Abstract
This systematic review aims to describe six types of physical activity interventions utilized with children and young adults ages 5–22 as a treatment for ASD. These interventions include swimming, cycling, neuromuscular training, yoga, sports, and exergaming. This examines the knowledge gaps regarding the details of these interventions via time (sessions, per week, overall length), the severity of ASD in participants (using a 4-point scale), and the outcomes specific to ASD (cognition, social skills, physical fitness, and behavior). A systematic search of peer-reviewed research articles was conducted across five databases focusing on physical activity as an intervention for children and young adults with ASD. From an initial screening of 387 records, 29 of the studies were included in the review. The analysis includes types of intervention, dependent measures, research design, and intervention duration. Types of intervention most studied (swimming, cycling, neuromuscular training, yoga, sports, and exergaming) were further analyzed. All studies found that physical activity as an intervention, improved aspects of physical fitness (endurance, strength, balance), cognition, social skills (language, eye contact, engaging with others), and/or behavior.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Anderson-Hanley, C., Tureck, K., & Schneiderman, R. L. (2011). Autism and exergaming: Effects on repetitive behaviors and cognition. Psychology Research and Behavior Management, 4, 129–137. https://doi.org/10.2147/PRBM.S24016
Arnell, S., Jerlinder, K., & Lundqvist, L. O. (2020). Parents’ perceptions and concerns about physical activity participation among adolescents with autism spectrum disorder. Autism, 24(8), 2243–2255.
Bahrami, F., Movahedi, A., Marandi, S. M., & Abedi, A. (2012). Kata techniques training consistently decreases stereotypy in children with autism spectrum disorder. Research in Developmental Disabilities, 33(4), 1183–1193. https://doi.org/10.1016/j.ridd.2012.01.018
Bass, M. M., Duchowny, C. A., & Llabre, M. M. (2009). The effect of therapeutic horseback riding on social functioning in children with autism. Journal of Autism and Developmental Disorders, 39(9), 1261–1267. https://doi.org/10.1007/s10803-009-0734-3
Batrakoulis, A., Jamurtas, A. Z., Georgakouli, K., Draganidis, D., Deli, C. K., Papanikolaou, K. et al. (2018). High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial. PloS one, 13(8), e0202390. https://doi.org/10.1371/journal.pone.0202390
Berger, D. L., Silver, E. J., & Stein, R. E. (2009). Effects of yoga on inner-city children’s well-being a pilot study. Altern Ther Health Med., 5, 36–42.
Bremer, E., Crozier, M., & McDonald, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20, 899–915.
Cai, K. L., Wang, J. G., Liu, Z. M., Zhu, L. N., Xiong, X., Klich, S., Maszczyk, A., & Chen, A. G. (2020). Mini-Basketball Training Program Improves Physical Fitness and Social Communication in Preschool Children with Autism Spectrum Disorders. Journal of Human Kinetics, 73, 267–278. https://doi.org/10.2478/hukin-2020-0007
Caro, K., Tentori, M., Martinez-Garcia, A. I., & Alvelais, M. (2017). Using the Froggy Bobby exergame to support eye-body coordination development of children with severe autism. International Journal of Human-Computer Studies, 105, 12–27. https://doi.org/10.1016/j.ijhcs.2017.03.005
Castillo, C., & Olive D. (2018). Biking? let’s make it happen!’: Cycling intervention to enhance motor skills, social interaction and inclusion of pupils with autism and other special needs.” 13th FIEP European Congress. https://www.academia.edu/42875687/_Biking_Lets_Make_it_Happen_Cycling_intervention_to_enhance_motor_skills_social_interaction_and_inclusion_of_pupils_with_Autism_and_other_special_needs
Chen, H., Wang, J., Uddin, L. Q., Wang, X., Guo, X., Lu, F., Duan, X., Wu, L., & Chen, H. (2018). Aberrant functional connectivity of neural circuits associated with social and sensorimotor deficits in young children with autism spectrum disorder. Autism Research, 11(12), 1643–1652. https://doi.org/10.1002/aur.2029
Cristian, P., & Elsayed, M. (2019). Effectiveness of neuromuscular training on functional balance for children with neurodevelopmental disorders. Science, Movement and Health, XIX, no. 2
DeFilippis, M., & Wagner, K. D. (2016). Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacology Bulletin, 46(2), 18–41.
