Autism is a neurological and developmental condition marked by difficulties in communication and interacting with others, having restricted interests, and displaying repetitive speech and behaviours. People with Autism may also have medical conditions like gastrointestinal (GI) disorders or experience other issues like sensory sensitivity, anxiety, depression, and attention deficits.
Although it can be diagnosed at any age, the symptoms of Autism often appear before the age of three. According to the WHO, Autism or Autism Spectrum Disorder (ASD) affects about 1 in 100 children.
Autism is referred to as a spectrum disorder because of the wide range of symptoms that appear with differing intensities. These differences mean that every child with Autism experiences it in very different ways. Their unique abilities and difficulties can range from being highly skilled to severely challenged. Autism impacts all areas of life.
Behaviours and Its Impact
Children with ASD frequently experience anxiety and exhibit behaviours such as hyperactivity and sensory integration issues. They may engage in problem behaviours such as tantrums, stereotyping, verbal aggression, physical aggression, property destruction, and even self-harm. These behaviours are perceived as problematic because they limit the child’s capacity to perform daily tasks and may even lead to exclusion from typical social and educational settings, which makes it even more difficult for them to achieve community integration.
Stereotypic behaviours, commonly known as stimming, are present in 90% of people with ASD. They spent as much as 60% of their time engaging in such behaviours. Although they serve several purposes, such as self-regulation in the face of anxiety or stress and self-stimulation to seek sensory input or as a way of expression, they are known to be reliable precursors for self-injurious behaviours.
Stimming interferes with the child’s ability to learn and retain information and increases their response time to their surroundings and other people. It also interferes with socially-appropriate play behaviours and can sometimes be socially stigmatising.
Sleep Influences Behaviour
Children with ASD have lower melatonin levels; melatonin is an important hormone that aids in regulating circadian rhythms and sleep. The Sleep Health Foundation estimates that up to 80% of children with Autism may experience ongoing sleep problems.
Further research found that sleep disorders, such as taking a long time to sleep and having disturbed sleep, can predict stereotypical behaviours, communication difficulties, and the severity of autism symptoms. The sleep disorder that is the most significant indicator of communication difficulty, stereotypical behaviour, and autism severity is Sleep Onset Delay. It is considered a delay when a person takes more than 20 minutes to fall asleep.
Besides elevating stress in their parents, the lack of sleep impairs cognitive functioning and attention in children with ASD. As a result, they struggle more to control their behaviour, leading to more behavioural problems that interfere with their social interactions, academic abilities, independence, and sense of self-worth. Many findings which found the relationship between specific sleep issues and symptoms, highlight the significance of treating sleep issues as part of the intervention for autistic children.
Benefits of Exercise on Sleep and Behaviour
One intervention that has shown a positive impact on sleep is exercise. Physical activity is essential to maintaining overall health and well-being for the general population. Not only does it lower the risk of health diseases, but it increases the production of melatonin, enhances sleep quality, and releases endorphins, our natural feel-good neurotransmitters and pain relievers.
There are many studies conducted on how physical activities affect sleep and behaviour. The findings showed that physical exercise helped the children to fall asleep faster, improve sleep duration, and shorten periods of wakefulness during night waking.
Various exercise interventions, such as jogging, horseback riding, martial arts, ball tapping, dance, swimming, and bicycle training, led to improved behavioural outcomes, including stereotypical behaviour, social-emotional functioning, attention, and cognition. The most effective interventions are horseback riding and martial arts, showing the most reductions in stereotypical behaviours .
The studies observed that certain exercises reduced specific behaviours. For instance, martial arts reduced restrictive and repetitive behaviours, whereas those who practised ball-tapping exercises saw a reduction in hand-flapping.
In one of the studies where jogging was an exercise intervention, parents reported positive changes to children’s sleep and behaviour. The study found the following:
- Increased melatonin levels
- Improved sleep efficiency, shorter wakefulness during night waking
- Fewer problem behaviours
- Reduced repetitive behaviours
The children in the study were aged 8-12 years old. They jogged outdoors in the morning twice a week for 12 weeks. They spent 30 minutes each session, used five minutes for warm-up and five minutes for cool-down, and jogged the rest of the 20 minutes at moderate intensity.
The positive changes observed during the study were sustained for about six weeks after the end of the study when the children stopped exercising. Although it is not a long-term change, it provides insight into how exercise can be a simple yet effective intervention for children with ASD.
Parental involvement in exercise intervention is vital. A study investigates the connection between parental support for physical activity and physical activity in children with ASD. The findings revealed a positive relationship between parent support and child physical activity behaviour. Parents who carried out their intentions supported their children using behavioural regulation techniques like goal setting and planning. Children with ASD may benefit from increased physical activity through parents’ behavioural regulation strategies and support.
Exercise Improves Quality of Life
As science examines the cause of stereotypic behaviours in the brain of children with ASD, we learn that the basal ganglia and cerebellum, which influence movement, cognition, and emotions, significantly influence these behaviours. Exercise studies have demonstrated that physical activity can alter brain health mechanisms. Furthermore, regular exercise boosts dopamine production, altering our brain’s reward system.
Exercise also plays a part in the sleep patterns of children with ASD. Besides increasing melatonin levels to better regulate their sleep-wake cycle, it also helps them fall asleep faster, stay in bed longer and have shorter wakefulness during the night. These improve the overall sleep quality, which helps improve cognitive functioning and attention span, reducing the occurrence of stereotypic behaviours.
Stereotypic behaviours arise out of necessity for children with ASD; for self-regulation, to seek sensory input or to express themselves. As a means of coping with the neurotypical world, it is crucial for a child with ASD to express these emotional responses in ways that are suited for them. However, when these behaviours hinder their ability to learn and function, interventions like exercise can help. Not only can it help reduce the need for stereotypic behaviours, but it will also allow them to learn better and function. With parental behavioural regulation strategies and support, children with ASD can improve sleep disorders and behaviours through exercise, improving their quality of life.
Other articles about Understanding Children with ASD:
Bremer, E., Crozier, M., & Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20(8), 899–915.
Brown, D. M., Arbour-Nicitopoulos, K. P., Martin Ginis, K. A., Latimer-Cheung, A. E., & Bassett-Gunter, R. L. (2020). Examining the relationship between parent physical activity support behaviour and physical activity among children and youth with autism spectrum disorder. Autism, 24(7), 1783–1794.
Tarr, C. W., Rineer-Hershey, A., & Larwin, K. (2019, October 18). The Effects of Physical Exercise on Stereotypic Behaviours in Autism: Small-n Meta-Analyses. Focus on Autism and Other Developmental Disabilities, 35(1), 26–35.
Tse, A. C., Lee, P. H., Zhang, J., Chan, R. C., Ho, A. W., & Lai, E. W. (2022). Effects of exercise on sleep, melatonin level, and behavioural functioning in children with autism. Autism, 26(7), 1712–1722.
Tudor, M. E., Hoffman, C. D., & Sweeney, D. P. (2012). Children With Autism: Sleep Problems and Symptom Severity. Focus on Autism and Other Developmental Disabilities, 27(4), 254–262.
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