efectos del ejercicio aerobico en autismo

7/28/2019 Efectos Del Ejercicio Aerobico en Autismo

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Journal of Autism and Developmental Disorders, Vol. 27, No. 2, 1997

Brief Report: The Effects of Exercise on theSelf-Stimulatory Behaviors and PositiveResponding of Adolescents with AutismAndreaRosenthal-Malek1Monmouth UniversityStella MitchellNe w York City Schools

Persons with autism are often characterized by their self-stimulatory be-havior such as body rocking, spinning, hand flapping, head-nodding, ob-ject-tapping, gazing at lights, and mouthing (Lovaas, Newson, & Hickman,1987; Sugai & White, 1986). Research literature has shown that these gen-eral behaviors interfere with both the performance of positive social be-haviors and learning (Bass, 1985; Kern, Koegel, Dyer, Blew, & Fenton,1982; Sugai & White, 1986). In addition, these negative behaviors oftenpresent a special problem for integration into the mainstream (Van Bour-gondien & Mesibov, 1989).

One promising area of research for decreasing these negative behav-iors without decreasing other positive behaviors has been the use of aerobicexercise. Specifically, the use of aerobic exercise with students in variousspecial populations has been shown to reduce aggressive behavior (Allison,Basile, & MacDonald, 1991; Gabler-Halle, Halle, & Chung, 1993; Yell,1988), unproductive and disruptive behavior (Bachman & Sluyter, 1988;McKimsey & Favell, 1988), stereotyped and self-injurious behavior (Bach-man & Fugua, 1983; Baumeister & MacLean, 1984; Morressey, Franzini,& Karen, 1992), and purposeless wandering (Whitaker & Saleem, 1994).In addition, structured aerobic exercise has been shown to improve atten-tion span (McGimsey & Favell, 1988), work performance (Beasley, 1982),and on-task behavior (Powers, Thibadeau, & Rose, 1992).1Address all correspondence to Andrea Rosenthal-Malek, Monmouth University, EducationDepartment, West Long Branch, New Jersey 07764-1898.

1930162-3257/97/0400-0193$12.50A> 1997 Plenum Publishing Corporation


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Effects of Exercise on Adolescents with Autism 195

independently. Cones were set up during the jogging session to control thedirection and area where the boys could run. Tb control for the possibilitythat any observed effects were simply due to a change in the usual routine,the aerobic jogging classes were established at the beginning of the schoolyear as part of the routine whereas data collection did not begin for a month.

The academic precondition consisted of an assortment of academicsubjects conducted in the regularly scheduled classrooms. No attempt wasmade to change the standard procedures the students normally followed.There were a total of 20 preconditions, 10 academic and 10 exercise;1 to 5 preconditions were scheduled each week and were arranged in ran-domized order. Each precondition was immediately followed by either theacademic or the community-based workshop condition. An assessment ofself-stimulatory behaviors as well as academic responding and work per-formance was conducted.

The dependent variables were (a) number of elicited self-stimulatorybehaviors, (b) number of correct academic responding, and (c) work com-

Table I. Subject Characteristics

SubjectJason

Michael

Sean

Kenny

Craig

Age15.5

15.1

14.1

14.9

14.8

IQ36

42

39

4648

Self-stimulatorybehaviors

Rotation of eyesFinger distortionBody rockingMouthing objectsShoe fixationFolding back eyelidsMasturbatingPicking fingersBiting selfWaving hands in airHand flappingBody rockingHitting studentsConstantly touchingeyeglassesFinger flappingInappropriate laughterConstant blinkingKissing objectsBody rockingFinger flappingCluckingJabbing students

Dependent Wiriables


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pleted during the workshop condition. Specifically, self-stimulation wasmeasured by the number of times a student elicited individualized self-stimulatory behaviors as defined in Table I. Each student was randomlyobserved for 5 seconds, then a second student was observed, then a third,and so on until all 5 boys were observed 10 times for a total of 50 secondsin each condition. The students received 1 point every time they eliciteda self-stimulatory behavior as individually defined in Table I. The totalnumber of points over the 10 sessions were added together to obtain anoverall score for each condition for each student.