Duffy, L., Baluch, B., Welland, S., & Raman, E. (2017). Effects of Physical Activity on Debilitating Behaviours. In 13- to 20-Year-Old Males with Severe Autism Spectrum Disorder. Journal of Exercise Rehabilitation, 13, 3:340–347. https://doi.org/10.12965/jer.1734960.480
Eime, R. M., Young, J. A., Harvey, J. T., Charity, M. J., & Payne, W. R. (2013). A systematic review of the psychological and social benefits of participation in sport for children and adolescents: Informing development of a conceptual model of health through sport. The International Journal of Behavioral Nutrition and Physical Activity, 10, 98. https://doi.org/10.1186/1479-5868-10-98
Ennis, E. (2011). The effects of a physical therapy-directed aquatics program on children with autism spectrum disorders. The Journal of Aquatic Physical Therapy, 19(1), 4–10.
Fowler, E. G., Knutson, L. M., DeMuth, S. K., Sugi, M., Siebert, K., Simms, V., Azen, S. P., & Winstein, C. J. (2007). Pediatric endurance and limb strengthening for children with cerebral palsy (PEDALS)–a randomized controlled trial protocol for a stationary cycling intervention. BMC Pediatrics, 7, 14. https://doi.org/10.1186/1471-2431-7-14
Fragala-Pinkham, M. A., Haley, S. M., & O’Neil, M. E. (2011). Group swimming and aquatic exercise programme for children with autism spectrum disorders: A pilot study. Developmental Neurorehabilitation, 14(4), 230–241. https://doi.org/10.3109/17518423.2011.575438
Gabriels, R. L., Pan, Z., Dechant, B., Agnew, J. A., Brim, N., & Mesibov, G. (2015). Randomized controlled trial of therapeutic horseback riding in children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(7), 541–549. https://doi.org/10.1016/j.jaac.2015.04.007
Gao, Y., & Mandryk, R. (2012). The acute cognitive benefits of casual exergame play. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI '12). Association for Computing Machinery, New York, NY, USA, 1863–1872. https://doi.org/10.1145/2207676.2208323
Han, A., Fu, A., Cobley, S., & Sanders, R. H. (2018). Effectiveness of exercise intervention on improving fundamental movement skills and motor coordination in overweight/obese children and adolescents: A systematic review. Journal of Science and Medicine in Sport, 21(1), 89–102. https://doi.org/10.1016/j.jsams.2017.07.001
Hauck, J., Jeong, L., Esposito, P., MacDonald, M., & Ulrich, D. (2014). (PDF) Benefits of bicycle riding in adolescents with autism and down syndrome.” ResearchGate, Taylor & Francis (Routledge), www.researchgate.net/publication/296047766_Benefits_of_Bicycle_Riding_in_Adolescents_With_Autism_and_Down_Syndrome.
Healy, S., Nacario, A., Braithwaite, R. E., & Hopper, C. (2018). The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Autism Research : Official Journal of the International Society for Autism Research, 11(6), 818–833. https://doi.org/10.1002/aur.1955
Heyn, P. (2003). The effect of a multisensory exercise program on engagement, behavior, and selected physiological indexes in persons with dementia. American Journal of Alzheimer’s Disease & Other Dementias, 18(4), 247–251. https://doi.org/10.1177/153331750301800409
Hilton, C. L., Cumpata, K., Klohr, C., Gaetke, S., Artner, A., Johnson, H. et al. (2014). Effects of exergaming on executive function and motor skills in children with autism spectrum disorder: a pilot study. American Occupational Therapy Association, 68(1), 57–65. https://doi.org/10.5014/ajot.2014.008664
Hutzler, Y., & Margalit, M. (2009). Skill acquisition in students with and without pervasive developmental disorder. Research in Autism Spectrum Disorders. https://doi.org/10.1016/j.rasd.2009.01.011
Jimeno, M. (2019). Improving the quality of life of children and adolescents with autism spectrum disorders through athletic-based therapy programs. The Educational and Developmental Psychologist, 36(2), 68–74. https://doi.org/10.1017/edp.2019.7
Kaur, M., & Bhat, A. (2019). Creative Yoga Intervention Improves Motor and Imitation Skills of Children With Autism Spectrum Disorder. Physical therapy, 99(11), 1520–1534. https://doi.org/10.1093/ptj/pzz115.
