Impact of Vigorous Exercise on Behavior Problems and Academic Engagement Among Adolescents with Autism Spectrum Disorder

Background: Children with autism spectrum disorder (ASD) experience less active lifestyles than their peers without ASD, which may place them at risk for poor mental and physical health outcomes. Regular, vigorous exercise may reduce these health risks and improve behavior and academic engagement for students with ASD. Few studies have examined the impact of exercise on well-being for adolescents with moderate to severe autism. Moreover, much of the past research has relied on subjective measurements of activity, such as heart rate and flushed faces, and small samples.

Objectives: The goal of the present study is to extend our understanding of the impact of vigorous exercise on behavioral and academic outcomes for adolescents with moderate to severe ASD, using objective measures of activity (Metabolic Equivalent Tasks or METs). We hypothesized that more vigorous (6-9 METs), but not strenuous (9+ METs), activity would predict fewer problematic behaviors and greater academic engagement during the school day.

Methods: The sample consisted of 21 junior high students (2 female) with ASD, recruited from four classrooms in a school for children with ASD in the Northeast. Mean age was 15.67 years (SD = 0.73). A research assistant reliable on the Autism Diagnostic Observation Schedule conducted ADOS-2 assessments and teachers completed the Child Behavior Checklist (CBCL/6-18) at baseline. Two of the classrooms were randomly assigned to jog outside for 20 minutes at the start of each school day for weeks 1 and 2, while the remaining two classrooms walked, stretched, and engaged in less vigorous activity at the same time (also outside). The conditions were counterbalanced in weeks 3 and 4. Immediately following the exercise period, students were videotaped during a standardized Basic Study lesson for 20 minutes. Students wore an Omron 750C accelerometer on their waist band during the school day that tracked METs at 10 second intervals. Teachers completed student behavior logs (e.g., tantrums, noncompliance, aggression) and a modified version of the Problem Behavior subscale of the Scales of Independent Behavior-Revised (SIB-R) on a randomly selected “target day” each week. Research assistants blind to student condition coded on and off task behaviors during Basic Study using the Behavioral Observation of Students in Schools (BOSS) on each student’s “target day”.

Results: The number of minutes of vigorous activity was significantly higher for students in the jogging condition, t(20) = -8.09, p < .001. Hierarchical linear modeling was used to examine the impact of vigorous exercise on outcomes. Analyses controlled for week number (Level-1), autism symptoms and externalizing behavior problems measured at baseline (Level-2). Greater vigorous exercise predicted significantly fewer behavior problems (Table 1). Students spent a significantly higher percentage of their time on task during the Basic Study lesson on days with greater vigorous activity.

Conclusions: Findings from the present study suggest that school-based exercise programs for adolescents with ASD may improve student outcomes by minimizing disruptive behaviors in the classroom and improving academic engagement. This is the first study to our knowledge to examine the effects of vigorous exercise in adolescents with ASD.