The Efficacy of a Brief Behavioral Sleep Intervention in School-Aged Children With ADHD and Comorbid Autism Spectrum Disorder Developmental Profiles of Infants and Toddlers with Autism Spectrum Disorders Identified Prospectively in a Community-Based Setting Managing Repetitive Behaviours in Young Children with Autism Spectrum Disorder (ASD): Pilot Randomised Controlled Trial of a New Parent Group Intervention Sleep behaviors and sleep quality in children with autism spectrum disorders. Effect of Omega-3 and -6 Supplementation on Language in Preterm Toddlers Exhibiting Autism Spectrum Disorder Symptoms Use of Social Stories to Improve Self-Regulation in Children with Autism Spectrum Disorders Early identification and intervention in autism spectrum disorders: Some progress but not as much as we hoped Melatonin for Sleep in Children with Autism: A Controlled Trial Examining Dose, Tolerability, and Outcomes Early Language and Communication Development of Infants Later Diagnosed with Autism Spectrum Disorder Autism spectrum disorders in extremely preterm children. Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study. A systematic review of peer-mediated interventions for children with autism spectrum disorder. Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder A prospective study of the emergence of early behavioral signs of autism. A prospective study of autistic-like traits in unaffected siblings of probands with autism spectrum disorder. Challenges in Evaluating Psychosocial Interventions for Autistic Spectrum Disorders Teacher-implemented joint attention intervention: pilot randomized controlled study for preschoolers with autism. Teaching Parents Behavioral Strategies for Autism Spectrum Disorder (ASD): Effects on Stress, Strain, and Competence The Effect of Karate Techniques Training on Communication Deficit of Children with Autism Spectrum Disorders Effects of Cognitive-Behavioral Therapy on Anxiety in Children with Autism Spectrum Disorders: A Randomized Controlled Trial Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial. Social involvement of children with autism spectrum disorders in elementary school classrooms. A Randomized Controlled Trial of the Social Tools And Rules for Teens (START) Program: An Immersive Socialization Intervention for Adolescents with Autism Spectrum Disorder.
Objective : Sleep problems are common in children with autism spectrum disorders ( ASD ) and ADHD and impact adversely on child and parent well-being . The study evaluated the efficacy of a brief behavioral sleep intervention in children with comorbid ADHD – ASD . Method : A sub sample of children with ADHD – ASD ( n = 61 ; 5 - 13 years ; 89 % male ) participating in the Sleeping Sound With ADHD study were included in the current investigation . The sub sample comprised of 28 children r and omized to the sleep intervention group , while 33 were r and omized to usual clinical care .  The intervention consisted of two clinical consultations and a follow-up phone call covering sleep hygiene and st and ardized behavioral strategies . Results : Children with ADHD – ASD who received the intervention had large improvements in sleep problems and moderate improvements in child behavioral functioning 3 and 6 months post-r and omization . Conclusion : These findings suggest that a brief behavioral sleep intervention can improve sleep problems in children with ADHD – ASD This prospect i ve , longitudinal , study charted the developmental profiles of young children with Autism Spectrum Disorders ( ASD ) identified through routine developmental surveillance . 109 children with Autistic Disorder ( AD ) , ‘ broader ’ ASD , and developmental and /or language delays ( DD/LD ) were assessed using the Mullen Scales of Early Learning ( MSEL ) at 12-months ( n = 10 assessment s ) , 18-months ( n = 45 assessment s ) , and 24-months ( n = 99 assessment s ) . The children with AD performed most poorly , overall , than the ASD and DD/LD groups on the MSEL . Furthermore , the children with AD/ASD displayed an uneven cognitive profile , with poorer performance on verbal ( particularly receptive language ) relative to nonverbal skills . There was also evidence of developmental slowing in verbal skills from 18- to 24-months for children on the spectrum , especially those with AD . Given that the poor receptive , relative to expressive , language profile emerges very early in life for children with AD/ASD , this cognitive profile may serve as an additional red flag to social attention and communication deficits . Receptive language should therefore be stringently monitored in any developmental surveillance program for autism spectrum disorders in the second year of life Early intervention for autism spectrum disorder ( ASD ) tends to focus on enhancing social-communication skills . We report the acceptability , feasibility and impact on child functioning of a new 8 weeks parent-group intervention to manage restricted and repetitive behaviours ( RRB ) in young children with ASD aged 3–7 years . Forty-five families took part in the pilot RCT . A range of primary and secondary outcome measures were collected on four occasions ( baseline , 10 , 18 and 24 weeks ) to capture both independent ratings and