JMIR Publications

ABSTRACT

Background:

The motor trajectories of children with ASD are often compromised leading to difficulties in gross motor performance and locomotor skills by late childhood. Our past work has suggested that whole-body movement interventions using rhythmic contexts can facilitate gross motor skills in children with ASD.

Objective:

This study compares the effects of whole-body movement interventions delivered face-to-face (F2F) versus via telehealth (TH) compared to a standard-of-care, seated play (SP) intervention on gross motor performance of children with ASD.

Methods:

45 children with ASD between 5 and 14 years were seen for 10 weeks with pretests and posttests conducted during the first and tenth weeks. Children were matched on age, gender, and level of functioning and then randomly assigned to either General Movement (GM), Creative Movement (CM), or Seated Play (SP) groups. An equal number of children in each group received the training via F2F and TH modes. Training was provided 2 sessions/week for 8 weeks, with sessions lasting 1-1.15 hours. The CM and GM groups received whole-body movement training, whereas the SP group engaged in table-top activities. The gross and fine motor subtests (fine motor precision, fine motor integration, balance, bilateral coordination, running speed and agility, and strength) of the Bruininks-Oseretsky Test of Motor Proficiency (BOT) were administered at pre- and post-tests. We report standard scores on body coordination, strength and agility, and fine manual control composites.

Results:

The CM and GM groups showed significant improvements on the body coordination composite (Means(SE): CM group - Pretest: 35.3(2.1), Posttest: 40.5(2.7), p <0.005; GM group - Pretest: 38.1(3.2), Posttest: 44.7(3.3), p <0.005). The GM group (Pretest: 36.1(2.6), Posttest: 40.9(3.1), p <0.001) also improved on the strength and agility composite with a trend for similar improvements in the CM group (Means(SE): Pretest: 32.5(2.4), Posttest: 34.5(2.7), p =0.09). The SP group did not show any improvements on the gross motor composites. The SP group instead showed significant improvements on the fine manual control composite (Means(SE): Pretest: 36.4(2.3), Posttest: 41.6(2.5), p<0.005). Fine motor skills remained unchanged in CM & GM groups. In each of the 3 groups, there were no significant differences in the amount of improvements (posttest-pretest) observed for children seen F2F versus via TH for the body coordination (CM group: F2F: 4.1(2.6) TH: 5.4(1.6), p=0.7; GM group: F2F: 6.5(2.7) TH: 5.6(2.5), p=0.8), strength and agility (CM group: F2F: 1.3(1.4) TH: 2(1.1), p=0.7; GM group: F2F: 3.7(1.3) TH: 5.6(1.5), p=0.4), and fine manual control composite standard scores (SP group: F2F: 2.2(2.8) TH: 1.9(1.2) p=0.8).

Conclusions:

Findings of our pilot study emphasize the importance of training gross and fine motor skills in children with ASD and suggest that virtual modes of intervention delivery can be used by movement clinicians to train these skills.