There is a consensus that individuals with Autism Spectrum Disorder (ASD) fall short of the recommended 60-minute daily moderate-to-vigorous physical activity (MVPA), and some experience motor delays and abnormalities. Yet ASD interventions focusing on addressing these challenges are insufficient in the existing literature. Research evidence supports the effectiveness of neurotypical (NT) sibling involvement in ASD intervention, therefore, using NT siblings as intervention agents to promote PA and motor skills in their sister/brother with ASD may be a viable option. The three studies within this dissertation were conducted during the COVID-19 pandemic when free and unstructured physical activity (PA) was suggested to be achieved by playing with siblings. This dissertation's first investigation was a qualitative study investigating the perceptions of NT siblings and caregivers on prospective sibling-guided motor intervention in children with ASD. The principal investigator also gathered information that ball games, in-person format, once or twice per week frequency, weekend days, and 30-minute session duration were most preferred. Prior to designing and implementing the PA intervention, a cross-sectional study was conducted with 18 parent-ASD-NT triads (54 participants) to understand PA, parental perceived motor competence, and PA-related family dynamics in children with ASD during COVID-19. The findings from the PA questionnaire revealed that children with ASD spent a significantly greater amount of time in sedentary behaviors (mean = 2379.06 mins; SD = 1480.10) during an entire week than in leisure time activities (mean = 316.88 mins; SD = 301.48) and sports activities (mean = 183.00 mins; SD = 153.94). Also, parents perceived their children's competence on most skills listed in the parental proxy of the Pictorial Scale of Perceived Movement Skill Competence (PMSC-parent) as not too good or sort of good. In addition, it was indicated that NT siblings' self-efficacy in supporting children with ASD was lower than that of parents. By incorporating the findings from the first two studies, the third study within this dissertation provided an online family-implemented PA intervention for children with ASD to promote the variables that were measured in the cross-sectional study. The intervention used a randomized control trial with three intervention conditions: (a) Group A: PA intervention carried out by both a parent and a NT sibling, (b) Group B: PA intervention delivered by a parent only, and (c) Group C: control condition with only sedentary activities provided, rather than PA intervention. Among families who completed more than 60% of the intervention, significant differences were found in scores of object control skills [F (1,6) = 17.163, p = 0.006, Îʺp2 = 0.741], fundamental motor skills [F (1,6) = 7.385, p = 0.035, Îʺp2 = 0.552], and PMSC-parent total scores [F (1,6) = 6.914, p = 0.039, Îʺp2 = 0.535] over time across the three groups [F (2,6) = 6.838, p = 0.028, Îʺp2= 0.695], [F (2,6) = 13.507, p = 0.006, Îʺp2 = 0.818], and [F (2,6) = 6.844, p = 0.028, Îʺp2 = 0.695], with Group A showed more significant improvements. In addition, a significant within-group difference was found in parent-ASD interaction across time [F (1,6) = 6.964, p = 0.039, Îʺp2 = 0.537]. Lastly, a process evaluation was conducted to examine the reach, dose, fidelity, and participant enjoyment. Results from this dissertation inform the design of future sibling-guided motor and PA interventions for children with ASD and encourage researchers to provide quality and enjoyable motor, PA intervention, and play-based services in an online format at the family level.
Read