parent-reported changes in RRB . This pilot established that parents were willing to be recruited and r and omised , and the format and content of the intervention was feasible . Fidelity of delivery was high , and attendance was 90 % . A fully powered trial is now planned STUDY OBJECTIVES ( 1 ) Compare sleep behaviors of children with autism spectrum disorders ( ASD ) with sleep behaviors of typically developing ( TD ) children using the Children 's Sleep Habits Question naire ( CSHQ ) ; ( 2 ) compare sleep quality --defined as mean activity , sleep latency , number of awakenings , sleep efficiency and total sleep time -- of the cohort of children with ASD and TD , as measured by 10 nights of actigraphy ; and ( 3 ) estimate the prevalence of sleep disturbances in the ASD and TD cohorts . DESIGN Descriptive cross-sectional study . SETTING The Children 's Hospital of Philadelphia . PARTICIPANTS R and omly selected children from the Regional Autism Center . The ASD cohort of 59 children , aged 4 to 10 years , ( 26 with autism , 21 with pervasive developmental disorder-not otherwise specified [ PDD-NOS ] , and 12 with Asperger disorder ) were compared with 40 TD control subjects . MEASUREMENTS AND RESULTS The  CSHQ  ,  sleep diaries  , and 10 nights of actigraphy  using the Sadeh algorithm of children with ASD and TD control subjects were compared . CSHQ showed 66.1 % of parents of children with ASD ( 62.5 % autism , 76.2 % PDD-NOS , 58.3 % Asperger disorder ) and 45 % of parents of the control subjects reported that their children had sleep problems . Actigraphic data showed that 66.7 % of children with ASD ( 75 % autism , 52.4 % PDD-NOS , 75 % Asperger disorder ) and 45.9 % of the control subjects had disturbed sleep . CONCLUSIONS The prevalence estimate of 45 % for mild sleep disturbances in the TD cohort highlights pediatric sleep debt as a public health problem of concern . The prevalence estimate of 66 % for moderate sleep disturbances in the ASD cohort underscores the significant sleep problems that the families of these children face . The predominant sleep disorders in the ASD cohort were behavioral insomnia sleep-onset type and insomnia due to PDD Delayed language development may be an early indicator of autism spectrum disorder ( ASD ) . Early intervention is critical for children with ASD , and the present study presents pilot data on a clinical trial of omega-3 and -6 fatty acid supplementation and language development , a secondary trial outcome , in children at risk for ASD . We r and omized 31 children to receive an omega-3 and -6 supplement or a placebo for 3 months , and measured their language abilities at baseline and after supplementation . Gesture use , but not word production , increased for children in the treatment group more than children in the placebo group . These results suggest possible effectiveness of omega-3 and -6 supplementation for language development in children at risk for ASD ABSTRACT A multiple baseline across participants design was used to evaluate the effects of Social Stories to help preschool-aged children with characteristics of Autism Spectrum Disorders ( ASD ) increase their engagement in functional behaviors and use sensory integrative-based strategies to promote self-regulation . Three children , 3–5 years old , from a self-contained preschool classroom were selected to participate in the study . The intervention package included reading individualized Social Stories that discussed desired behaviors and self-regulation strategies . The research ers measured the percentage of intervals in which participants engaged in desired behaviors . The frequency of desired behaviors increased for all participants . The use of self-regulation strategies varied across participants . These findings suggest that the intervention was successful in increasing desired behaviors of the three children . Further research is recommended on the effectiveness of embedding sensory integrative strategies into Social Stories . Practitioners may consider the use of Social Stories as a tool to increase independence and encourage self-regulated behaviors in children with characteristics of ASD Abstract Camarata 's ( 2014 ) review summarizes the progress that has been made in the field of early identification and early intervention in autism spectrum disorders ( ASD ) over the past few decades , but also provides a salutary reminder that much still needs to be done . Whilst it is possible to prospect ively identify cases of ASD using screening instruments ; it is critical that those using such screens in clinical practice underst and how to interpret data from published studies and consider how screening information is communicated to parents . After several decades when few r and omized controlled trials of early intervention in ASD were conducted , the last decade has seen an explosion of new studies . Despite initial optimism , as more trials are published they have highlighted the limits of , and challenges to , early intervention in ASD . Given the complex nature of ASD these sobering lessons are perhaps not surprising . Rather than promote despondency , they need to inspire and inform the next decade of clinical research to move the field forward