Open Collections

UBC Graduate Research

Effects of Exercise Interventions on Stereotypic Behaviors of Children with Autism Spectrum Disorder Adamson, Sarah; Block, Laurie; Adamson, Sarah; Petrus, Chris; Shahnefried, Maryam; Harris, Susan 2006

You don't seem to have a PDF reader installed, try download the pdf

Item Metadata

Download

Media
Effects of Exercise Interventions on Stereotypic Behaviors of Children with Autism Spectrum Disorder.pdf [ 704.49kB ]
[if-you-see-this-DO-NOT-CLICK]
[if-you-see-this-DO-NOT-CLICK]
team_exercise.mp3 [ 47.61MB ]
[if-you-see-this-DO-NOT-CLICK]
Metadata
JSON: 1.0081240.json
JSON-LD: 1.0081240+ld.json
RDF/XML (Pretty): 1.0081240.xml
RDF/JSON: 1.0081240+rdf.json
Turtle: 1.0081240+rdf-turtle.txt
N-Triples: 1.0081240+rdf-ntriples.txt
Original Record: 1.0081240 +original-record.json
Full Text
1.0081240.txt
Citation
1.0081240.ris

Full Text

The Effects of Exercise Interventions The Effects of Exercise Interventions on Stereotypic Behaviors of Children on Stereotypic Behaviors of Children with Autism Spectrum Disorderwith Autism Spectrum DisorderBy: Sarah AdamsonLaurie BlockSarah EinarsonChris PetrusMaryamSharifnejadSupervisor: Susan HarrisSchool of Rehabilitation Sciences Department of Physical TherapyOverviewOverview????PurposePurpose????IntroductionIntroduction????MethodsMethods????ResultsResults????DiscussionDiscussion????ConclusionConclusion????LimitationsLimitations????RecommendationsRecommendationsPurposePurposeTo conduct a To conduct a systematic review of systematic review of studies examining the studies examining the effect of exercise effect of exercise interventions on interventions on stereotypic behaviors stereotypic behaviors of  children with of  children with autism spectrum autism spectrum disorder (ASD)disorder (ASD)IntroductionIntroductionAutism Spectrum Disorder (ASD):Autism Spectrum Disorder (ASD):????refers to individuals with:refers to individuals with:????a specific a specific autism diagnosisautism diagnosis????Similar core deficits:Similar core deficits:????Pervasive Developmental DisorderPervasive Developmental Disorder??Not Not Otherwise Specified (PDDOtherwise Specified (PDD--NOS)????AspergerAspergerSyndrome Syndrome ????Childhood Disintegrative Disorder Childhood Disintegrative Disorder ????RettRettSyndrome Syndrome IntroductionIntroductionASD:ASD:????Increasing in prevalenceIncreasing in prevalence1????Current prevalence: Current prevalence: >1 in >1 in 2002002????Four times as many males Four times as many males as females affectedas females affected3????More prevalent in the More prevalent in the pediatric population than pediatric population than each of cancer, diabetes, each of cancer, diabetes, spinaspinabifida, or Down bifida, or Down syndromesyndrome4Introduction Introduction ASD ASD --Possible CausesPossible Causes5????Genetic Genetic ????NeuroanatomicalNeuroanatomicaldifferencesdifferences????PrePre--natal factorsnatal factors????Exposure to Exposure to environmental toxinsenvironmental toxins????Viral infectionsViral infections????Immune system Immune system deficienciesdeficienciesIntroduction Introduction ASD ASD ??triad of featurestriad of features66????impairments in socializationimpairments in socialization????impairments in verbal and impairments in verbal and nonverbal communicationnonverbal communication????stereotypic and repetitive stereotypic and repetitive patterns of patterns of behavioursbehavioursIntroduction Introduction InterventionsInterventions7: : ????Sensory integration therapySensory integration therapy????Sensory stimulation techniquesSensory stimulation techniques????Auditory and visual interventionsAuditory and visual interventions????Sensorimotor handling techniquesSensorimotor handling techniques????Physical exercisePhysical exerciseGoals:Goals:????To treat the three features of ASDTo treat the three features of ASD????To facilitate the academic, leisure To facilitate the academic, leisure and selfand self--care skills of children with care skills of children with autismautismIntroduction Introduction Benefits of Exercise:Benefits of Exercise:????Overall positive effects shown in adults with autismOverall positive effects shown in adults with autism8????Few articles on exercise and stereotypic behaviours of Few articles on exercise and stereotypic behaviours of children with autismchildren with autism????Aerobic exercise may cause physiologically changes that Aerobic exercise may cause physiologically changes that modulate stereotypic behaviours in persons with modulate stereotypic behaviours in persons with autismautism7Introduction Introduction