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Remón S, Ferrer-Mairal A, Sanclemente T. Food and Nutrition in Autistic Adults: Knowledge Gaps and Future Perspectives. Nutrients 2025; 17:1456. [PMID: 40362765 PMCID: PMC12073154 DOI: 10.3390/nu17091456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2025] [Revised: 04/19/2025] [Accepted: 04/23/2025] [Indexed: 05/15/2025] Open
Abstract
Proper nutrition is a critical component in supporting the overall health and development of individuals with autism spectrum disorder (ASD) who experience eating difficulties associated with their autistic traits. Evidence regarding the prevalence, origins, and consequences of eating issues related to ASD is largely derived from studies on autistic children, while information pertaining to adults remains scarce. It is therefore essential to critically review existing research focusing on autistic adults to draw robust conclusions and identify clear research gaps. A computer-aided search in PubMed, Science Direct, Scopus, and Web of Science databases spanning the years 2013-2024 using the search terms covering ASD/Autism, Adult, Nutrition/Nutritional Status, and Diet yielded 43 full-text articles. In our literature review, we explored three critical aspects of nutrition in adults with ASD: their food preferences and sensory processing patterns, studies on nutritional status, and whether dietary and nutritional interventions have improved their adherence to healthier diets. Autistic adults appear to select food based on sensory perceptions. This selection pattern can affect their nutritional status, with a tendency toward overweight and nutritional deficiencies. The most promising intervention strategies incorporate sensory adaptation and structured meal planning. Further research should apply rigorous methodologies that account for this population's specific characteristics.
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Affiliation(s)
- Sara Remón
- Departamento de Producción Animal y Ciencia de los Alimentos, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza-CITA, M Servet 177, 50013 Zaragoza, Spain; (S.R.); (A.F.-M.)
- Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Pl. Universidad, 3, 22002 Huesca, Spain
| | - Ana Ferrer-Mairal
- Departamento de Producción Animal y Ciencia de los Alimentos, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza-CITA, M Servet 177, 50013 Zaragoza, Spain; (S.R.); (A.F.-M.)
| | - Teresa Sanclemente
- Departamento de Producción Animal y Ciencia de los Alimentos, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza-CITA, M Servet 177, 50013 Zaragoza, Spain; (S.R.); (A.F.-M.)
- Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Pl. Universidad, 3, 22002 Huesca, Spain
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Lee D, Frey GC, Shih PC. Gamified Mobile Health Strategies for Promoting Physical Activity in Autistic Adults. Exerc Sport Sci Rev 2025; 53:68-76. [PMID: 39654140 DOI: 10.1249/jes.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2025]
Abstract
Physical inactivity and sedentarism among autistic adults are a growing public health concern. By integrating behavior change theories and emphasizing unique preferences for visuospatial learning and gaming technology, we hypothesize that gamified mobile health (mHealth) applications can be effective at increasing free-living physical activity and reducing sedentary behavior in autistic adults.
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Affiliation(s)
- Daehyoung Lee
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE
| | - Georgia C Frey
- Department of Kinesiology, Indiana University, Bloomington, IN
| | - Patrick C Shih
- Department of Informatics, Indiana University, Bloomington, IN
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Xing Y, Huang S, Zhao Y, Wu X. Effects of group sports activities on physical activity and social interaction abilities of children with autism spectrum disorders. Front Psychol 2025; 15:1496660. [PMID: 39980883 PMCID: PMC11840914 DOI: 10.3389/fpsyg.2024.1496660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Accepted: 12/18/2024] [Indexed: 02/22/2025] Open
Abstract
Introduction Group sports activities have been demonstrated to have an impact on the physical activity and social interaction abilities of children with autism spectrum disorder (ASD). Methods Thus, this work, taking different types of group sports as the primary variable, explored the impact of 12-week group sports activities on the physical activity and social interaction abilities of children with ASD. A quasi-experimental design was used to divide 21 children with ASD into Experimental group (N = 11) and Control group 1 (N = 10), while healthy children of the same age were selected as Control group 2 (N = 12). The experimental group performed group sports activities for 60 min/time, 4 times/week, for a total of 12 weeks, while the control group maintained the traditional sports activities of Peizhi School. Physical activity was monitored using a three-axis accelerometer (Model: ActiGraph GT3X+), and social interaction ability was measured using the playground observation of peer engagement (POPE) observation scale to evaluate the social interaction states of children in the experimental group after the physical activities. Results and discussion After the intervention, the sitting time of children in the experimental group was significantly reduced (t = -12.735, p < 0.001, Cohen d = 2.75), and the time of moderate and high-intensity physical activity was significantly increased (t = -8.79, p < 0.001, Cohen d = 1.82). In social interaction ability, the duration of loneliness was significantly reduced (t = -2.567, p < 0.017, Cohen d = 0.57), and the duration of joint participation (t = -3.009, p < 0.007, Cohen d = 0.02) and the regular game (t = -2.511, p < 0.026, Cohen d = 0.46) were significantly increased, respectively. 4 weeks after the intervention, the sedentary behavior and loneliness of the experimental group both continued to decrease. Group physical activities can improve the physical activity levels and social interaction skills of children with ASD and have a good effect on the maintenance.
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Affiliation(s)
- Yu Xing
- School of Physical Education, Hainan University, Haikou, China
- Hainan Provincial Key Laboratory of Sports and Health Promotion, Key Laboratory of Emergency and Trauma, Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, China
| | - Shuaibin Huang
- School of Physical Education, Hainan University, Haikou, China
| | - Yatong Zhao
- School of Physical Education, Hainan University, Haikou, China
| | - Xueping Wu
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
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Wang J, Yao J, He Y. A comparison of the physical activity levels of 3-to-6-year-old children with autism spectrum disorder and children with typical development. Front Psychol 2024; 15:1432389. [PMID: 39295756 PMCID: PMC11408300 DOI: 10.3389/fpsyg.2024.1432389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/14/2024] [Indexed: 09/21/2024] Open
Abstract
Background Physical activity during early development is closely related to health. Differences in physical activity between young children with autism spectrum disorder and those with typical development are unclear. The purpose of this study was to compare the physical activity levels in children with autism spectrum disorder and typically developing children from the same area, including their sedentary physical activity, light physical activity, moderate-to-vigorous physical activity, and number of days in which the moderate-to-vigorous physical activity guideline recommendation of 60 min per day was met. Methods A total of 77 participants aged 3-6 years were included: 41 children with autism spectrum disorder (mean age = 61.41 ± 10.69 months) and 36 children with typical development (mean age = 60.36 ± 10.16 months). The physical activity of the children was measured using an ActiGraph GT3x accelerometer. Results There were no significant differences in daily sedentary physical activity (439.70 ± 54.98 vs. 450.42 ± 53.67) or moderate-to-vigorous physical activity (46.62 ± 18.93 vs. 47.47 ± 18.26) between the two groups. The average daily moderate-to-vigorous physical activity of the two groups did not reach 60 min, and they had similar proportions of participants who reached 60 min a given number of times (24.4% vs. 25%). Daily light physical activity was significantly higher in the autism spectrum disorder group (263.96 ± 43.17 vs. 242.32 ± 37.91, p < 0.05). The moderate-to-vigorous physical activity of both groups was similar and lower than the recommended minimum physical activity. Conclusion Targeted interventions should be considered in early intervention programs for children with autism spectrum disorder to increase their moderate-to-vigorous physical activity.
