By: Elizabeth Zeppernick, M.Ed., BCBA, LBA

The health benefits of physical activity are clearly established.  For children, the Center for Disease Control and Prevention (2016) recommends 60 minutes of physical activity each day.  While only 25% of children meet this daily minimum, those diagnosed with Autism Spectrum Disorder (ASD) are even less likely to hit this daily goal (Pan, 2008; Pan et al., 2016; Stanish et al., 2017).  

Aside from the more obvious benefits to one’s health, researchers Goldman et al. (2021) recently published a study on the connection between physical activity and its effects on stereotypy, with a focus on the population of individuals with ASD.  Stereotypy is repetitive and often restrictive movements or vocalizations that serve no obvious purpose.  Common examples of stereotypy include hand flapping, vocalizations, body rocking or spinning objects.  Goldman et al. (2021) looked at interventions to increase physical activity, and looked at the effect of physical activity on stereotypy and the duration it had a positive effect on on-task behavior. 

Existing research has established that physical activity has been shown to reduce stereotypy in individuals with ASD (Bremer et al., 2016; Lang et al., 2010; Petrus et al., 2008).  In this recent study Goldman et al. (2021) worked with four males with ASD who were seven and eight years old.  These participants engaged in hand flapping, hand mouthing, tapping items, stomping and vocal stereotypies.  A Functional Analysis, which is a controlled study to find out what causes the behavior, was conducted for all participants.  The analysis indicated that for all four participants, the behavior was maintained by automatic reinforcement, which means the behaviors could be self-stimulating and not caused or reinforced by any other person.  Essentially, the stereotypy of these participants were not likely to be occurring for attention, to gain or to avoid something. 

Researchers used a preference assessment to find out in which types of physical activity the participants were most likely to engage.  The physical activity options offered to participants included access to an indoor trampoline, bicycle, scooter, exercise and soccer ball and basketball.  They measured physical activity versus sedentary activity and introduced an intervention to increase the percentage of physical activity during each session.  The intervention varied based on what was most reinforcing for each participant but included access to a highly preferred video, time with wireless headphones playing music and a token reinforcement system.  These were used to reinforce active and continual engagement in the exercise presented.  For the participant who had the token system, they were used to reward continual physical activity and then could be traded in for highly preferred activities. 

Researchers measured the total time engaged in stereotypy before and after physical activity.  They also measured the total on-task behavior following physical activity.  On-task behavior was defined as time spent seated while responding to instructional tasks promptly.  On average, the sessions that ranged from 10 to 15 minutes of physical activity produced the greatest decrease in stereotypy and the greatest increase in on-task behavior.  On average, the reduction in stereotypy and increase in on-task behavior was greatest during the first 10 minutes that followed physical activity. 

While this participant pool of four is a small sampling, this study highlights the effectiveness of using physical activity to address stereotypy and to increase on-task behavior.  It also speaks to the importance of preference assessments to determine the most motivating activities and accompanying reinforcers.  By assessing the duration of time that exercise has a positive effect on stereotypy and on-task behaviors, practitioners can support teachers and parents to assess the cost-benefit and practicality of building in opportunities for physical activity within the daily routine of individuals with ASD.  

Sources:

Bremer, E., Crozier, M., & Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20(8), 899-915. https://doi.org//10.1177/1362361315616002

Centers for Disease Control and Prevention. (2016). Current physical activity guidelines. Retrieved from https://www.cc.gov/cancer/dcpc/prevention/policies_practices/physical_activity/guidelines.htm

Goldman, K. J., DeLeon, I. G., Schieber, E., Weinsztok, S. C., & Nicolini, G. (2021). Increasing physical activity and analyzing parametrically the effects on stereotypy in children with autism spectrum disorder. Behavioral Interventions, 1– 25. https://doi.org/10.1002/bin.1812

Lang R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576. https://doi.org/10.1016/j.rasd.2010.01.006

Pan, C. Y., (2008). Objectively measure physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan. Journal of Autism and Developmental Disorders, 38(7), 1291-1301. https://doi.org/10.1007/s10803-007-0518-6

Pan, C. Y., Tsai, C. L., Chu, C. H., Sung, M.C., Ma, W. Y., & Huang, C. Y. (2016). Objectively measure physical activity and health-related physical fitness in secondary school-aged male students with autism spectrum disorders. Physical Therapy, 96(4), 511-520. https://doi.org/10.2522/ptj.20140353

Petrus, C., Adamson, S. R., Block, L. Einarson, S. J., Sharifnejad, M., Harris, S. R. (2008). Effects of exercise interventions on stereotypic behaviours in children with autism spectrum disorder. Physiotherapy Canada, 60(2), 134-145. https://doi.org/10.3138/physio.60.2.134

Stanish, H.I., Curtin, C., Must, A., Phillips, S., Maslin, M., & Bandini, L. G. (2017). Physical activity levels, frequency, and type among adolescents with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(3), 785-794. https://doi.org/10.1007/s10803-016-3001-4

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