Review paper -Part2
By Dr Ali Saber Mohamed
Neurology and Psychiatry consultant
2023
Physical activity interventions for children with autism spectrum disorder – part 1
Martial arts:
Among the physical activities that help to treat ASD are martial arts routines, which can coordinate the body movements . strengthen the coordination of the whole body –hand-eye-body method, and promote the healthy development of body and mind ( 11 ). How ?
1-Children with autism are generally reluctant to contact people , and their response is relatively slow. Martial arts routines emphasize learning from opponents, attacking and defending , advancing and retreating. Therefore, having children practice martial arts moves can improve their reaction speed.
2-Children with autism are more resistant to changes in the environment. their behavior is more rigid, and they often make some repetitive actions. Martial arts movements are mostly flexible and focus on the combination of movement and stillness, therefore can enhance children physical coordination.
3-Children with autism often shake their hands constantly and have poor control ability, while martial arts have their own set of movement paradigms.
Martial arts include : karate , judo, aikido, taekwondo programs, etc (Stamenkovic A et al, 2022).
After 12 weeks Karate training, the intervention group showed greater socio-emotional competence such as communication, cooperation and engagement better executive functioning ability such as cognitive flexibility, inhibitory control and working memory, and a lower aggressiveness, sadness, anxiety and hyperactivity (Greco G and DeRonzi R, 2020) . Teaching Karate techniques to children with Autism Spectrum Disorder leads to significant reduction in their communication deficit (Fatimah B et al, 2016).
Kata is a pattern of martial arts movements practiced as a way to memorize and perfect execution. After 14 weeks Kata techniques training, there were improvement in social interaction (Movahedi A et al, 2013). Also, Kata techniques training consistently decreases stereotypy in children with Autism Spectrum Disorder (Fatimah B et al, 2012).
Taekwondo is a kind of martial arts that involves punching, kicking, jump kicks, and use of hands and feet to attack or defend (Fong SS, Ng GY, 2011) . Taekwondo training is a funny, feasible, and effective therapeutic option for balance improvement of children with Autism Spectrum Disorder (Yumi Kim et al, 2016). The effects of Taekwondo training on balance have also been investigated in children with developmental coordination disorder, who demonstrate similar motor delays and balance deficits as children with Autism Spectrum Disorder with successful results (Fong SS et al ,2013 ).
Participation in Taekwondo appears to speed up the development of postural control and vestibular function in adolescents (Fong SS et al,2012). An increase in knee extensor muscle strength and standing on one leg during kicking can be considered a reason for improving posture control (Rabeeh Hariri et al, 2022).
Aquatic Therapy:
Water–based exercises differ from land-based ones, considering the water’s frictional force and buoyancy. In addition, training in water may be more pleasant for children promoting their adherence to treatment.
There is an increasing evidence to support the view that a hydrotherapy intervention may be effective in improving the social interactions and behaviors of children with ASD in addition to motor and swimming skills. Caputo G et al (2018) found after 10 months of aquatic program for children improvements in functional adaptation, emotional response, adaptation to change and swimming skills. Mortimer R et al (2014) concluded after review of studies that hydrotherapy shows potential as a treatment method for social interactions and behaviors in children with ASD. Marzouki H et al (2022) suggest that swimming programs could improve gross motor skills and emotional impairments in children with ASD. Pilot study of Fragala- Pinkhan MA et al (2011) showed potential for improving swimming ability in children with ASD. Pan CY (2010) found the same results after 10 weeks swimming program on 16 boys. Battaglia G et al ( 2019) published 3 case reports of effective program for the development of gross motor skills and social behaviors in children with ASD. Yilmaz I et al ( 2004) reported a case report with the same results.
Ansari S et al (2021) compared aquatic versus karate and concluded that land-based and swimming –based exercise programs improved balance abilities in children with ASD. Baccouch R et al (2015) reported the same results after applying Kung-fu and swimming training.
Conclusion:
Children with ASD generally express less physical activity level and have motor abnormalities, so assessment and interventions in this field is a vital aspect of their care. This includes exercise and sports. Selection of type depends upon many factors ( abilities of child, severity of core autism symptoms, hobby and preference of child and family, availability, experience of physical educator and therapist, etc). My review is a start of hopeful project to establish this intervention for ASD therapy.
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