Focus on Secondary Condition Prevention: Walking Program to Reduce Secondary Conditions in Adolescents with Autism
|Jennifer Rowland, Ph.D.|
In recognition of National Autism Awareness Month, this column explores the benefits of exercise in preventing secondary conditions such as obesity in adolescents with autism. Youth with autism often lead sedentary lifestyles (Pitetti, Yarmer, & Fernhall, 2001) and are at risk for low fitness levels and potential health problems later in life. There is evidence that exercise can improve fitness in people with mild to moderate intellectual disabilities (Frey et al., 1999; Rimmer et al., 2004). Therefore, it is important to explore a variety of exercise programs and their effectiveness in improving fitness and health for these youth.
Many physical activity and recreation options exist for youth with autism (see NCHPAD fact sheet: Autism and Considerations in Recreation and Physical Activity Settings at http://www.ncpad.org/315/1452/Autism~and~Considerations~in~Recreation~and~Physical~Activity
~Settings) that include walking, jogging, biking, and swimming. Recent research by Pitetti, Rendoff, Grover, and Beets (2007) examined the efficacy of a treadmill walking program on exercise capacity and weight reduction for adolescents with severe autism. In this study, 10 adolescents with autism ages 14-19 years (6 male, 4 female) who were living in a Midwestern residential/school treatment facility for people with severe developmental disabilities participated in a treadmill walking program. Before starting the program, participants were taught to walk without holding onto the treadmill railing 1-3 times per week for 5-10 minutes during a regularly scheduled class time. The initial treadmill walking program began with a duration of 8 minutes and a frequency of 2 times per week and eventually progressed to 20 minute sessions 5 times per week. The treadmill speed was set at 2.4-3.5 mph, increasing to 3.7-4.1 mph, and the initial incline was 0%, progressively increasing by increments of 0.5%. At the end of 9 months, participants in the treadmill walking program demonstrated a significant decrease in body mass index (BMI) as compared to a control group who participated in 30 minutes of leisure activity 3 times per week involving activities such as basketball, roller skating, and bicycling. The gradual decrease in BMI was in conjunction with a gradual increase in caloric expenditure over the same amount of time for the treadmill walking group. Results of this study indicated treadmill walking was an effective exercise option in promoting weight loss for this population. Although this study did not test the recommended physical activity recommendations of 30 minutes of moderate intensity physical activity for 5-7 days per week (U.S. Department of Health and Human Services, 1996), walking at a rate of 3-4 mph is considered to be a moderate intensity activity that may reduce the risks for type 2 diabetes, heart disease, and stroke.
According to the Autism Society of America (www.autism-society.org), one in 150 American children and 1 in 94 boys is diagnosed with autism. Despite this high prevalence, not much has been written in the peer-reviewed literature defining secondary conditions for people with autism. Exploring ways of reducing or preventing secondary conditions through exercise and other health promotion efforts is an important part of improving quality of life and should be a key component of individual and family health education programming.
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- Autism Society of America (2008). http://www.autism-society.org
Centers for Disease Control (2007). http://www.cdc.gov
- Chanias, A. K., Reid, G., & Hoover, M. L. (1998). Exercise effects on health-related physical fitness of individuals with an intellectual disability: A meta-analysis. Adapted Physical Activity Quarterly, 15, 119-140.
- Frey, B. C., McCubbin, J. A., Hannington-Down, S., Kasser, S. L., & Skaggs, S. O. (1999). Physical fitness of trained runners with and without mental retardation. Adapted Physical Activity Quarterly, 16, 126-137.
- National Institutes of Health (NIH) and National Heart, Lung, and Blood Institute (NHLBI). (1998). Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Evidence report. Bethesda, MD: NIHNHLBI (online). Available: www.nhlbi.nih.gov.
- Pitetti, K. H., Rendoff, A. D., Grover, T., & Beets, M. W. (2007). The efficacy of a 9-month treadmill walking program on the exercise capacity and weight reduction for adolescents with severe autism. J Autism Dev Discord, 37, 997-1006.
- Rimmer, J. H., Heller, T., Wang, E., & Valerio, I. (2004). Improvement in physical fitness in adults with Down syndrome. American Journal on Mental Retardation, 109, 165-174.