Physical Activity and Screen Time in Children with Autism Spectrum Disorders

Background: Regular physical activity is important to health and well-being; however, physical activity behaviors in children with autism spectrum disorders (ASDs) have received little research attention.  We hypothesized that because of social deficits and difficulties with motor skills and communication, children with ASDs would have lower physical activity levels (measured by accelerometry or questionnaire) than typically developing children and would spend more time in sedentary behaviors.

Objectives: To compare objectively measured physical activity levels, time spent in participation in a variety of physical activities, and time spent with electronic media between children with ASDs and typically developing children.

Methods: Fifty-three (53) children with ASDs (44 males/9 females) and 58 typically developing children (45 males/13 females) ages 3-11 (mean age ~6.6 years) participated in the Children’s Activity and Meal Patterns Study (CHAMPS). Children wore an activity monitor (accelerometer) for 5 weekdays and 2 weekend days. Parents completed a questionnaire that queried types and duration of children’s participation in physical activities and the amount of “screen time,” i.e., TV, computer, video games, in the past year.

Results:  After adjustment for age and sex, percent time spent in moderate/vigorous activity measured by accelerometry was similar in children with ASDs (21.3%) and typically developing children (22.4%). In contrast, based on questionnaires, children with ASDs participated in fewer different physical activities than did typically developing children (7.1 vs. 9.8, p<0.001).  Total time spent annually in activities, adjusted for age and sex, was also lower for children with ASDs compared to typically developing children (159 vs. 225 hr/y, p<0.0001).  For typically developing children, but not for children with ASDs, time spent in physical activity overall increased with age.  After adjustment for age and sex, total adjusted weekly screen time was significantly higher in children with ASDs than typically developing children (11.6 vs. 7.2 hr/wk, p<0.001).

Conclusions:   Children with ASDs are reported to engage in fewer types of activities and for less time than typically developing children.  Children with ASDs also spend more time engaged with electronic media (“screen time”) than do typically developing children. Contrary to our hypothesis, the contrasting observation that both groups of children engage in similar levels of moderate/vigorous activity as measured by accelerometry, but that children with ASDs engage in fewer physical activities and for less time according to parental report, may indicate that some of the activity in children with ASDs is not captured by standard questionnaire-based measures. In particular, children with ASDs are known to engage in repetitive self-stimulatory behaviors such as hand flapping, spinning, and pacing. Such behaviors may be captured as moderate-vigorous activity by accelerometry although would not likely be reported by parents as time spent in physical activity. Furthermore, children with ASDs may engage in spontaneous activity while watching television or videos.  This suggests that exploration of factors associated with physical activity in children with ASDs may require specially developed questionnaires and/or different methodologic approaches.

Supported by NICHD-R21HD48989