Koenig, K. P., Buckley-Reen, A., & Garg, S. (2012). Efficacy of the Get Ready to Learn yoga program among children with autism spectrum disorders: A pretest-posttest control group design. The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association, 66(5), 538–546.
Kozlowski, K. F., Lopata, C., Donnelly, J. P., Thomeer, M. L., Rodgers, J. D., & Seymour, C. (2020). Feasibility and associated physical performance outcomes of a high-intensity exercise program for children with autism. Research Quarterly for Exercise and Sport, 1, 12. https://doi.org/10.1080/02701367.2020.1726272
Lang, R., Koegel, L. K., Ashbaugh, K., et al. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4, 565–576.
Lawson, L. M., & Little, L. (2017). Feasibility of a swimming intervention to improve sleep behaviors of children with autism spectrum disorder. Therapeutic Recreation Journal, 51(2), 97–108. https://doi.org/10.18666/trj-2017-v51-i2-7899
Lee, J., & Porretta, D. (2012). Enhancing the Motor Skills of Children with Autism Spectrum Disorders: A Pool-based Approach. Journal of Physical Education, Recreation & Dance, 84(1), 41–45. https://doi.org/10.1080/07303084.2013.746154
Lee, J., & Porretta, D. (2016). The effect of instruction on stereotypic behaviors of boys with autism spectrum disorder: A pilot study. Palestra, 30(1), 18–22.
Lochbaum, M., & Crews, D. (2003). Viability of cardiorespiratory and muscular strength programs for the adolescent with autism. Complementary Health Practice Review, 8, 225–233. https://doi.org/10.1177/1076167503252917
Magnusson, J. E., Cobham, C., & McLeod, R. (2012). Beneficial effects of clinical exercise rehabilitation for children and adolescents with autism spectrum disorder. Journal of Exercise Physiology (online), 15(2), 71–79.
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M. et al. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1). https://doi.org/10.1186/2046-4053-4-1
Moon, H. Y., & van Praag, H. (2018). On the run for hippocampal plasticity. Cold Spring Harbor perspectives in medicine, 8(4), a029736.
Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American Journal of Medical Sciences, 6(5), 199–209. https://doi.org/10.4103/1947-2714.132935
Narasingharao, K. (2017). Efficacy of structured yoga intervention for sleep, gastrointestinal and behaviour problems of asd children: An exploratory study. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/jcdr/2017/25894.9502
National Autism Center. (2015). National Standards Project, Phase 2. National Autism Center at May Institute. Retrieved January 15, 2021, from https://nationalautismcenter.org/national-standardsproject/phase-2/
Oriel, K. N., George, C. L., Peckus, R., & Semon, A. (2011). The effects of aerobic exercise on academic engagement in young children with autism spectrum disorder. Pediatric Physical Therapy, 23, 197–193.
Pan, C.-Y. (2010). Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders. Autism, 14(1), 9–28. https://doi.org/10.1177/1362361309339496
Paterno, M. V., Myer, G. D., Ford, K. R., & Hewett, T. E. (2004). Neuromuscular training improves single-limb stability in young female athletes. Journal of Orthopedic Sports and Physical Therapy, 34(6), 305–316. https://doi.org/10.2519/jospt.2004.34.6.305 PMID: 15233392.