to the benefit of young children with ASD and those who care for them Supplemental melatonin has shown promise in treating  sleep onset insomnia in children with autism spectrum disorders ( ASD ) . Twenty-four children , free of psychotropic medications , completed an open-label dose-escalation study to assess dose – response , tolerability , safety , feasibility of collecting actigraphy data , and ability of outcome measures to detect change during a 14-week intervention . Supplemental melatonin improved sleep latency , as measured by actigraphy , in most children at 1 or 3 mg dosages . It was effective in week 1 of treatment , maintained effects over several months , was well tolerated and safe , and showed improvement in sleep , behavior , and parenting stress . Our findings contribute to the growing literature on supplemental melatonin for insomnia in ASD and inform planning for a large r and omized trial in this population ABSTRACT . It is well recognized that delayed " first words " is among the most common presenting symptoms of autistic spectrum disorders ( ASD ) . However , data on earlier language and communication development in children with ASD are limited to retrospective reports from parents and from home videos . In this study , we prospect ively collected parent report data on early communication and language development in 97 infant siblings of children with ASD and 49 low-risk controls . Parents completed the  MacArthur Communicative Development Inventory-Infant Form  at 12 and 18 months . Analysis compared 3 groups defined on the basis of diagnostic assessment at 24 months : ( 1 ) siblings with ASD ( n = 15 ) , ( 2 ) siblings not meeting diagnostic criteria for ASD ( n = 82 ) , and ( 3 ) low-risk controls , none of whom had ASD ( n = 49 ) . Children with ASD showed delays in early language and communication compared with non-ASD siblings and controls . At 12 months , the ASD group was reported to underst and significantly fewer phrases and to produce fewer gestures . At 18 months , they showed delays in their underst and ing of phrases , comprehension and production of single words , and use of gestures . Siblings not diagnosed with ASD also used fewer play-related gestures at 18 months than low-risk controls , even when children with identified language delays were excluded . Overall , this prospect i ve study confirms that delays in communication and language development are apparent early in life in children with ASD , and emphasizes that developmental surveillance should include monitoring for delays in gesture , which may be among the earliest signs of ASD OBJECTIVES To investigate the prevalence , correlates , and antecedents of autism spectrum disorders ( ASD ) in extremely preterm children . STUDY DESIGN We conducted a prospect i ve study of all births < 26 weeks gestation in the United Kingdom and Irel and in 1995 . Of 307 survivors at 11 years , 219 ( 71 % ) were assessed and compared with 153 term-born classmates . Parents completed the  Social Communication Question naire ( SCQ )  to assess autism spectrum symptoms , and ASD were diagnosed by using a psychiatric evaluation . An IQ test and clinical evaluation were also administered . Longitudinal outcome data were available for extremely preterm children . RESULTS Extremely preterm children had significantly higher SCQ scores than classmates ( mean difference , 4.6 points ; 95 % CI , 3.4 - 5.8 ) . Sixteen extremely preterm children ( 8 % ) were assigned an ASD diagnosis , compared with none of the classmates . By hospital discharge , male sex , lower gestation , vaginal breech delivery , abnormal cerebral ultrasound scanning results , and not having had breast milk were independently associated with autism spectrum symptoms . By 6 years , independent associates were cognitive impairment , inattention and peer problems , withdrawn behavior at 2.5 years , and not having had breast milk . CONCLUSIONS Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood . These symptoms and disorders were associated with neurocognitive outcomes , suggesting that ASD may result from abnormal brain development in this population The purpose of this pilot study was to establish a model for r and omized controlled trial research , identify appropriate outcome measures , and address the effectiveness of sensory integration ( SI ) interventions in children with autism spectrum disorders ( ASD ) . Children ages 6 - 12 with ASD were r and omly assigned to a fine motor or SI treatment group . Pretests and posttests measured social responsiveness , sensory processing , functional motor skills , and social-emotional factors . Results identified significant positive changes in Goal Attainment Scaling scores for both groups ; more significant changes occurred in the SI group , and a significant decrease in autistic mannerisms occurred in the SI group . No other results were significant . The study discusses considerations for design ing future outcome studies for children with ASD BACKGROUND Peer mediated intervention ( PMI ) is a promising practice used to increase social skills in children with autism spectrum disorder ( ASD ) .  