Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 META ANALYISIS – REFEREED ARTICLE JOURNAL IMPACT OF ‘SWIMMING’ ‘AQUATIC THERAPY’ AND ‘HYDROTHERAPY’ FOR ‘CHILDREN WITH ASD’. Bil 1. Scope 1.Aquatic program 2.Physical fitness 3.Children with and without ASD Author / Year Purpose Of Study Pan 2010, Taiwan The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders Method Instrument / Validity and reliability ASD: N = 16 Within-participant (ages 6–9, all repeated-measures male; 8 HFA, 8 design AS) All study procedures were reviewed and approved by the university human subjects review board. Study objectives and methods were individually explained to and written consent and assent obtained from parents and children, respectively. Height and weight were assessed using an Intervention Data Analysis Finding Discussion Swimming program: 10 weeks, 2 sessions/week, 90-min/session 1.Aquatic skills: HAAR checklist 2.Social behaviors:-SSBS 3.Children’s cardiovascular fitness : The Progressive Aerobic Cardiovascular Endurance Run (PACER) 4.Muscular strength/endur ance : the curlup 5. children’s flexibility : Sitand-reach test 6.Body composition of 1.Improved physical fitness and aquatic skills except subtest of body composition (BMI and percent body fat). Limitations: 1.To increase the clinical utility and confidence in conclusions regarding the use of aquatic program for improving motor skills and physical fitness components in children with different disabilities, future research is warranted to establish the applicability of the current findings to other age groups and other developmental disabilities. 2.Physical activity intervention settings should focus on improving health-related physical fitness, not just Sample 2.Decreased antisocial behavior problems the Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 automatic fitness measuring system (The Accuratus ACC810, Taiwan) for the calculation of body mass index (BMI; kg/m2 ) children bioelectrical impedance analysis : motor skills, in children with ASD. 3.It is important to gain a better understanding of the factors that influence children’s participation in order to encourage sustained physical activity involvement. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 2. 1.Water exercise swimming program (wesp) 2.Aquatic skills and social behaviors 3.children with autism spectrum disorders Pan 2010, Taiwan To determine the effectiveness of a 10 week water exercise swimming program (WESP) on the aquatic skills and social behaviors 16 boys with autism spectrum disorders (ASDs). A within-participant repeated-measures design was adopted. The WESP design was based on the Humphries Assessment of Aquatic Readiness (HAAR: Humphries, 2008) assessment instruction developed according to the foundations of the Halliwick Method (Martin, 1981) 10 week phase (phase I), eight children (group A) received the WESP while eight children (group B) did not. A second 10 week phase (phase II) immediately followed, with the treatments reversed. Aquatic skills The HAAR checklist 1.Improvements were seen in aquatic skills for both groups subsequent to the WESP. 2.Following phase I, significant social improvements were seen in group A. 2.Following phase II, social improvements were seen for group B, whereas group A merely maintained the improvements they attained through the implementation of the WESP during phase I. Results indicate that the WESP improved aquatic skills . Future research 1.To establish the applicability of the current findings to individuals of both genders and at different stages of the life cycle through replication studies. 2.Differences in cognitive abilities and gross motor skills were not evaluated and might have influenced findings. Further research is needed to understand the impact of it. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 3. 1.Aquatic intervention 2.Children with ASD, peer and sibling 3.Interaction behaviours Chu & Pan 2012, Taiwan The effect of peerand sibling-assisted aquatic program on interaction behaviours and aquatic skills of children with autism spectrum disor- ders and their peers/siblings 21 children with autism and 21 children who were typically developing from middle income families living in urban communities 16 weeks, 2 sessions per week, 60 min each Interaction behaviours (both physical and social) and aquatic skills based on HAAR checklist, including: mental adjustment, introduction to water environment, rotations, balance and control 1.Aquatic skills increased significantly in all children. 2.There were no statistically significant differences between groups Limitations 1.This study was limited in scope because the number of participants was relatively small. 2.The repeated measurement design of all groups participated in all three conditions over a 16-week period may confound the results as there are likely to be lasting effects that carry over from one condition to another condition. 3.The presence of the researcher in the pool during each class may have elicited reactivity by the participants. 4. Even though children with ASD were mild or high-functioning end of autism, differences in social skills, behaviors, cognitive abilities, and motor skills were not evaluated and might have influenced findings. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 Future studies : 1.Examine the effect of trained peers/siblings on other components of the lesson, such as the fitness component. 2.Eexamine the relationship between interaction behaviors and fitness levels or physical activity performance Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 4. 