18746
Exergaming to Improve Physical and Mental Fitness in Children with Autism Spectrum Disorders
Although differences in executive function (EF) and motor skills are not included in the diagnostic criteria for ASD (American Psychiatric Association, 2013), impairments in these areas have been consistently observed in individuals diagnosed with ASD (David, Baranek, Giuliani, Mercer, Poe & Thorpe, 2009; Dziuk, Gidley-Larson, Apostu, A., Mahone, Denckla, & Mostofsky, 2007; Ghaziuddin & Butler, 1998; Hilton, Zhang, White, Klohr, & Constantino, 2012; Ming, Brimacombe, & Wagner, 2007; Provost, Thibadeau, & Rose 2007). EF refers to higher order cognitive processes that are used to guide behavior in a changing environment, and includes the constructs of planning, inhibition, impulse control, working memory, cognitive flexibility, creativity, and initiation of action (Sachse, et al., 2013).
Motor deficits are recognized as symptoms associated with ASD by the World Health Organization (2001). Motor deficits often associated with ASD may include problems in motor planning, coordination difficulties, and an inability to participate in developmentally appropriate activities, which affect the child’s ability to initiate motor activities or switch between motor tasks (Abu-Dahab, Skidmore, Holm, Rogers & Minshew, 2013; Lloyd, MacDonald & Lord, 2013; Hilton et al., 2012; Wiggins, Robins, Bakeman, & Adamson, 2009).
Objectives:
We investigated the effects of using the Makoto arena intervention, a speed-based exergame, on EF, motor skills, and response speed in 17 school-aged children with ASD.
Methods:
We used a single-group, pretest–posttest intent-to-treat research design for this study. 17 children with ASD between 8 and 18 years old participated in this pilot study. A diagnosis of ASD, a full-scale IQ score of at least 65, and a willingness to participate in the Makoto arena intervention approximately 3 times per week were required for inclusion in this study. Individuals with lower IQs were excluded to avoid the potential for confusion between impaired intelligence and impaired EF. Participants were evaluated before and after intervention on the Behavior Rating Inventory of Executive Function (BRIEF) and the Bruininks-Oseretsky Test of Motor Proficiency- Second Edition (BOT-2). Average reaction speed was recorded at each Makoto intervention session. Participants completed two minutes of Makoto intervention a minimum of three times per week until thirty intervention sessions were completed, with a total of approximately 1,800 repetitions for each participant.
Results:
All areas of EF improved, with significance in the overall global executive composite and in the metacognition index, and in specific areas of initiate, working memory and plan/organize. All motor skills improved except fine manual coordination, with significance in strength and agility. Participants increased response speed showing a large effect size.
Conclusions:
Findings suggest that use of exergaming may be a valuable addition to standard intervention for children with ASD who have motor and EF impairments, although further examination of dosage, alternative exergames, long-term effects, and specific effects on school performance are warranted. Significant correlations between certain EF and motor scores suggest a relationship between the two constructs and continued work addressing this line of inquiry to further understand and possibly increase the benefits of various types of exergaming for people with ASD will be valuable steps toward best practice.