Associations of meeting 24-hour movement behavior guidelines with social and emotional function in youth with ASD/ADHD.

BACKGROUND: The 24-hour movement behavior (24-HMB) guidelines recommend that children and adolescents (youth) should limit screen time (ST), get an adequate amount of sleep (SL), and engage in sufficient physical activity (PA) to ensure health and healthy development. Meeting 24-HMB guidelines is associated with positive mental health outcomes (e.g., social and emotional function) in the general population. However, it is unclear whether such findings extend to youth with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Thus, we examined associations of meeting 24-HMB guidelines with social and emotional function in youth with comorbid ASD/ADHD. METHODS: Data from the 2020-2021 National Survey of Children's Health - a U.S. national, population-based, cross-sectional study - were used. We extracted and analyzed data on youth (aged between 6 and 17 years) diagnosed with comorbidity of ASD/ADHD. Data on movement behaviors (PA, ST, and SL) and specific outcome variables (social function and emotional function) were collected through caregiver-proxy reports. Logistic regressions were performed to examine the associations between meeting 24-HMB guidelines and social and emotional outcomes adjusting for covariates (e.g., age, sex, ethnicity, weight status, birth status, socio-economic status, and receiving medication/behavioral treatment). RESULTS: Among 979 children and adolescents with comorbid ASD/ADHD, only 3.8 % met all three 24-HMB guidelines. In total, 45.0 % of participants met at least one guideline, and 25.5 % of those met at least two guidelines. Compared to those who did not meet any 24-HMB guidelines, meeting SL + ST guidelines was significantly associated with lower odds of poorer social function (being bullied: OR = 0.3, 95%CI [0.1-0.7]; arguing: OR = 0.2, 95%CI[0.1-0.4]). Furthermore, meeting PA + ST + SL guidelines was associated with lower odds of poorer emotional function (depression: OR = 0.5, 95%CI[0.3-0.7]). CONCLUSION: Meeting 24-HMB guidelines was associated with better social and emotional function in U.S. youth with comorbid ASD/ADHD; however, currently very few with comorbid ASD/ADHD meet all 24-HMB guidelines. These results emphasize the importance of promoting adherence to the 24-HMB guidelines among youth facing the challenges of comorbid ASD/ADHD. These cross-sectional findings point to the need for further empirical evidence from longitudinal studies to support our conclusions.

Development of an Online Mind-Body Physical Activity Intervention for Young Adults during COVID-19: A Pilot Study.

The purpose of this study was to examine the association between the implementation of an online mind-body physical activity (MBPA) intervention and physical activity (PA), stress, and well-being in young adults during COVID-19. The participants were a sample of college students (N = 21; 81% female). The MBPA intervention was organized in four online modules that were administered asynchronously for 8 weeks with three separate 10 min sessions per week. The intervention components consisted of traditional deep breathing, diaphragm mindful breathing, yoga poses, and walking meditation. Objective PA behaviors were assessed using wrist-worn ActiGraph accelerometers, and stress and well-being data were collected using validated self-report instruments. A 2 (sex) × 3 (time) doubly multivariate analysis of variance test with a univariate follow-up showed that the % of wear time in light (LPA) and moderate-to-vigorous physical activity (MVPA) was significantly higher at the end of the intervention compared to baseline (LPA mean difference = 11.3%, p = 0.003, d = 0.70; MVPA mean difference = 2.9%, p < 0.001, d = 0.56). No significant differences were observed for perceived stress and well-being, and there was no moderating effect of sex. The MBPA intervention showed promise, as it was associated with higher PA in young adults during COVID-19. No improvements were observed for stress and well-being. These results warrant further testing of the intervention's effectiveness using larger samples.

"I Felt Grounded and Clear-Headed": Qualitative Exploration of a Mind-Body Physical Activity Intervention on Stress Among College Students During COVID-19.

