by ~ 25% in the Tai Chi Chuan group. Behavioral change was maintained at follow up since there was no significant difference between that and the posttest. In conclusion, Tai Chi Chuan training is a useful and appropriate intervention to modulate behavior in individuals with autism spectrum disorder.

The Effect of Physical Activity Interventions on Executive Function Among People with Neurodevelopmental Disorders: A Meta-Analysis

The current meta-analysis comprehensively examined the effects of physical activity interventions on executive function among people with neurodevelopmental disorders. The meta-analysis included 34 studies with 1058 participants aged 5-33 years. Results indicated an overall significant medium effect of physical activity interventions on improving executive function in people with neurodevelopmental disorders under the random-effect model (Hedges' g = 0.56, p < .001). Significant moderators of the effects of physical activity intervention on executive function included age, intervention length and session time, executive function subdomains, and intervention dose (total minutes in the intervention). This meta-analysis provides support for the effectiveness of physical activity interventions on executive function among people with neurodevelopmental disorders. Future studies and limitations are discussed.

Physical and Sedentary Activity Patterns in Youths with Autism Spectrum Disorder

Little is known about the patterns of sedentary behavior and physical activity (PA) within different school levels (i.e., primary school and secondary school) and on different day types (i.e., weekdays and weekend days) among youths with autism spectrum disorder (ASD). The sample was recruited from one city in Taiwan. A total of 68 male youths with ASD, aged 6–17 years, participated in the study. PA was assessed using an ActiGraph accelerometer, and sedentary behaviors (i.e., TV viewing, computer use, and reading time) were determined using a self-report log. The main findings were that (a) primary school youths with ASD were more active than secondary school youths with ASD on both weekdays and weekend days, but primary school youths with ASD also had more sedentary time than did secondary school youths with ASD on both weekdays and weekend days; (b) secondary school youths with ASD were more active but also more sedentary on weekdays compared with weekend days, but they had more screen use on weekend days compared with on weekdays. Future interventions are required to decrease sedentary behavior and increase PA to improve the health of these youths according to school level and day of the week.

Effects of mind-body exercise on PTSD symptoms, depression and anxiety in PTSD patients: A protocol of systematic review and meta-analysis

BACKGROUND

The present study aimed to systematically analyze the effects of mind-body exercise on PTSD symptom, depression and anxiety among patients with post-traumatic stress disorder (PTSD) and to provide a scientific evidence-based exercise prescription. Meanwhile, it will also help reduce the global mental health burden of COVID-19.

METHODS

Both Chinese and English databases (PubMed, Web of Science, the Cochrane Library, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were used as sources of data to search for randomized controlled trials (RCTs) published between January 1980 to September 2020 relating to the effects of mind-body exercise on PTSD symptom, depression and anxiety in PTSD patients.

CONCLUSION

This systematic review and meta-analysis will provide stronger evidence on the effectiveness and safety of mind-body exercise for PTSD symptoms in PTSD patients.

SYSTEMATIC REVIEW REGISTRATION

INPLASY2020120072.

Brief Report: Mindfulness Training for Chinese Adolescents with Autism Spectrum Disorder and Their Parents in Hong Kong

This study investigated the feasibility and preliminary effectiveness of a concurrent mindfulness program (MYmind) on Chinese adolescents with autism spectrum disorder and their parents in Hong Kong, China using a randomized controlled trial with a waitlist control group. Results showed the study had 80% compliance rate, 0% dropout rate, and 89% response rate. Between-group comparisons showed mindfulness had trend effects on parent’s rumination (g = 1.16), mindful parenting (d = 0.6), parenting style (d = 0.59), and parenting stress (d = 0.5). The study demonstrated the feasibility of the MYmind program in the Chinese context. A larger trial with longer follow-up period is suggested to better examine the effect of mindfulness on adolescents with ASD and their parents.