The "correct academic responding" score was obtained by tallying thecorrect responses for the 10 questions asked of each subject during eachacademic condition. The "tasks completed" score was obtained by tallyingthe number of tasks correctly completed during the hands-on workshopcondition. Responses in all conditions were tallied individually for each boy.

ProcedureThe boys participated as a group in both the academic and workshop

conditions. Both conditions were conducted by the regular teachers withthe assistance of a paraprofessional. Upon completion of both the precon-ditions, the boys were brought to either the regular classroom or the com-munity-based workshop. During both of these conditions, the teacherconducted the sessions as usual but made no attempt to control the boys'self-stimulatory behaviors.

The academic sessions consisted of teacher-directed review lessons incoin values. The format of the lesson consisted of the teacher handing outa worksheet of 10 problems. Each problem was discussed by asking indi-vidual subjects to verbally name the coin value. The students were ques-tioned in a random sequence and all responded verbally except for Michael.When Michael responded, he independently utilized a "facilitated" boardwhere the various com values were listed. He merely pointed to the correctanswer without any teacher assistance. Correct responses were followed bya verbal reinforcer and were tallied by a second observer.

The general format of the hands-on community workshop sessionswere individual in nature. Each boy walked to a table where individualizedwork was waiting for him. The individual jobs, which were part of eachboy's normal routine, consisted of the following: Jason placed eggs into anegg carton; Michael twisted off plastic tie clips and placed them into a bin;Sean assembled pens; and Kenny and Craig counted SO beads and placedthem into a box. The teacher ensured that the subjects remained in theirseats but did not control the amount of work the boys completed.

196 Rosentbal-Malek and Mitchell


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ReliabilityReliability measures were obtained for the self-stimulatory behaviors

during both the academic and workshop conditions. Two observers inde-pendently recorded occurrences of all self-stimulatory behaviors in bothconditions. The average percentage agreement for recording self-stimula-tory behaviors across the 20 intervals for the five students in both conditionswere 96% (range: 66-100%).

RESULTSResults were calculated separately for each dependent variable. Figure

1 and Figure 2 describe the results of the first variable, the amount ofself-stimulatory behaviors elicited during the academic and the community-workshop setting, respectively, for each boy for each session. The graphsindicate that in every instance in both conditions, the boys showed lower

Fig. 1. Number of self-stimulatory behaviors elicited during the academic condition.


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198 Rosenthal-Malek and Mitchell

levels of self-stimulatory behaviors after the aerobic exercise preconditionversus the academic precondition. It should be noted that in general, allsubjects' level of self-stimulatory behaviors were generally higher duringthe academic condition over the workshop condition regardless of the pre-condition.To assess whether a statistically significant difference existed betweenthe effects of the exercise precondition and the academic precondition forthe occurrence of self-stimulatory behaviors, a t test for paired values (two-tailed) was employed for both conditions. The t tests revealed a statisticallysignificant difference between effects of the two preconditions for both theacademic and the workshop conditions, t(4) = 4.26, p < .01, and t(4) =1.46, p < .001, respectively.

It also appeared important to determine if decreases were specific toself-stimulatory behavior, or if some sort of fatigue effect was occurringand other positive behaviors would also decrease. Therefore, data regardingthe second and third variables, correct academic responding and tasks com-pleted were also collected.

Fig. 2. Number of self-stimulatory behaviors elicited during the workshop condition.


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With regards to academic responding, the subjects' total number ofcorrect responses were greater after the exercise precondition than afterthe academic precondition (M = 33.60, SD = 16.15; M = 29.60, SD =15.57, respectively). In fact, the t test for paired values (two-tailed) revealeda significant difference in the two sessions and showed that after aerobicexercise, the subjects' correct responding increased significantly, t(4) =2.83, p < .05.

With regards to the number of tasks completed during the workshopcondition, the boys completed a greater number of task after the exerciseprecondition than after the academic precondition (M = 24.20, SD = 6.42;M = 21.80, SD = 6.98, respectively). Again, the t test for paired values(two-tailed) revealed a significant difference in the two sessions and indi-cated that after aerobic exercise, the subjects' number of completed tasksincreased significantly, t(4) = 4.71, p < .01.

