Introduction
Autism spectrum disorder (ASD) is a developmental disorder characterized by impairments in social interaction, communication, and restricted and repetitive behaviors. Children with ASD often have difficulties in various aspects of motor skills, such as dressing, tying shoelaces, using scissors, writing, catching a ball, or skipping rope. These motor difficulties can affect their daily life and lead to secondary psychosocial problems, such as low self-esteem or social isolation. Therefore, it is essential to provide developmental support that focuses on enhancing motor skills for children with ASD from an early age. Moreover, some studies have suggested a link between motor skills and social skills, and the possibility that motor development can facilitate other developmental domains, such as socialization. These findings indicate the need to promote higher levels of motor development for children with ASD.
The purpose of this study was to conduct a scoping review of the literature on exercise intervention for children with ASD in Japan, and to clarify the current situation and implications for future research and practice.
Methods
The authors searched PubMed, Ichushi Web, CiNii, and Medical Online databases, and performed a hand search on Google, using the following keywords: “autism spectrum disorder”, “exercise”, “intervention”, “Japan”, and their Japanese equivalents. They screened the retrieved articles according to the inclusion and exclusion criteria, which were:
(1) the participants were children with ASD aged 18 years or younger,
(2) the intervention involved exercise or physical activity,
(3) the study was conducted in Japan,
(4) the study was published in a peer-reviewed journal, and
(5) the study was written in Japanese or English.
Results
The final number of articles included in the review was nine. The characteristics of the studies, such as the participants, the intervention, the outcome measures, and the results, were summarized. The main findings were as follows:
- The exercise interventions for children with ASD in Japan were diverse, ranging from individualized programs to group activities, and from structured exercises to free play.
- The exercise interventions were mainly aimed at improving motor skills, such as balance, coordination, agility, strength, and endurance, but some also targeted social skills, such as communication, cooperation, and self-regulation.
- The exercise interventions were generally effective in improving both motor skills and social skills for children with ASD, as measured by various standardized tests, behavioral observations, and questionnaires.
- The exercise interventions were well accepted by the children with ASD and their parents, and had positive effects on their motivation, enjoyment, and quality of life.
Conclusion
The scoping review revealed that exercise intervention for children with ASD in Japan was effective in enhancing not only motor skills but also social skills. However, the studies had some limitations in terms of research design, such as small sample size, lack of control group, and short duration. Therefore, further studies are needed to verify the effectiveness and feasibility of exercise intervention for children with ASD, and to establish evidence-based guidelines for clinical practice.
Faq
What are the types of exercise interventions for children with ASD?
Exercise interventions for children with ASD can be classified into two main categories: individualized and group-based. Individualized exercise interventions are tailored to the specific needs and preferences of each child, and are usually delivered by a trained professional, such as a physical therapist, an occupational therapist, or a special education teacher. Group-based exercise interventions involve multiple children with ASD participating in the same activity, such as a sport, a game, or a dance. Group-based exercise interventions can foster social interaction and peer support among the children, and can be led by a coach, an instructor, or a peer mentor.
What were the main characteristics of the exercise interventions in the studies?
The exercise interventions in the studies varied in terms of the type, intensity, duration, frequency, and setting of the exercise. The types of exercise included aerobic exercise, resistance training, yoga, martial arts, dance, and ball games. The intensity of the exercise ranged from low to high, depending on the heart rate, perceived exertion, or metabolic equivalent of the participants. The duration of the exercise ranged from 10 to 60 minutes per session, and the frequency ranged from once to five times per week. The setting of the exercise varied from indoor to outdoor, and from individual to group.
What are the benefits of exercise for children with ASD?
Exercise can have positive effects on various aspects of physical and mental health for children with ASD. Some of the benefits of exercise include:
- Improving motor skills, such as balance, coordination, agility, strength, and endurance
- Enhancing social skills, such as communication, cooperation, and self-regulation
- Reducing stress, anxiety, and depression
- Increasing self-esteem and confidence
- Promoting general well-being and quality of life
What are the challenges of implementing exercise interventions for children with ASD?
