Piece It Together: Exercise and Wellness Program for Transitional Age Youth with Autism Spectrum Disorders and Mild Developmental Disorders

Background: Youth with Autism Spectrum Disorder (ASD) and other neurodevelopmental disorders are at increased risk of poor health and obesity due to limited interests, sedentary lifestyles, sensory challenges, restricted diets, and medications used to treat their disorder. The “Piece It Together” Program was developed by multidisciplinary professionals with expertise in fitness, nutrition and mental health to provide a comprehensive wellness program for teens and young adults with ASD and other mild neurodevelopmental disabilities. Five primary components of the program include nutrition, exercise, socialization, stress reduction, and opportunities to get out of your comfort zone. The curriculum includes strength and cardiovascular conditioning, nutrition education, mindfulness, yoga and stress reduction strategies to promote healthy lifestyle choices.

Objectives: To provide an organized environment for transitional age youth with ASD and other mild neurodevelopmental disorders to increase exercise, improve nutrition, socialize with peers with and without disabilities, practice stress reduction strategies, and encourage opportunities to get outside of your comfort zone.

Methods: Participants attended 90 minute sessions at the Medical University of South Carolina Wellness Center twice-a-week, for six-weeks. As each individual had unique strengths and weaknesses, each established nutrition, fitness, socialization, and stress reduction goals. FitBit devices were distributed to participants. Assessments were done at the first and last classes, including InBody 570 Analyzer©2014 assessments, PHQ-9, 5-2-1-0 Healthy Habits Questionnaire, Flourish and Fitness Scale, PHQ-9 questionnaire, and lifestyle questionnaires. Volunteers provided support in class and have included health profession trainees.

Results: The 2015 Summer Program included 12 individuals (7 males) ages 15 to 27. Average PHQ-9 depression scores decreased from 7.67 to 3.42 (from mild to minimal depression; p<0.000063). Self-reported 5-2-1-0 Heathy Habits data revealed more fruits and veggies in the diet at time 2 (p =0.04) and modest improvement in self-efficacy related questions (e.g., I like the way I look/I am a good worker; p=0.03). In 2016, the Summer program included 21 participants (16 males), ages 13-28 that attended regularly and for some it was their fourth summer participating. Challenges were noted with youth with high irritability and cognitive deficits. However, pre and post testing revealed decreases in depression scores, increases in skeletal muscle, decreases in visceral body fat, improvements in nutrition and increases in socialization. The increased support to use Fitbits appeared to increase movement as well as social engagement through Fitbit friends.

Conclusions: This 6-week Summer program successfully brought together a unique group to build friendships and make healthier lifestyle choices and has continued as a weekly program. Individual successes are numerous as each individual has a success story of individualized goals that have been met, and the greatest success has been measured by continued participation focused on 5 main components that are commonly needed for youth with ASD. The use of Fitbits provided a platform for goal setting and increased physical activity outside of class. Almost all participants continue to participate in a weekly class and communicate with each other outside of class. Future efforts are to encourage maintenance of lifestyle changes and minimize barriers to participation.