Multidisciplinary Telerehabilitation Practices in Autism

The study, titled The Effect of Physiotherapy and Nutrition Services Provided by Telerehabilitation Methods on the Physical, Nutritional and Psychological Conditions of Children with Autism and Their Families, aimed to evaluate the effects of physiotherapy and nutrition education to be given to the participants. Participants were children with autism spectrum disorder and parents of children with autism spectrum disorder. There will be surveys that researchers will ask participants to answer. Parent telerehabilitation group participants via smartphone video conferencing; Researchers involved in this project; A physiotherapist and a physiotherapist senior physiotherapy intern will send 1 session of online simultaneous exercise training to the parent telerehabilitation group participants, then an exercise video containing the exercises and brochures will be sent and the parent telerehabilitation group participants will be asked to do the exercises 3 days a week. Participants will be asked to keep an exercise diary and the status of the diaries will be monitored once a week. Additionally, the concepts of physical activity and recreational activity in autism will be explained to the participants. Again, via smartphone video conferencing, the researchers participating in this project; 3 different nutrition trainings will be given by 1 dietitian and 1 senior dietitian trainee within the scope of basic nutrition and nutrition-health information at 15-day intervals. Waist, hip and height measurements of autistic child participants will be measured with a tape measure, and their body weight will be measured with a scale. The study will last 2 months.

There are studies in the literature to investigate physical activity and nutrition in the diagnosis of Autism Spectrum Disorder (ASD). This project will be a multidisciplinary and comprehensive study conducted on children with ASD and their parents with the participation of a physiotherapist and dietitian in Turkey. It will contribute to the literature as it is a randomized controlled study that evaluates primary school age (6-11) children with autism from a multidisciplinary perspective in terms of physiotherapy and nutrition and provides physical activity and nutrition education to the family. In this study, there are two groups: telerehabilitation group and control group; There are 4 participant types: telerehabilitation parent, telerehabilitation child, control parent, control child. The surveys for both groups are in the form of pre-test and post-test. Quality of life, activity participation and recreational activity levels of children with autism will be measured. In line with these measurements, recreational activities that will guide telerehabilitation parent participants in ASD will be explained and consultancy will be given on their implementation. For all participating parents; Quality of life, functional status and stress levels will be evaluated. As a result of these evaluations, breathing, resistance and posture exercises and walking training will be given and the effectiveness of these trainings will be evaluated. In this training, the current approach, telerehabilitation, will be used. Telerehabilitation is a cost-effective, easy-to-access alternative to traditional treatment options.

In the literature, attention is drawn to nutritional problems such as food rejection, food selectivity, and obesity in children with ASD. Adequate and balanced nutrition is very important for children's mental and physical health, growth and development. For this purpose, it was aimed to raise awareness of the participants about nutrition. In the study, the nutritional status, food consumption frequency and food selectivity/rejection of children with ASD will be determined. Anthropometric measurements such as height, weight, upper middle arm circumference (UMAC), and body mass index (BMI) will be taken and evaluated according to the children's age and gender. The nutritional knowledge level of all participating parents will be measured at the beginning, and the knowledge level at the end of the study will be determined by providing nutrition education during the study.

The training will be given simultaneously, using technological devices, and the training will be transferred as a video later so that parents can easily access it.

Eligibility Criteria:
Inclusion Criteria:

* Volunteering to participate in the study
* 6-11 years old child
* Have an approved medical diagnosis for Asperger's syndrome, autism, or a specific developmental disorder (DSM 5), by the standards set in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition
* Children with mild to moderate autism according to the childhood autism rating scale
* Not having received physical activity and nutrition counseling before
* Children with normal orally fed and functioning gastrointestinal tract

Exclusion Criteria:

* Having any serious condition (such as orthopedic or any acute) for which it is contraindicated to the viewer of recreational entertainment programs
* Recent (less than 4 weeks) children on any psychotropic medication
* Those who have high-intensity activity according to the International Physical Activity Questionnaire (IPAQ)
* Children with chewing and swallowing difficulties
* You can enter as a child suitable for children.
* Children with diagnosed nutritional problems (absorption disorder, metabolic structure)
* have Gastroenterol patients suitable for medical intervention or bowel segments,
* Leukemia or other cancers,
* Hypothyroidism or other chronic conditions that can grow and turn into energy
* Acute myocarditis, active endocarditis, control eg missed heart probe, tachyarrhythmia, bradyarrhythmia, hypertrophic cardiomyopathy