Physical activity, sedentary behavior and their correlates in children with Autism Spectrum Disorder: A systematic review

Abstract

Autism Spectrum Disorder affects up to 2.5% of children and is associated with harmful health outcomes (e.g. obesity). Low levels of physical activity and high levels of sedentary behaviors may contribute to harmful health outcomes. To systematically review the prevalence and correlates of physical activity and sedentary behaviors in children with Autism Spectrum Disorder, electronic databases (PsycINFO, SPORTDiscus, EMBASE, Medline) were searched from inception to November 2015. The review was registered with PROSPERO (CRD42014013849). Peer-reviewed, English language studies were included. Two reviewers screened potentially relevant articles. Outcomes of interest were physical activity and sedentary behaviour levels and their potential correlates. Data were collected and analysed in 2015. Of 35 included studies, 15 reported physical activity prevalence, 10 reported physical activity correlates, 18 reported sedentary behavior prevalence, and 10 reported sedentary behavior correlates. Estimates of children’s physical activity (34–166 mins/day, average 86 mins/day) and sedentary behavior (126–558 mins/day in screen time, average 271 mins/day; 428–750 mins/day in total sedentary behavior, average 479 mins/day) varied across studies. Age was consistently inversely associated, and sex inconsistently associated with physical activity. Age and sex were inconsistently associated with sedentary behavior. Sample sizes were small. All but one of the studies were classified as having high risk of bias. Few correlates have been reported in sufficient studies to provide overall estimates of associations. Potential correlates in the physical environment remain largely unexamined. This review highlights varying levels of physical activity and sedentary behavior in children with Autism Spectrum Disorder. Research is needed to consistently identify the correlates of these behaviors. There is a critical need for interventions to support healthy levels of these behaviors.

Investigating the participation of children on the autism spectrum across home, school, and community: A longitudinal study

“…The decline in participation in physical activities (organized and unstructured) with age is consistent with previous research on children on the autism spectrum (Jones et al, ; Ratcliff et al, ) and their typically developing peers (Dumith, Gigante, Domingues, & Kohl, ). There was a decrease in the number of children involved in organized physical activities from Y1 ( n = 51; 60.7%) to Y3 ( n = 39; 46.4%).…”

“…The nature and culture of group and team programmes has been identified as a restricting influence on the involvement of children on the autism spectrum in organized activities (see review by Askari et al, ). By Y3, the median frequency for attending organized physical activities had decreased to “never” and unstructured physical activities decreased to “a few times a month.” The decrease in participation is more commonly reported in older children (Dumith et al, ; Jones et al, ) and raises concerns for the long‐term physical activity and health of children on the spectrum.…”

The effect of physical activity interventions on youth with autism spectrum disorder: A meta‐analysis

“…The moderator analysis also indicated a significant influence of the intervention facilitator having training in APE on the overall effect of the intervention (reported in three studies). It has been suggested (Jones et al, ) that due to complexities of ASD and the prevalence of ASD comorbidities that may affect physical activity participation, specialized facilitators are most suited to implementing interventions. In addition, the moderator analysis indicated that studies not utilizing parental support within the study protocols had the greatest influence on the performance of experimental groups.…”

Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight‐Related Topics in Healthcare Consultations

“…Pediatric obesity is a global health concern, and can significantly impact quality of life for children (Public Health Agency of Canada, 2011). Children and youth (herein children) with autism spectrum disorder (ASD) appear to be at higher risk of having obesity (Curtin, Jojic, & Bandini, 2013) given their low levels of physical activity participation (Jones et al, 2017), and high levels of sedentary activities (Must et al, 2013). Furthermore, children with ASD often demonstrate dysregulated eating patterns, higher intake of sugar-sweetened beverages (Evans et al, 2012), and disordered sleep patterns (Zuckerman, Hill, Guion, Voltolina, & Fombonne, 2014); all of which have been linked to higher weights.…”