Effects of an 8-Week Judo Program on Behaviors in Children with Autism Spectrum Disorder: A Mixed-Methods Approach

Prior studies suggest that a combination of physical activity and mind-body exercises, often seen in martial arts, may attenuate negative behaviors in youth with Autism Spectrum Disorder (ASD). Therefore, the aim of this study was to examine the effects of an 8-week judo program on behavioral factors in children with ASD, using a mixed-methods approach. A total of 25 children (ages 8-17), diagnosed with ASD, participated in an 8-week judo program (1 × week). Parents of participants were given the Aberrant Behavior Checklist (ABC) to compare the severity of ASD-related behavior at baseline and at the end of the program. A subset of parents (n = 9) participated in semi-structured interviews that focused on their child's behaviors during the judo program. Non-parametric paired t-tests were conducted to compare differences in the ABC scores from at baseline and at the end of the program. Interviews were coded independently by two trained researchers and categorized into behavioral themes. Participants attended an average of 7.04 ± 1.06 classes (out of 8 sessions). There were no significant changes in ABC scores, however, parent interviews revealed that 78% of parents observed improvements in both social skills and self-esteem as a result of the judo program. Despite no significant differences in ABC scores pre and post-judo, data from parent interviews indicate improvements in self-esteem and social skills. Future studies should further examine the effects of judo in a larger sample of youth with ASD, and include control conditions (e.g. no-exercise group) for comparison purposes.

A mind-body lifestyle intervention enhances emotional control in patients with major depressive disorder: a randomized, controlled study

To investigate the effects of the Dejian mind-body intervention (DMBI), on depressive symptoms and electroencephalography (EEG) changes in relation to emotional processing in patients with depression. Seventy-five age-, gender-, and education-matched participants with depression were randomly assigned to receive either Cognitive Behavior Therapy (CBT) or DMBI or were placed in a control group. Overall depressive syndrome, specific mood-related symptoms (Hamilton Psychiatric Rating Scale for Depression, Beck Depression Inventory), and EEG data were collected individually during a resting state and during affective image viewing before and after 10 weeks of intervention. After intervention, both the DMBI and CBT groups showed significantly reduced levels of overall depressive syndrome and mood-related symptoms (Ps ≤ 0.002) than the control group. In addition, the DMBI group demonstrated a significantly greater extent of elevation in fronto-posterior EEG theta coherence on the right hemisphere when viewing different mood-induction (neutral, positive, and negative) stimuli than the CBT and control groups (Ps < 0.03). The elevated intra-right fronto-posterior coherence when viewing mood-induction stimuli correlated with improved mood levels after the intervention (Ps < 0.05). Our findings also showed that, only in the DMBI group, there was a significant suppression of theta source activity at the posterior and subcortical brain regions that are known to mediate negative emotional responses and the self-absorbed mode of thinking. The findings of reduced depressive symptoms and elevated frontoposterior coherence suggest that the DMBI can enhance emotional control in depression.

Brief Report: Preliminary Efficacy of a Judo Program to Promote Participation in Physical Activity in Youth with Autism Spectrum Disorder

To examine the preliminary efficacy of an 8-week judo program to promote moderate-to-vigorous physical activity (MVPA) and reduce sedentary behavior (SB) in youth with Autism Spectrum Disorder (ASD). Fourteen children diagnosed with ASD participated in a weekly judo program over a period of 8 weeks. Participants wore an Actigraph accelerometer to measure activity levels at baseline and post-judo. All 14 children attended at least 75% of the 8 judo classes. Percentage of time spent in daily MVPA (8% vs 4%, p = .05) increased following the intervention. A high rate of participation and an increase in time spent in MVPA was observed following the 8-week program. Further research to examine causal mechanisms is warranted.

Physical activity rates in children and adolescents with autism spectrum disorder compared to the general population

Physical activity may improve symptoms and skill deficits associated with autism spectrum disorder (ASD). The objective of this study was to compare the reported frequency of physical activity and covariates in a large sample of children with ASD with children of similar age from the general population. The sample with ASD was derived from the Autism Treatment Network Registry Call Back Assessment (n = 611), and the general population data were derived from the National Survey of Children's Health (NSCH) (n = 71,811). In addition, demographic, child, and family (parent) factors were examined in relation to frequency of recent physical activity in children with ASD. Among males in the 6-11 year-old age group, those with ASD participated in physical activity less often (p <0.001) than those in the NSCH general population. Specifically, 33 % of boys 6-11 years old in the NSCH group vs. only 17 % in the RCBA group 6-11 years old engaged in some physical activity every day, while 4 % of boys in the NSCH group vs. 18 % in the RCBA group engaged in no physical activity whatsoever. A similar effect was seen across other age groups and in females but was not statistically significant. The demographic, child, and family characteristics associated with physical activity in children and adolescents with ASD included ethnicity in females, DSM-IV ASD diagnosis, IQ, and PAM-13 total score in females. Parents and caregivers are encouraged to find suitable physical activity programs for children with ASD. This may be especially important for 6-11 year-old boys with ASD who engage in significantly less physical activity than their peers in the general population.

