Research

In October, OAR’s Board of Directors authorized funding for eight new applied autism research studies in 2019. These new grants, totaling $228,036, bring OAR’s total research funding to over $3.7 million since 2002. This is the seventh of eight previews to be featured in The OARacle this year.

Children with autism spectrum disorder (ASD) experience a range of health disparities, including high rates of obesity and inactivity. Participation in physical activity plays an integral role in preventing obesity and maintaining a healthy weight and offers benefits in terms of quality of life and better sleep. It can also help children with ASD with social skills because they have more opportunities to interact with peers during play. However, it requires requisite levels of motor skill competence, which children with ASD often lack.

To understand the “key ingredients” needed for future interventions to increase physical activity, Determining Intervention Targets to Promote Positive Trajectories of Health for Children with ASD will examine physical activity, sedentary behavior, motor skill competence, fitness, quality of life, weight status, and the relationships among these components between children with and without ASD. Kerri Staples, PhD, a postdoctoral fellow at the Center on Physical Activity & Health for Pediatric Disabilities at the University of Michigan, is the principal investigator for this two-year study.

Methodology

The research team will recruit 30 children with ASD ages 6 to 9, 30 typically developing children in the same age range matched by sex, and 30 typically developing children matched to the level of motor skill competence and sex. This OAR-funded study will follow the children over 18 months. The research team plans to pursue additional funding to extend the study and follow the children for a total of three years.

The age range of the group of children with ASD coincides with a critical time in typical development when mastery of fundamental motor skills is attained. To ensure the full range of functioning among children with ASD, there will be no IQ cut-off. Dr. Staples expects that three to four times as many boys as girls with ASD will be recruited.

The age-matched group of children will enable Dr. Staples and her team to examine performance differences and relationships among components of health relative to same-age peers. The second group of typically developing children is likely to be younger — between 3 and 6 years old. That group will indicate the extent that children with ASD are delayed in the development of motor skill competence and provide the framework to examine the influence of motor skill competence on other components of health.

To measure physical activity and sedentary behavior, the children will wear accelerometers that measure bursts of activity. The level of activity will be classified by intensity, including sedentary, light, moderate, and vigorous. Parents will record as many daily activities as possible in a log, from watching television and doing homework to going to sports practice and physical therapy.

Motor skill competence will be assessed using an evaluation tool that measures the performance of 13 movement skills that are foundational for successful participation in physical education and active play, using locomotor and ball skills.

The 2016 U.S. Report Card on Physical Activity for Children and Youth, which assessed the levels of physical activity and sedentary behaviors in American children and youth, facilitators and barriers for physical activity, and health outcomes related to physical activity, will be used to compare children with and without ASD. Dr. Staples and her research team developed a questionnaire for the participants to compare them to Report Card results. Parents will assist children in reflecting on the previous six months to answer the questionnaire.

Physical fitness will be measured using a fitness test that will measure cardiovascular endurance, muscular strength and endurance. Health-related quality of life will be examined using a pediatric inventory that measures the physical, emotional, and social dimensions of health and school functioning. Because communication and understanding may be lower in the ASD and younger, developmentally matched comparison groups, the parent report version will be used for all three groups.

Body composition will also be measured using body mass index.

Outcomes

Because the study incorporates both cross-sectional and longitudinal elements, it affords the ability to examine differences between the groups, assess change over time, and identify trends within and between groups. When combined, these approaches produce an opportunity for a thorough examination of the overall research questions. Understanding rates of development will help researchers ascertain key components to include in intervention. Understanding the relationships among related components of health will enable the research team to develop effective interventions that will promote increased participation.

Ultimately, the results of the study will guide the research team in the development of a large-scale, multi-site study. The future study will examine the effectiveness of intervention on influencing trajectories of physical activity, weight status, and overall health among children with ASD.

Increasing the levels of physical activity of children with ASD should influence a variety of outcomes, including weight status, social and motor competence, quality of life, and sleep.

Although it is known that all components of health play a role in some way, researchers do not yet know which components to target and when to target them to have the greatest impact on long-term trajectories of physical activity and health. Identifying critical periods in development when rates of change are highest (and are most susceptible to influence) and when trajectories of children with and without ASD begin to diverge will provide a strong framework to guide the development of intervention.