Enhancing Health, Well-Being and Physical Activity Among Adolescents with Autism Spectrum Disorder

Background: Despite the numerous health/social benefits of regular physical activity participation (PAP), adolescents with Autism Spectrum Disorder (ASD) are less likely to be physically active compared to their age-related peers. Research suggests that they become even less active during adolescence in both school/community settings. With declining PAP during adolescence, side effects of psychotropic medication treating core symptoms often resulting in weight gain, and high levels of sedentary activity participation, they are at significantly higher risk to develop complex acute/chronic health conditions such as cardiovascular disease, psychological disorders, and musculoskeletal disorders. Given these health complications, there is a need then to examine how to potentially increase PAP in an attempt to mitigate some of these preventable health complications. To date, much of the research examining PAP has drawn from the somato-motor performance (issues with balance, gait and joint flexibility) deficits associated with ASD. As such there is a paucity of research, and no research in Canada that has examined how non-bio-physical factors influence PAP.

Objectives: The purpose of this study was to examine the social, psychological, and behavioural, factors which influence PAP.

Methods: A qualitative study was conducted to elicit an in-depth examination and understanding of the factors which facilitate/constrain PAP. Ten adolescents with ASD (aged 11-18 years) and ten caregivers were interviewed from Ontario, Canada to maximize the depth/breadth of perspectives. Data was analyzed thematically where interview transcripts were coded to develop a preliminary understanding of the data. Codes with common patterns were then clustered and themes were generated. Negative cases within the data were used to test the rigour of the interpretations. Analytic memo writing and final integrative writing about PAP were employed to ensure findings were grounded in participant data. Participant quotes were drawn out to support research findings.

Results: Among adolescents, little exposure to PAP during childhood, bullying/traumatic experiences, and feeling an incessant pressure to camouflage in order to act ‘normal to fit in’ functioned to dissuade participation. Caregivers outlined that they prioritized behavioural/communication interventions over PAP throughout their child’s life, and the lack of participation during formative childhood years shaped physical activity interests during adolescence. Caregivers also described experiencing systemic challenges when accessing physical activity programs, including a lack of awareness about ASD among service providers, funding challenges, and limited/few program options. The lack of PAP individualization and competing commitments contributed to tremendous strain on families where caregivers expressed a need for guidance to help them balance family life, schooling, and therapies with PAP.

Conclusions: Study findings demonstrate that the lack of PAP among adolescents with ASD is not merely influenced by bio-physical deficits. Rather, findings suggest that inactivity is tied within complex psycho-social/behavioural mechanisms which intersect at individual, community, and policy levels. Findings suggest that there is a need to work collaboratively with policy makers and service providers in the community in an effort to create optimal physical, social, cultural, sensory, and behavioural conditions that could facilitate PAP. Solutions on how to potentially achieve such conditions of possibility will be discussed.