Peña, O., Cibrian, F. L., & Tentori, M. (2020). Circus in motion: A multimodal exergame supporting vestibular therapy for children with autism. Journal on Multimodal User Interfaces. https://doi.org/10.1007/s12193-020-00345-9
Perez-Gomez, J., Olmedillas, H., Delgado-Guerra, S., Ara, I., Vicente-Rodriguez, G. et al. (2008). Effects of weight lifting training combined with plyometric exercises on physical fitness, body composition, and knee extension velocity during kicking in football. Applied Physiology, Nutrition, and Metabolism, 33(3), 501–510. https://doi.org/10.1139/H08-026
Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA.2018;320(19):2020–2028. https://doi.org/10.1001/jama.2018.14854
Radhakrishna, S., Nagarathna, R., & Nagendra, H. R. (2010). Integrated approach to yoga therapy and autism spectrum disorders. Journal of Ayurveda and Integrative Medicine, 1(2), 120. https://doi.org/10.4103/0975-9476.65089
Ringenbach, S. D. R., Lichtsinn, K. C., & Holzapfel, S. D. (2015). Assisted cycling therapy (ACT) improves inhibition in adolescents with autism spectrum disorder. Journal of Intellectual & Developmental Disability, 40, 376–387. https://doi.org/10.3109/13668250.2015.1080352
Rosenthal-Malek, A., & Mitchell, S. (1997). Brief report: The effects of exercise on the self-stimulatory behaviors and positive responding of adolescents with autism. Journal of Autism and Developmental Disorders, 27, 193–202.
Sam, K., Chow, B., & Tong, K. (2015). Effectiveness of exercise-based interventions for children with autism: A systematic review and meta-analysis. International Journal of Learning and Teaching, 1(2), 98–103.
Sansi, A., Nalbant, S., & Ozer, D. (2020). Effects of an inclusive physical activity program on the motor skills, social skills and attitudes of students with and without autism spectrum disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-020-04693-z
Schmid, A., Puymbroeck, M., Altenburger, P., Schalk, N., Dierks, T., Miller, K., & Williams, L. (2012). Poststroke balance improves with yoga. Stroke, 43(9), 2402–2407. https://doi.org/10.1161/STROKEAHA.112.658211
Schmitz O., Stefanie; Mcfadden, B.A., Golem, D. L., Pellegrino, J.K., Walker, A.J., Sanders, D.J., & Arent, S.M. (2017). The effects of exercise dose on stereotypical behavior in children with autism. Medicine & Science in Sports & Exercise, 49, 983-990https://doi.org/10.1249/MSS.0000000000001197
Shams-Elden, M. (2017). Effect of aquatic exercises approach (Halliwick-therapy) on motor skills for children with autism spectrum disorders. Science, Movement and Health, XVI, I(2), 490–496.
Shavikloo, J., & Norasteh, A. (2018). The effect of integrative neuromuscular training on postural control of children with autism spectrum. Neurology and Neurosurgery, 1(2), https://doi.org/10.15761/nns.1000107
Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2018). Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010. Journal of Autism and Developmental Disorders, 48(8), 2663–2676. https://doi.org/10.1007/s10803-018-3521-1
Sotoodeh, M. S., Arabameri, E., Panahibakhsh, M., Kheiroddin, F., Mirdoozandeh, H., & Ghanizadeh, A. (2017). Effectiveness of yoga training program on the severity of autism. Complementary Therapies in Clinical Practice, 28, 47–53.
Staiano, A. E., & Calvert, S. L. (2011). Exergames for Physical Education Courses: Physical, Social, and Cognitive Benefits. Child development perspectives, 5(2), 93–98. https://doi.org/10.1111/j.1750-8606.2011.00162.x
Tiner, S., Cunningham, G. B., & Pittman, A. (2021). “Physical activity is beneficial to anyone, including those with ASD”: Antecedents of nurses recommending physical activity for people with autism spectrum disorder. Autism, 25(2), 576–587.
Toscano, C. V. A., Carvalho, H. M., & Ferreira, J. P. (2017). Exercise effects for children with autism spectrum disorder: Metabolic health, autistic traits, and quality of life. Perceptual and Motor Skills, 125(1), 126–146. https://doi.org/10.1177/0031512517743823
Yilmaz, I., Yanardağ, M., Birkan, B., & Bumin, G. (2004). Effects of swimming training on physical fitness and water orientation in autism. Pediatrics International, 46(5), 624–626.
Young, S., & Furgai, K. (2016). Exercise effects in individuals with autism spectrum disorder: A short review. Autism Open Access, 6(180), 2.
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Hynes, J., Block, M. Effects of Physical Activity on Social, Behavioral, and Cognitive Skills in Children and Young Adults with Autism Spectrum Disorder: a Systematic Review of the Literature. Rev J Autism Dev Disord 10, 749–770 (2023). https://doi.org/10.1007/s40489-022-00319-5
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DOI: https://doi.org/10.1007/s40489-022-00319-5