Exercise Effects on Patients with Autism
My go to line when educating parents about Autism and Sensory Dysfunction, is that “every child with an Autism diagnosis has Sensory Dysfunction, but not all clients with Sensory Dysfunction have Autism”. The diagnostic process of Autism is a complicated one and in the last few years we have seen a spike in the diagnosis; whether that is a true spike in the disorder or if it is an over diagnosis issue, is not for us as therapists to say necessarily. So instead of focusing on the diagnosis itself, we should be treating what we identify as dysfunction or deficit.
AUTISM & EXERCISE EFFECT ON MOTOR, SOCIAL AND SPEECH SKILLS
It is very common to see individuals with an Autism Spectrum Diagnosis (ASD) be “characterized by social interactions and communication skills impairments that include intellectual disabilities, communication delays and self-injurious behaviors; often are present systemic comorbidities such as gastrointestinal disorders, obesity and cardiovascular disease”(Ranieri, 2023). There is an extensive amount of research on the benefits of exercise on this population to improve more than just physical strength. It is common knowledge that physical exercise promotes physical and mental health, so the impacts of exercise on the ASD population should be evaluated as well. “Sixteen studies describing exercise-based interventions reported positive and promising effects in two of the three core symptom domains: motor and social deficits”(Sowa, 2011). This has been seen in clinics as we challenge patients with heavy play activities such as jogging or running, trampoline activities or water based exercises and see an increase in attention and learning immediately following these activities, which is supported by the article by Ferreira (2019). Utilizing physical activity prior to learning activities has appeared to increase learning and ability to sit for longer amounts of time for tasks. The article by Ferreira (2019), showed that vigorous activity for 15 minutes decreased stereotypical behavior of children with ASD for at least two hours and found “new evidence that some types of exercise such as Kata techniques, due to its specific characteristics, may have an effect for a longer duration on the reduction of stereotypic behavior in children with ASD. In this specific case, the effect lasted at least for 30 days”. It is incredible to think that specific exercise programs developed for individuals with ASD could have a lasting impact of up to 30 days! It is important to remember that individualized programs are key here as “each person with autism has a highly individualized set of symptoms and characteristics” (Sefen, 2020). Occupational and Physical Therapists are very useful in developing a program that is specific to the individual client. Occupational Therapists, in particular, create sensory diets in collaboration with the parents to facilitate a routine that improves learning and attention to meet goals and improve quality of life for the child and the families.
AUTISM & EXERCISE EFFECT ON GUT BIOME & NERVOUS SYSTEM
It has been shown in multiple studies that individuals diagnosed with ASD are at higher risk for obesity, obesity related conditions, and may have altered cholesterol metabolism. “Cholesterol is also responsible for the correct function of neurotransmitters, and its impaired metabolism could cause brain dysfunction”(Ranieri, 2023). Recently, there has been research done on the relation of the gut microbiome and the stimulation of different areas of the brain. The gut-brain connection can be a little complicated so we will simplify it here to further explain how exercise can impact this. It has been shown “that gut-resident microbes and their metabolites can communicate with the brain through the “gut-brain axis”. This network of bi-directional signals is crucial for the establishment of a correct gut-brain crosstalk and is able to regulate the development and functions of the central nervous system” (Ranieri, 2023). Individuals with ASD have been shown to have altered gut biome that creates a lot of different symptoms that are gut related, but also can be nervous system related. To get into the specific gut biomes, please refer to the cited article by Ranieri (2023). The two primary gut biomes to be discussed here are GABA, an amino acid neurotransmitter that functions as an important transmitter in the brain, and Clostridium perfringens, which is a gram positive bacterium. GABA has been well researched and is decreased in individuals with ASD. Research has shown that physical exercise increases GABA. Clostridium perfringens is also well studied and is known to be increased in individuals diagnosed with ASD. Research has also shown that physical activity can decrease this. Many times, there are pharmacological options for the gut and central nervous system symptoms, but exercise has been shown to be a non-pharmacological option to alter the gut biome and affect these symptoms. “The use of therapies based on physical activity in children with ASD would make it possible to stimulate different areas of the brain through external stimuli by acting on cognitive, behavioral and motor skills. In addition, these therapies act on the composition of the microbiome by modulating gastrointestinal symptoms and improving their quality of life with the reduction of the risk of developing systemic comorbidities such as obesity, gastrointestinal disorders and heart disease” (Ranierri, 2023). With the findings revealing such a positive effect of exercise on the gut microbiota composition, which can modulate the nervous system, therapists and parents should be including physical activity in the routine.
AUTISM & EXERCISE PRESCRIPTION
There are obviously a large variety of exercises that are beneficial to people physically, but specific exercises have more research than others for individuals with ASD symptoms. It has been shown that swimming, horseback riding, karate, and minibasket have positive impacts on stimulating the brain. These exercises can be graded to be easier or harder based on the individuals’ needs. Many children with ASD diagnosis tend to be sedentary due lack of interest or motivation, so the above exercises are a good variety to appeal to the interest of a wider population. Physical and Occupational Therapists are excellent at finding client’s motivations and grading the exercises to challenge them appropriately. Having a professional guide the family and the child to develop a positive routine to impact the gut and the brain through physical exercise is well researched and supported. Reach out now to Movement Matters PT OT for an evaluation or with any questions. Now offering Telehealth appointments at discounted rates to answer questions and provide information for parents and families!
Good Resources for Parents/Families of individuals with ASD:
https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits
ARTICLES
1. Ranieri A, Mennitti C, Falcone N, et al. Positive effects of physical activity in autism spectrum disorder: how influences behavior, metabolic disorder and gut microbiota. Front Psychiatry. 2023;14:1238797. Published 2023 Oct 10. doi:10.3389/fpsyt.2023.1238797
2. Sowa, M., & Meulenbroek, R. (2011). Effects of physical exercise on autism spectrum disorders: A meta-analysis. Research in Autism Spectrum Disorders, 6(1), 46–57. https://doi.org/10.1016/j.rasd.2011.09.001
3. Ferreira JP, Ghiarone T, Cabral Júnior CR, Furtado GE, Moreira Carvalho H, Machado-Rodrigues AM, Andrade Toscano CV. Effects of Physical Exercise on the Stereotyped Behavior of Children with Autism Spectrum Disorders. Medicina. 2019; 55(10):685. https://doi.org/10.3390/medicina55100685
4. Sefen, J. A., Al-Salmi, S., Shaikh, Z., AlMulhem, J. T., Rajab, E., & Fredericks, S. (2020a). Beneficial use and potential effectiveness of physical activity in managing autism spectrum disorder. Frontiers in Behavioral Neuroscience, 14. https://doi.org/10.3389/fnbeh.2020.587560