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Affiliation(s)
- Jing Wang
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Jiaxin Yao
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Yingli He
- Tianjin Rehabilitation Service Guidance Center for the Disabled, Tianjin, China
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Holloway JM, Gray HL, Buro AW, Thomas J, Sauls R, Howard AM. Measurement Tools to Assess Usual Dietary Intake and Physical Activity in Individuals with Autism Spectrum Disorder: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2024; 11:504-524. [DOI: 10.1007/s40489-022-00349-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
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Lee D, Frey GC, Cothran DJ, Harezlak J, Shih PC. Concordance Between Accelerometer-Measured and Self-Reported Physical Activity and Sedentary Time in Adults with Autism. J Autism Dev Disord 2024; 54:1517-1526. [PMID: 36637594 DOI: 10.1007/s10803-022-05862-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/14/2023]
Abstract
This study examined the concordance between accelerometry-measured and self-reported physical activity (PA) and sedentary time in adults with autism. Twenty-four participants wore an ActiGraph GT3X + accelerometer for seven consecutive days and completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) on the last day of their study participation. Bland-Altman plots assessed the magnitude of agreement between the two measures. Nearly 80% of the participants accumulated the recommended ≥ 150 min of moderate to vigorous PA (MVPA)/week, but were also sedentary for over nine hours/day according to accelerometry data. Findings showed that adults with autism tended to overreport MVPA (b = 1.606, p < 0.01) and underreport sedentary time (b = 1.161, p = 0.03) via the IPAQ-SF, as compared to objective measurements.
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Affiliation(s)
- Daehyoung Lee
- Department of Applied Human Sciences, University of Minnesota Duluth, MN, Duluth, USA.
| | - Georgia C Frey
- Department of Kinesiology, Indiana University, Bloomington, IN, USA
| | | | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, USA
| | - Patrick C Shih
- Department of Informatics, Indiana University, Bloomington, IN, USA
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Schröder SS, Danner UN, Spek AA, van Elburg AA. Exploring the intersection of autism spectrum disorder and eating disorders: understanding the unique challenges and treatment considerations for autistic women with eating disorders. Curr Opin Psychiatry 2023; 36:419-426. [PMID: 37781983 DOI: 10.1097/yco.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
PURPOSE OF REVIEW Autistic women struggle with high levels of both autistic eating behaviours and disordered eating behaviours , which might make them particularly vulnerable to develop eating disorders. Research investigating the presence and characteristics of eating disorders in autistic women is however limited, as is research examining the role of autism in the treatment and recovery of an eating disorder in autistic women. RECENT FINDINGS The link between autism and eating disorders has mainly been investigated from the field of eating disorder research, with studies finding an overrepresentation of autism or autistic traits in eating disorders populations. Findings also suggest that autism or autistic traits are associated with a more serious presentation of the eating disorders, including a higher chance of a chronic course of the eating disorders. Most studies however lack comprehensive autism assessments, making it difficult to determine the actual prevalence of autism and its role in women with eating disorders. SUMMARY Autistic women with an eating disorder seem to suffer from more complex eating disorders and seem to not benefit from current treatment modalities. This could be partly related to specific autism characteristics such as sensory sensitivities, which are not being considered by current treatment protocols. Future research needs to shed light on what underlies the eating behaviours of autistic women with an eating disorder, in order to help to adapt current treatment modalities to meet the unique needs of these women.
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Affiliation(s)
- Sabrina S Schröder
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
| | - Annelies A Spek
- Autism Expert Center, Goyergracht Zuid 39, Eemnes, The Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
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Haghighi AH, Broughani S, Askari R, Shahrabadi H, Souza D, Gentil P. Combined Physical Training Strategies Improve Physical Fitness, Behavior, and Social Skills of Autistic Children. J Autism Dev Disord 2023; 53:4271-4279. [PMID: 36083392 DOI: 10.1007/s10803-022-05731-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
The present study aimed to investigate the effects of combined physical training (CPT) on social skills and physical fitness (PF) in children with ASD. Sixteen children with autism (age 6-10 years) were randomly assigned into two groups: CPT and control. The CPT group participated in a program involving ball game, rhythmic movements, and resistance training for eight weeks (three sessions per week). PF and behavior profile were assessed before and after training. CPT program had a significant effect on indicators of social skills such as stereotypic behavior and communication, as well as PF such as handgrip strength, upper and lower body power, flexibility, balance, and agility (P < 0.05). CPT in autistic children can improve indicators of social skills and PF.
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Affiliation(s)
| | | | - Roya Askari
- Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Hadi Shahrabadi
- Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Daniel Souza
- College of Physical Education and Dance, Federal University of Goias, Goiania, Brazil.
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goias, Goiania, Brazil
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Nakhostin-Ansari A, Shayestehfar M, Hasanzadeh A, Gorgani F, Memari A. Organized physical activity and sedentary behaviors in children and adolescents with autism spectrum disorder, cerebral palsy, and intellectual disability. World J Psychiatry 2023; 13:685-697. [PMID: 37771640 PMCID: PMC10523200 DOI: 10.5498/wjp.v13.i9.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/11/2023] [Accepted: 08/01/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND There is little data on physical activity (PA), organized PA (OPA), and sedentary behaviors in autism spectrum disorders (ASD) and other neurodevelopmental disorders in developing countries. AIM To examine OPA, non-OPA, and sedentary behaviors and their associated factors in children and adolescents with ASD, cerebral palsy (CP), and intellectual disability (ID). METHODS A total of 1020 children and adolescents with ASD, CP, and ID were assessed regarding the child and family information as well as the Children's Leisure Activities Study Survey. RESULTS The results showed that the OPA level was significantly lower than non-OPA in all groups. Furthermore, the OPA level was significantly lower in the CP group compared to ASD and ID groups (P < 0.001). Also, moderate (P < 0.001), vigorous (P < 0.05), and total (P < 0.001) physical activity levels were significantly different between all three groups, with the values being higher in the ASD group compared to the other two. The mean of the total sedentary behavior duration in the ASD group (1819.4 min/week, SD: 1680) was significantly lower than in the CP group (2687 min/week, SD: 2673) (P = 0.007) but not ID group (2176 min/week, SD: 2168.9) (P = 0.525). CONCLUSION Our findings remark on the participation rate of PA, OPA, and sedentary behaviors of children and adolescents with ASD, CP, and ID in a developing country. In contrast, the need for developing standards of PA/OPA participation in neurodevelopmental disorders is discussed.
