News and Knowledge

In October, OAR’s Board of Directors authorized funding for six new applied autism research studies in 2018. These new grants, totaling $176,090, bring OAR’s total research funding to over $3.6 million since 2002. This is the second of six previews to be featured in The OARacle this year.

Individuals with autism spectrum disorder (ASD) and intellectual disability (ID) often do not engage in healthy levels of physical activity, putting them at risk of health problems like diabetes and heart disease. Low motivation, poor motor skills, and behavioral challenges combine to make engaging in physical activity challenging.

OAR-funded researchers, Kara Hume, Ph.D., and Melissa Savage, Ph.D., plan to evaluate a self-management program that could increase physical activity for adults with ASD and ID in their study, “Step It Up: Increasing Physical Activity for Adults with ASD and ID through Self-Management.” Dr. Hume is an advanced research scientist at the Frank Porter Graham Child Development Institute at UNC-Chapel Hill. Dr. Savage is a postdoctoral research associate at the institute.

Study Goals

Dr. Hume and Dr. Savage plan to answer these questions through their one-year study:

1. Does implementation of a self-managed exercise program result in increased engagement in physical activity, improved health measures, and an increase in perceived quality of life?
2. Is the self-managed exercise program a feasible intervention for adults with ASD?

Study Format

Forty adults with ASD and ID will be recruited through local autism groups. All participants will receive Fitbits and Fitbit training. Twenty participants will be assigned to a control group while the remaining 20 will be assigned to the intervention group and participate in the self-managed exercise program.

The intervention program will use self-management strategies, including goal setting, scheduling, reminders, self-evaluation, self-monitoring, and self-reinforcement, to engage participants in aerobic activity. A family or community member will act as a mentor/interventionist.

For the first seven days, participants in both groups will wear their Fitbits and engage in their usual daily activities to provide the research team with baseline measurements.

At the end of that week, both groups will receive training on how to use their Fitbits through an instructional video. Participants in both groups will continue to have access to this training video and can refer to the video as needed.

Mentors will receive a 90-minute web-based training session to learn how to implement self-management strategies including setting up a daily step goal, scheduling exercise sessions, setting reminders, implementing self-evaluating and self-monitoring procedures, and identifying reinforcers. Mentors will receive data collection sheets and a self-management implementation checklist to help ensure intervention components are being followed consistently. The mentors will then train participants on the intervention components and set times for weekly mentor meetings. Those trainings will be video-recorded.

Once training is complete, participants in the intervention group will begin a 12-week exercise program. At the end of each scheduled exercise day, participants will sync the Fitbit and check to see if they met their daily step goals.

At their weekly meetings with their mentors, they will determine their daily step goal and an exercise schedule based on the previous week’s progress and set up reminders on their Fitbits for scheduled exercise days and times. Mentors will collect data on the level of independence for intervention components.

At the end of the program, participants will complete post-assessments, including weight and BMI measurements as well as the same quality-of-life inventory completed at pre-assessment. Mentors will complete a life events questionnaire and a feasibility questionnaire. Researchers will interview both participants and mentors.

Outcomes

The researchers anticipate that adults with ASD and ID in the self-managed exercise program will achieve better outcomes than those in the control group. Their expectation is that participants in the self-managed exercise group will have:

• Increased their levels of physical activity
• Decreased their BMI
• Increased their quality of life score

If this pilot study is successful, the program could be disseminated more widely to families as well as to community agencies like fitness centers for use with clients with ASD. The researchers also plan to organize a larger study to examine the effectiveness of intervention components, including:

• Maintenance of physical activity engagement
• Addition of strength, flexibility, and agility exercises
• Generalization of using the self-management intervention in settings beyond the home, like community fitness centers, for example

Physical activity is an important part of a healthy lifestyle for all individuals. For individuals with ASD and ID, who typically don’t engage in recommended levels of physical activity, it’s crucial to identify interventions that promote an increased fitness.