Parents' experiences of information-seeking and decision-making regarding complementary medicine for children with autism spectrum disorder: a qualitative study

Background

Complementary and alternative medicine and therapies (CAM) are widely used by parents of children with autism spectrum disorder (ASD). However, there is a gap in our understanding of how and why parents of children with ASD make decisions about CAM treatment, and how “evidence” influences their decision-making. The aim of this study was to explore views and perspectives on CAM decision-making among parents of children with ASD in Australia.

Methods

Semi-structured interviews were conducted with parents of children with ASD (18 years and under) who were living in Australia. The interviews were digitally recorded, transcribed and then analysed using thematic analysis.

Results

Twenty-one parents were interviewed (20 women and one man). The mean age of participants was 43 years, (SD = 5.12 years), the majority of whom were born in Australia (71%), and almost half (43%) had a bachelor degree or higher. Three main themes were identifiedin the thematic analysis. First theme was ‘Parents’ experiences of researching CAM treatments, the second theme was, “Navigating CAM information and practices”, which comprises of the subthemes: Assessing information on CAM treatments’ What counts as ‘evidence’? and Assessing the impact of CAM treatments on the child - What counts as effective?, and the final theme was, “Creating a central and trustworthy source about CAM”.

Across themes parents’ CAM decision-making was described as pragmatic, influenced by time, cost, and feasibility. Parents also reported that information on CAM was complex and often conflicting, and the creation of a centralised and reliable source of information on CAM was identified as a potential solution to these challenges.

Conclusion

The development of evidence-based information resources for parents and supporting CAM health literacy may assist with navigating CAM decision-making for children’s with ASD.

Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis

Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD = −0.76, 95% CI −0.91 to −0.60, p = 0.04, I² = 47.4%) and depression (SMD = −0.86, 95% CI −1.14 to −0.58, p = 0.000, I² = 71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

Promoting Executive Functioning in Children with Autism Spectrum Disorder Through Mixed Martial Arts Training

The present study evaluated the effectiveness of a mixed martial arts (MMA) intervention in improving executive functions (EFs) in a sample with autism spectrum disorder (ASD). School-aged children with ASD were randomly assigned to a MMA intervention group or a waitlist control (WLC) group. The intervention featured a 26-class program over a 13-week period; the WLC group did not participate in any martial arts between pre- and post-test. Results indicated that the MMA group had significantly better EFs at post-test compared to the WLC group. The intervention appeared to be efficacious in meeting its goals of improving the executive functioning of children with ASD. The present study extends the current literature on the malleability of EFs among children with ASD.

Review: Yoga and mindfulness for youth with autism spectrum disorder: review of the current evidence

BACKGROUND

Yoga and mindfulness-based programs are becoming increasingly popular as a supplemental intervention for children and adolescents with autism spectrum disorders (ASD). Increasing numbers of children, parents, and schools are participating in programs around the country with an enthusiasm that far exceeds the research support for their efficacy. Therapies that are safe but not effective may not cause immediate harm. Nevertheless, the misappropriation of limited time and financial resources may result in missed opportunities. The need for clearly defined, evidence-based therapies for youth with ASD is essential.

METHOD

Electronic databases were searched for peer-reviewed intervention research studies using the key words autistic or autism in combination with yoga, mindfulness, or meditation. Eight studies met inclusion criteria.

RESULTS

The findings are described in this critical review of eight empirical research studies that implemented yoga and mindfulness-based interventions for children with ASD. Although few studies reported improvements in core symptoms of ASD, preliminary findings suggest that yoga and mindfulness-based interventions are feasible and may improve a variety of prosocial behaviors, including communication and imitative behaviors; increased tolerance of sitting and of adult proximity; self-control; quality of life; and social responsiveness, social communication, social cognition, preoccupations, and social motivation. Reductions in aggressive behaviors, irritability, lethargy, social withdrawal, and noncompliance were also reported.