DISCUSSIONTo summarize, the results of the data indicate that (a) there is a sig-

nificant decrease in self-stimulatory behavior following the physical exerciseprecondition as compared to the self-stimulatory behaviors following theregular academic precondition, (b) the level of correct responding; signifi-cantly increased following the aerobic exercise precondition as comparedto the academic precondition, and (c) the number of tasks completed dur-ing the community-based workshop situation significantly increased follow-ing the aerobic exercise as compared to the academic precondition.

The findings of the investigation confirm Watters and Watters (1980),Kern et al. (1984), Powers et al. (1992), and Elliot et al's (1994) studiesregarding the effects of exercise on the reduction of self-stimulatory be-haviors of persons with autism, thus expanding their results to adolescentswith autism. Further, although researchers have shown that using aerobicexercise reduces the level of self-stimulatory behavior in persons withautism, a major concern regarding exercise has been the issue of the fatigueeffect. In fact, this study again confirms Watters and Watters (1980) andKern et al.'s (1982) observations that mildly strenuous aerobic exercise (jog-ging) decreases the self-stimulatory behavior of persons with autism whileincreasing the level of academic performance. In addition, this studyshowed an increase in work-related performance, confirming Elliot et al.'s(1994) study. Thus, while aerobic exercise directly decreases the self-stimu-latory behaviors of persons with autism, it does not appear to lower otherpositive behaviors in this population.



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Another benefit of aerobic exercise, besides the obvious health bene-fits, is that unlike the use of behavior management techniques that areimplemented during the training sessions, the exercise intervention takesplace before the training sessions. Thus, exercise has the advantage of notinterrupting the classroom teaching. In addition, since the exercise proce-dure is relatively easy to administer, the teacher does not need to be asextensively trained as the teacher who uses sophisticated behavior manage-ment techniques.

An additional issue involves the amount of time and the level of in-tensity that is needed to produce these results. A number of researchers(e.g., Kern et al., 1984) have studied the differential effects of level of in-tensity and length of aerobic exercise sessions on self-stimulatory behaviors,and in fact found differing effects depending on both these variables. Wat-ters and Watters (1980), Kern et al. (1984) as well as this study all usedmildly strenuous jogging exercise for a period ranging from 8 to 20 minutes,whereas Elliot et al. (1994) used strenuous aerobic exercise. It is plausiblethat the exact duration of the exercise as well as the level of intensity maybe important variables for the level of improvement. To find the most prof-itable aerobic exercise program, further research is warranted.

Another issue is the durability of the behavior change. Unfortunately,little evidence is available regarding long-term effects of aerobic exerciseon maladaptive behaviors. Those studies which did look at duration of ef-fects found the greatest degree of change immediately following the exer-cise (Gabler-Halle et al., 1993). In fact, Jansma and Combs (1987) foundthat within 2 weeks after exercise, maladaptive behaviors returned to origi-nal levels for adults with developmental disabilities. No other study haslooked at the long-term effects of aerobic exercise on students with autism(Gabler-Halle et al., 1993).In addition, in all cases the subjects elicited more self-stimulatory be-haviors regardless of the precondition during the academic setting ratherthan the community-based setting. The second author, who was familiarwith the students also noted this finding anecdotally, claiming that this ap-pears to be the case on a regular basis. One possible explanation for theseresults is that the work-related sessions may be inherently less challengingor stress-inducing than the academic sessions since the former require noverbal or social interaction. Thus, this decreased level of stress may indi-rectly decrease self-stimulatory behaviors during the workshop sessions.

Finally, with regard to the applicability of these findings to the class-room, although many programs for persons with autism include minor lev-els of physical exercise, few teachers include systematic physical exerciseof the amount and type of this study. In light of the results of this andother applied studies, the systematic programming of aerobic activities into



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the student's day may be an easy, cost-effective way to help improve thestudent's positive functioning in the classroom.

