Trajectories of physical activity among autistic children and their caregivers: Outcomes of a virtual 1-year longitudinal intervention.

BACKGROUND: Participation in regular physical activity (PA) is a critical component of overall well-being. However, opportunities to engage in health-enhancing PA for families who have an autistic child are relatively obsolete. A virtual PA intervention has the potential to address many participation barriers and represents a timely opportunity to promote positive trajectories of PA among vulnerable populations. OBJECTIVE: To examine PA trajectories during a one-year virtual intervention for autistic children and their caregiver and to explore relationships in activity participation within child-caregiver dyads. METHODS: Twenty-nine families, including autistic children and their caregiver participated in the full intervention. Caregivers completed questionnaires to measure PA behavior at baseline and four-month intervals throughout the intervention. RESULTS: Reported PA significantly increased among autistic children and caregivers during the intervention. No association in PA was observed within dyads at baseline, but moderate relationships were observed during the intervention. CONCLUSION: Findings demonstrate the initial effectiveness of a virtual PA intervention for autistic children and their caregiver.

Low Muscle Strength, Low Bone Mineral Density, and High Body Mass Index Among Adult Special Olympics Athletes: A Cross-Sectional Examination.

Adults with intellectual disabilities have increasing life expectancy but may be susceptible to early aging-related conditions. The purpose of this study was to examine associations between the presence of low muscle strength, low bone mineral density, and high body mass index with age and sex in adult Special Olympics athletes. Grip strength (n = 6,477; 40.9% female), chair stand time (n = 6,444; 40.5% female), body mass index (n = 7,824; 43.7% female), and bone mineral density (n = 3,091; 43.2% female) measurements were provided by Special Olympics International. Poor grip strength, chair stand time, bone mineral density, and body mass index were identified in 43.8%, 46.2%, 28.7%, and 50.3% of each sample, respectively. Increasing age was a risk factor for all conditions (odds ratio = 1.30-10.89; p < .05). High rates of adverse health conditions were observed in a sample of adults with intellectual disabilities. Increased risk was observed as early as the fourth decade of life.

Associations of fundamental motor skill competence, isometric plank, and modified pull-ups in 5-year old children: An observational analysis of 2012 NHANES NYFS.

There are purported relationships between fundamental motor skills (FMS), health-related physical fitness, physical activity, and obesity among children. The purpose of this observational, secondary data analysis was to further examine these associations in children from the 2012 National Youth Fitness Survey (NYFS). 121 five-year old children (51% female) from the NYFS database completed the Test of Gross Motor Development, 2nd edition (TGMD-2), muscular fitness measures of plank and modified pull-ups, and weight status based on body mass index (BMI) percentile. Significant positive correlations were identified between TGMD-2 scores and both pull-ups and plank. Linear regression models, controlling for sex, weight status, and Hispanic ethnicity also identified both modified pull-ups completed and plank time as significant predictors of TGMD-2 total raw score. No demographic factors were significant factors in any of the models. This secondary data analysis identified associations between FMS and health-related physical fitness (i.e., muscular fitness), with both modified pull-ups and plank performance, in five-year old children. Results underscored the importance of different facets of health-related physical fitness contributing significantly to FMS performance and the need for more work related to physical fitness in preschool-age children.

Virtual Reality and Powerpoint Grocery Store Tours: Equally Effective in Improving Self-efficacy in Randomised Control Trial.

PURPOSE: Compare computer-based virtual reality (CBVR) and voice-over PowerPoint (PP) grocery store tours (GST) on adult nutrition literacy (NL) and healthful food purchasing self-efficacy (HFPSE). DESIGN: Participants (n = 68) recruited from University worksite wellness program and randomly assigned to CBVR or PP (CBVR = 35; PP = 33). INTERVENTION: Four-week culinary/nutrition education program. Initial three weeks provided identical education for both groups. Week four implemented GST intervention using CBVR or PP. MEASURES: NL and HFPSE surveys before, after, and three-months post from the start of program. ANALYSIS: Intent-to-treat (ITT) analysis with RMANOVA (95% confidence intervals [CI] and effect sizes) to examine change in NL and HFPSE between CBVR and PP groups over 4-week intervention and 3-month retention period. RESULTS: 43 of 68 participants [CBVR (n = 19) and PP (n = 24)] were included in analyses. Both groups significantly improved HFPSE over time (P<.001, CBVR = 46.23% PP = 33.34%), but there were no differences between groups (P = .21) or group by time interaction (P = .31). NL did not change for either group (P = .83, CBVR = 1.11%; PP = .12%) nor were there differences between groups (P = .07). CONCLUSIONS: CBVR and PP GST significantly improved and maintained higher HFPSE scores.