CONCLUSIONS

Based on the available literature, the empirical evidence to support the efficacy of yoga and mindfulness-based interventions for children and adolescents with ASD is inconclusive. The current body of research has significant limitations, including small sample sizes, no fidelity measures, and no control groups. Each of the eight studies, however, reported some positive effects on social, emotional, or behavioral metrics. These early results are promising and sufficient to warrant support for further research.

Physical Activity Interventions for Children with Social, Emotional, and Behavioral Disabilities-A Systematic Review

OBJECTIVE

Perform a systematic review of the available literature regarding the effectiveness of exercise interventions on children with any type of social, emotional, or behavioral disability (SEBD), with attention to a range of physiological, behavioral, and mood outcomes.

METHODS

Six databases were searched using a systematic methodology. References of included studies, as well as relevant reviews, were also examined. The review was limited to studies published since 2000 reporting a quantitative analysis of the effects of a physical activity (PA) intervention on at least 1 behavioral, psychological, or cognitive outcome in children aged 21 and under, diagnosed with a SEBD. Only studies with a control group were included.

RESULTS

We identified 24 eligible studies. Studies varied in design, participant characteristics, and intervention characteristics (single-bout vs repeated exposure, duration, intensity level, mode of exercise). Of the 20 behavioral outcome assessments, there was 1 negative finding, 12 null findings, 5 positive findings, and 2 mixed findings. For the 25 executive functioning outcome assessments, there were 5 null findings, 18 positive findings, and 2 mixed findings. For the remaining outcome domains, 1 of 2 studies looking at academic performance, 3 of 6 studies looking at objective neurological measures, and 1 of 3 studies looking at affect outcomes found positive results. All other results were null or mixed.

CONCLUSION

Although additional research is warranted to further understand the mechanisms by which PA affects behavioral and cognitive outcome measures in children with SEBDs, PA offers a safe and alternative form of treatment for this population.

Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder

We examined the association of two types of restricted and repetitive behaviors, repetitive sensory motor (RSM) and insistence on sameness (IS), with sleep problems in children with autism spectrum disorder (ASD). Participants included 532 children (aged 2-17) who participated in the Autism Speaks Autism Treatment Network research registry. Confirmatory factor analysis of the Autism Diagnostic Interview-Revised detected the presence of RSM and IS. RSM behaviors were positively associated with parent-reported sleep problems, and this relationship remained significant after controlling for anxiety symptoms. IS was not significantly associated with sleep problems. Better understanding of the relationship between specific types of repetitive behaviors and sleep problems may allow providers to tailor interventions to the individual presentations of their patients with ASD.

A Chinese Chan-based Mind-Body Intervention Improves Memory of Older Adults

There is growing interest in the adoption of lifestyle interventions to remediate age-related declines in memory functioning and physical and psychological health among older adults. This study aimed to investigate whether a Chinese Chan-based lifestyle intervention, the Dejian Mind-Body Intervention (DMBI), leads to positive benefits for memory functioning in older adults. Fifty-six adults aged 60 years or older with subjective memory complaints (SMC) were randomly assigned to receive the DMBI or a control intervention (i.e., a conventional memory intervention; MI) once a week for 10 weeks; 48 of the adults completed the intervention. Participants’ verbal and visual memory functioning before and after the intervention were compared. In addition, changes in the participants’ subjective feelings about their memory performance and physical and psychological health after the intervention were examined. The results showed that both the DMBI and MI resulted in significant improvements in both verbal and visual memory functioning and that the extent of the improvements was correlated with participants’ level of performance at baseline. In addition, compared to the MI group, the DMBI group had significantly greater improvements in subjective physical and psychological health after the intervention. In summary, the present findings support the potential of the DMBI as an alternative lifestyle intervention for improving memory functioning, subjective physical and psychological health of older adults with SMC.

Autism and Mind-Body Therapies: A Systematic Review

BACKGROUND

Mind-body therapies are often used by people with autism spectrum disorders (ASD). However, there has been little examination into which types of mind-body therapies have been investigated for people with ASD and for what purposes. A systematic review was conducted to evaluate the existing evidence for mind-body therapies for people with ASD, particularly to determine the types of mind-body therapies used and the outcomes that are targeted.