The COVID-19 pandemic affected college students' overall health. The aims of this qualitative inquiry were to provide a more comprehensive understanding of the effectiveness of the mind-body physical activity (MBPA) intervention and to explore the MBPA intervention experiences through the use of journals and photographs (photovoice) of a purposeful sample of 21 college students during the COVID-19 pandemic. An inductive qualitative process was used to explore the data that emerged from photovoice images and journals. Students' experiences were encapsulated in 6 key themes: (1) holistic individual well-being; (2) physical activity as a matter of necessity; (3) mind-body physical activity intervention impacts; (4) broadening strategies for adapting and reacting; (5) systemic effect of stress management changes; and (6) perceiving causes of stress. Participants reflected collective intellectual, physical, and emotional fatigue as obstacles and perceived stress. The quality of COVID-19 related perspectives and stressful experiences are defined from traumatic and overwhelming to higher than normal. Findings from this study contribute to our understanding of the distinctive factors of the COVID-19 era among college students. Health educators should consider the implementation of multilevel and multicomponent MBPA interventions, and our findings highlight the utility of supporting higher education students in a meaningful way.

Determinants of physical activity of transitioning adult children with Autism Spectrum Disorder.

Many young adults on the autism spectrum do not attain the recommended minimum weekly amount of moderate to vigorous physical activity (MVPA) to prevent significant health risks. Autism symptoms as well as environmental factors may play a key role in the physical activity (PA) behaviors of young adults on the autism spectrum. The socioecological model (SEM) has been previously used to identify determinants of PA among people within many disability categories. Aims: Explore the overall relationship between determinants of PA of MVPA among parents and their young adult child with ASD as well as MVPA determinants segmented by caregiver level of support. Methods: 336 parents of adult children with ASD completed the Determinants of Physical Activity and Eating Behaviors for Young Adults with ASD Scale. Results: Children's weekly time spent in MVPA was predicted by parent self-reported MVPA, exercise competency, video game use, social skills, and neighborhood qualities. Parent weekly time spent in MVPA was predicted by their child's weekly MVPA, parent exercise competency, parent discretionary time, available home exercise equipment, and parent attitude towards physical activity. Conclusion: These results support the administration of quality community-based motor development, motor skills, and exercise skills programs focused on increasing physical activity and parent's influential role in their children's weekly MVPA.

Intergeneration transfer of diet patterns? Parental self-report of diet and their report of their young adult children with ASD.

Autism Spectrum Disorder (ASD) affects two percent of American children and often results in neophobia, hypersensitivity to foods, and firmly set food preferences, leading to higher proportions of individuals suffering from diet-related chronic diseases. Our objective was to conduct an explorative pilot study to examine parents' perception of food intake for themselves and their young adult children with ASD. We employed comparative analysis to discover potential pathways to improve diet quality and lower the risk for chronic disease in individuals with ASD. Data from an online survey in n = 493 parent-child dyads on parentally reported intake patterns, food group, and food consumption was analyzed using kappa statistics to determine the level of agreement between reported parental and child intake patterns, body weight status and activity level. Average age was 48 years for parents and 22 years for their children, respectively. Parent-child agreement for obesity was high. We found very strong agreement between the reported diet variety (kappa = 0.82) and changing daily intake (kappa = 0.63) and strong agreement for some vegetable intake patterns (kappa = 0.61 for orange, white, and starchy vegetables) but not in meat intake (no agreement). Results of this study indicate evidence for perceived intergenerational transfer of dietary intake patterns, which may offer effective approaches to change parental diet, to subsequently improve diet quality in young adults with ASD and prevent diet-related chronic diseases in individuals with ASD.

Exploring Future Research in Adapted Physical Education.

Quality physical education can play a critical role in helping students become more active, physically literate, and develop the skills and interests to remain physically active throughout their lives. The healthy, physically active student is more likely to be academically motivated, alert, and successful in school. Unfortunately, findings from multiple studies interviewing students with disabilities suggest that students with disabilities are often less active and feel more socially separated from the class compared to their classmates without disabilities in general physical education. Clearly, more research is needed to identify best practices or strategies for creating a positive learning environment in physical education for all students. This paper examines future research considerations based on what we currently know about the physical education experiences and concerns of students with disabilities as well as concerns voiced by general physical educators. Considerations include: (1) What evidence do we have and what evidence do we need to show students with 3 disabilities are receiving appropriate physical education whether included or in a separate setting? (2) What evidence do we have and what evidence do we need to show that physical educators are properly trained and qualified to provide physical education to students with disabilities? (3) What evidence do we have and what evidence do we need to show that particular curricular and teaching models are effective when including students with disabilities in general physical education and when working in small groups or one-on-one? (4) What evidence do we have and what evidence do we need to show that students with disabilities are socially part of the class and not simply physically present.

Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis.

Mind-Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges' g = -1.71, 95% Confidence Interval (CI): -2.43, -0.98), cortisol (Hedges' g = -1.32, 95% CI: -2.50, -0.16), and systolic and diastolic blood pressure (Hedges' g = -1.04, 95% CI: -1.53, -0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

A multiple-method review of accommodations to gross motor assessments commonly used with children and adolescents on the autism spectrum.

The purpose of this study is to understand the common accommodations used during standardized motor assessment of children on the autism spectrum. This study was completed in three parts: (1) a narrative review of the literature; (2) an open-ended survey sent to the first authors of the identified articles; and (3) a descriptive analysis of responses. Results revealed that 56.7% of the identified articles did not report enough information of assessment procedures, 18.9% followed the assessment manual, 16.9% provided accommodations on a needs basis, and 7.5% used a consistent modified protocol. Individual responses showed that extra demonstrations (n = 5) were the most frequent accommodation, followed by extra breaks (n = 3), picture cards (n = 2), and hand-over-hand assistance (n = 1); some respondents stated that they did not provide accommodations. The findings indicate that a clear set of accommodation for motor skill assessments does not exist, though some commonalities were reported. Further research is necessary to understand the impact of accommodations in the assessment process, as well as which accommodations are needed and/or effective.

Physical activity in young adults with autism spectrum disorder: Parental perceptions of barriers and facilitators.

The importance of physical activity in persons with disabilities is well known, yet the prevalence of inactivity remains high. The physical activity behaviors among adults on the autism spectrum are largely unexplored. It is presumed that sedentary behavior and obesity are a greater health issue among young adults on the autism spectrum who no longer receive Individuals with Disabilities Education Act services and supports such as school-based physical education. Using a phenomenology approach, the parents of eight young adults on the autism spectrum were interviewed about their perceptions of the barriers and facilitators to getting their young adults on the autism spectrum physically active. The purpose of this study was to investigate parent's perspective of physical activity barriers and facilitators of their adult children on the autism spectrum. Common themes of both physical activity barriers and facilitators included parents, behaviors associated with autism spectrum disorder, and access and opportunities.

Psychometric Properties of the Physical Educators' Self-Efficacy Toward Including Students With Disabilities-Autism Among Chinese Preservice Physical Education Teachers.

Teachers' self-efficacy is a critical predictor for successful inclusive physical education. However, little is known about preservice physical educators' self-efficacy toward teaching students with autism spectrum disorders in China. A sound instrument is necessary to measure their self-efficacy level. This validation study examined the psychometric properties of the Chinese version of the Physical Educators' Self-Efficacy Toward Including Students with Disabilities-Autism. A multisection survey form was administered to preservice physical educators in Mainland China (n = 205) and Hong Kong (n = 227). The results of confirmatory factor analysis confirmed the one-factor model of the scale in the total sample and each of the two samples. Invariance tests across the two samples supported configural and metric invariance but not scalar invariance. The scale scores showed good internal reliability and were correlated with theoretically relevant constructs (i.e., burnout and life satisfaction) in the total sample and subsamples. These findings generally support the utility of the scale for use among Chinese preservice physical educators.

Implementing the adapted physical education E-learning program into physical education teacher education program.

According to the Ministry of Education Korea (2014), the approximately 70.4% of all students with disabilities are included in general schools in Korea. However, studies show that Korean GPE teachers do not feel comforatble or prepared to include students with disabilities (Oh & Lee, 1999; Roh, 2002; Roh & Oh, 2005). The purpose of this study was to explore whether an APE e-learning supplement would have an impact on the level of self-efficacy and content knowledge of pre-service teachers related to including students with intellectual disabilities. An APE supplement was developed based on the Instructional Design Model (Dick, Carey, & Carey, 2005) to provide three sources of self-efficacy, mastery experience, vicarious experience, and social persuasions. Three groups of pre-service teachers (N=75) took the same content supplement with different delivery system, E-learning group (n=25) with online, traditional group (n=25) with printed handout, and control group (n=25) without supplement. Two instruments, the Physical Educators' Situation-Specific Self-efficacy and Inclusion Student with Disabilities in Physical Education (SE-PETE-D) and the content knowledge test, were given to all participants twice (i.e., pretest and posttest). A 3×2 mixed effect ANOVA revealed that pre-service teachers' perceived self-efficacy (p=0.023) improved after taking the e-learning supplement. However, there was no significant difference in the level of content knowledge (p=0.248) between the learning group and tranditional group.