1.CTD Procedure 2.Children with ASD 3.Foudation al swimming skills Rogers et al 2010, USA Determine if 4s CTD (constant time delay)procedure is effective in teaching foudational swimming skills 21 children with ASD and 21 TD The CEPI-PE categorical variables have been validated in two pilot studies for its use with elementary school students in general PE setting (Klavina, 2007). The instrument evidences a high degree of inter- and intra-observer reliability. It also demonstrates face validity and concurrent validity 12 weeks Swimming prog, 2 session per week 45 - 60 min per session 1.The operational measurements in two main behavior categories (physical and social) are classified as interaction behaviors according to the Computerized Evaluation Protocol of Interactions in Physical Education (CEPIPE, 2.Aquatic skills The HAAR checklist was used to assess each participant’s aquatic skills. It is designed based on the Halliwick CTD procedure was effective in teaching faoudational swimming skills (a) PG and SG of children with ASD showed significantly more improvement on physical and social interactions with their TD peers/siblings during peer/siblingassisted condition as compared to CG (p < 0.01), (b) PG and SG of children with ASD showed significantly more improvement on physical interactions with their TD peers/siblings (p < 0.01) and social Limitation 1.Llimited in scope because the number of participants was relatively small, and therefore were not necessarily representatives of the larger population of elementary school children with ASD and their TD peers/siblings. 2.The repeated measurement design of all groups participated in all three conditions over a 16-week period may confound the results as there are likely to be lasting effects that carry over from one condition to another condition 3.The presence of the researcher in the pool during each class may have elicited reactivity by the participants. Finally, even though children Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 Method (Martin, 1981) which has been reported to be safe for people of all ages and with many types of disabilities (MacKinnon, 2003). The HAAR demonstrates face validity and a high degree of inter-rater reliability (above 0.90, Humphries, 2008). interactions with their teachers and other children with ASD (p < 0.01) with ASD were mild or high-functioning end of autism, differences in social skills, behaviors, cognitive abilities, and motor skills were not evaluated and might have influenced findings. Future studies 1.Examine the effect of trained peers/siblings on other components of the lesson, such as the fitness component. 2.Examine the relationship between interaction behaviors and fitness levels or physical activity performance. 3.Should consider assessing the costs and benefits of implementing peer- or siblingassisted techniques to increase interaction behaviors and aquatic skills as well as other outcome measures. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 4.Examine children with different types and levels of disabilities and across a wider variety of settings and age groups. 5.Examine systematically how the characteristics of the peers/siblings (e.g., age, gender) are related to intervention effectiveness of the program. 6.Use class wide peer tutoring so that all students in the class have the opportunity to interact with students with disabilities. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 5. 1.CTD Procedure 2.Children with ASD 3.Rotation skills Yilmaz, Konukman ,Birkan, Yanardag, Camursoy 2010, Turkey Effects of a CTD (constant time delay) procedure on the Halliwick’s method of swimming rotation skills for children with autism Three boys with ASD, aged 8–9 years Constant time delay teaching procedure Reliability data were collected during at least 35% of all experimental sessions. Interobserver reliability was calculated by using point by point method with a formula of the number of agreements divided by the number of agreements plus disagreements multiplied by 100 10 weeks, 3 times a week, 60 min per session A constant time delay procedure (2 types of trials: 0 s and 4 s time delay) 1.All participants successfully mastered the two target behaviours. 2.Maintenance trials were successful for the first, second and fourth week of generalisation phase Future research : 1. 1 to 1 teaching arrangement and single opportunity method to teach swimming rotation skills was used. 2.Recommended to teach different swimming skills to children with autism for future experimental research. 3.Children enjoyed these aquatic drills during sessions, and children improved their social and communication skills with peers compared to their out of pool behaviors. 4.children had less stereotypical motor behaviors (e.g., swinging their bodies backward and forward, playing fingers, moving head in a circular motion and, jumping) in the water during training sessions. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 6. 1.Exercise intervention 2.Children with ASD 3.Posture, cardiovascul ar fitness, BMI, hamstring flexibility, coordination , balance and agility in individuals with ASD. Natalia Neophytou 2016, Johannes burg To determine The Efficacy of a 12-week Exercise Intervention in 11-16 Year Old Adolescents with Autism Spectrum Disorder 27 andolescent with ASD 1.Posture was assessed using a posture grid, and scores out of 10 were given per body area. 2.Body composition, and physical fitness were assessed using the Brockport 3.Physical Fitness Test (BPFT), and balance and coordination were assessed using the MABC-2 test and checklist. 