PICO:PICO:????PPopulation: opulation: children under 19 years of age, with a children under 19 years of age, with a diagnosis of autism or ASDdiagnosis of autism or ASD????IIntervention: ntervention: exercise interventionsexercise interventions????CComparison: N/Aomparison: N/A????OOutcome: utcome: reduction of stereotypic reduction of stereotypic behavioursbehavioursMethodsMethodsComprehensive Search Strategy:Comprehensive Search Strategy:????Searching electronic databasesSearching electronic databases????HandHand--searching reference listssearching reference lists????Communicating with experts in the fields of pediatric Communicating with experts in the fields of pediatric physical therapy and autismphysical therapy and autismMethods Methods Electronic databases searched:Electronic databases searched:????MEDLINEMEDLINE????EMBASEEMBASE????PsycINFOPsycINFO????PEDroPEDro????ERICERIC????CINAHLCINAHL????Cochrane Database of Systematic ReviewsCochrane Database of Systematic Reviews????Cochrane Controlled Trials RegisterCochrane Controlled Trials Register????Search terms: Search terms: autism, autism spectrum disorder, exercise, physical activity and physical educationMethods Methods The Web of Science database was used to The Web of Science database was used to perform:perform:????author searchesauthor searches????journal searches including: journal searches including: ????Journal of Autism and Developmental DisordersJournal of Autism and Developmental Disorders????Pediatric Physical TherapyPediatric Physical Therapy????Physical and Occupational Therapy in PediatricsPhysical and Occupational Therapy in Pediatrics????Developmental Medicine and Child NeurologyDevelopmental Medicine and Child Neurology????European Academy of Childhood Disability European Academy of Childhood Disability Methods Methods First Search / Papers First Index was searched First Search / Papers First Index was searched to find published papers from:to find published papers from:????CongressesCongresses????SymposiumsSymposiums????ConferencesConferences????ExpositionsExpositions????workshops and meetingsworkshops and meetingsMethods Methods Grey Literature:Grey Literature:????HandHand--searching of relevant articlessearching of relevant articles????Contacting key individuals for assistance in Contacting key individuals for assistance in finding relevant studiesfinding relevant studiesMethods Methods Study Selection:Study Selection:????Search LimitsSearch Limits????English, Human SubjectsEnglish, Human Subjects????Title ScreenTitle Screen????Excluded if Excluded if they were related to medications, they were related to medications, genetics, cognition, memory, communication, or genetics, cognition, memory, communication, or executive functioningexecutive functioningMethods Methods Study Selection (contStudy Selection (cont??d):d):????Abstract Screen (reviewed by 2 authors)Abstract Screen (reviewed by 2 authors)????Excluded if did Excluded if did notnotadhere to the following adhere to the following criteria:criteria:????intervention study using either exercise or intervention study using either exercise or physical activity as the independent variablephysical activity as the independent variable????frequency of stereotypic behaviours as the frequency of stereotypic behaviours as the dependent variabledependent variable????children under 19 years oldchildren under 19 years old????subjects stated to have autism or autism spectrum subjects stated to have autism or autism spectrum disorderdisorderMethods Methods Study Selection (contStudy Selection (cont??d):d):????FullFull--text Screentext Screen????Entire studies reviewed by two independent authorsEntire studies reviewed by two independent authors????Exclusion criteria same as abstractsExclusion criteria same as abstractsMethods Methods Data Extraction:Data Extraction:????An adapted version of the AACPDM Study An adapted version of the AACPDM Study Data Extraction Summary FormData Extraction Summary Form9was used was used ????This form included analysis of: This form included analysis of: ????evidence levelevidence level????quality of the studyquality of the study????descriptive information about the studydescriptive information about the study????outcome of interestoutcome of interestMethods Methods Levels of Evidence:Levels of Evidence:????The AACPDM Level of EvidenceThe AACPDM Level of Evidence9????Harris Level of Evidence for Single Subject Harris Level of Evidence for Single Subject Designs (Adapted from AACPDM)Designs (Adapted from AACPDM)Methods Methods Study Quality Assessment:Study Quality Assessment:Three scales were used for the analysis