Fundamental Motor Skill Delays in Preschool Children With Disabilities: 2012 National Youth Fitness Survey.

Delays in fundamental motor skill (FMS) competency have been observed in a variety of children with disabilities. However, evidence of FMS delays is largely limited to small, geographically specific, limitedly diverse, and non-representative samples. The purpose of this study was to examine the association between FMS competency and reported disability status among pre-school children, ages 3-5 years, using the 2012 National Youth Fitness Survey (NYFS). In total, 329 preschool children (49% female; 4.00 ± 0.04 years of age) from the 2012 NYFS completed the Test of Gross Motor Development-2, including 43 preschoolers identified with a disability based on parental report (44% female; 4.20 ± 0.16 years). Associations were examined with logistic regression using sampling weights. Poor FMS competency, defined as gross motor quotient scores ≤ 79, was observed in significantly more children with disabilities (29%) than children without disabilities (10%, OR = 3.5, p = 0.04). While not statistically significant, there was a growing disparity in FMS competency at age 5 (41 vs. 11%) compared to age 3 (15 vs. 9%, OR = 1.80, p = 0.30). The results provide additional evidence for poor FMS competency among pre-school children with disabilities. FMS should be an early part of comprehensive assessments for all children suspected of disability or development delay as it is critical to identify and intervene upon FMS delays before discrepancies can widen.

Promoting physical activity participation and nutrition education through a telehealth intervention for children on the autism spectrum and their caregivers.

There is growing empirical support which suggests children on the autism spectrum, as well as their caregivers experience significant health disparities. The global COVID-19 pandemic has only magnified the need to address health among vulnerable populations. While there has been a growing trend in the delivery of telehealth interventions, the delivery of such methods for children on the autism spectrum, and their caregivers remains relatively under examined. The primary goal of PLANE (Physical Literacy And Nutrition Education) is to promote positive trajectories of health for children on the autism spectrum and their primary caregivers through the delivery of a telehealth physical activity and nutrition education program. The study is a pre-experimental analysis of PLANE across 12 months. All activities will be delivered virtually through weekly synchronous and asynchronous programming. A total of 180 participants will be enrolled in this intervention, including children on the autism spectrum and caregivers. Each week a new physical activity skill along with opportunities for recipe assembly will be delivered remotely. Supplemental material will be disseminated online including; step by step directions outlining behavioral skill methodology, opportunities for additional skill practice, and reading material that support weekly topics. Study outcomes will be examined in the parent-child dyad and include rates of overweight/obesity, physical activity, nutrition and quality of life. Finally, feasibility of the telehealth intervention will also be measured. Justification for the conceptualization and delivery of PLANE is well warranted, and PLANE represents a promising intervention which is scalable, sustainable, and replicable.

The Relationship Between Developmental Coordination Disorder and Concurrent Deficits in Social Communication and Repetitive Behaviors Among Children with Autism Spectrum Disorder.

Children with Autism Spectrum Disorder (ASD), characterized by core deficits in social communication and restrictive behaviors, can exhibit concurrent motor incoordination and/or intellectual disability (ID). While pervasive delays in motor behavior are common, formal diagnosis of Development Coordination Disorder (DCD) is uncommon. It is not clear how DCD and ID impact core deficits in ASD. This study utilized the Simons Foundation SPARK cohort to describe the scope of motor incoordination among children with ASD and examine the interrelationships between DCD risk, ID, and ASD core deficits. 10,234 children with ASD, between the ages of 5 and 15 years, were included in the analysis. Parents completed online versions of the DCD Questionnaire (DCD-Q), Social Communication Questionnaire (SCQ) and Restrictive Behavior Scale (RBS-R). 85% of children with ASD had DCD-Q scores consistent with being at-risk for DCD, but only 14% reported a formal diagnosis. Children with ID exhibited significantly greater motor incoordination compared to children without ID (P < 0.001). Significantly, greater core deficits were identified in both children at-risk for DCD (P < 0.001) and with ID (P < 0.001). However, the effects of DCD risk were independent of ID and exhibited a medium effect size for SCQ (η2p = 0.063) and a small effect size for RBS-R (η2p = 0.04) scores. Collectively, study outcomes reinforce the pervasiveness of motor incoordination among children with ASD, both with and without concurrent ID, and provide further justification for the inclusion of motor behavior in the early intervention and prescription for children with ASD. LAY SUMMARY: This secondary data analysis of the Simons Foundation SPARK cohort found high rates (85%) of DCD risk among children with ASD. Deficits in motor coordination were greater among children with ASD with concurrent ID diagnoses. Meaningful differences in ASD core deficits (social communication and repetitive behaviors) were independently found in children at risk for DCD, both with and without ID. Autism Res 2021, 14: 804-816. © 2021 International Society for Autism Research and Wiley Periodicals LLC.