METHODS

PubMed, PsychInfo, and Scopus were searched using terms for ASD and mind-body therapies. Sixteen studies were selected for review; these studies tested interventions using mindfulness, meditation, yoga, Nei Yang Gong, and acceptance commitment therapy. Most study outcomes targeted behavior, psychological symptoms, and quality of life for children and adults with ASD as well as their parents.

RESULTS

There was little overlap between studies on the types of mind-body therapies used and associated outcomes, and only three of the studies were randomized controlled trials. Most studies were small and uncontrolled. Some studies modified the mind-body therapies to increase accessibility for people with ASD.

CONCLUSION

The evidence for mind-body therapies for people with ASD is limited and would benefit from larger randomized controlled trials.

Evaluating Exercise as Evidence-Based Practice for Individuals with Autism Spectrum Disorder

Background

The purpose of this study was to conduct a systematic review of the literature to evaluate empirical support for the use of exercise as an evidence-based practice (EBP) for individuals with autism spectrum disorder (ASD), aged 1–21 years, using the Adapted Physical Activity Taxonomy (APAT) (1).

Method

A systematic review of research, published within the past 10 years and accessible in SPORTDiscus, ProQuest Nursing, Science Direct, ERIC, Ovid MEDLINE, and PsychINFO databases, was conducted following seven inclusion criteria. An initial 169 articles were identified of which 23 articles were found that met the inclusion criteria including implementation of an exercise intervention for participants diagnosed with ASD and utilization of an experimental/quasi experimental, correlational, single–subject, or qualitative research design. These 23 articles were evaluated using the APAT to determine the quality of the research and the strength of the recommendation in establishing exercise as an EBP.

Results

Of the 23 articles evaluated, 17 employed an experimental/quasi experimental design, 1 article employed a correlational design, and 5 articles employed a single-subject design. Only one article (2) was found to meet the minimum overall quality indicator of moderate (i.e., Level 2) when evaluated on the APAT. In total, 13 of the 23 articles (57%) had method sections evaluated as weak, and 17 of the 23 articles (74%) had results sections evaluated as weak.

Conclusion

From the findings of this systematic review, and in accordance with the Every Student Succeeds Act of 2015 (3) definition of an EBP, it appears that exercise can be considered an EBP for school-aged children with ASD. However, this recommendation is based solely on moderate evidence from one well-designed and well-implemented experimental study; therefore, generalization is still pending further similar findings. Recommendations for future research are offered.

Reduced endogenous urinary total antioxidant power and its relation of plasma antioxidant activity of superoxide dismutase in individuals with autism spectrum disorder

Individuals with autism spectrum disorders (ASD) have impaired detoxification capacity. Investigating　the neurobiological bases of　impaired antioxidant capacity is thus a research priority in the pathophysiology of ASD.　We measured　the urinary levels of hexanoyl-lysine (HEL) which is a new oxidative stress　biomarker, total antioxidant power (TAP) and DNA methylation biomarker 8-hydroxy-2'-deoxyguanosine (8-OHdG), and the plasma levels of superoxide dismutase (SOD), which is a major antioxidant enzyme. We examined whether the urinary levels of these enzymes and biomarkers may be related to symptoms of social impairment in 20 individuals with ASD (meanage,11.1±5.2years) and 12 age- and gender-matched healthy controls (meanage,14.3±6.2years). Symptoms of social impairment were　assessed using the Social Responsiveness Scale (SRS). The dietary TAP of the fruit juice, chocolate, cookies, biscuits, jam and marmalade were significantly higher in the ASD group than in the control group, although the intake of nutrients was not significantly different between the groups. The urinary TAP levels were significantly lower in the ASD group than in the control group. There were no significantly differences in urinary HEL and 8-OHdG levels between the ASD and control groups. The SRS scores were significantly higher in the ASD group than in the control group. Stepwise regression analysis revealed that urinary TAP levels and plasma SOD levels can differences in the biomarkers and the SRS scores between the ASD group and the control group. The endogenous antioxidant capacity may be deficient without altered urinary HEL and 8-OHdG levels in individuals with ASD. The plasma SOD levels may be related to reduced endogenous antioxidant capacity.

