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Autism

Is Your Child Active Enough?

Physical exercise has many benefits for young people on the autism spectrum..

Key points

  • Physical Exercise can be beneficial in many ways
  • Consider the type of exercise. Vigorous exercise may be more helpful than mild exercise for certain behaviors
  • The effects of vigorous exercise are most evident after about an hour then gradually return to pre-levels
  • Incorporating regular physical exercise into daily routines can be helpful and enjoyable

Over the years, a lot of effort has gone into understanding and reducing autistic children’s restricted and repetitive behaviors (RRBs), also colloquially called “self-stimulatory behavior” or “stim.” Some types of RRBs are inconsequential, and may not warrant addressing, unless...:

  1. They are bothersome to the individual who engages in them. (I’ve had autistic adults ask me to help them reduce these as they felt it interfered with dating success.)
  2. They are having a negative effect on family life. (I’ve had spouses and parents of individuals on the spectrum ask me to eliminate behaviors that made certain routines difficult.)
  3. They interfere with important life goals, such as employment. (One grocery store manager indicated that he wouldn’t hire one of our adults because he had a fascination with the automatic doors and would go in and out more often than was necessary.)

Other types of RRBs are more interfering and can negatively impact learning and socialization. Studies have shown that when interfering RRBs are reduced, learning and socialization improve, so it makes sense that there have been efforts over time to reduce them.

In the late 1970s, in our after-school center, we worked with children who had high levels of interfering RRBs. We took frequent breaks during the hours-long teaching sessions, and noticed that the children seemed to respond better right after each break, with noticeably reduced RRBs. We decided to try to pinpoint the various reasons this might be true, to figure out which break-time activities led to the most positive improvements.

We first assessed whether vigorous physical exercise (jogging) would result in decreases in interfering RRBs. We gradually worked up to 20 minutes of jogging with the children, followed by either a play time activity (ball play) or an academic one. We saw improvement, but wanted to be certain that the jogging was the cause, so we alternated these breaks: jogging, no jogging, jogging, no jogging, and so on. After each jogging session, the children’s responsiveness improved, regardless of the activity, and the interfering RRBs decreased. This wasn’t the case after the no-jogging breaks.

This was great news, as many of the interventions designed to decrease interfering behaviors used response consequences that were often aversive. Physical exercise was an antecedent procedure that was healthy and effective.

Given this information, we also wanted to understand whether physical activity could be effectively incorporated into a school setting. To do this, we jogged with students during recess periods at school, and compared their school performance with time periods when they hadn’t jogged. We looked at on-task classroom responsiveness, levels of RRBs, and interfering behavior such as meltdowns, aggression, and fleeing. After recesses that included jogging, the children always showed lower levels of RRBs and other interfering behaviors, and higher levels of responsiveness and correct responses.

Often, during research, unexpected events will arise that lead to ideas for further studies, and this study was no exception. Interestingly, one participant seemed to improve only slightly — not to the degree of the other participants. Upon discussion, the tall undergraduate student who was jogging with that child mentioned that he walked next to the child, and the child sort of walked-trotted-jogged next to him; they never really built up any speed. That gave us the idea that perhaps the exercise needed to be aerobic or vigorous to be effective. Thus, in a subsequent study, we interspersed a low-energy anaerobic activity (ball playing) with vigorous jogging. The children performed better with low levels of interfering behaviors after the jogging, but after the ball-playing sessions, there were few changes in these areas. We concluded that vigorous exercise was important for this effect.

Finally, we wanted to understand how long the effects of jogging might last. To do this we recorded data every 15 minutes following the jogging sessions. Our data suggested that the most positive changes were about an hour after the the 20-minute jog, after which they gradually returned to pre-jogging levels.

There are several important take-aways from this research. First, the benefits of jogging were not a result of general fatigue from vigorous exercise. If it had been fatigue, the children would most likely not have responded at a higher rate in follow-up activities. Second, for this type of effect, vigorous exercise, such as jogging, appeared to be more effective than less active exercise, such as ball playing. While other studies have shown the benefits of mild exercise routines in other areas, the areas we focused on were more positively affected by vigorous exercise. Next, the exercise was non-contingent. We did not exercise the children as a consequence of poor responding or high levels of interfering behavior. Instead, we took them jogging as a regular and fun activity throughout the day. Finally, we measured the children’s affect during our research. It is important that children on the autism spectrum — especially those who have communication challenges — show outward signs of positive affect. Our studies showed that after jogging sessions the children showed more interest in and enthusiasm for their academic lessons.

Ideas for increasing physical exercise

Note: Make sure your child enjoys the activity. It may take a bit to work up to the ideal exercise period, especially if your child has been sedentary, but the payoff will be well worth it.

  • Walk or bike to school instead of driving.
  • Find ways to add short walks or runs into the day. One parent reported that she dropped her son and husband several blocks away from home after outings so they could briskly walk or jog home.
  • Ask the school to incorporate regular physical exercise into your child’s schedule. Work with them on a plan to have your child involved in preferred physical activities. Many autistic children do not participate in playground activities when left on their own, so there has to be a concerted effort to include and encourage them.
  • Enroll your child in afterschool sports, something autistic children may not gravitate toward naturally, and provide training to the coaches on how to effectively work with your child. Additionally, you may be able to secure support services from your insurance company or state agency.
  • Consider purchasing equipment for your home that will provide opportunities for physical activity. Trampolines are great. A stationary bike or treadmill can be fun, too.

While our work focused on interfering behaviors and task engagement, other studies have found that regular vigorous exercise can improve sleep, executive functioning, social competence, motor coordination, balance, and flexibility, and can also reduce body mass index (BMI), and so on. Thus, the positive effects of regular and frequent exercise are well worth the effort.

References

Kern, L., Koegel, R. L., & Dunlap, G. (1984). The influence of vigorous versus mild exercise on autistic stereotyped behaviors. Journal of autism and developmental disorders, 14(1), 57-67.

Kern, L., Koegel, R. L., Dyer, K., Blew, P. A., & Fenton, L. R. (1982). The effects of physical exercise on self-stimulation and appropriate responding in autistic children. Journal of autism and developmental disorders, 12(4), 399-419.

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.

Liang, X., Li, R., Wong, S. H., Sum, R. K., Wang, P., Yang, B., & Sit, C. H. (2022). The effects of exercise interventions on executive functions in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis. Sports Medicine, 52(1), 75-88.

Sam, K. L., Chow, B. C., & Tong, K. K. (2015). Effectiveness of exercise-based interventions for children with autism: A systematic review and meta-analysis. International Journal of Learning and Teaching, 1(2), 98-103.

Tse, A. C., Lee, P. H., Zhang, J., Chan, R. C., Ho, A. W., & Lai, E. W. (2022). Effects of exercise on sleep, melatonin level, and behavioral functioning in children with autism. Autism, 26(7), 1712-1722.

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