PMIs engage typically developing peers as social models to improve social initiations , responses , and interactions . METHOD The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group design s. Five studies met the pre-specified review inclusion criteria : four r and omized controlled trials and one pre- and post-test design . RESULTS Four of the studies were conducted in school setting s , whereas one study was conducted in a camp setting . The studies all reported that participants improved in social skills ( e.g. , social initiations , social responses , social communication ) post intervention . Additionally , sustainment , generalization , and fidelity of implementation were examined . CONCLUSION PMI is a promising approach to address social skills in children with ASD , and this approach can be conducted in meaningful real-word context s , such as schools . Limitations of the studies as well as future directions are discussed BACKGROUND Autism spectrum disorder ( ASD ) is a frequent developmental disorder characterized by pervasive deficits in social interaction , impairment in verbal and nonverbal communication , and stereotyped patterns of interests and activities . It has been previously reported that there is vitamin D deficiency in autistic children ; however , there is a lack of r and omized controlled trials of vitamin D supplementation in ASD children . METHODS This study is a double-blinded , r and omized clinical trial ( RCT ) that was conducted on 109 children with ASD ( 85 boys and 24 girls ; aged 3 - 10 years ) . The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children . ASD patients were r and omized to receive vitamin D3 or placebo for 4 months . The serum levels of 25-hydroxycholecalciferol ( 25 (OH)D ) were measured at the beginning and at the end of the study . The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale ( CARS ) , Aberrant Behavior Checklist ( ABC ) , Social Responsiveness Scale ( SRS ) , and the Autism Treatment Evaluation Checklist ( ATEC ) . TRIAL REGISTRATION NUMBER UMIN-CTR Study Design : trial number : UMIN000020281 . RESULTS Supplementation of vitamin D was well tolerated by the ASD children . The daily doses used in the therapy group was 300 IU vitamin D3/kg/day , not to exceed 5,000 IU/day . The autism symptoms of the children improved significantly , following 4-month vitamin D3 supplementation , but not in the placebo group . This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD . CONCLUSIONS This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients . Depending on the parameters measured in the study , oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD . At this stage , this study is a single RCT with a small number of patients , and a great deal of additional wide-scale studies are needed to critically vali date the efficacy of vitamin D in ASD OBJECTIVE To examine prospect ively the emergence of behavioral signs of autism in the first years of life in infants at low and high risk for autism . METHOD A prospect i ve longitudinal design was used to compare 25 infants later diagnosed with an autism spectrum disorder ( ASD ) with 25 gender-matched low-risk children later determined to have typical development . Participants were evaluated at 6 , 12 , 18 , 24 , and 36 months of age .  Frequencies of gaze to faces , social smiles , and directed vocalizations were coded from video and rated by examiners . RESULTS The frequency of gaze to faces , shared smiles , and vocalizations to others were highly comparable between groups at 6 months of age , but significantly declining trajectories over time were apparent in the group later diagnosed with ASD . Group differences were significant by 12 months of age on most variables . Although repeated evaluation documented loss of skills in most infants with ASD , most parents did not report a regression in their child 's development . CONCLUSIONS These results suggest that behavioral signs of autism are not present at birth , as once suggested by Kanner , but emerge over time through a process of diminishment of key social communication behaviors . More children may present with a regressive course than previously thought , but parent report methods do not capture this phenomenon well . Implication s for onset classification systems and clinical screening are also discussed CONTEXT The presence of autistic-like traits in relatives of individuals with autism spectrum disorder ( ASD ) is well recognized , but , to our knowledge , the emergence of these traits early in development has not been studied . OBJECTIVE To prospect ively investigate the emergence of autistic-like traits in unaffected ( no ASD diagnosis ) infant siblings of prob and s diagnosed as having ASD . DESIGN Two groups of children unaffected with ASD were assessed prospect ively-siblings of prob and s diagnosed as having ASD ( high risk [ HR ] ) and control subjects with no family history of ASD ( low risk [ LR ] ) . Scores on a measure of autistic-like traits at 12 months of age were used in a cluster analysis of the entire sample . SETTING A prospect i ve study of infant siblings of prob and s with ASD from 3 diagnostic centers in Canada . PARTICIPANTS The study included 170 HR and 90 LR children , none of whom was diagnosed as having ASD at age 3 years . MAIN OUTCOME MEASURES