Running Head: RESEARCH PAPER
Research Paper
Tuba ERFİDAN 1804673
Middle East Technical University
Faculty of Education
Department of Early Childhood Education
PHYSICAL ACTIVITY LEVEL OF CHILDREN WITH AUTISM SPECTRUM DISORDER CHILDREN
Abstract
Objective: To systematically review the available evidence of physical activity level of children with autism spectrum disorder and compare their physical activity with typically developing children. Design:Literature review. Population: Children with ASD and typically developing children. Method: EBSCOhost, Eric, SAGEjournals, BioMed Central, PubMed ELSEVIER, and SpringerLink databases were used in the review. Conclusions: It is contradictory. Even though some studies show that children with ASD have the similar physical activity level with their peers, some studies reveal that the children with ASD have less physical activity level compared to typically developing children.
Key Words: Autism Spectrum Disorder, Physical Activity and Children
Introduction
According to American Psychiatric Association (1994), autism spectrum disorder is a developmental characterized by difficulties in social interaction,
language and communication as well as by repetitive, restricted interest and
behaviours (cited in Chu et al., 2011). ASD also affects children with respect to
physical activity, social engagement, communication skill,behavioural control, making eye control, making friends
(Autism Society ofAmerica, 2002). Regular physical activity is an important factor to promote andmaintain a healthy lifestyle along the whole life cycle (Ekelund et al., cited in Chu et al., 2011). When children with ASD are compared with children without ASD, they have limited opportunities in order to participate in physical activity because of their
school-aged children with ASD (Green et al., Ozonoff et al., Pan, Tsai, & Chu cited in Chu et al., 2011).
Besides, statistics show that when children with ASD are compared with their typically developing peers, they are 40% more likely be obese and overweight (Anderson, Bandini, Curtin & Must, 2010). This present review will provide a way to compare physical activity patterns of children with autism and typically developing children.
Literature Review
The majority of children with ASD display weakness in posture, movement and strength (Kurtz, 2008). Because they have the lack of motor coordination, they may struggle to keep up with their peers in physical activity (Menear&Neumeier, 2015).
Biological differences may explain the difficulties with motor coordination of children with ASD. Neuroimaging studies have discovered that there are structural
brain differences between individuals with ASD and individuals without ASD (Lenroot& Yeung; Maximo, Cadena, & Kana, cited in Menear&Neumeier, 2015 ). However, whether the structural brain differences are results or causes of ASD is not known. Moreover, according toMenearandNeumeier (2015), structural differences may be barriers for individuals with ASD in order to approach physical activity.
study that has investigated physical activity between children with and without ASD (Pan, 2008). Pan and Frey (2006) examined that while children with ASD met minimum physical activity recommendations, they were less active than previous reports on peers without ASD using similar methodology. In contrast, Rosser-Sandt and Frey (2005) did not support Pan and Frey’s findings. They found that physical activity levels were not different in children with ASD and typically developing children. During recess, the groups acquired a majority of daily moderate physical activity. There is another study parallel to Pan and Frey (2006) study. In the study, Pan (2008) examined the percentage of time children with and without ASD spent in moderate-to vigorous physical activity (MVPA) during overall lunchtime, recess, first and second morning recess compared to those without disabilities.
The importance of physical activity to overall health for all individuals has been
well- documented and increasing physical activity among youth is critical. Nevertheless, there are limited studies about physical activity levels of children with ASD.
Studies examining physical activity level of children with ASD are mostly conducted with limited sample sizes. This is a weakness because small samples cannot
represent the
populationmeaningfully.Moreover, there is a limited descriptive and intervention-based study about physical activity of children with ASD and studies show that the rate of obesity in children with ASD is high. On the other hand, according to Frey and Pan (2006), overall research results provide novel and meaningful information with regard to physical activity patterns of children with ASD.
effects of physical activity on children with ASD and typically developing children. Methods
The following databases were searched to find related articles:EBSCOhost, Eric, SAGEjournals, BioMed Central, ELSEVIER, PubMed and SpringerLink. Key words were autism spectrum disorder, physical activity and children. At first, more than 10 articleswere found but all them was not directly related to physical activity level of children with ASD. Thus, some articles were eliminated and 10 articles were selected for the research paper. During the searching articles, to reach further articles, found articles’ reference lists were used.
One article was related to barriers, benefits, and strategies for success of children with ASD to physical activity. One of them examined school time physical activity of students with and without autism spectrum disorders during physical education and recess. Another study was about physical activities of
children with ASD and typically developing children during inclusive recess settings in Taiwan. Other study reviewed physical activity of children with ASD in middle school physical education. Also, the rest were related to physical activity patterns of children with ASD. Hence, these 10 articles were used in the different parts of the review.
Results
According to results, at first, children with ASD were less physically active than children without ASD in physical
education time (Hsieh, Pan & Tsai, 2011). (Table 1).