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Affiliation(s)
- Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1417653761, Iran
| | - Monir Shayestehfar
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1417653761, Iran
| | - Alireza Hasanzadeh
- Medical School, Tehran University of Medical Sciences, Tehran 1417653761, Iran
| | - Fateme Gorgani
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1417653761, Iran
| | - Amirhossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1417653761, Iran
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Salvador-Garcia C, Valverde-Esteve T, Chiva-Bartoll O, Maravé-Vivas M. Dynamic balance improvement in children with Autism Spectrum Disorder after an extracurricular Service-Learning Physical Education program. Dev Neurorehabil 2023; 26:18-26. [PMID: 36191252 DOI: 10.1080/17518423.2022.2131922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study aimed to examine the acute changes in dynamic balance Postural Control experienced by children with Autism Spectrum Disorder (ASD) who undertook a 6-month extracurricular Service-Learning Physical Education (PE) program. The study used a quasi-experimental design with 23 participants divided into an experimental group and a control group. Limits of Stability protocol was used to measure the children's postural control. The results showed that the experimental group achieved statistically significant improvements. To conclude, this study provides substantial input about how extracurricular PE activities aimed at developing the general motor proficiency of ASD children can improve their dynamic balance.
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Affiliation(s)
- Celina Salvador-Garcia
- Department of Pedagogy and Didactics of the Social Sciences, Language and Literature, Universitat Jaume I, 12071 Castellón, Spain
| | - Teresa Valverde-Esteve
- Department of Didactics of Music, Visual and Body Expression, University of Valencia, 46022 Valencia, Spain
| | - Oscar Chiva-Bartoll
- Department of Education and Specific Didactics, Faculty of Humanities and Social Sciences, Universitat Jaume I, 12071 Castellón, Spain
| | - María Maravé-Vivas
- Department of Education and Specific Didactics, Faculty of Humanities and Social Sciences, Universitat Jaume I, 12071 Castellón, Spain
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Tomaszewski B, Savage MN, Hume K. Examining physical activity and quality of life in adults with autism spectrum disorder and intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:1075-1088. [PMID: 34514893 PMCID: PMC8918041 DOI: 10.1177/17446295211033467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 06/01/2023]
Abstract
Adults with autism and co-occurring intellectual disability engage in low levels of physical activity and are at increased risk of developing secondary health conditions attributed to physical inactivity compared to adults in the general population. Few studies have examined the use of objective measures to characterize physical activity levels for adults with autism and intellectual disability. The current study aimed to examine the relationship between physical activity, using an activity tracker, and quality of life in adults with autism and intellectual disability. In the current study, 38 adults with autism and intellectual disability, ages 18-55, wore a Fitbit Flex 2® activity tracker for 1 week, and completed the Quality of Life Questionnaire. The relationship between average daily step count quality of life was examined. Most adults in the sample were overweight and taking fewer daily steps than recommended guidelines. Increased average daily step count was significantly associated with quality of life.
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Affiliation(s)
- Brianne Tomaszewski
- Brianne Tomaszewski, TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, 100 Renee Lynn Court, Carrboro, NC 27510, USA. Emails: ;
| | - Melissa N Savage
- The Department of Educational Psychology, University of North Texas, USA
| | - Kara Hume
- School of Education, University of North Carolina at Chapel Hill, USA
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Arkesteyn A, Van Damme T, Thoen A, Cornelissen V, Healy S, Vancampfort D. Physical activity correlates in children and adolescents with autism spectrum disorder: a systematic review. Disabil Rehabil 2022; 44:6539-6550. [PMID: 34455885 DOI: 10.1080/09638288.2021.1970251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE This systematic review examined correlates of physical activity (PA) at all levels of the socio-ecological model (i.e., intrapersonal, interpersonal, environmental and policy level) in children and adolescents with autism spectrum disorder (ASD). MATERIALS AND METHODS Major electronic databases were searched from inception until March 23rd, 2021. A summary coding was used to analyze the data for children (3-12 years) and adolescents (13-18 years) with ASD separately. RESULTS Out of the 79 potential PA correlates, retrieved from 32 studies (991 657 children; 3857 adolescents), only five correlates were consistently examined as a PA correlate (i.e., examined in four or more studies) in children and adolescents with ASD. Only age was inversely associated with PA in children and adolescents with ASD. Data on gender, body mass index, autism severity level and day of the week being physically active in children with ASD were mixed. CONCLUSIONS We only found consistent evidence for age being inversely related to PA. Our review indicates that more research is needed to explore intrapersonal, interpersonal, environmental and policy-related correlates of PA in children and adolescents with ASD.IMPLICATIONS FOR REHABILITATIONRehabilitation programs should take into account that in particular older children and adolescents with autism spectrum disorder are at risk for physical inactivity.Boys and girls with autism spectrum disorder need the same care when motivating them to be more physically active.
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Affiliation(s)
- Anke Arkesteyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Anoushka Thoen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Sean Healy
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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Li H, Shi B, Wang X, Cao M, Chen J, Liu S, Zhan X, Jin C, Gui Z, Jing J, Zhu Y. Associations of emotional/behavioral problems with accelerometer-measured sedentary behavior, physical activity and step counts in children with autism spectrum disorder. Front Public Health 2022; 10:981128. [PMID: 36299767 PMCID: PMC9588958 DOI: 10.3389/fpubh.2022.981128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/22/2022] [Indexed: 01/25/2023] Open
Abstract
Background The evidence for associations of emotional/behavioral status with sedentary behavior (SB), physical activity (PA) and step counts is scarce in children with autism spectrum disorder (ASD). Also, ASD-related deficiencies may affect actual levels of PA. We aimed to describe accelerometer-measured SB, PA and step counts in children with ASD, and to examine the associations of emotional/behavioral problems with SB, PA and step counts after assessing associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies. Methods A total of 93 ASD children, aged 6-9 years, were recruited from the Center for Child and Adolescent Psychology and Behavioral Development of Sun Yat-sen University in Guangzhou, China. Participants wore an accelerometer for seven consecutive days. Of the original 93, 78 participants' accelerometer-measured valid PA were obtained, and the data were shown as time spent in SB, light, moderate, moderate-to-vigorous and vigorous PA, and step counts. Participants' emotional/behavioral problems were assessed via the Strengths and Difficulties Questionnaire (SDQ), and anxiety symptoms were evaluated by the Screen for Child Anxiety Related Emotional Disorders (SCARED). ASD-associated deficiencies include restricted repetitive behaviors (Repetitive Behavior Scale-Revised), poor social competence (Social Responsiveness Scale Second Edition) and motor development restrictions (Developmental Coordination Disorder Questionnaire). Results Of the 78 participants, daily vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) averaged 15.62 and 51.95 min, respectively. After adjustment for covariates, SDQ emotional symptoms (β = -0.060, p = 0.028) were inversely associated with the average daily minutes in VPA. Meanwhile, SDQ emotional symptoms (β = -0.033, p = 0.016) were inversely associated with the average daily MVPA minutes in the crude model. After adjustment for covariates, SCARED somatic/panic (β = -0.007, p = 0.040) and generalized anxiety (β = -0.025, p = 0.014) were negatively associated with the average daily VPA minutes; SCARED total anxiety (β = -0.006, p = 0.029) was conversely associated with daily MVPA duration. After adjustment for covariates, no significant associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies were found (p > 0.05). Conclusions Accelerometer-measured SB, PA and step counts showed no associations with ASD-related deficiencies. On this basis, we further found that the emotional symptoms were inversely associated with VPA and MVPA. These results emphasize the importance of VPA and MVPA in children with ASD. The longitudinally investigations on the directionality of these associations between emotional symptoms with VPA and MVPA are needed in the future.
