Effects of Physical Exercise on Stereotypy and Academic Engagement of Children with Autism Spectrum Disorder: A Systematic Replication of Neely et al. (2015)

Author

Alyssa Coha, Southern Illinois University CarbondaleFollow

Date of Award

5-1-2023

Degree Name

Master of Science

Department

Behavior Analysis and Therapy

First Advisor

Hurtado-Parrado, Camilo

Abstract

Exercise interventions are effective in reducing stereotypical behaviors in children with ASD, with high-intensity exercise enhancing the effects significantly (Teh et al., 2021). Neely et al.’s (2015) found a moderate-to-large effect of exercise on stereotypy and academic engagement; however, the intensity of exercise was only indirectly assessed using behavioral indicators of satiation (e.g., flushed face). It was hypothesized that Neely et al.’s (2015) protocol could be more consistently effective if the intensity was directly controlled and matched to what previous systematic reviews and meta-analysis had suggested as the most effective (CDC 2020, 64% - 76% of an individual’s maximum heart rate). The present study systematically replicated Neely et al.’s (2015) study controlling the intensity of the exercise using a physiological measurement (heart rate) and examining its effects on stereotypic responses and academic engagement. Participants were two children with a diagnosis of autism spectrum disorder and evidence of stereotypy maintained by automatic reinforcement. Neely et al.’s (2015) design and conditions were replicated, namely a multielement design with (a) no exercise (baseline), and (b) physical exercise until participants showed behavioral indicators of satiation. A third condition was introduced to test for controlling the intensity of the exercise using the heart rate measure. Percentage of intervals with stereotypic responses and academic engagement and heart rate were measured across conditions. Neely et al.’s main findings were reproduced, namely antecedent exercise reduced stereotypic responses and increased academic engagement. Physiological measurement provided some evidence of a functional relationship between heart rate and stereotypic and academic engagement responses (as heart rate increased, stereotypic responses decreased while academic engagement increased). An effect size analysis (Tau-U index; Parker et al., 2011) was conducted to supplement visual analysis and allow for comparisons with previous research (meta-analyses and Neely et al.’s findings). The effect of exercise on stereotypy was large across conditions and participants. Effects on academic engagement varied between participants, with low-to-moderate effects for one participant and large effect for a second participant. Our findings overall confirm the effectiveness, reliability, and social validity of Neely et al.’s exercise intervention. However, adding a physiological measurement to control the intensity of exercise seems to produce a more robust and consistent effect, especially on stereotypy. The present modified version of Neely et al.’s intervention could be used to continue testing the effects of exercise on other behaviors associated with autism spectrum disorder (e.g., out of seat behavior, aggression, self-injurious behaviors; Wong et al. 2022).