Environmental Factors Associated with Physical Activity and Screen Time Among Children With and Without Autism Spectrum Disorder

Healy, Seán; Garcia, Jeanette M.; Haegele, Justin A.

doi:10.1007/s10803-018-3818-0

Cited by 34 publications

(41 citation statements)

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“…Research regarding the contextual factors related to participation in physical activity among children with ASD is limited. Recent reviews by Jones et al [ 15 ] and Healy et al [ 19 ], respectively, have identified a significant negative association between physical activity and age and significant positive associations between physical activity and male sex, but have not found meaningful associations between physical activity and additional personal factors, such as socioeconomic status or level of enjoyment in physical activity. The consideration of socioenvironmental factors on participation in physical activity among children with ASD may be even more critical given the ability to change aspects of one’s environment through intervention and policy.…”

Section: Introductionmentioning

confidence: 99%

“…The consideration of socioenvironmental factors on participation in physical activity among children with ASD may be even more critical given the ability to change aspects of one’s environment through intervention and policy. Yet, there is limited research on socioenvironmental factors and the limited research has yet to identify factors that are associated with participation in physical activity among children with ASD [ 15 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Participation in Physical Activity Among Canadian School-Aged Children with Autism Spectrum Disorder: An Application of the International Classification of Functioning, Disability and Health

Bremer

Ginis

Bassett‐Gunter

et al. 2020

IJERPH

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We have a limited understanding of the socioenvironmental factors associated with participation in physical activity among school-aged children with autism spectrum disorder (ASD), particularly regarding how the school environment may influence their participation. Using the International Classification of Functioning, Disability and Health (ICF) as a framework, this study examined the effect of body functions and structure, activity, and personal factors on in-school physical activity; and whether in-school physical activity, considered a socioenvironmental factor, is associated with out-of-school physical activity (i.e., participation) among elementary school-aged children (6–13 years of age) with ASD. Parents of 202 children with ASD (78.2% boys; Mage = 9.4 years) completed an online survey, as part of a larger study, to assess their child’s functioning and physical activity in- and out-of-school. Results indicated that the majority of children (85.1%) did not meet physical activity guidelines. In-school physical activities significantly predicted out-of-school physical activities including leisure-time moderate-to-vigorous physical activity (R2 = 0.27, F(10,154) = 5.67, p < 0.001) and meeting the physical activity guidelines (R2 = 0.23, 2 (10) = 31.9, p < 0.001). These findings underscore the importance of supporting children with ASD to be physically active in school, which may impact physical activity levels out-of-school.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors Associated with Participation in Physical Activity Among Canadian School-Aged Children with Autism Spectrum Disorder: An Application of the International Classification of Functioning, Disability and Health

Bremer

Ginis

Bassett‐Gunter

et al. 2020

IJERPH

View full text Add to dashboard Cite

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“…Environmental factors have been identified as a critical influence on children's health behaviors, including PA [Aarts, Mathijssen, van Oers, & Schuit, 2013; Davison & Lawson, 2006; Healy, Garcia, & Haegele, 2018; Jin & Yun, 2013; Masoumi, 2017; Yan, Voorhees, Clifton, & Burnier, 2010]. Bronfenbrenner's Social Ecological Model (SEM) considers how the various levels of an individual's environment interact with one another, ultimately influencing behavior [Gauvain & Cole, 2005].…”

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confidence: 99%

“…In fact, Obrusnikova and Miccinello [2012] examined how children with ASD interact with the various components of the Social Ecological Model in respect to PA. Intrapersonal barriers, such as engaging in sedentary behaviors and lack of motivation, were reported as one of the most common factors to negatively impact engagement in PA. Extending this to the interpersonal and community levels, children with ASD may require greater social supports compared to their peers without ASD [Healy et al, 2018]. Additionally, they may face external barriers within their environment, such as excess noise or lights and crowdedness, which can have a negative effect on their participation [Krieger et al, 2018].…”

mentioning

confidence: 99%

“…Given the potential influence of the neighborhood environment on PA behaviors of children and the unique characteristics of children with ASD, there is a need to investigate the relationship between neighborhood factors and engagement in PA specifically among children with ASD. A few previous studies have investigated the influence of neighborhood factors on PA among this population [Healy et al, 2018; Obrusnikova & Miccinello, 2012], but it is necessary to examine multiple neighborhood variables given the nuanced experiences of children with ASD. Furthermore, it is important to obtain updated estimates using nationally representative data considering previous national survey questions have been updated to better align with current PA recommendations.…”