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Affiliation(s)
- Hailin Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bijun Shi
- Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Muqing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiajie Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Siyu Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoling Zhan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengkai Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China,*Correspondence: Jin Jing
| | - Yanna Zhu
- Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Yanna Zhu
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Lee J, Healy S, Haegele JA. Environmental and social determinants of leisure-time physical activity in children with autism spectrum disorder. Disabil Health J 2022; 15:101340. [PMID: 35644892 DOI: 10.1016/j.dhjo.2022.101340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/29/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is increasingly recognized that children's physical activity behaviors are shaped by neighborhood environment factors and their parent's support. However, these factors have been scarcely studied among children with autism spectrum disorder (ASD), a population at risk of inactivity. OBJECTIVE This cross-sectional survey study was designed to examine how neighborhood environmental factors and parental support are related to physical activity levels of children with ASD. Also, this study examined if the relationship between the environment and physical activity is modified by demographic factors and COVID-19 related concerns. METHODS An online survey was completed by parents of children with ASD aged 10-17 years. The questionnaire included items related to environmental factors (i.e., distance to school, distance to park, existence of sidewalks, walkability), parent support for physical activity (i.e., encouraging, watching, and providing transportation), child's physical activity, and demographic characteristics. The instrument also queried parental concerns about COVID-19 and their child's physical activity participation. RESULTS The results indicate that proximity to a local park and to school is positively associated with physical activity. Parent's encouraging behavior correlated with and predicted children's physical activity levels. Also, higher levels of COVID-19 related concerns among parents were related to decreased physical activity supporting behaviors. CONCLUSIONS This study demonstrated that the neighborhood environment, in particular the distance between home and parks and schools, and parent support behavior are influential factors that may shape physical activity behaviors for children with ASD.
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Affiliation(s)
- Jihyun Lee
- Department of Kinesiology, San Jose State University, One Washington Sq, San Jose, CA 95192, USA.
| | - Sean Healy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Ireland.
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, USA.
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15
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Healy S, Brewer B, Hoopes E, Paller A, Mayberry S, Maguire J, Daly J, Laxton P, Patterson F. Identifying the most proximal multi-level factors associated with meeting each of the 24-h movement behavior recommendations in a sample of autistic adults. Disabil Health J 2022; 15:101367. [PMID: 36089505 DOI: 10.1016/j.dhjo.2022.101367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autistic adults have poorer 24-h movement behaviors, including lower levels of physical activity, more time spent being sedentary, and shorter sleep duration than neurotypical adults. Social ecological frameworks posit that 24-h movement behaviors are determined by multi-level domains; however, not known is which multi-level factors are most important to meeting each of the 24-h movement behavior guidelines among autistic adults. OBJECTIVE This study examined the relative importance of a range of multi-level determinants on meeting guidelines for the 24-h movement behaviors of aerobic physical activity, sedentary behavior, and sleep. METHODS We administered at cross-sectional electronic survey to a national self-selecting, convenience sample of autistic adults and caregivers of autistic adults residing in the USA. We used machine learning to examine the relative variable importance (VIMP) of 55 multi-level variables with meeting recommendations for physical activity, sedentary behavior, and sleep duration. VIMPs >0 indicate predictive variables/domains. RESULTS A greater number of group activities attended in the last 3-months, and greater independence in completing activities of daily living were most important to meeting aerobic physical activity guidelines. Group activity participation and marital status were important to meeting sedentary behavior guidelines while having a fewer number of comorbidities was most important to achieving adequate sleep. CONCLUSIONS These data support hypotheses about the role of family and social level interventions targeting movement behaviors in autistic adults.
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Affiliation(s)
- Sean Healy
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - Benjamin Brewer
- College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Elissa Hoopes
- College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Alexis Paller
- College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Shannon Mayberry
- College of Health Sciences, University of Delaware, Newark, DE, USA
| | | | | | - Paige Laxton
- College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Freda Patterson
- College of Health Sciences, University of Delaware, Newark, DE, USA.
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16
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Lee D, Frey GC, Cothran DJ, Harezlak J, Shih PC. Effects of a Gamified, Behavior Change Technique-Based Mobile App on Increasing Physical Activity and Reducing Anxiety in Adults With Autism Spectrum Disorder: Feasibility Randomized Controlled Trial. JMIR Form Res 2022; 6:e35701. [PMID: 35900808 PMCID: PMC9377470 DOI: 10.2196/35701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Physical activity (PA) has an impact on physical and mental health in neurotypical populations, and addressing these variables may improve the prevalent burden of anxiety in adults with autism spectrum disorder (ASD). Gamified mobile apps using behavior change techniques present a promising way of increasing PA and reducing sedentary time, thus reducing anxiety in adults with ASD. OBJECTIVE This study aimed to compare the effectiveness of a gamified and behavior change technique-based mobile app, PuzzleWalk, versus a commercially available app, Google Fit, on increasing PA and reducing sedentary time as an adjunct anxiety treatment for this population. METHODS A total of 24 adults with ASD were assigned to either the PuzzleWalk or Google Fit group for 5 weeks using a covariate-adaptive randomization design. PA and anxiety were assessed over 7 days at 3 different data collection periods (ie, baseline, intervention start, and intervention end) using triaxial accelerometers and the Beck Anxiety Inventory. Group differences in outcome variables were assessed using repeated-measures analysis of covariance, adjusting for age, sex, and BMI. RESULTS The findings indicated that the PuzzleWalk group spent a significantly longer amount of time on app use compared with the Google Fit group (F2,38=5.07; P=.01; partial η2=0.21), whereas anxiety was unfavorably associated with increases in light PA and decreases in sedentary time after intervention (all P<.05). CONCLUSIONS Further research is needed to clarify the determinants of physical and mental health and their interrelationship in adults with ASD to identify the factors that facilitate the use and adoption of mobile health technologies in these individuals. Despite these mixed results, the small changes in PA or anxiety may be clinically significant for adults with ASD. TRIAL REGISTRATION ClinicalTrials.gov NCT05466617; https://clinicaltrials.gov/show/NCT05466617.
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Affiliation(s)
- Daehyoung Lee
- Department of Applied Human Sciences, University of Minnesota Duluth, Duluth, MN, United States
| | - Georgia C Frey
- Department of Kinesiology, Indiana University, Bloomington, IN, United States
| | - Donetta J Cothran
- Department of Kinesiology, Indiana University, Bloomington, IN, United States
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, United States
| | - Patrick C Shih
- Department of Informatics, Indiana University, Bloomington, IN, United States
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17
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Yarımkaya E, Esentürk OK, İlhan EL, Kurtipek S, Işım AT. Zoom-delivered Physical Activities Can Increase Perceived Physical Activity Level in Children with Autism Spectrum Disorder: a Pilot Study. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:189-207. [PMID: 35677592 PMCID: PMC9163290 DOI: 10.1007/s10882-022-09854-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Although the benefits of regular physical activity are clearly expressed, children with Autism Spectrum Disorder (ASD) are less physically active than their typically developing peers. Recent empirical studies have revealed that the level of physical activity of children with ASD has further decreased during the novel coronavirus (COVID-19) pandemic, which has adversely affected the whole world. The aim of this study was to evaluate the potential efficacy of a Zoom-delivered physical activities for children with Autism Spectrum Disorder (ASD). Twenty-two families (parent and child dyads) participated in the study. Families were assigned randomly to an experimental group (n = 11) and a control group (n = 11). Families in the experimental group were engaged in 10 weeks of the Zoom-delivered physical activities. Data were collected using multiple data collection strategies (Personal Information Form- Leisure Time Exercise Questionnaire-Semi-Structured Interview). After the Zoom-delivered physical activities, a significant increase was observed in the physical activity level of children with ASD in the experimental group (F = 95.396, p = 0.000, Ƞ 2 = 0.834). Parents reported that Zoom-delivered physical activities are a viable and useful intervention to increase the level of physical activity of children with ASD. The findings suggest that Zoom-delivered physical activities merit further investigation as an intervention to increase physical activity in children with ASD.
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Affiliation(s)
- Erkan Yarımkaya
- Şehitler Secondary School, Ministry of National Education, Bayburt, TR-69300 Turkey
| | - Oğuz Kaan Esentürk
- School of Physical Education and Sports, Erzincan Binali Yıldırım University, Erzincan, TR-24000 Turkey
| | | | - Serkan Kurtipek
- Faculty of Sports Sciences, Gazi University, Ankara, TR-06500 Turkey
| | - Ayşe Türksoy Işım
- Faculty of Sports Sciences, Istanbul-Cerrahpaşa University, Istanbul, TR-34098 Turkey
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18
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Physical activity, Sedentary Behaviour and Their Correlates in Adults with Autism Spectrum Disorder: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00305-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract
The aim of this systematic review was to investigate what is currently known about autistic adults’ participation in physical activity and sedentary behaviour and explore any associated correlates of these behaviours. The databases EMBASE, MEDLINE, PsycINFO, PubMed, and SPORTDiscus were searched for relevant literature. The review was registered with PROSPERO (No. 189187). The search identified 2834 papers, with 12 meeting the criteria for inclusion. Correlates of physical activity and/or sedentary behaviour were reported in eight included studies. The limited evidence identified suggest that autistic adults are unlikely to meet Australia’s physical activity guidelines. Future research should use device-derived measurement to more accurately quantify activity levels within the autistic adult population.
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19
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Li R, Liang X, Zhou Y, Ren Z. A Systematic Review and Meta-Analysis of Moderate-to-Vigorous Physical Activity Levels in Children and Adolescents With and Without ASD in Inclusive Schools. Front Pediatr 2021; 9:726942. [PMID: 34722420 PMCID: PMC8549567 DOI: 10.3389/fped.2021.726942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The health benefits of physical activity (PA) participation are well-documented. Little was known about the PA levels of students with autism spectrum disorder (ASD) and their typically developing (TD) peers in inclusive schools. This study aimed to synthesize available studies examining PA levels of children and adolescents with and without ASD and its associated factors that affected their PA participation during inclusive schools applying the social-relational model of disability (SRMD). Methods: Eight databases were searched including CINAHL Complete, SPORTDiscus with Full Text, PubMed, Embase, Web of Science, Eric, APA PsycINFO, and Scopus from inception through May 2021 to identify related studies. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. The McMaster Critical Reviewer Form for quantitative studies was used to evaluate the methodological quality of the included articles. Results: A total of seven articles were included in this systematic review. Overall, meta-analysis results indicated that children and adolescents with ASD had a moderately decreased PA levels compared with their TD peers [SMD = -0.585, 95% CI (-0.774, -0.425), p < 0.01]. Individual-, social-, and environmental-level factors that influence PA levels in children and adolescents with ASD were identified from the perspective of SRMD. Conclusion: This review indicates that children and adolescents with ASD have lower PA levels than their TD peers in inclusive schools and multilevel factors affect their PA.
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Affiliation(s)
- Ru Li
- The Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Xiao Liang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR China
| | - Yujuan Zhou
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Zhanbing Ren
- The Faculty of Physical Education, Shenzhen University, Shenzhen, China
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20
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Healy S, Brewer B, Palmiere K, Daly J, McGuire J, Patterson F. 24-h movement behaviors among autistic adults: Differences by sex, age, and level of independence. Disabil Health J 2021; 14:101108. [PMID: 33935022 DOI: 10.1016/j.dhjo.2021.101108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 04/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autistic adults have low levels of physical activity [PA], high levels of sedentary behavior [SB], and insufficient sleep. Not known is the extent to which engagement in these movement behaviors vary by sex, age, and level of independence in activities of daily living (ADLs). OBJECTIVE To characterize movement behaviors in a national sample of autistic adults by sex, age, and level of independence in ADLs. METHODS A national sample of autistic adults and caregivers of autistic adults self-reported PA, SB and sleep behaviors as well as demographic variables using an electronic survey. Levels of engagement in movement behaviors were described, and compared by sex, age (young-adult versus middle-age), and level of independence in ADLs. RESULTS Data were collected on 361 autistic adults (60.3% male, n = 217, mage = 30.82 years, SD = 10.24). Overall, 44% did not meet the PA guideline; PA guideline adherence was lowest among males and those who were dependent on others in ADLs. Overall, the SB guideline was not met by 43% of the sample at weekdays and 48% at weekends. SB guideline adherence was lowest among adults who were middle-aged, and those who were fully independent in ADLs. Overall, 35.2% did not meet the total sleep time (TST) guideline. Middle-aged autistic adults had the lowest adherence to the TST guideline. CONCLUSIONS These finding should prompt researchers to consider these demographic differences, and tailor research and programmatic efforts to account for the unique movement behavior profiles of different segments of this heterogenous population.
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Affiliation(s)
- Sean Healy
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA.
| | - Benjamin Brewer
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Katherine Palmiere
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA
| | | | | | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA
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21
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Blagrave AJ, Colombo-Dougovito AM, Healy S. "Just Invite Us": Autistic Adults' Recommendations for Developing More Accessible Physical Activity Opportunities. AUTISM IN ADULTHOOD 2021; 3:179-186. [PMID: 36601469 PMCID: PMC8992896 DOI: 10.1089/aut.2020.0055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Autistic adults engage in lower levels of physical activity (PA) than their nonautistic peers, and over 60% do not meet national guidelines for PA. In addition, autistic adults face myriad barriers to PA participation that can make accessing activities challenging. To support the inclusion of autistic adults in PA, this study sought to explore first-hand recommendations for PA participation from autistic adults' perspective. Methods We interviewed 23 autistic adults aged 18 to 75 years about their PA experiences across their lifespan, including querying the participants' recommendations for supporting autistic adults in PA. A qualitative descriptive design with a constructivist lens guided the thematic analysis. Results The analysis resulted in two overarching themes: (1) It's helpful to have someone there to support; and (2) It's that sensory thing, it always is. Each theme includes participant-provided recommendations to guide professionals in the field of PA. Conclusions The autistic adult voice, long absent from conversations about PA, is a valuable and needed addition to understand how to improve PA experiences for this population. Recommendations from this study include (1) listening to the perspectives and insight of autistic adults, (2) consideration of sensory stimulus when planning for PA participation, and (3) encouraging and providing social supports for PA participation. Lay summary Why was this study done?: Autistic adults have many health concerns such as anxiety, depression, and obesity. Physical activity can improve these health concerns. Yet, professionals lack knowledge about how to provide optimal physical activity experiences for autistic individuals. Very little research has engaged autistic adults to directly ask their recommendations about their own physical activity needs.What was the purpose of this study?: This study wanted recommendations from autistic adults on how to make physical activity more accessible and enjoyable. By doing this, the authors hope to increase the voices of autistic adults in physical activity research.What did the researchers do?: The researchers asked 23 autistic adults for their recommendations on how to improve physical activity experiences.What were the results of the study?: Participants' responses were grouped into two categories: (1) It's helpful to have someone there to support and (2) It's that sensory thing, it always is. The first theme highlights the social supports that many autistic adults feel they need to be successful. Supports include individuals within the close social circles of the autistic adults, such as parents, friends, and other close people. They can also include professionals, such as teachers or exercise trainers. The second theme highlights the need to address the sensory sensitivities of the individual before activity can take place; if an environment or activity is not "sensory friendly" or is not accommodating, then autistic adults are less likely to engage.What do these findings add to what was already known?: Autistic adults face many barriers to physical activity participation. These findings offer first-hand accounts by autistic adults about how to improve their physical activity experiences. These results also offer ideas on how to increase physical activity engagement for autistic individuals. Other research has focused on improving physical activity in those who are autistic, but this research is rarely from the perspective of the autistic individual. This study is one of a very small number of studies that has done this and is the first to ask autistic adults to give recommendations for physical activity participation.What are potential weaknesses in the study?: This study only interviewed autistic adults who prefer to communicate verbally, and so the study sample is not representative of all autistic adults. Many participants in the sample were from the United States, and autistic adults in other countries may have different opinions about physical activity participation. Finally, the researchers may have recruited individuals with an interest in physical activity-autistic adults who are not interested or dislike physical activity may have different recommendations.How will these findings help autistic adults now or in the future?: This study will help professionals provide more appropriate physical activity experiences to autistic adults. Also, this research could help practitioners and researcher make physical activity spaces more welcoming and enjoyable for autistic adults.
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Affiliation(s)
| | | | - Sean Healy
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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22
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Lee D. Knowledge Gaps in Mobile Health Research for Promoting Physical Activity in Adults With Autism Spectrum Disorder. Front Psychol 2021; 12:635105. [PMID: 33841267 PMCID: PMC8024466 DOI: 10.3389/fpsyg.2021.635105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/01/2021] [Indexed: 12/27/2022] Open
Abstract
A growing body of research highlights that adults with autism spectrum disorder (ASD) have poor health outcomes, yet effective health interventions are lacking for this population. While mobile health applications demonstrate potential for promoting physical activity (PA) in adults with ASD, scientific evidence for supporting this tool’s long-term effectiveness on PA behavior change remains inconclusive. This study aimed to provide the latest information on PA research and the prospective role of mobile health applications for promoting PA in adults with ASD. A literature review demonstrated that a few available studies show contradictory results regarding PA levels in adults with ASD, and behavior change techniques and gamification-guided mobile health applications can be promising tactics to leverage autism’s strengths and increase PA in these individuals. Optimizing design decisions based on needs analysis and user feedback is crucial to identifying and developing a sustainable mobile health intervention for PA promotion in adults with ASD.
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Affiliation(s)
- Daehyoung Lee
- Department of Applied Human Sciences, University of Minnesota Duluth, Duluth, MN, United States
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23
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Yarımkaya E, Esentürk OK, İlhan EL, Karasu N. A WhatsApp-delivered intervention to promote physical activity in young children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:732-743. [PMID: 36210901 PMCID: PMC9542335 DOI: 10.1080/20473869.2021.1887436] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 06/15/2023]
Abstract
Objective: The aim of this study was to examine the effects of WhatsApp-delivered physical activities on the physical activity level of children with Autism Spectrum Disorder (ASD). Method: This study used the mixed-method sequential exploratory design that consisted of the quantitative stage and the qualitative stage. The 42 family (parent and child dyads) participated in the study. Families were assigned randomly to an experimental group (n: 21) and a control group (n: 21). Families in the experimental group were engaged in 6 weeks of the WhatsApp-delivered physical activities. The data were collected through Leisure Time Exercise Questionnaire (LTEQ) and Semi-Structured Interview Questions. A two-way mixed ANOVA (2 groups × 2 time points) was used to determine the effects of WhatsApp-delivered physical activities on the physical activity level of children with ASD. Results: After the WhatsApp-delivered physical activities, a significant increase was observed in the physical activity level of children with ASD in the experimental group compared to the control group. Conclusions: The results provided evidence that WhatsApp-delivered physical activities positively affect the physical activity level of children with ASD.
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Affiliation(s)
- Erkan Yarımkaya
- TOBB Örence Secondary School, Ministry of National Education, Bayburt, Turkey
| | - Oğuz Kaan Esentürk
- School of Physical Education and Sports, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | | | - Necdet Karasu
- Faculty of Education Sciences, Gazi University, Ankara, Turkey
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24
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Li YJ, Xie XN, Lei X, Li YM, Lei X. Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention-deficit hyperactivity disorder: A systematic review and meta-analysis. Obes Rev 2020; 21:e13123. [PMID: 32783349 DOI: 10.1111/obr.13123] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 12/27/2022]
Abstract
Individuals with autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD) may have unhealthy bodyweight. This meta-analysis was performed to understand the weight status in individuals with ASD or ADHD. PubMed, Embase, Cochrane and ISI Web of Science databases were searched from inception until June 2020 to identify relevant studies. Prevalence estimates and their 95% confidence intervals (CIs) of obesity, overweight and underweight were separately pooled using random-effects models. A total of 95 studies were included in the meta-analysis. The pooled estimates of the prevalence of obesity, overweight and underweight were 21.8%, 19.8% and 6.4% in individuals with ASD and 14.7%, 20.9% and 4.0% in individuals with ADHD. In subgroup analyses, an increasing trend in the prevalence of unhealthy weight was observed from children aged 2 to 5 years to adults with ASD (obesity: from 16.7% to 31.3%, overweight: from 16.2% to 27.2%, underweight from 5.3% to 8.6%) and from children aged 6 to 12 years to adults with ADHD (obesity: from 13.5% to 19.3%, overweight: from 18.8% to 31.2%). The worrisome epidemic of obesity and overweight in individuals with ASD, ADHD highlighted the need for weight management.
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Affiliation(s)
- Yong-Jiang Li
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xue-Ni Xie
- Shuda College, Hunan Normal University, Changsha, China
| | - Xue Lei
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Ya-Min Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xianyang Lei
- Office of the President, Central South University, Changsha, China
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25
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Kassee C, Babinski S, Tint A, Lunsky Y, Brown HK, Ameis SH, Szatmari P, Lai MC, Einstein G. Physical health of autistic girls and women: a scoping review. Mol Autism 2020; 11:84. [PMID: 33109257 PMCID: PMC7590704 DOI: 10.1186/s13229-020-00380-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is a growing recognition of sex and gender influences in autism. Increasingly, studies include comparisons between sexes or genders, but few have focused on clarifying the characteristics of autistic girls'/women's physical health. METHODS A scoping review was conducted to determine what is currently known about the physical health of autistic girls/women. We screened 1112 unique articles, with 40 studies meeting the inclusion criteria. We used a convergent iterative process to synthesize this content into broad thematic areas. RESULTS Autistic girls/women experience more overall physical health challenges compared to non-autistic girls/women and to autistic boys/men. Emerging evidence suggests increased prevalence of epilepsy in autistic girls/women compared to non-autistic girls/women and to autistic boys/men. The literature also suggests increased endocrine and reproductive health conditions in autistic girls/women compared to non-autistic girls/women. Findings regarding gastrointestinal, metabolic, nutritional, and immune-related conditions are preliminary and inconsistent. LIMITATIONS The literature has substantial heterogeneity in how physical health conditions were assessed and reported. Further, our explicit focus on physical health may have constrained the ability to examine interactions between mental and physical health. The widely differing research aims and methodologies make it difficult to reach definitive conclusions. Nevertheless, in keeping with the goals of a scoping review, we were able to identify key themes to guide future research. CONCLUSIONS The emerging literature suggests that autistic girls/women have heightened rates of physical health challenges compared to non-autistic girls/women and to autistic boys/men. Clinicians should seek to provide holistic care that includes a focus on physical health and develop a women's health lens when providing clinical care to autistic girls/women.
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Affiliation(s)
- Caroline Kassee
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Stephanie Babinski
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Sociology, University of Toronto, Toronto, Canada
| | - Ami Tint
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
- Department of Psychology, University of Toronto, Toronto, Canada.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Gillian Einstein
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
- Tema Genus, Linköping University, Linköping, Sweden
- Rotman Research Institute, Baycrest Hospital, Toronto, Canada
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Lang CE, Barth J, Holleran CL, Konrad JD, Bland MD. Implementation of Wearable Sensing Technology for Movement: Pushing Forward into the Routine Physical Rehabilitation Care Field. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5744. [PMID: 33050368 PMCID: PMC7601835 DOI: 10.3390/s20205744] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/01/2023]
Abstract
While the promise of wearable sensor technology to transform physical rehabilitation has been around for a number of years, the reality is that wearable sensor technology for the measurement of human movement has remained largely confined to rehabilitation research labs with limited ventures into clinical practice. The purposes of this paper are to: (1) discuss the major barriers in clinical practice and available wearable sensing technology; (2) propose benchmarks for wearable device systems that would make it feasible to implement them in clinical practice across the world and (3) evaluate a current wearable device system against the benchmarks as an example. If we can overcome the barriers and achieve the benchmarks collectively, the field of rehabilitation will move forward towards better movement interventions that produce improved function not just in the clinic or lab, but out in peoples' homes and communities.
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Affiliation(s)
- Catherine E. Lang
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA; (J.B.); (C.L.H.); (J.D.K.); (M.D.B.)
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63122, USA
| | - Jessica Barth
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA; (J.B.); (C.L.H.); (J.D.K.); (M.D.B.)
| | - Carey L. Holleran
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA; (J.B.); (C.L.H.); (J.D.K.); (M.D.B.)
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63122, USA
| | - Jeff D. Konrad
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA; (J.B.); (C.L.H.); (J.D.K.); (M.D.B.)
| | - Marghuretta D. Bland
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA; (J.B.); (C.L.H.); (J.D.K.); (M.D.B.)
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63122, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63122, USA
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Liang X, Li R, Wong SHS, Sum RKW, Sit CHP. Accelerometer-measured physical activity levels in children and adolescents with autism spectrum disorder: A systematic review. Prev Med Rep 2020; 19:101147. [PMID: 32637302 PMCID: PMC7327848 DOI: 10.1016/j.pmedr.2020.101147] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/06/2020] [Accepted: 06/10/2020] [Indexed: 12/27/2022] Open
Abstract
Associations between physical activity (PA) and health benefits are well documented. Evidence indicates that children and adolescents with autism spectrum disorder (ASD) are less physically active than their typically developing peers. The purpose of this systematic review is to provide a comprehensive summary of the PA levels of children and adolescents with ASD and the associated factors that affect their PA levels by applying a socio-ecological model (SEM). Seven databases (PubMed, CINAHL, SPORTDiscus with Full Text, MEDLINE, EMBASE, ERIC, and PsychINFO) were searched in June 2019 to identify studies examining accelerometer-measured PA and factors affecting the PA levels of children and adolescents with ASD, aged 6-17 years. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. Twenty-one studies were included in the detailed review. Only 42% of the participants met the PA guidelines (i.e., children and adolescents aged 5-17 years should do at least 60 min of moderate to vigorous PA daily). By applying the SEM, multi-level factors ranging from intrapersonal to community levels that positively or negatively influenced PA levels in children and adolescents with ASD were identified. This review indicates that children and adolescents with ASD have low PA levels, and that there are multi-level factors that affect their PA. There is a pressing need to design effective PA interventions that promote activity accrual in the school, family, and community settings for children and adolescents with ASD.
