The Effects of Motor and Cognitive Impairments on Daily Living Activities and Quality of Life in Children with Autism

Equine-assisted services for motor outcomes of autistic children: A systematic review

LAY ABSTRACT

Equine-assisted services use various aspects of horses, like their movement, warmth, and size, to enhance individuals' overall well-being. Many studies have underscored the positive impact of equine-assisted services on autistic children, affecting areas such as social interaction, communication, engagement, stereotypical behaviors, and motor functions. Given the growing recognition of motor functions as clinical specifiers in autism, it is imperative to specifically investigate how equine-assisted services influence these outcomes. To address this, we conducted a systematic review to synthesize existing literature on the effects of equine-assisted services on motor outcomes of autistic children. Our review encompassed study characteristics, features of equine-assisted service interventions, and major motor outcomes. We also evaluated the methodological quality of the equine-assisted service studies to offer insights for future research directions. Through thorough database searches and the use of the standardized procedure of conducting a systematic review (The Preferred Reporting Items for Systematic Reviews and Meta-analyses), 12 research studies were identified and included. These studies reported the effects of various equine-assisted service types (such as therapy, horsemanship, or learning) on motor outcomes of autistic children. Significant enhancements in coordination, strength, balance, posture, and overall motor skills indicate the effectiveness of equine-assisted services in improving motor outcomes of autistic children. Building on these findings, we provide recommendations for future research endeavors aimed at enhancing the reliability and validity of using equine-assisted services to improve motor outcomes of autistic children. This work contributes to a deeper understanding of how equine-assisted services can benefit this population and guides the development of more effective equine-assisted service interventions.

Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review

BACKGROUND

The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention.

METHODS

A systematic review was carried out following the PRISMA methodology and using three databases: Web of Science, PubMed and Scopus. The studies included were those aimed at children from 0 to 6 years of age, focused on early intervention, and which alluded to the family-centered model and/or tele-intervention.

RESULTS

a total of 33 studies were included. Five main themes were identified: (1) The participation of children and family is facilitated and improved by the family-centered model of care; (2) the feeling of competence, self-efficacy, satisfaction and empowerment in professionals and families have a positive impact on quality of life; (3) the use of tele-intervention as a tool for prevention and intervention; (4) preparation for telepractice can improve the development of commitment; (5) tele-intervention as a possible solution to contextual barriers.

CONCLUSIONS

Tele-intervention in pediatrics is presented as a tool inherent to the family-centered model since its implementation involves several common strategies. Future lines of research should explore the use of this tool as a possible solution to contextual barriers.

Mediating effect of sequential memory on the relationship between visual-motor integration and self-care performance in young children with autism spectrum disorder

Objective

Visual perception is a skill that contributes to the performance of self-care and important development tasks in early childhood. The relationship between self-care and visual perception is especially significant for young children with autism spectrum disorder (ASD), who have been described as visual learners. However, this relationship is not clearly understood among young children with ASD. We investigated the role of motor-free visual perception on the relationship between self-care and visual-motor integration in young children with ASD.

Methods

A sample of 66 children with ASD aged 48 to 83 months were recruited. Measurements included the Assessment of Motor and Process Skills, the Developmental Test of Visual Perception—Third Edition, and Test of Visual-Perceptual Skills—Third Edition.

Results

The results indicated that self-care performance had significant positive correlations with visual-motor integration, visual discrimination, visual memory, visual spatial relationships, and visual sequential memory. Of these, visual sequential memory and visual spatial relationships were the main factors related to self-care performance. Sequential memory was a mediator of the relationship between visual-motor integration and self-care performance.

Conclusion

This study establishes a deeper understanding of self-care and motor-free visual perception among young children with ASD. Understanding the relationship between visual perception and self-care in young children with ASD may aid professionals in providing self-care interventions for this population.