of study Three scales were used for the analysis of study quality: quality: ????AACPDM Study Quality ScaleAACPDM Study Quality Scale????The Clinical Relevance Tool for Case Studies The Clinical Relevance Tool for Case Studies Modified from van Modified from van TulderTulder????Quality, Quality, RigourRigouror Evaluative Criteria for Single or Evaluative Criteria for Single Subject Research DesignsSubject Research DesignsMethods Methods Data Synthesis:Data Synthesis:????Studies were classified into three tables to clearly Studies were classified into three tables to clearly depict:depict:????study quality and design typestudy quality and design type????population characteristicspopulation characteristics????intervention typeintervention type????outcome of interestoutcome of interest????resultsresultsResultsResults????Preliminary studies = 200 Preliminary studies = 200 ????Seven relevant studiesSeven relevant studiesMEDLINE(n=43)EMBASE(n=121)CINAHL(n=9)Cochrane Central Register of Controlled Trials (n=2)ERIC(n=20)Cochrane Database of Systematic Review(n=5)Potentially relevant citations identified through electronic searches (n=200)Citations excluded after title screening (n=158)Abstracts retrieved for review (n=42)Studies excluded after abstract screening (n=29)Full articles retrieved for detailed review (n=13)Studies excluded after full text review (n=6)Relevant studies included in systematic review (n=7)Evidence Level and Quality of the Evidence Level and Quality of the seven studiesseven studies????Quality:Quality:????range 2 to 5 (out of 7), mean 3.9, mode 5range 2 to 5 (out of 7), mean 3.9, mode 5????42% moderate, 58% weak 42% moderate, 58% weak ????Evidence:Evidence:????range II to Vrange II to V????2 level II, 2 level IV, 3 level V 2 level II, 2 level IV, 3 level V Brief summary of seven studiesBrief summary of seven studies????Study designs:Study designs:????4 single subject, 2 group designs, 1 case study4 single subject, 2 group designs, 1 case study????Stereotypic behaviours:Stereotypic behaviours:????As defined within each studyAs defined within each study????Interventions:Interventions:????6 jogging, 1 hydrotherapy6 jogging, 1 hydrotherapy????Subjects:Subjects:????26 total, male and female, age range 4 to 1526 total, male and female, age range 4 to 15????Diagnosis of each subject:Diagnosis of each subject:????ASD or autism, many stated to have high levels of ASD or autism, many stated to have high levels of stereotypic behavioursstereotypic behavioursBrief summary of seven studiesBrief summary of seven studies????PostPost--exercise stereotypic behaviours:exercise stereotypic behaviours:????All studies measured using time samplingAll studies measured using time sampling????Results of exercise on stereotypic behaviours :Results of exercise on stereotypic behaviours :????All studies reported a decrease in stereotypic All studies reported a decrease in stereotypic behavioursbehaviours????Three studies documented this effect over timeThree studies documented this effect over time????Effect was temporaryEffect was temporary????Results of exercise on other simple cognitive/play Results of exercise on other simple cognitive/play tasks:tasks:????Mixed findings for improvementMixed findings for improvementDiscussionDiscussion7 articles:7 articles:????3: Exercise on stereotypic behaviour and 3: Exercise on stereotypic behaviour and academic performanceacademic performance????1: Hydrotherapy 1: Hydrotherapy ????3: Vigorous 3: Vigorous vsvsmild exercisemild exerciseExercise effects on Exercise effects on stereotypic stereotypic behaviours behaviours / academic performance/ academic performance????Watters & Watters (1980)Watters & Watters (1980)1111????Level IV, 5Level IV, 5????IV: Effects of jogging, TV watching, academic IV: Effects of jogging, TV watching, academic classroom activities classroom activities ????No change in academic performanceNo change in academic performance????Stereotypic behaviours decreased postStereotypic behaviours decreased post--exerciseexercise????Jogging only IV affecting stereotypic behavioursJogging only IV affecting stereotypic behaviours????Moderate evidence based on quality scaleModerate evidence based on quality scale????Higher Level of study design neededHigher Level of study design neededExercise effects on stereotypic Exercise effects on stereotypic behaviours / academic performancebehaviours / academic performance????RosenthalRosenthal--MalekMalek(1997)(1997)12????Level IV, 5Level IV, 5????IV: 20 minutes of jogging, academic IV: 20 minutes of jogging, academic precondition (classroom activity)precondition (classroom