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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

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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.

    Book  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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 Congresshttps://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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • 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

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

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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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