Influence of an awareness program on Portuguese middle and high school students' perceptions of peers with disabilities.

The ongoing topic of attitudes toward inclusion of students with disabilities in Physical Education (PE) classes emphases the role of schools as a primary place where attitudes toward disabilities can be changed. The effect of an awareness program on students' attitudes toward the inclusion of peers with disabilities in PE was examined, as well as variables such as sex, age, previous contact with disability, and competitiveness. The participants were 509 students (235 girls, 274 boys; M age = 13.3 yr., SD = 1.1, range = 11-16), who attended middle and high Portuguese schools. The awareness intervention comprised a one-week program (2 PE classes, 90 min. and 45 min.). Attitudes were assessed before and after the intervention. The awareness program appeared to have a positive influence on changing students' attitudes toward inclusion in PE.

Creation and validation of the self-efficacy instrument for physical education teacher education majors toward inclusion.

The purpose was to validate a self-efficacy (SE) instrument toward including students with disability in physical education (PE). Three scales referring to intellectual disabilities (ID), physical disabilities (PD), or visual impairments (VI) were administered to 486 physical education teacher education (PETE) majors. The sample was randomly split, and exploratory and confirmatory factor analyses (EFA and CFA, respectively) were conducted. After deleting items that did not meet inclusion criteria, EFA item loadings ranged from 0.53 to 0.91, and Cronbach's alpha reliability was high (for ID = .86, PD = .90, and VI = .92). CFA showed that the ID scale demonstrated good goodness-of-fit, whereas in the PD and in the VI scales demonstrated moderate fit. Thus, the content and construct validity of the instrument was supported.

Physical education teachers' beliefs and intentions toward teaching students with disabilities.

The Theory of Planned Behavior (TpB) measures the effect that individuals' behavioral belief normative belief and control beliefs have on their intentions to perform a specific behavior The purpose of this study was to examine: (a) whether the TpB could predict physical educators' intentions and (b) whether physical educators' intentions and control beliefs could predict their self-reported teaching behavior. A sample of 220 physical educators completed the questionnaire. Stepwise multiple regression analysis revealed that the TpB significantly predicted physical educators' intentions, F(3, 216) = 57.21, p < .01. However, only intention was a significant predictor of physical educators'self-reported behavior in teaching students with disabilities, F(2, 123) = 34.04, p < .01.

The effect of peer tutoring on interaction behaviors in inclusive physical education.

This study assessed the effect of peer tutoring on physical, instructional, and social interaction behaviors between elementary school age students with severe and multiple disabilities (SMD) and peers without disabilities. Additional measures addressed the activity time of students with SMD. The study was conducted in inclusive general physical education settings under three instructional support conditions for students with SMD: (a) teacher-directed, (b) peer-mediated, and (c) voluntary peer support. During peer-mediated and voluntary peer support conditions, the instructional and physical interaction behaviors between students with SMD and their peers increased, while social interactions remained low. The activity engagement time data increased for all target students throughout intervention sessions. Interactions between students with SMD and teachers decreased toward the end of intervention.

Inclusion in physical education: a review of the literature from 1995-2005.

The purpose of the review is to critically analyze English-written research articles pertaining to inclusion of students with disabilities in physical education published in professional journals both within and outside of the United States from 1995-2005. Each study included in this review had to meet seven a priori criteria. Findings of the 38 selected studies were divided into six focus areas: (a) support, (b) affects on peers without disabilities, (c) attitudes and intentions of children without disabilities, (d) social interactions, (e) ALT-PE of students with disabilities, and (f) training and attitudes of GPE teachers. Recommendations for future practice and research are embedded throughout the article.