activity)????Exercise had significantly improved Exercise had significantly improved outcomes as compared to academic outcomes as compared to academic preconditionprecondition????Jogging: decrease in stereotypic Jogging: decrease in stereotypic behaviourbehaviour; increase in on; increase in on--task task behaviourbehaviour; ; increase in academic performanceincrease in academic performance????Moderate supportModerate support????Stronger Level of study design neededStronger Level of study design neededExercise effects on stereotypic Exercise effects on stereotypic behaviours / academic performancebehaviours / academic performance????Kern et al. (1982)Kern et al. (1982)1313????Level II,3Level II,3????Intervention: Jogging (mildly strenuous); 5Intervention: Jogging (mildly strenuous); 5--10 min 10 min initially, 20 min by end of experimentinitially, 20 min by end of experiment????Decrease in stereotypic behaviour postDecrease in stereotypic behaviour post--joggingjogging????Increase in academic responding and ball playing Increase in academic responding and ball playing frequency postfrequency post--joggingjogging????Weak support, based on quality scaleWeak support, based on quality scaleHydrotherapy Effect on Stereotypic Hydrotherapy Effect on Stereotypic BehavioursBehaviours????BuminBuminet al. (2003)et al. (2003)1414????Level V, 2Level V, 2????HalliwickHalliwickmethod of hydrotherapymethod of hydrotherapy????Decrease in stereotypic behavioursDecrease in stereotypic behaviours????Weak support, based on quality scaleWeak support, based on quality scale????Additional studies neededAdditional studies neededVigorous vs. Mild ExerciseVigorous vs. Mild Exercise????Kern et al. (1984)Kern et al. (1984)1515????Level II, 5Level II, 5????Jogging vs. Jogging vs. ballplayingballplaying????Jogging decreased stereotypic behaviours; Jogging decreased stereotypic behaviours; ballplayingballplayingno effectno effect????Moderate supportModerate supportVigorous vs. Mild ExerciseVigorous vs. Mild Exercise????CelibertiCeliberti(1997)(1997)1616????Level V, 3Level V, 3????Jogging vs. walkingJogging vs. walking????Jogging decreased stereotypic behaviours, walking no Jogging decreased stereotypic behaviours, walking no effecteffect????Weak supportWeak support????Stronger study design neededStronger study design neededVigorous vs. Mild ExerciseVigorous vs. Mild Exercise????Levinson & Reid (1993)Levinson & Reid (1993)1717????Level V, 3Level V, 3????Jogging vs. walkingJogging vs. walking????Jogging Jogging decreased stereotypic decreased stereotypic behavioursbehaviours????Walking had no effectWalking had no effect????Weak supportWeak support????Stronger study design neededStronger study design neededEvidence AppliedEvidence Applied????More intensive aerobic activity is of greater More intensive aerobic activity is of greater effect on stereotypic behaviourseffect on stereotypic behaviours????Difficult to develop exercise prescription due to:Difficult to develop exercise prescription due to:????Study design heterogeneity Study design heterogeneity ????Varied forms/monitoring of exerciseVaried forms/monitoring of exercise????Duration of decreased stereotypic behaviours Duration of decreased stereotypic behaviours postpost--exercise: up to 1.5 hrsexercise: up to 1.5 hrsLiterature FindingsLiterature Findings????Lack of Research in area:Lack of Research in area:????7 articles examining exercise effects on stereotypic 7 articles examining exercise effects on stereotypic behavioursbehaviours????Dates of Publication:Dates of Publication:????7 articles; 19807 articles; 1980--20032003????23 year span, no timeline set as exclusion criteria23 year span, no timeline set as exclusion criteria????Poor study designs (evidence level IIPoor study designs (evidence level II--V)V)????Overall weak study qualities (mean quality score 3.9/7)Overall weak study qualities (mean quality score 3.9/7)Limitations of Limitations of Systematic ReviewSystematic Review????English language onlyEnglish language only????Published articles Published articles onlyonlyConclusion/Conclusion/RecommendationsRecommendations????Purpose:Purpose:????To assess the link between exercise and stereotypic To assess the link between exercise and stereotypic behaviours in children with ASD behaviours in children with ASD ????The literature suggests:The literature suggests:????exercise decreases stereotypic behaviours in this exercise decreases stereotypic behaviours in this population.population.????higher intensity exercise is more effective in higher intensity exercise is more effective in decreasing self stimulation than lower intensity