Get FRESH: Evaluation of A Healthy Lifestyles Group for Teens with ASDs and Their Parents

Background: Health and fitness are important to quality of life as they are linked to cognitive performance, social functioning, and self-esteem (Kwak et al, 2009; McAuley, Mihalko, & Bane, 1997). Youth with autism spectrum disorders (ASDs) engage in less health and fitness activities due to limited interest in physical play, lack of motivation to engage in social fitness activities, limited self-awareness, and restricted food interests. Thus, education and intervention are needed in this area. A recent review of physical exercise with individuals with ASDs demonstrated decreases in child problem behaviors such as stereotypy, aggression, and off-task behavior (Lang et al, 2010). The studies reviewed typically focus on one fitness behavior, do not include a health curriculum, and lack a parent component. To better address health and fitness outcomes for youth with ASDs, more comprehensive health and fitness curriculum must be developed and evaluated.

Objectives: The aim of the current study was to evaluate the effectiveness of a group-based parent and teen curriculum designed to improve adolescent's fitness, increase healthy lifestyle changes, and attain specific fitness goals. Further, the study aimed to assess possible secondary gains including global changes in social skills, problem behavior, and quality of life.

Methods: Twenty-two adolescents (14 male, 8 female) ages 12-16 (m = 14.27; SD =1.12) and their parents were recruited for the current study. A wait-list control was used to compare groups. Participants attended 90 minute, weekly sessions for 12 weeks. Teen and parent groups included fitness exercises and a healthy lifestyle curriculum covering a variety of topics (e.g., healthy eating, positive sleep habits). Analyses of pre and post group measures included an observational exercise assessment by a certified fitness trainer; and parent reports of child activity level, eating habits, individualized goal attainment, social skills, problem behavior, community integration, sleep, and quality of life.

Results: Results indicate significant improvement in exercise skills as measured by a certified fitness trainer (t (18) = -.3.47, p < .002). Gains were made in parent-reported child activity level (t (18) = 2.24, p < .039), fitness goal attainment (t (18) = -7.52, p < .001), some social functioning such as self-control (t (18) = 2.20, p < .042), overall problem behavior (t (18) = 2.27, p < .036), and task compliance (t (18) = -2.55, p < .020). There were no significant changes in parent fitness, child and parent eating style, other aspects of social skills, community integration, quality of life, and sleep.

Conclusions: Findings demonstrate the benefits of group-based health and fitness curriculum for youth with ASDs and their parents. Improvements were noted in health and fitness outcomes, as well as on social and behavioral functioning. Limitations and recommendations for future research directions in health and fitness will be discussed.