Table 1
Physical activity levels and patterns during physical education
ASD (n=19)Non-ASD (n=76) Mean Mean CPM 1,603.63 2,088.74
during PE, there is another comparison of the groups during recess. Davies and Joughin (1993) found that children without disabilities spent more time in moderate-to-vigorous physical activity (MVPA) than children with ASD during overall recess but in contrast Rosser-Sandt and Frey’ (2005) study did not support David and Joughin’s findings and then elaborated. In that study of Rosser-Sandt and Frey, it was found that children with ASD were
similarly active compared to other children without a disability during recess.
Thirdly, some studies examined children with ASD during physical education and recess time with respect to physical
activity and social engagement. Pan (2009) found that children with ASD were more active physically and socially during physical education than recess. (Table 2).
Table 2
Physical activity and social engagement during PE and recess (n=25)
PE Recess
PA 1538.35±862.38 1318.61±852.49 (Counts/min)
SE
(Total SE) 114.22±44.23 79.36±48.80 Note. PA= physical activity; PE= physical education; SE= social engagement.
Moreover, Pan (2009) compared MVPA of children with ASD and without ASD during PE and recess. Children with and without ASD spent a higher proportion of time in MVPA during physical education than recess.
In a study of 30 children with ASD within elementary (n=9), middle (n=9) and high (n=12) school, Frey and Pan (2006) found that elementary school children were more active than the other groups.
(2012) found that boys with ASD were significantly more active than girls with ASD. (Table 3).
Table 3
Level of physical activity between two genders
PA variables Gender
Boys (n=52) Girls (n=28) Overall PA 1637±570 1336±552 Weekdays PA 1622±574 1319±519 Weekends PA 1674±625 1379±625 School PA 1521±709 1271±778 After-school PA 1701±686 1342±464 Note. PA= physical activity.
As it can be seen on results, when children with ASD are compared with their typically developing peers, researches reached different results. While some of them asserted that children with ASD had less physical activity level during recess time and PE, some of them found that they had similar physical activity level.
Moreover, there are also studies which support the two results. A study conducted
in Taiwan by Pan, Tsai, and Hsieh (2011) also support the results. The study
indicated that children with ASD were less active than their peers without ASD during PE. On the other hand, Pan (2008) found that physical activity level of children with and without ASD was similar during PE. Besides, results show that physical activity level of children with ASD decreases with age (Pan &Frey, 2006). There is another study about the issue. Chu, et al., (2011) study of 35 children with ASD in different grades found that lower grade children were the most active compared with other older groups.
In Turkey, there is no clear data on the literature about physical activity and children with ASD. In a study conducted by Aydın and Sarol (2014), it is indicated that economic difficulties are the most important factors to participate in physical activity programs for individuals with ASD.
There are some suggestions for future studies. Firstly, there are differences in cognitive abilities, gross motor skills, social behaviours and skills and they might influence findings. Thus, future research is needed to understand the impact of some variables on physical activity behaviour in the population of children with ASD and results of these investigations should be interpreted with these limitations in mind (Pan, 2008).
Secondly, studies examining the physical activity level of children with ASD are lack of longitudinal design. However,
longitudinal study is necessary to properly identify social engagement and age
influences on physical activity. Thus, the researches need to design longitudinal designs (Pan, 2009)
Thirdly, sample size of studies is limited. The limited sample size affects the
homogeneity of sample and it does not representative of the population. Hence, further work with a larger sample of children with ASD is needed (Pan, 2008).
Additionally, the descriptive studies are lack of interventions. Thus, future
descriptive studies should be supported with intervention programs (Esposito, MacDonald, & Ulrich, 2011).
Finally, the teacher specialty has an effect on PA behaviour of students. Thus, the factor should be also considered in the future (Hsieh, Pan, & Tsai, 2011).
Implications
There are some implications for PE teachers, school policy makers, society and families.
First of all, for youth with and without ASD, extracurricular activities form a large part of activity options. On the other hand, Rosser (2004) found that extracurricular physical activity programs for youth withASD were lacking, depending on parents and teacher reports. For this reason, creating physical activity
programmes through appropriate activity modification and staff training is
necessary supports for the aim (Frey & Pan, 2006).
Secondly, Memari et al., (2012) asserted that because socio-demographic profile is also responsible for PA level of children with ASD, the children should be provided with PA opportunities depend on their socio-demographic profile. For this reason, teachers can cooperate with families so that they can learn children’s family structure, culture and background and then prepare their activities depend on these factors. Moreover, in order to this, PE teachers can arrange parent visits and parent-class activities.
Thirdly, teacher education is critical with respect to physical activity level of
children with ASD. Seminars, interactive programs can be organized. Also, special training about the issue can be provided to PE teachers. Books and magazines can be distributed to schools to reach PE teachers. Workshops can be arranged. Consequently, teachers not only learn what they should teach but also they have a chance to experience them with hands-on trainings.
Additionally, Esposito, Ulrich, and MacDonald (2011) declared that vigorous bouts of physical activities should be designed instead of stereotypy and self-stimulating behaviours. Hence, PE teachers and school policy makers should design programs and the environment by taking into account the fact.
Finally, according to Hsieh, Pan and Tsai (2011), school policies should include the content of physical activity of children with ASD and they should help to remove
barriers to promote PA among the population.
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