decreasing self stimulation than lower intensity activityactivityConclusion/Conclusion/RecommendationsRecommendations????Clinical implications for pediatric physiotherapists:Clinical implications for pediatric physiotherapists:????Consider the literatureConsider the literature????Difficult to determine specific prescription of Difficult to determine specific prescription of exercise for children with ASD. exercise for children with ASD. ????Further research required:Further research required:????Exercise prescription for children with ASDExercise prescription for children with ASD????Longer exercise interventions and longLonger exercise interventions and long--term effects term effects of exerciseof exercise????Other physiotherapy treatments for children with Other physiotherapy treatments for children with ASDASD????Improved study design and study qualityImproved study design and study quality?? Questions ???? Questions ??ReferencesReferences1.NewschafferCJ, FalbMD, Gurney JG.National autism prevalence trends from United States special education data. Pediatrics 2005 Mar;115(3):e277-82.2.FombonneE. Modern Views of Autism. Can. J. Psychiatry 2003;48:503-5053.FombonneE. The epidemiology of autism: a review. PsycholMed 1999 Jul;29(4):769-86.4.FilipekPA, AccardoPJ, BaranekGT, Cook EH Jr, Dawson G, Gordon B, Gravel JS, Johnson CP, KallenRJ, Levy SE, MinshewNJ, OzonoffS, PrizantBM, RapinI, Rogers SJ, Stone WL, TeplinS, Tuchman RF, VolkmarFR.The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord1999 Dec;29(6):439-84.5.Autism Society of Canada. Research into Causes. Available at: http://www.autismsocietycanada.ca/asd_research/causes_of_autism/http://www.autismsocietycanada.ca/asd_research/causes_of_autism/index_e.html.Accessed June 12, 2006.6.American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR (fourth edition, text revision). Washington DC: American Psychiatric Association, 2000.7.BaranekGT. of sensory and motor interventions for children with autism. J Autism Dev Disord2002;32(5):397-422. Efficacy 8.Elliott Jr RO, Dobbin AR, Rose GD, SoperHV. Vigorous, aerobic exercise versus general motor training activities: effects on maladaptive and stereotypic behavioursof adults with both autism and mental retardation. J Autism Dev Disord1994;24(5):565-576.9.O?Donnell, Darrah, Adams, Roxborough, Damiano. AACPDM methodology for developing evidence tables and reviewing treatment outcome research: 2004 Version (revised 2005). American academy for cerebral palsy and developmental medicine 2005; www.aacpdm.org10.Harris SR (unpublished). Level of Evidence for Single Subject Designs, 2006.11Watters RG, Watters WE. Decreasing self-stimulatory behaviourwith physical exercise in a group of autistic boys. J Autism Dev Disord1980;10:379?387.12Rosenthal-MalekA, Mitchell S. Brief Report: The Effects of Exercise on the Self-Stimulatory Behavioursand Positive Responding of Adolescents with Autism. J Autism DevDisord1997;27(2):193-201.13Kern L, KoegelLR, Dyer K, Blew PA, Fenton LR. The effects of physical exercise on self-stimulation and appropriate responding in autistic children. J Autism Dev Disord1982;12:399?419.14BuminG, UyanikM, YilmazI, KayihanH, TopcuM. Hydrotherapy for RettSyndrome. J RehabilMed, 2003;35:44-45.15Kern L, KoegelRL, Dunlap G. The influence of vigorous versus mild exercise onautistic stereotyped behaviours. J Autism Dev Disord1984;14:57?67.16CelibertiDA, BoboHE, Kelly KS, Harris SL, HandlemanJS.The differential and temporal effects of antecedent exercise on the self-stimulatory behaviourof a child with autism. Res Dev Disabil1997;18(2):139-150.17Levinson LJ, Reid G. The effects of exercise intensity on the stereotypic behavioursof individuals with autism. Adapted Physical Activity Quarterly 1993;10(3):255?268.18DaddsM, Schwartz S, Adams T, Rose S. The effects of social context and verbal skill on the stereotypic  and task-involved behaviourof autistic children. J Child PsycholPsychiatry 1988 Sep;29(5):669-676.

Cite

Citation Scheme:

    

Usage Statistics

Country Views Downloads
United States 24 3
Canada 11 3
India 9 0
China 8 13
Israel 6 2
Brazil 5 0
United Kingdom 5 1
Taiwan 3 0
Turkey 2 1
Portugal 2 0
Iran 2 0
Ireland 2 1
Thailand 1 0
City Views Downloads
Unknown 25 6
Beijing 8 0
Coronado 8 3
Mumbai 7 0
Mississauga 3 0
Seattle 2 0
Haifa 2 2
Brattleboro 2 0
Edinburgh 2 1
Uckfield 2 0
Ashburn 2 0
Welland 2 1
Dublin 2 1

{[{ mDataHeader[type] }]} {[{ month[type] }]} {[{ tData[type] }]}
Download Stats

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
http://iiif.library.ubc.ca/presentation/dsp.12674.1-0081240/manifest

Comment

Related Items