Comparison of Exergaming and Adaptive Physical Education on Physical Activity, On-task Behavior, and Communication in Children with Autism Spectrum Disorder

Abstract

This study compared objectively-assessed physical activity (PA), on-task behavior, and communication during adaptive physical education (AdPE) and exergaming sessions in children with autism spectrum disorder (ASD). In Spring 2016, five boys with diagnosed ASD in the U.S. (all African American; M̅ age=6.8±2.1 years) participated in a mixed methods 3week observational study. Observations were conducted during one AdPE and one exergaming session each week for three consecutive weeks (six total). Accelerometry tracked PA while direct observation assessed on-task behavior and communication between teachers/aides and children. Teachers/aides completed open-ended surveys regarding the facilitators and barriers of our main outcomes during AdPE and exergaming. Compared to AdPE, exergaming had higher moderate-to-vigorous PA duration (16.9 vs. 12.2 min., respectively), but lower durations of light PA (10.8 vs. 13.0 min., respectively) and sedentary behavior (22.3 vs. 24.7 min., respectively). Greater percentages of on-task behavior and communication were seen during AdPE (93.0% and 34.0%, respectively) vs. exergaming (67.0% and 16.1%, respectively). Space allocation/size were barriers during both PA sessions. Observations indicated that AdPE was superior in promoting on-task behavior/communication compared to exergaming. As on-task behavior/communication is vital to promote in children with ASD, exergaming programs in this population are cautioned.

The Non-Fitness-Related Benefits of Exergames for Young Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review

“…Both of these elements are found within dance-based exergames such as 'Just Dance' (Wii) which requires the player(s) to rhythmically mirror/copy the avatar on screen. Due to this cross over between exergames and successful elements of DMT, it seems plausible that dance-based exergames may still be able to improve social skills, despite the previous findings from Pope et al (2019) and Chung et al (2015). More recently, 'Just Dance' as compared to another almost identical movementbased intervention has been observed to produce significant positive psychological and psychosocial effects in a large sample of TD primary school children (n=417; Quintas et al, 2020 (Constantino, 2013), social skills improvement scale (Gresham & Stephen, 2007), and/or coded observations in a given context (Heimann et al, 2006;Nadel et al, 2000;White et al, 2007).…”

“…Most of the included papers were repeated measures, pre-and post-test study designs (Caro et al, 2017;Collins et al, 2015;Edwards et al, 2017;Flynn & Colon, 2016;. However, two were within-subject experimental designs with an A-B-A exposure (Anderson-Hanley et al, 2011;Chung et al, 2015), one was a two-arm parallel single-blinded trial (Lau et al, 2020), and another was a mixedmethods observational study (Pope et al, 2019). Only one study included in this review was a randomised controlled trial (Rafiei Milajerdi et al, 2020).…”

“…To examine the effect of exergames on motor skills and motor proficiencies most studies enlisted the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2; Bruininks & Bruininks, 2005), however one study used the Movement Assessment Battery for Children-Second Edition (MABC-2; Henderson et al, 2007) and another used the Test of Gross Motor Development-Third Edition (TGMD-3; Ulrich, 2016). When exploring the effect of exergames on social behaviours, Pope et al (2019) and Chung et al (2015) both videotaped their participants during intervention sessions, subsequently observing the tapes to score behaviours according to a coding manual and to assess changes in social behaviours.…”

“…Chung et al (2015) noted no substantial improvement in social behaviours, including positive joint affect, reciprocal communication, or aggression within their participants, following their active videogame intervention in comparison to the sedentary videogame condition. Pope et al (2019) reported that exergames, mostly 'Just Dance 4', were able to promote an increase in PA levels, on-task behaviours, and communication.…”

“…Out of ten studies, only two included a control group; the first was a randomised controlled trial (Rafiei Milajerdi et al, 2020) and the second was a two-arm, single-blinded trial (Lau et al, 2020). One other study included an active comparison task for children to also complete (Pope et al, 2019). Although non-randomised controlled trials are useful for feasibility studies and still allow for the critical examination and analysis of the available evidence, it is somewhat difficult to draw conclusions that the intervention generates the observed outcome in studies that do not include control groups (Gerstein et al, 2019).…”