Exercise interventions for children with ASD may face some challenges, such as:
- Lack of motivation or interest in exercise
- Difficulty in following instructions or rules
- Sensory issues or discomfort with certain environments or stimuli
- Behavioral problems or tantrums
- Limited availability or accessibility of suitable facilities or equipment
- Lack of knowledge or training of the staff or caregivers
How can these challenges be overcome?
Some of the strategies that can help overcome these challenges are:
- Using positive reinforcement, such as praise, rewards, or feedback
- Providing choices and options for the type, intensity, duration, and frequency of exercise
- Adapting the exercise to the child’s level of ability and preference
- Using visual cues, such as pictures, symbols, or timers
- Creating a safe, comfortable, and stimulating environment for exercise
- Providing individualized support and guidance
- Collaborating with the child’s family, school, and other professionals
What are the best practices for designing and delivering exercise interventions for children with ASD?
Some of the best practices for designing and delivering exercise interventions for children with ASD are:
- Conducting a comprehensive assessment of the child’s physical, cognitive, social, and emotional needs and strengths
- Setting clear and realistic goals and objectives for the exercise intervention
- Choosing appropriate outcome measures and evaluation methods
- Applying evidence-based principles and methods of exercise prescription and instruction
- Monitoring and adjusting the exercise intervention based on the child’s progress and feedback
- Communicating and coordinating with the child’s family, school, and other professionals
How can children with ASD be safe and comfortable in exercise or physical activity?
Some of the ways that children with ASD can be safe and comfortable in exercise or physical activity are:
- Providing a safe, comfortable, and stimulating environment for exercise or physical activity, such as a spacious, clean, and well-lit area, with appropriate equipment and materials
- Providing visual cues, such as pictures, symbols, or timers, which can help the children understand and follow the instructions or rules of the exercise or physical activity
- Providing individualized support and guidance, such as physical, emotional, or verbal assistance, which can help the children perform and complete the exercise or physical activity
- Providing breaks and rest, such as water, snacks, or relaxation, which can help the children recover and refresh from the exercise or physical activity
How can children with ASD generalize and transfer the skills and benefits of exercise or physical activity to other domains or settings?
Some of the ways that children with ASD can generalize and transfer the skills and benefits of exercise or physical activity to other domains or settings are:
- Providing repeated and varied practice, such as different types, levels, or contexts of exercise or physical activity, which can help the children consolidate and apply the skills and benefits of exercise or physical activity
- Providing feedback and reinforcement, such as reminders, cues, or rewards, which can help the children maintain and sustain the skills and benefits of exercise or physical activity
- Providing opportunities and challenges, such as new or different tasks, goals, or situations, which can help the children extend and expand the skills and benefits of exercise or physical activity
- Providing modeling and demonstration, such as examples, scenarios, or role plays, which can help the children observe and imitate the skills and benefits of exercise or physical activity
How can exercise intervention improve social skills for children with ASD?
Exercise intervention can improve social skills for children with ASD by providing opportunities for social interaction, communication, cooperation, and self-regulation. Some of the possible mechanisms are:
- Exercise can stimulate the release of endorphins, oxytocin, and serotonin, which are neurotransmitters that regulate mood, social bonding, and empathy
- Exercise can enhance the activity of the mirror neuron system, which is a brain network that enables imitation, empathy, and theory of mind
- Exercise can improve the executive functions, such as attention, working memory, planning, and inhibition, which are essential for social cognition and behavior
- Exercise can reduce the stress, anxiety, and depression, which can interfere with social functioning and well-being
How can exercise intervention be integrated into the school curriculum for children with ASD?
Exercise intervention can be integrated into the school curriculum for children with ASD by incorporating physical education, recess, and extracurricular activities that involve exercise or physical activity. Some of the possible strategies are:
- Providing individualized or adapted physical education programs that meet the needs and preferences of each child with ASD
- Providing inclusive or peer-mediated physical education programs that promote social interaction and peer support among children with and without ASD
- Providing structured or supervised recess activities that encourage physical activity and social play among children with ASD
- Providing after-school or weekend clubs or teams that offer exercise or sports activities for children with ASD
Source:
https://www.jstage.jst.go.jp/article/rika/39/1/39_60/_article/-char/ja/