JMIR Publications

ABSTRACT

Background:

Children with Autism Spectrum Disorder (ASD) demonstrate impairments in postural strength and control, both of which are important for activities of daily living (Bhat et al., 2010). With the onset of the COVID-19 pandemic, more focus has been placed on telehealth interventions.

Objective:

Our RCT assessed the effects of a general movement (GM) intervention compared to a standard-of-care seated play (SP) intervention delivered via face-to-face (F2F) and telehealth (TH) based modes of intervention delivery in children with ASD.

Methods:

Thirty 5-14-year-old children were matched at baseline and randomly assigned to the GM or SP groups. Children participated in a 10-week study with pretests and posttests conducted during the first and last weeks and training in the intermediate 8 weeks (2 sessions/week at 1.5 hours/session). The strength subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)3 and a custom-developed functional strength test were administered at pretest and posttest. In addition, we assessed functional strength using 15 upper and lower body exercises that were administered during early and late training sessions. All strength tests were coded for errors in movement form and movement quality during execution.

Results:

On the BOT-2, the GM group (Means(SE): Pretest: 8.3(1.1), Posttest: 10.31(1.3), p=0.007) but not SP group showed improvements in scaled scores on the strength subtest. There were no differences in the amount of change for children seen F2F versus TH in the GM group (F2F: 2.3(0.8); TH: 1.8(0.9), p=0.7). In the GM group, 77% of participants showed improvement in Front Raise and 50% improved on both Sumo Squat and Donkey Kick. Of the 15 upper and lower body functional strength exercises performed, 7 provided significant results at a significance level of p = 0.05; Upper body - back row (Means(SE): Early: 81.3(4.6), Late: 57.0(7.8), p = 0.01), spread your wings (Means(SE): Early: 55.5(6.0), Late: 32.1(5.4), p = 0.008), press ups (Means(SE): Early: 72.1(5.3), Late: 46.8(8.0), p = 0.01), and superman reach (Means(SE): Early: 74.4(2.8), Late: 58.9(6.8), p = 0.009), Lower body - donkey kicks (Means(SE): Early: 69.2(2.9), Late: 40.2(6.0), p < 0.001), do-a-dot (Means(SE): Early: 77.4(3.3), Late: 56.3 (6.3), p = 0.008) and superman kick (Means(SE): Early: 71.9(2.9), Late: 49.8(6.8), p = 0.008). Across all 7 moves, a comparable or higher proportion of children seen via TH showed improvement in movement performance scores compared to children seen F2F. For 6 out of 7 movements, the mean reduction in percent movement performance errors (early - late) was greater for children seen via TH compared to children seen via F2F.

Conclusions:

Although preliminary, our data suggests that TH is an effective mode of delivery of gross motor interventions and can be used to promote functional upper and lower body muscle strength in children with ASD.