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confidence: 99%

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Influence of Neighborhood Environment on Physical Activity Participation among Children with Autism Spectrum Disorder

et al. 2020

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Despite the positive influence of environmental factors on physical activity (PA) levels of children, further investigation is necessary when considering the unique characteristics of children with autism spectrum disorder (ASD). The purpose of this study was to examine the relationship between neighborhood environment factors and PA among children with ASD by examining the extent to which (a) the built environment, (b) neighborhood safety, and (c) neighborhood support contributes to PA. A secondary data analysis using the 2016 and 2017 combined dataset of the National Survey of Children's Health was used. The total sample included 14,944 children between the ages of 6–17 years; of this, a sample of 494 children had a parent‐reported diagnosis of ASD. Multivariate logistic regressions were conducted to explore the unique influences of the above three neighborhood environment factors on PA engagement. Among children with and without ASD, an association was found between feeling safe and engaging in PA, that is, the odds of engaging in PA are greater among children who were safe in their neighborhoods than children who were not in safe neighborhoods. Surprisingly, other neighborhood factors do not have a significant relationship with PA participation among children with ASD at this time. Future studies should consider how to incorporate the support of others and feeling of safety into the neighborhood along with how to improve accessibility of the built environment in order to increase PA for children with ASD. Lay Summary The results of this study showed that neighborhood factors influence physical activity (PA) among children with ASD differently compared to their peers without ASD. Children with ASD who live in safe neighborhoods are more likely to engage in PA, while other neighborhood factors, such as playgrounds and support, are not associated with an increased likelihood of engaging in PA at this time. Efforts should be made to improve neighborhood accessibility and design in order to increase PA among children with ASD.

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Screen Time and Autism Spectrum Disorder

Ophir,

Rosenberg,

Tikochinski

et al. 2023

JAMA Netw Open

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ImportanceContemporary studies raise concerns regarding the implications of excessive screen time on the development of autism spectrum disorder (ASD). However, the existing literature consists of mixed and unquantified findings.ObjectiveTo conduct a systematic review and meta-analyis of the association between screen time and ASD.Data SourcesA search was conducted in the PubMed, PsycNET, and ProQuest Dissertation &amp; Theses Global databases for studies published up to May 1, 2023.Study SelectionThe search was conducted independently by 2 authors. Included studies comprised empirical, peer-reviewed articles or dissertations published in English with statistics from which relevant effect sizes could be calculated. Discrepancies were resolved by consensus.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two authors independently coded all titles and abstracts, reviewed full-text articles against the inclusion and exclusion criteria, and resolved all discrepancies by consensus. Effect sizes were transformed into log odds ratios (ORs) and analyzed using a random-effects meta-analysis and mixed-effects meta-regression. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Publication bias was tested via the Egger z test for funnel plot asymmetry. Data analysis was performed in June 2023.Main Outcomes and MeasuresThe 2 main variables of interest in this study were screen time and ASD. Screen time was defined as hours of screen use per day or per week, and ASD was defined as an ASD clinical diagnosis (yes or no) or ASD symptoms. The meta-regression considered screen type (ie, general use of screens, television, video games, computers, smartphones, and social media), age group (children vs adults or heterogenous age groups), and type of ASD measure (clinical diagnosis vs ASD symptoms).ResultsOf the 4682 records identified, 46 studies with a total of 562 131 participants met the inclusion criteria. The studies were observational (5 were longitudinal and 41 were cross-sectional) and included 66 relevant effect sizes. The meta-analysis resulted in a positive summary effect size (log OR, 0.54 [95% CI, 0.34 to 0.74]). A trim-and-fill correction for a significant publication bias (Egger z = 2.15; P = .03) resulted in a substantially decreased and nonsignificant effect size (log OR, 0.22 [95% CI, −0.004 to 0.44]). The meta-regression results suggested that the positive summary effect size was only significant in studies targeting general screen use (β [SE] = 0.73 [0.34]; t58 = 2.10; P = .03). This effect size was most dominant in studies of children (log OR, 0.98 [95% CI, 0.66 to 1.29]). Interestingly, a negative summary effect size was observed in studies investigating associations between social media and ASD (log OR, −1.24 [95% CI, −1.51 to −0.96]).Conclusions and RelevanceThe findings of this systematic review and meta-analysis suggest that the proclaimed association between screen use and ASD is not sufficiently supported in the existing literature. Although excessive screen use may pose developmental risks, the mixed findings, the small effect sizes (especially when considering the observed publication bias), and the correlational nature of the available research require further scientific investigation. These findings also do not rule out the complementary hypothesis that children with ASD may prioritize screen activities to avoid social challenges.

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Environmental Factors Associated with Physical Activity and Screen Time Among Children With and Without Autism Spectrum Disorder

Cited by 34 publications

References 30 publications

Factors Associated with Participation in Physical Activity Among Canadian School-Aged Children with Autism Spectrum Disorder: An Application of the International Classification of Functioning, Disability and Health

Factors Associated with Participation in Physical Activity Among Canadian School-Aged Children with Autism Spectrum Disorder: An Application of the International Classification of Functioning, Disability and Health

Influence of Neighborhood Environment on Physical Activity Participation among Children with Autism Spectrum Disorder

Screen Time and Autism Spectrum Disorder

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