REFERENCES

Allison, D. B., Basile, V C, & MacDonald, R. B. (1991). Brief report: Comparative effectsof antecedent exercise and lorazepam on the aggressive behavior of an autistic man. Jour-nal of Autism and Developmental Disorders, 21, 89-94.Bachman, J. E., & Fugua, R. W (1983). Management of inappropriate behaviors of trainablementally impaired students using antecedent exercise. Journal of Applied Behavior Analysis,16, 477-484.Bachman, J. E., & Sluyter, D. (1988). Reducing inappropriate behaviors of developmentallydisabled adults using antecedent aerobic dance exercises. Research in Developmental Dis-abilities, 9, 73-83.Bass, C. K. (1985). Running can modify classroom behavior. Journal of Learning Disabilities,18, 160-161.Baumeister, A., & MacLean, W (1984). Deceleration of self-injurious and stereotypic respond-ing by exercise. Applied Research in Mental Retardation, 5, 385-393.Beasley, C. R. (1982). Effects of a jogging program on cardiovascular fitness and work per-formance of mentally retarded adults. American Journal of Mental Deficiency, 86, 609-613.Elliot, Jr., R. O., Dobbin, A. R., Rose, G. D., & Soper, H. V (1994). Vigorous, aerobic exerciseversus general motor training activities: Effects on maladaptive and stereotypic behaviorsof adults with both autism and mental retardation. Journal of Autism and DevelopmentalDisorders, 24, 565-576.Gabler-Halle, D., Halle, J. W., & Chung, Y. B. (1993). The effects of aerobic exercise onpsychological and behavioral variables of individuals with developmental disabilities: Acritical review. Research in Developmental Disabilities, 14, 359-386.Jansma, P, & Combs, C. S. (1987). The effects of fitness training and reinforcement onmaladaptive behaviors of institutionalized adults classified as mentally retarded/emotion-ally disturbed. Education and Training of the Mentally Retarded, 22, 268-279.Kern, L., Koegel, R. L., & Dunlap, G. (1984). The influence of vigorous versus mild exerciseon autistic stereotyped behaviors. Journal of Autism and Developmental Disorders, 14, 57-67.Kern, L., Koegel, R. L., Dyer, K., Blew, P A., & Fenton, L. R. (1982). The effects of physicalexercise on self-stimulation and appropriate responding in autistic children. Journal ofAutism and Developmental Disorders, 12, 399-419.Lovaas, L, Newsom, C., & Hickman, C. (1987). Self-stimulatory behavior and perceptual re-inforcement. Journal of Applied Behavior Analysis, 20, 45-68.McKimsey, J. F., & Favell,J. E. (1988). The effects of increased physical exercise on disruptivebehavior in retarded persons. Journal of Autism and Developmental Disorder, 18, 167-179.Morressey, P. A., Franzini, L. R., & Karen, R. L. (1992). The salutary effects of light calis-thenics and relaxation training on self-stimulation in the developmentally disabled. Be-havioral Residential Treatment, 7, 373-389.Powers, S., Thibadeau, S., & Rose, K. (1992). Antecedent exercise and its effects on self-stimulation. Behavioral Residential Treatment, 7, 15-22.Sugai, G., & White, W. J. (1986). Effects of using object self-stimulation as a reinforcer onthe prevocational work rates of an autistic child. Journal of Autism and DevelopmentalDisorders, 16, 459-471.Van Bourgondien, M., & Mesibov, G. (1989). Diagnosis and treatment of adolescents andadults with autism. In G. Dawson (Ed.), Autism: Nature, diagnosis, and treatment (pp.367-385). New York: Guilford.



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Watters, A. M., & Watters, W E. (1980). Decreasing self-stimulatory behavior with physicalexercise in a group of autistic boys. Journal of Autism and Developmental Disorders, 10,379-387.Whitaker, S., & Saleem, A. (1994). The effect of non-contingent exercise on purposeless wan-dering and self-injury in a man with a profound learning difficulty. Behavioral and Cog-nitive Psychotherapy, 22, 99-102.Yell, M. L. (1988). The effects of jogging on the rates of selected target behaviors of behav-iorally disordered students. Behavioral Disorders, 13, 273-279.



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efectos del ejercicio aerobico en autismo

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