Clinical Validity of the Test of Gross Motor Development-3 in Children With Disabilities from the U.S. National Normative Sample.

The Test of Gross Motor Development (TGMD) measures fundamental motor skills competency and is frequently used for eligibility determination of adapted physical education services in children with disabilities. The purpose of this study was to determine if the TGMD-3 is clinically sensitive to detect deficits in the fundamental motor skills of children with disabilities (i.e., intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, language and articulation disorders). Eighty-five children with disabilities and 85 matched controls (i.e., typically developing, individually matched on age, sex, ethnicity, and race) completed the TGMD-3. Mann-Whitney U tests identified significant differences in the total TGMD-3 scores for children with intellectual disability (p < .001), autism spectrum disorder (p < .001), and attention deficit hyperactivity disorder (p = .032). No differences were identified for children with language and articulation disorders. Comparisons of subscales (i.e., locomotor and ball skills) differed across disability groups. This study provides evidence that the TGMD-3 is clinically sensitive to identify deficits in fundamental motor skills competency.

The Instructional Sensitivity of the Test of Gross Motor Development-3 to Detect Changes in Performance for Young Children With and Without Down Syndrome.

The Test of Gross Motor Development is among the most commonly used measures of gross motor competency in children. An important attribute of any developmental assessment is its sensitivity to detect change. The purpose of this study was to examine the instructional sensitivity of the Test of Gross Motor Development-third edition (TGMD-3) performance criteria to changes in performance for 48 children (age 4-7 years) with and without Down syndrome following 10 weeks of physical education. Paired t tests identified significant improvements for all children on locomotor (p < .01) and ball skills (p < .01). These significant differences were associated with moderate to large effect sizes. SEM was low relative to the maximum raw score for each subtest, indicating high confidence in the scores. These findings provide evidence that the TGMD-3 is sensitive to change in performance for children with and without Down syndrome.

Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework.

Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.

Association between Physical Activity and Adiposity in Adolescents with Down Syndrome.

PURPOSE: Obesity is highly prevalent among adolescents with Down syndrome (DS); however, reported associations between body composition and moderate-to-vigorous physical activity (MVPA) have been small and nonsignificant. The purpose of this study was to compare group differences between adolescents with and without DS, including dual-energy x-ray absorptiometry (DXA) measured body composition and accelerometer-measured physical activity, and then examine associations within adolescents with DS. METHODS: Thirty-nine adolescents (22 with DS and 17 typically developing controls) 12-18 yr of age participated in the study. Groups had similar distributions of age, sex, and Tanner pubertal stage. Body composition was assessed by DXA, body mass index (BMI), and BMI percentile. MVPA was measured with ActiGraph GT3X+ accelerometers. RESULTS: Adolescents with DS had significantly higher BMI, BMI percentile, and DXA-derived percent body fat (%BF) as well as lower MVPA compared with controls (P < 0.05). Associations between MVPA and %BF in adolescents with DS were moderate (r = -0.39, P = 0.07) but substantially stronger than BMI (r = -0.19, P = 0.40). However, linear regression analyses identified Tanner stage (ß = -0.77, P < 0.001) and MVPA (ß = -0.34, P = 0.047) as significant predictors of %BF. No relevant associations between body composition and MVPA were observed in adolescents with typical development (P > 0.05). CONCLUSIONS: Our findings suggest that MVPA is associated with adiposity when measured with DXA among adolescents with DS.

Inter- and Intrarater Reliabilities of the Test of Gross Motor Development-Third Edition Among Experienced TGMD-2 Raters.

The purpose of this study was to examine the inter- and intrarater reliabilities of the Test of Gross Motor Development-third edition (TGMD-3). The TGMD-3 was administered to 10 typically developing children. Five raters with experience using the Test of Gross Motor Development-second edition (TGMD-2) scored the digitally recorded performances and then rescored the same performances after a period of 2 weeks. Intraclass correlation (ICC) was used to examine both inter- and intrarater reliabilities of scores. Interrater reliability for the total score, locomotor subscale, and ball skills subscale (ICC: 0.92-0.96) were all excellent, while individual skills (ICC: 0.51-0.93) had fair-to-excellent reliability. Intrarater reliability across all raters was also excellent (ICC: 0.77-0.98) but varied widely for individual raters (ICC: 0.28-1.00) including multiple examples of poor reliability. While raters experienced with the TGMD-2 can produce consistent scores for TGMD-3 total scale and subscales, additional training is needed to improve skill-specific reliability.