The Autism Observation Scale for Infants was used to measure autistic-like traits and derive clusters at 12 months of age . Clusters were compared on ASD symptoms , cognitive abilities , and social-emotional difficulties at age 3 years . RESULTS Two clusters were identified . Cluster 1 ( n = 37 ; 14.2 % of total sample ) had significantly higher levels of autistic-like traits compared with cluster 2 . Within cluster 1 , 33 children came from the siblings ( 19.4 % of HR group ) and only 4 came from the control subjects ( 4.5 % of LR group ) . At age 3 years , children from cluster 1 had more social-communication impairment ( effect size > 0.70 ; P < .001 ) , lower cognitive abilities ( effect size = -0.59 ; P < .005 ) , and more internalizing problems ( effect size = 0.55 ; P = .01 ) . Compared with control subjects , HR siblings had a relative risk of 4.3 ( 95 % CI,1.6 - 11.9 ) for membership in cluster 1 . CONCLUSIONS Study findings suggest the emergence of autistic-like traits resembling a broader autism phenotype by 12 months of age in approximately 19 % of HR siblings who did not meet ASD diagnostic criteria at age 3 years In 2002 , the National Institutes of Health sponsored a meeting concerning method ological challenges of research in psychosocial interventions in Autism Spectrum Disorders . This paper provides a summary of the presentations and the discussion s that occurred during this meeting . Recommendations to federal and private agencies included the need for r and omized clinical trials of comprehensive interventions for autism as the highest , but not the sole priority . Ongoing working groups were proposed to address psychosocial interventions with a focus on relevant statistics , st and ardized documentation and methods of diagnosis , development of outcome measures , establishment of st and ards in research ; and the need for innovative treatment design s , including application of design s from other research areas to the study of interventions in ASD OBJECTIVE The vast majority of children with an autism spectrum disorder ( ASD ) attend public preschools at some point in their childhood . Community preschool practice s often are not evidence based , and almost none target the prelinguistic core deficits of ASD . This study investigated the effectiveness of public preschool teachers implementing a vali date d intervention ( the Joint Attention and Symbolic Play/Engagement and Regulation intervention ; JASP/ER ) on a core deficit of autism , initiating joint attention . METHOD Sixteen dyads ( preschoolers with ASD and the public school teachers who worked in the child 's classroom ) were r and omly assigned to the 6-week JASP/ER intervention or a control group . RESULTS At the end of the intervention , JASP/ER teachers used more  JASP/ER strategies than the control teachers , and JASP/ER preschoolers used more joint attention in their classroom than control children . Additionally , JASP/ER children spent more time in supported engagement and less time in object engagement than control preschoolers on a taped play interaction . CONCLUSIONS Findings suggest that teachers were able to improve a core deficit of children with ASD in a public preschool context We report on parent outcomes from a r and omized clinical trial of parent training ( PT ) versus psychoeducation ( PEP ) in 180 children with autism spectrum disorder ( ASD ) and disruptive behavior . We compare the impact of PT and PEP on parent outcomes : Parenting Stress Index ( PSI ) , Parent Sense of Competence ( PSOC ) , and Caregiver Strain Question naire ( CGSQ ) . Mixed-effects linear models evaluated differences at weeks 12 and 24 , controlling for baseline scores . Parents in PT reported greater improvement than PEP on the PSOC ( ES = 0.34 ) , CGSQ ( ES = 0.50 ) , and difficult child subdomain of the PSI ( ES = 0.44 ) . This is the largest trial assessing PT in ASD on parent outcomes . PT  reduces disruptive behavior in children , and improves parental competence while reducing parental stress and parental strain Abstract This investigation examined the long term effect of Karate techniques training on communication of children with autism spectrum disorders ( ASD ) . Thirty school aged children with ASD were r and omly assigned to an exercise ( n = 15 ) or a control group ( n = 15 ) . Participants in the exercise group were engaged in 14 weeks of Karate techniques training .  Communication deficit at baseline , post-intervention ( week 14 ) , and at 1 month follow up were evaluated . Exercise group showed significant reduction in communication deficit compared to control group . Moreover , reduction in communication deficit in the exercise group at one month follow up remained unchanged compared to post-intervention time . We concluded that teaching Karate techniques to children with ASD leads to significant reduction in their communication deficit We compared the effects of a 16-week Cognitive-Behavioral Therapy ( CBT ) program and a Social Recreational ( SR ) program on anxiety in children with Autism Spectrum Disorders ( ASD ) . Seventy children ( 9–16 years old ) were r and omly assigned to either of the programs ( nCBT = 36 ; nSR = 34 ) . Measures on child ’s anxiety using the Spence