# Exercise as it relates to Disease/The effects of physical activity on the social behaviour of children with Autism

This Wiki-book aims to critique the research study The Effects of Structured Physical Activity Program on Social Interaction and Communication for Children with Autsm by Mengxian Zhao and Shihui Chen.

## What is the background to this research?

Autsm Spectrum Disorder is a neurological and developmental disease causing many deficits in children’s social interactions and communication skills. This results in not only consequences for the child but also for their families and/or caretakers. Children with this disorder struggle with everyday activities creating great barriers towards interacting in social environments. This disease is becoming more and more prevalent, with a recent study in the United States revealing that 1 in every 44 (2.3%) eight- year-old's are being diagnosed with autsm spectrum disorder. Autsm can be diagnosed in children as young as 18 months of age making it vital to have early interventions available to reduce the significance of the disease. Children suffering from autsm are at a greater risk of developing further diseases due to their limited opportunities to participate in physical exercise. Inactivity in children poses a great threat to their health, development and overall quality of life. The proposed intervention aims at investigating the effectiveness of physical activity on the communication skills of children living with autsm spectrum disorder.

## Where is the research from?

The study was published in 2018 in the BioMed Research International Journal which publishes original research articles from a range of biomedical topics. The journal publication states that all researchers and editors are specialised experts in their field of study and all articles are peer reviewed and meet standards of academic excellence. The authors of the article are Mengxian Zhao and Shihui Chen. The authors declared that there were no conflicts of interest regarding the publication of the article, as well as providing information on their credentials adding to the credibility of the article.

## What kind of research was this?

A quasi-experimental design with an experimental group and a control group was utilized in this study to investigate the effects of a 12-week exercise program on children with autsm spectrum disorder. Using a quasi-experimental design means the participants were not randomly assigned but were put into groups based on non-random criteria. A recent study on the integrity of quasi-experimental designs suggests the lack of random assignment could weaken the study as questions arise regarding alternative explanations for causation.

## What did the research involve?

The study involved 50 participants aged 5 to 8 years old, selected from a special school of Shandong Province. The participants were recruited based on the DSM-V criteria . 25 of the participants were placed in the experimental group to participate in a structured physical activity program, while the remaining 25 were placed in the control group for regular physical activity. The 12-week structured program ran for 60 minutes per session with a total of 24 sessions. The intervention comprised of four parts; get-ready and warm up activities, one-to-five small group instructions, whole-group exercises and cool down. Both groups adopted the pre-test, interim-test and post-test design to monitor the progressive changes in the participants behaviour and social interactions. The intervention utilized the Treatment and Education of Autistic and Communication Handicapped Children model. The program was specialized to meet the needs of children with autsm, following specific recommendations and guidelines. Further tools were used to reduce drop-out rates such as a reward system to encourage the participants.
The short length of the study limited opportunities to observe long-term effects of the intervention and whether barriers to progression were present. The sample size of participants was small. This small sample size limited the possibility that generalisations could be accurately made from the study. Further, the cohort was selected from a specific school which limits applicability to the wider community and raises the question of causation.

## What were the basic results?

The main results from this study were collected using quantitative and qualitative instruments. The results from the experimental group showed overall improvements made in social skills, communication and cooperation (p < 0.005). SSIS and ABLIS-R results showed improvements in social skills and interactions across interim and post-tests in the experimental group p= 0.001 (p<0.005). Conversely, there were no statistically significant results in the control group (0 > 0.005). Parents, interviewers and volunteers responded to questionnaires which indicated significant changes in the participants social interactions by the end of the program. Changes were identified through improved eye contact, group participation and relationship building between the teachers and participants.
Researchers conclusion
The conclusions made by the researchers seem plausible and align with previous studies, promoting the idea of physical activity for children with autsm. The authors made note of the minor effects physical activity had in some aspects as well as the bigger impacts it had in other aspects of behaviour. Recognition of withdrawals were made by the authors, concluding that out of the fifty original participants, forty-one completed the full 12-weeks.

## What conclusions can we take from this research?

The study provides evidence suggesting that physical activity provides improvements in communication and social skills in children with Autsm Spectrum Disorder. A common barrier when working with this population is adherence and motivation. This was overcome by constructing an adaptive and purposeful program which naturally integrated communication elements into regular physical activities. A literature review looked at the fitness levels of children with autsm. While this doesn’t directly relate to implications in communication skills, it provides insight to the level of physical activity this population is participating in. The study found that children with autsm have a much weaker level of physical fitness compared with their peers, reinforcing the importance of finding ways to combat the low levels of physical activity within this population. Further research in this area is necessary to support the findings from this intervention allowing the results to become more applicable to the wider population.

## Practical advice

* Physical activity not only helps children with autsm better engage with their environment but also promotes a healthy lifestyle, reducing further risk factors for this population.
* Research from other studies have found keeping exercise programs simple and easy to follow, while including a variety of different activities that promote fitness, social interaction and independence important factors when constructing a program for this population. The current intervention implemented these factors providing a good example for further studies.
* The program did not result in any injuries or illnesses from the participants, deeming it safe for this population. Practitioners and caretakers of children with autsm should look to use a similar program to the one implemented in this study.

## Further information/resources

For further information on this topic please visit:
* https://www.healthdirect.gov.au/autism
* https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits
* https://raisingchildren.net.au/autism/learning-about-autism/about-autism/asd-overview

## References

Add in the references using this code
* 1 2 Zhao, M., & Chen, S. (2018). The effects of structured physical activity program on social interaction and communication for children with autism. BioMed research international, 2018.
* 1 2 The Royal Children's Hospital Specialist Autsm Team. (2021) 'Autsm Spectrum Disorder'. https://www.rch.org.au/kidsinfo/fact_sheets/Autism_spectrum_disorder/
* ↑ National Institute of Mental Health. (2022) 'Autsm Spectrum Disorder' https://www.nimh.nih.gov/health/statistics/autism-spectrum-disorder-asd
* ↑ Raising Children Network, (2022). 'Autsm: What is it?' https://raisingchildren.net.au/autism/learning-about-autism/about-autism/asd-overview
* 1 2 3 4 5 Memari, A. H., Panahi, N., Ranjbar, E., Moshayedi, P., Shafiei, M., Kordi, R., & Ziaee, V. (2015). 'Children with autism spectrum disorder and patterns of participation in daily physical and play activities.' Neurology research international, 2015.
* 1 2 Hindawi. (2022) 'Publication ethics' https://www.hindawi.com/publish-research/authors/publication-ethics/
* 1 2 3 Harris, A. D., McGregor, J. C., Perencevich, E. N., Furuno, J. P., Zhu, J., Peterson, D. E., & Finkelstein, J. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Informatics Association, 13(1), 16-23.
* ↑ Regier, D. A., Kuhl, E. A., & Kupfer, D. J. (2013). The DSM‐5: Classification and criteria changes. World psychiatry, 12(2), 92-98.
* ↑ Srinivasan, S. M., Pescatello, L. S., & Bhat, A. N. (2014). Current perspectives on physical activity and exercise recommendations for children and adolescents with autism spectrum disorders. Physical therapy, 94(6), 875-889.
* 1 2 Sean Healy. (2018) 'Autsm and Exercise: Special Benefits' https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits