Exercise as it relates to Disease/Aerobic exercise, a positive influence on young Autistic children before class

This is a critical analysis of the original journal article "The Effects of Aerobic Exercise on Academic Engagement in Young Children With Autism Spectrum Disorder" - Oriel, Kathryn N. PT, EdD; George, Cheryl L. PhD; Peckus, Rebecca DPT; Semon, Amanda DPT.

What is the background to this research?
With the prevalence of autism spectrum disorder (ASD) on the rise, the need for effective educational interventions is increasing Autism Spectrum Disorder is defined as “a neurobehavioral syndrome marked by qualitative impairments of social interaction and communication, and by restricted, repetitive, and stereotyped patterns of behaviour". Stereotypical behaviour involve toe walking, hand-and-arm flapping, rocking or spinning the body, or finger flicking.

According to the National Institute of Child Health and Human Development, health care providers envision autism on a spectrum, as a group of disorders with similar features. This group includes autistic disorder, Asperger syndrome, pervasive developmental disorder not otherwise specified,and Rett syndrome.

Participants in this study were from 4 early intervention autistic support classrooms. The 24 children in these early intervention classrooms had a diagnosis of ASD (Autism Spectrum Disorder) and were between the ages of 3 and 6 years.

Where is the research from?
This study was approved by the Institutional Review Board at Lebanon Valley College,and was funded by the PLEET Grant.

Kathryn Oriel is a well known Physical Therapist whom has extensive research in exercising autistic children. Kathryn has published Journal Articles such as The Impact of Aquatic Exercise on Sleep Behaviours in Children with Autism Spectrum Disorder and The Impact of a rock climbing program for adolescents with Autism Spectrum Disorder

What kind of research was this?
This study used a within-subjects crossover design, that focused on a treatment condition and a control condition. In this study, two of the 4 classes were randomly assigned to the treatment condition and the other 2 classrooms to the control condition. This was applied for the first 3 weeks of the study. During the subsequent 3 weeks of the study, each class received the opposite condition.

According to Spencer et al,19, the crossover design minimizes the effects of pre-existing differences between classrooms, such as academic levels of students, age/grade levels, as well as differences in curricula. This design allows each student to receive both treatments and serves as his or her own control, which also minimizes the possibility of differential attrition within treatment conditions.

What did the research involve?
Dependant Measures:

Four dependent variables were measured: (1) correct academic responses, (2) incorrect academic responses, (3) stereotypic behaviors, and (4) on-task behaviour.

Treatment Condition:

The treatment condition was approximately 15 minutes of running/jogging as a group. A consistent pace of running/jogging was maintained through the use of prompts that were established by the child's classroom teacher, such as edible reinforcements and verbal instruction. After the completion of the exercise, the children participated in gentle seated stretching and were given a cup of water. Children were then assisted back to their classroom. Classroom activity immediately began upon returning to the class.

Controlled Condition:

The control condition consisted of participation in a classroom task that was not preceded by exercise. Classroom teachers were asked to discourage aerobic activity prior to the classroom task being assessed while children participated in the control condition. Examples of academic probes includ solving a 4- to 6-piece puzzle, putting shapes in a container, cutting a piece of paper and communicating verbally.

Classroom tasks remained the same for the treatment and control conditions.

Limitations:

Because this study was short in duration, improvements are unclear if academic responding would increase, maintain, or decrease over time. Although the measurement of heart rate using a pulse oximeter was the original plan, the children in this study were unable to tolerate the use of the device. Teachers were given the monitors four weeks in advance so the children could adapt, although, teachers reported inappropriate behaviour with the use of the device. While the study examined flushed faces and increased breathing as means of working aerobically, it was stated that more objective means to determine exercise intensity should be considered in future studies.

What were the basic results?
From this summary of results it can be observed that exercise only significantly improved correct/incorrect responses in the Wilcoxon Signed Test, although time to complete the task and stereotypical behaviour did not show any change after exercise intervention within ASD population.

These findings are consistent with additional studies.

What conclusions can we take from this research?
This study concludes that aerobic exercise, prior to classroom activities, may improve academic responding in young children with ASD. However, children who are diagnosed with ASD are more likely to lack motivation towards aerobic activity. This is evident in this study as a couple children didn't benefit, due to a lack of motivation. In this situation, motivation becomes the bigger problem.

Kathryn Oriel has conducted various other studies, all focussing on exercise and its impact on young children with ASD. The Impact of Aquatic Exercise on Sleep Behaviours in Children with Autism Spectrum Disorder, is a another study conducted that proves there is a positive influence when it comes to exercise and children with ASD.

Practical advice
In all exercise testing, formed consent is compulsory. This study focusses on children, and in some circumstances, non verbal children. Conditions as such allow parental consent.

Appropriate equipment is vital to record accurate data. This study aimed to use a pulse oximeter, although was reported that it negatively impacted behaviour. Prior testing of multiple, appropriate and tested equipment must be considered.

Further Readings

- The Impact of Aquatic Exercise on Sleep Behaviours in Children with Autism Spectrum Disorder

-The Impact of a Rock Climbing Program for Adolescents with Autism Spectrum Disorder