Effects of Square-Stepping Exercise on Motor and Cognitive Skills in Autism Spectrum Disorder Children and Adolescents: A Study Protocol

Individuals with autism spectrum disorder (ASD) diagnoses present not only cognitive, emotional, communicative, and social challenges but also movement issues that affect their everyday activities, learning, and leisure. The use of the square-stepping exercise (SSE), a motor program initially created to strengthen the lower limbs of older adults, is spreading because of its advantages (e.g., balance and lower limb strength improvements). A study protocol to assess the SSE effects on motor, sensory, and cognitive skills in Spanish children and adolescents between 6 and 12 years old with ASD diagnoses is presented. A randomised clinical will be performed, recruiting 52 children and adolescents with ASD who will be distributed into two groups: an experimental (n = 26) and a control (n = 26) group. The SSE sessions will be held for 9 weeks (two times per week). The main variable will be balance, which will be measured with the Movement Assessment Battery for Children 2 (MABC2), and secondary outcomes will include sensory processing, attention, and executive functions. Assessments will be carried out before and at the end of the program implementation, including an additional follow up one month later. If this program obtains positive results, it should be implemented in different settings (schools, clinics, associations, etc.) to improve the quality of movement and development in children and adolescents with ASD, as it is an easy-to-use and structured tool.

Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.

A Novel Tool to Assess Basic Activities of Daily Living in Spanish Preschoolers

BACKGROUND

Basic activities of daily living (BADLs) are those related to self-care. Their performance depends on the development of sensorimotor and cognitive skills, as well as social and environmental aspects. A good performance in BADLs is required for independence and social participation, so they play an important role in early education and early care. We aim to create a tool for BADLs assessment for Spanish preschoolers.

METHODS

The tool was administered to 303 participants (48.5% boys and 51.5% girls) between three and six years of age. Analyses to find out the factorial structure and internal consistency was carried out.

RESULTS

The instrument was composed of 84 items in four scales (eating, personal hygiene, dressing, and daily functioning) with nine factors (oral sensitivity, good manners, manual dexterity, brushing teeth, toilet management, hygiene and grooming, dressing, higher-order and core executive function). Reliability values were from acceptable to preferred (0.74-0.94).

CONCLUSIONS

The instrument could be useful and shows preliminary good indicators in construct validity and reliability.

Sustainable Service-Learning in Physical Education Teacher Education: Examining Postural Control to Promote ASD Children's Well-Being

As classrooms become more and more diverse, it is imperative to provide physical education teacher education (PETE) students with opportunities to develop competencies that promote quality education for all students. In this study, PETE students applied a physical education service-learning (SL) program aimed at enhancing Autism Spectrum Disorder (ASD) children’s motor domain and general well-being—objectives that are connected to the third focus of the United Nations’ Sustainable Development Goals (SDGs). Traditionally, research on SL has focused on students’ outcomes, and there is a call to examine SL’s effects on service receivers, which is the gap this paper aspires to fill. The aim of this study was to measure the postural control of children with ASD who were involved in a 6-month SL program in comparison to ASD peers in a control group. A quasi-experimental design was used in which a total of 29 children with ASD participated. The results of the experimental group showed a significant improvement in the vestibular pathways, an improvement trend in the somatosensorial and visual pathways and improvements in the dynamic tests. This study provides valuable feedback about how SL programs can benefit ASD children to improve their postural control, thus contributing to the third SDG concerned with well-being promotion.

A Complementary Sensory Tool for Children with Autism Spectrum Disorders

BACKGROUND

Sensory integration (SI) issues are widely described in people with autism spectrum disorder (ASD), impacting in their daily life and occupations. To improve their quality of life and occupational performance, we need to improve clinical and educational evaluation and intervention processes. We aim to develop a tool for measuring SI issues for Spanish children and adolescents with ASD diagnosis, to be used as a complementary tool to complete the Rivière's Autism Spectrum Inventory, a widely used instrument in Spanish speaking places to describe the severity of ASD symptoms, recently updated with a new sensory scale with three dimensions.

METHODS

458 Spanish participants complemented the new questionnaire, initially formed by 73 items with a 1-5 Likert scale.

RESULTS

The instrument finally was composed of 41 items grouped in three factors: modulation disorders (13 items), discrimination disorders (13 items), and sensory-based motor disorders (15 items). The goodness-of-fit indices from factor analyses, reliability, and the analysis of the questionnaire's classification capability offered good values.