Child Anxiety Scale — Child ( SCAS-C ) and the Clinical Global Impression — Severity scale ( CGI-S ) were administered at pre- , post-treatment , and follow-ups ( 3- and 6-month ) . Children in both programs showed significantly lower levels of generalized anxiety and total anxiety symptoms at 6-month follow-up on SCAS-C. Clinician ratings on the CGI-S demonstrated an increase in the percentage of participants rated as “ Normal ” and “ Borderline ” for both programs . Findings from the present study suggest factors such as regular sessions in a structured setting , consistent therapists , social exposure and the use of autism-friendly strategies are important components of an effective framework in the management of anxiety in children and adolescents with ASD Clinical ly elevated anxiety is a common , impairing feature of autism spectrum disorders ( ASD ) . A modular CBT program design ed for preteens with ASD , Behavioral Interventions for Anxiety in Children with Autism ( BIACA ; Wood et al. , 2009 ) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety . Thirty-three adolescents ( 11 - 15 years old ) were r and omly assigned to 16 sessions of CBT or an equivalent waitlist period . The CBT model emphasized exposure , challenging irrational beliefs , and behavioral supports provided by caregivers , as well as numerous ASD-specific treatment elements . Independent evaluators , parents , and adolescents rated symptom severity at baseline and posttreatment/postwaitlist . In intent-to-treat analyses , the CBT group outperformed the waitlist group on independent evaluators ' ratings of anxiety severity on the Pediatric Anxiety Rating Scale ( PARS ) and 79 % of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment , as compared to only 28.6 % of the waitlist group . Group differences were not found for diagnostic remission or question naire measures of anxiety . However , parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity . The CBT manual under investigation , enhanced for early adolescents with ASD , yielded meaningful treatment effects on the primary outcome measure ( PARS ) , although additional developmental modifications to the manual are likely warranted . Future studies examining this protocol relative to an active control are needed BACKGROUND Children with autism spectrum disorders ( ASD ) are increasingly included in general education classrooms in an effort to improve their social involvement . METHODS Seventy-nine children with ASD and 79 r and omly selected , gender-matched peers ( 88.6 % male ) in 75 early ( K-1 ) , middle ( 2nd-3rd ) , and late ( 4th-5th ) elementary classrooms across 30 schools completed social network surveys  examining each child 's reciprocal friendships , peer rejection , acceptance , and social involvement . RESULTS Across grade levels , peers less frequently reciprocated friendships with children with ASD than students in the matched sample . While children with ASD were not more likely to be rejected by peers , they were less accepted and had fewer reciprocal friendships than matched peers at each grade level . Although 48.1 % of children with ASD were involved in the social networks of their classrooms , children with ASD were more likely to be isolated or peripheral to social relationships within the classroom across all grade levels , and this difference is even more dramatic in later elementary grade s. CONCLUSIONS In inclusive classrooms , children with ASD are only involved in peers ' social relationships about half of the time , and appear to be even less connected with increasing grade level . Promoting children with ASD 's skills in popular activities to share with peers in early childhood may be a key preventive intervention to protect social relationships in late elementary school grade Adolescents with ASD face numerous personal and context ual barriers that impede the development of social motivation and core competencies , warranting the need for targeted intervention . A r and omized controlled trial was conducted with 40 adolescents to evaluate the merits of a multi-component socialization intervention that places emphasis on experiential learning . This investigation evaluated the impact of the 20-week START program on the social functioning of adolescents with ASD . Significant Group × Time differences between START and waitlist control groups were found across multiple measures . Secondary analyses of the entire program cohort also yielded significant improvement trends across all measures . These findings may be an important step in identifying optimal strategies to target the complex factors limiting optimal social development in ASD
DISCUSSION Physical activity has a positive impact on the health and wellness of human beings , as well as a major role in the prevention of several chronic pathologies .
Planned and correctly directed physical activity allows developing motor skills and generating positive psychological context s and behavioral changes in children with ASD
OBJECTIVE To identify the strategies used in the development of planned and scientifically documented physical activity , as well as the results achieved with those interventions in children with Autism Spectrum Disorder ( ASD ) .