Development and application of neuropsychology in Hong Kong: implications of its value and future advancement

OBJECTIVE

To review the development, application, and value of neuropsychology, and the standard education and training pathway for neuropsychologists or clinical neuropsychologists in Hong Kong.

METHOD

The information provided here was gathered via a literature review of the status of neuropsychology and the validity of commonly adopted neuropsychological tests in Hong Kong. Additional details were acquired via the internet about local tertiary education curricula and the related requirements, the availability of professional associations for licensure or board certification, and relevant statistics/surveys conducted by the government. Some information about the clinical practice of neuropsychology was collected through personal communication with local clinical psychologists.

RESULTS

The development of neuropsychology in Hong Kong over the past 20 years is rapid and productive, given the increasing application of advanced neuroimaging techniques, neuropsychological tests, and opportunities for exchanging up-to-date neuropsychological knowledge and professional training through international conferences, workshops, and seminars. Given that neuropsychology services are often provided by clinical psychologists who are master's degree graduates in clinical psychology, the relatively limited training in neuropsychological knowledge and skills and the lack of division for membership or mandatory registration as a neuropsychologist/clinical neuropsychologist may have an impact on the quality of clinical neuropsychological services and the development of this specialty.

CONCLUSIONS

These findings signify a need for further improvement or refinement of educational and training pathways for neuropsychologist or clinical neuropsychologist along with the recognition of its value in clinical practice through registration of different disciplines of psychology in Hong Kong.

The impacts of physical activity intervention on physical and cognitive outcomes in children with autism spectrum disorder

This study examined the effects of a 12-week physical activity intervention on the motor skill proficiency and executive function of 22 boys (aged 9.08 ± 1.75 years) with autism spectrum disorder. In Phase I of the 12 weeks, 11 boys with autism spectrum disorder (Group A) received the intervention, whereas the other 11 boys with autism spectrum disorder (Group B) did not (true control, no intervention). The arrangement was reversed in Phase II, which lasted an additional 12 weeks. The Bruininks–Oseretsky Test of Motor Proficiency, Second Edition, and the Wisconsin Card Sorting Test were conducted three times for each participant (Group A, primary grouping: baseline (T1), post-assessment (T2), and follow-up assessment (T3); Group B, control grouping: T1−T2; intervention condition, T2−T3). The main findings were that both groups of children with autism spectrum disorder significantly exhibited improvements in motor skill proficiency (the total motor composite and two motor-area composites) and executive function (three indices of the Wisconsin Card Sorting Test) after 12 weeks of physical activity intervention. In addition, the effectiveness appeared to have been sustained for at least 12 weeks in Group A. The findings provide supporting evidence that physical activity interventions involving table tennis training may be a viable therapeutic option for treating children with autism spectrum disorder.

Neuroenhancement of Memory for Children with Autism by a Mind-Body Exercise

The memory deficits found in individuals with autism spectrum disorder (ASD) may be caused by the lack of an effective strategy to aid memory. The executive control of memory processing is mediated largely by the timely coupling between frontal and posterior brain regions. The present study aimed to explore the potential effect of a Chinese mind–body exercise, namely Nei Gong, for enhancing learning and memory in children with ASD, and the possible neural basis of the improvement. Sixty-six children with ASD were randomly assigned to groups receiving Nei Gong training (NGT), progressive muscle relaxation (PMR) training, or no training for 1 month. Before and after training, the participants were tested individually on a computerized visual memory task while EEG signals were acquired during the memory encoding phase. Children in the NGT group demonstrated significantly enhanced memory performance and more effective use of a memory strategy, which was not observed in the other two groups. Furthermore, the improved memory after NGT was consistent with findings of elevated EEG theta coherence between frontal and posterior brain regions, a measure of functional coupling. The scalp EEG signals were localized by the standardized low resolution brain electromagnetic tomography method and found to originate from a neural network that promotes effective memory processing, including the prefrontal cortex, the parietal cortex, and the medial and inferior temporal cortex. This alteration in neural processing was not found in children receiving PMR or in those who received no training. The present findings suggest that the mind–body exercise program may have the potential effect on modulating neural functional connectivity underlying memory processing and hence enhance memory functions in individuals with autism.