CONCLUSIONS

The new questionnaire shows good psychometric properties and seems to be a good complementary tool to complete new the sensory scale in the Rivière's Autism Spectrum Inventory.

Participation in Everyday Activities of Children with and without Neurodevelopmental Disorders: A Cross-Sectional Study in Spain

Children with neurodevelopmental disorders (NDDs) often report significant difficulties performing activities of daily living (ADLs), which may restrict their daily participation. The aim of this study was to investigate the differences in ADLs participation between children with NDDs and typically developing (TD) children, and to explore the associations between different daily participation contexts. A cross-sectional study was conducted that included twenty children with a medical diagnosis of an NDD and 26 sex- and age-matched TD controls. The daily participation across home, community, school, and instrumental living activities was measured using the Child and Adolescent Scale of Participation (CASP). The results show that children with NDDs engaged in lower participation in all CASP contexts (Δ = 1.7-5.5, p < 0.001) and had a significantly higher prevalence of moderate or severe restricted participation than their TD peers (OR = 23.4, 95% CI = 3.6-154.2, p < 0.001). Additionally, a strong association was found between the different contexts of participation (r = 0.642-0.856). Overall, the children with NDDs experienced significant participation restrictions on their daily activities. This study adds to the growing evidence showing that intervention strategies in this population should adopt a participation-oriented approach.

Relationship Between the Performance of Self-Care and Visual Perception Among Young Children With Autism Spectrum Disorder and Typical Developing Children

Studies investigating the performance of self-care and visual perception in young children with autism spectrum disorder (ASD) are limited. The relationship between self-care performance and visual perception ability in young children with ASD is not yet clearly understood. Here, self-care performance was evaluated by the caregivers and therapists of children with ASD. The differences in self-care performance and visual perception ability were investigated in 66 children with ASD and 66 typically developing (TD) children between the ages of 48-83 months. The relationships between self-care and visual perception were tested in both two groups. The Assessment of Motor and Process Skills (AMPS) and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C) were used to assess the children's self-care performance. The Test of Visual Perceptual Skills-Third Edition (TVPS-3) and the Developmental Test of Visual Perception-Third Edition (DTVP-3) were used to evaluate visual perception ability. Young children with ASD obtained significantly lower scores for self-care performance (AMPS and PEDI-C) and visual perception ability (TVPS-3 and DTVP) compared with TD children. Additionally, positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD. The findings of this research highlight the need for pediatric practitioners to include self-care and visual-motor integration evaluations for young children with ASD. LAY SUMMARY: Young children with ASD obtained significantly lower scores for self-care performance and visual perception ability compared with TD children. Positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD.

A New Assessment for Activities of Daily Living in Spanish Schoolchildren: A Preliminary Study of its Psychometric Properties

BACKGROUND

Activities of daily living (ADL), which are divided into basic (BADL) and instrumental (IADL), allows us to survive and to live in the society. Cognitive skills are a key aspect in BADL outcomes. After reviewing existing BADL tools for Spanish schoolchildren, issues such as not covering the full age range or not having a BADL-centred vision were found. We aim to develop a new tool for BADL assessment in Spanish schoolchildren.

METHODS

The new tool was administered to 375 participants (47.2% boys and 52.8% girls) from 6 to 12 years of age. Analyses were carried out to find out the structure (semiconfirmatory factor analysis) and internal consistency (ordinal alpha) of BADL.

RESULTS

Four scales formed the instrument (Eating, Personal Hygiene, Getting Dressed, and General Functioning) with an interpretable solution of 12 factors (Manual Dexterity, Proprioception, Oral Sensitivity, Good Manners, Hygiene and Grooming, Toileting Needs Communication, Bladder and Bowel Control, Showering, Independent Dressing Tasks, Full Dressing, Executive Functions, and Self-Regulation) with 84 items + 6 qualitative items for girls. The reliability values obtained were acceptable (.70-.88).

CONCLUSIONS

The tool seems to be a practical and reliable instrument to assess BADL and cognitive skills during BADL in Spanish schoolchildren.