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Affiliation(s)
- Xiao Liang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Ru Li
- Physical Education Unit, Shenzhen University, China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Raymond K W Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
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28
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Effect of a Service-Learning Program on the Active Lifestyle of Children with Autism Spectrum Disorder: A Pilot Study. SUSTAINABILITY 2020. [DOI: 10.3390/su12114354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: active lifestyles and Physical Activity (PA) are closely related to health. Healthy habits such as being physically active should be consolidated during childhood. Children with Autism Spectrum Disorders (ASD) present fewer opportunities to be involved in PA. For this reason, we conducted a Service-Learning (SL) program to enhance the possibility of participating ASD children enjoying PA sessions. The aim of this study was to analyze and describe the evolution in terms of the frequency and intensity of PA performed by ASD children who participated in the SL program. Methods: we used a quasi-experimental design. The sample was formed by 26 children with ASD (Experimental group: n = 16; 4 girls, 12 boys) (Control group: n = 10; 1 girl, 9 boys) with ASD level 1. Results: after the intervention program, moderate PA during the week increased significantly (Pre-Median: 92.04, Range: 35.71–126.47 min; Post-Median: 212.67, Range: 99.75, 271.04 min) (p ≤ 0.001). When comparing both groups, the tendency to do PA in the Experimental group remained more stable. Also, the improvements in moderate intensities were higher in the Experimental group after the intervention. Conclusion: a six-month SL program improved the moderate PA routines of ASD children. However, longer programs and longitudinal studies are required.
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Kinnaird E, Sedgewick F, Stewart C, Tchanturia K. Exploring Self-Reported Eating Disorder Symptoms in Autistic Men. AUTISM IN ADULTHOOD 2019; 1:306-310. [PMID: 36601317 PMCID: PMC8992817 DOI: 10.1089/aut.2019.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Although research suggests a relationship between restrictive eating disorders (EDs) and autism, there is a lack of research in this area from the perspective of autistic men. Our aim was to explore whether ED symptoms are heightened in autistic men compared with nonautistic men. Methods We recruited 103 autistic and nonautistic participants through an online study. We assessed ED symptoms, autistic features, anxiety, depression, and body mass index (BMI) using self-report measures. Results Autistic men (n = 54) exhibited significantly higher levels of ED symptoms in the areas of eating (p < 0.001), shape (p = 0.005), and weight (p = 0.001) concerns, and the global score (p = 0.046) than nonautistic men (n = 49). However, autistic men scored significantly lower in the area of dietary restraint (p = 0.032). Global ED scores did not correlate with autistic traits, but did correlate with anxiety (p < 0.001) and BMI (p < 0.001) in the autistic group. Conclusions This exploratory study suggests that heightened ED symptoms in autistic men may be related to heightened levels of anxiety and higher BMIs, rather than autistic traits. It also highlights that autistic men may experience symptoms not relating to dietary restraint. Future research should consider further exploring the relationship between anxiety, BMI, and disordered eating in autism. Lay Summary Why was this study done?: There is a lot of interest in the relationship between autism and eating disorders (EDs). Research suggests that as many as one in four people with anorexia could be autistic. However, most research has been done (1) on women and (2) looking at autistic traits in women with anorexia. There is less research looking at the relationship from the perspective (1) of men and (2) looking at ED symptoms in autistic people.What was the purpose of this study?: We aimed to explore whether autistic men experience more ED symptoms than nonautistic men.What did the researchers do?: This was an online study. We asked participants to fill out self-report measures of autistic traits and ED symptoms. We also asked participants to self-report whether they were autistic, and whether they had been previously diagnosed with an ED. We included 54 autistic men and 49 nonautistic men.What were the results of the study?: We found that although autistic men did experience higher levels of ED symptoms than nonautistic men, this did not appear to be related to autistic traits. Instead ED symptoms were related to anxiety and higher rates of being overweight or obese. In addition, autistic men in fact experienced significantly lower levels of ED symptoms associated with dietary restraint than nonautistic men.What do these findings add to what was already known?: Our findings reflect some previous research findings that ED symptoms may be heightened in autistic people. They also suggest that these symptoms are related to higher levels of anxiety or body mass indexes (BMIs) in autistic people, rather than autistic traits themselves. Also, most previous research has focused on symptoms of restraint in EDs and autism, for example, limiting the amount you eat or not eating certain foods. In our study, restraint was not found to be heightened, suggesting that focusing on restraint symptoms might be less relevant to autistic men.What are potential weaknesses in the study?: One key weakness is our use of self-report measures, particularly asking participants to self-report their autism diagnosis. An additional limitation is the small sample size, which makes it hard to generalize findings.How will these findings help autistic adults now or in the future?: More research is needed to understand the relationship between anxiety, BMI, autism, and ED symptoms. Our findings could help our understanding of disordered eating in autistic adults as they suggest we need to pay more attention to autistic adults experiencing ED symptoms that are not related to dietary restriction, such as binge eating.
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Affiliation(s)
- Emma Kinnaird
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Felicity Sedgewick
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Catherine Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Illia State University, Tbilisi, Georgia
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Zanobini M, Solari S. Effectiveness of the Program "Acqua Mediatrice di Comunicazione" (Water as a Mediator of Communication) on Social Skills, Autistic Behaviors and Aquatic Skills in ASD Children. J Autism Dev Disord 2019; 49:4134-4146. [PMID: 31267291 DOI: 10.1007/s10803-019-04128-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The study aims to analyze the effectiveness of a swimming program on interpersonal skills, autistic mannerisms, and aquatic abilities in children with autism spectrum disorders (ASD). Research on aquatic therapy showed improvements in motor skills, whereas there is little evidence of effectiveness of this approach on social impairments of ASD. Participants included 25 children, 13 in the experimental group and 12 in the control group, matched for gender, age and autism score. The results showed an advantage in the relational skills for the experimental group at the post-test. The tendency to ameliorate other symptomatology, e.g., autonomy and negative behaviors, persisted at follow-up. Likewise, positive changes in aquatic skills were maintained 6 months after the end of the program.
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Affiliation(s)
- Mirella Zanobini
- Dipartimento di Scienze della Formazione, (Departement of Education Sciences), University of Genoa, Corso Podestà 2, 16128, Genoa, Italy.
| | - Silvano Solari
- Dipartimento di Scienze della Formazione, (Departement of Education Sciences), University of Genoa, Corso Podestà 2, 16128, Genoa, Italy
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