This is a pilot randomized clinical trial to evaluate the feasibility and acceptability, and preliminary outcomes of delivering a Nintendo Switch exergaming (NE group) intervention in a group of autistic youth with autism spectrum disorder (ASD) between 5 and 30 years compared to an age-matched, no intervention control group of autistic youth (Control group) .
Parents of each ASD participant completed a screening form and the parent and participant completed an additional screening interview before participating in a pretest visit to confirm study eligibility. After the motor and cognitive pretests and parent questionnaires were completed and eligibility was confirmed, each participant was randomly assigned to the Nintendo exergaming (NE) intervention or no intervention control group. Each participant in the NE group received 8 weeks of exergaming intervention for 45-60 minutes per session @2 sessions per week. After the intervention period was completed motor and cognitive posttests and parent questionnaires were completed to assess preliminary outcomes. We also completed feasibility and acceptability measures using parent, trainer, and child surveys.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
Each exergaming intervention session included RingFit warm-up, RingFit Adventure Games to target multiple motor domains including body coordination, strength, and endurance and the Nintendo Switch Sports virtual sports targeted body coordination and visuomotor skills.
Health Sciences Campus, University of Delaware
Newark, Delaware, United States
Bruininks Oseretsky Test of Motor Performance
The BOT-2 is a standardized motor test that is a reliable and valid motor measure for youth between the ages of 4 to 21 years (Bruininks \& Bruininks, 2005). Participants' gross motor skills were assessed using the balance (BAL), bilateral coordination (BLC), strength (STN), and agility (AGIL) subtests of BOT-2. Subtests are combined to provide a body coordination (BC, includes BAL and BLC), strength/agility (SA, includes STR and AGIL) and manual coordination (MC, includes MD and ULC) composite standard score at pretest and posttest. Change in composite standard scores (BC, SA, and MC) were assessed between pretest and posttest performance.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.
Bilateral Motor Coordination Subtest of there Sensory Integration and Praxis Test (SIPT-BMC) Battery
The SIPT BMC subtest assesses a youth's ability to imitate 22 novel hand and feet rhythmic actions shown by the tester. During the test, the tester asks the child to repeat bilateral rhythmic sequences of the hands or feet. An error occurrs if the youth does correctly imitate the sequence or rhythm of the tester's movements. A spatial error was scored if the youth's scale or pattern of movement differed from that of the tester. A temporal error occurred if the youth paused during the motor sequence, or moved slow/fast compared to tester. Total spatial and temporal errors were calculated across all imitated actions at pretest and posttest.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.
Developmental Coordination Disorder Questionnaire (DCD-Q)
Parents completed the 15-item motor screening tool to report their child's fine- motor, gross-motor, and general coordination abilities compared to their peers. The total score at pretest and posttest were compared.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.
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Behavior Rating Inventory of Executive Function (BRIEF)
Parents completed the BRIEF to assess the youth's executive functioning skills during everyday tasks. The total score at pretest and posttest was compared.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.
Computerized Modified Flanker Task
All participants completed the Modified Flanker Task to assess the inhibitory control component of executive functioning. The task consisted of four experimental blocks, with incongruent and congruent conditions presented in random order within each block of 30 trials, with 15 incongruent and 15 congruent trials. a) Congruent: Five fish facing in the same direction, b) Incongruent: The outer four fish faced the same direction while the center fish faced the opposite direction. Participants were instructed to click the arrow button on the screen to indicate the direction of the center fish and to respond as quickly and accurately as possible. We compared the average reaction time at pretest and posttest.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.
Computerized Modified Stroop Word-Color Task
The Stroop Task assessed the task switching, flexibility, and response inhibition components of executive functioning. The task consisted of two conditions: Color and Word. Participants were instructed to press the button on the screen to match the color of the letters shown in the color condition, or to match the spelling of the word shown in the Word condition. Each block consisted of 40 trials. Average reaction times at pretest and posttest were compared.
Time frame: Pretest and posttests were conducted within 2 weeks before or after intervention, respectively.