4.Gait was assessed using Dartfish twodimensional video analysis, and agility was assessed using a standard agility Ttest. 5.Fisher’s exact test was used for categorical variables. 12 weeks Swimming prog, 2 session per week 60 min per session 1.The Wilcoxon signed-rank test -To compare variables during pre-and postinterventio n within groups for continuous variables, 2. Mc vi Nemar’s test for symmetry -To compare variables during pre and post intervention within groups, for categorical variables was used. 3.Data analysis was performed using Stata version 13.1. Significant increase in posture,cardiovas cuar, ftness, strength,flexibity, coordination and agibility Limitation 1. During the pre- and post-intervention testing, participants were asked to take off their shoes and socks as well as any bulky clothing, and some of the participants refused to do this whilst others were unable to do so without assistance, this often led to a delay in testing Future study : purpose of standardisation, these individuals were tested preand postintervention in the same manner Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 7. 1.Aquatic exercise 2.Children with ASD 3.Fitness and swimming skills FragalaPinkham et.al. 2011, USA Examine effectiveness of a group aquatic exercise program on fitness and swimming skills ASD: N = 12 (ages 6–12, 11 male; 6AS, 6 PDD-NOS, 1 HFASD Randomized control trial; pre- and posttesting Swimming: 2x/week for 14 weeks, 40- min sessions 1.Swimming skills: Swimming Classification Scale, YMCA Water Skills Checklist 2.Muscle endurance: curlup and isometric push-ups 3.Mobility skills: Multidimention al Pediatric Evaluation of Disability Inventory Mobility Scale 1.Significant improvement in swimming skills 2.No statistically significant results for muscular endurance†, cardiorespiratory endurance†, or † mobility limitation 1. Physical Activity Questionnaire that used was not validated. Future study : 1.Develop guidelines on how to progress children from a specialized program to an inclusive program. 2.Develop an aquatic exercise program manual with program development guidelines and aquatic activities. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 8. 1.Aquatic Katrhryn N. Oriel program 2014, USA 2.Children with ASD 3.Sleep To determine if participation in an aquatic program improves sleep in children with ASD 8 Children with ASD An A-B-A withdrawal design 4 week, 2X / week 60 min aquatic exercise One repeated measure analysis variance (ANOVA) way of 1.Significant different existed for sleep lantency (p<.001) and sleep duration (p<.001) 1.Suggested that participation in aquatic exercise may improve the sleep habits of children with ASD Limitations 1.included extraneous variables such as bedroom setup, season, and participants’ activity level 2.Number of participants Future studies : 1.should consider usage of an actigraphy wristband to monitor sleep and movement throughout the night Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 9. 1.Systematic aquatic therapy 2.Children with ASD 3.Gross motor and social skills Giuseppe Battaglia , Gianna Agrò , Pietro Cataldo , Antonio Palma and Marianna Alesi 2019, Italy To investigate the afficacy of a specific multi-systematic aquatic therapy on gross motor and social skills 3 adolescents with ASD CI-MAT program and Post-Test. Approved by institution’s research council (Consiglio di Dipartimento di Scienze Psicologiche, Pedagogiche e della Formazione Prot. 12 week program Battery of tests incorporating anthropometric measurement, gross motor development test 1.Subject improved social skills and object control skills following the program in different way 1.The results of this study showed that the CI-MAT program was effective for the development of gross-motor skills and social behaviors in subjects with ASD. 2.There is an urge to carry out a whole psychological assessment targeting both motor and adaptive development suitable to provide educational and vocational plans of exercises for people with ASD. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 10. 1.Hydrotherapy 2.Children with ASD 3.Mental health and well being Whitney Mills, Nicholas Kondakis , Robin Orr , Michael Warburto n and Nikki Milne , 2020 Australia Determine whether hydrotherapy influences behaviours which impact mental health and well being in children with ASD 8 children aged 6-12 years old diagnosed with ASD allocated to group 1 and group 2 The child behaviour Checklist (CBCL)measured behaviour Anxious/Depressed subdomain (p = 0.02) and the Internalising Problems Domain Summary (p = 0.026), with large effect size (d = 1.03 and d = 1.06 respectively). Thought Problems (p = 0.03) and Attention Problems (p = 0.01) both significantly improved postintervention. 8 week Observe different between group 1 and group 2 (Paired samples test) The Total Problems score significantly improved postintervention (p = 0.018) with a large effect size (d = 1.04). 4.Hydrotherapy may enhance behaviours impacting mental health and well being of children with ASD Limitations 1.Included extraneous variables such as bedroom setup, season, and participants’ activity level. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 11 Multisystem aquatic Children with ASD Behavioural, social and swimming skills Giovanni Caputo · Giovanni Ippolito · Marina M azzotta · Luigi Sente nza · Mara Rosa ria Muzio Sara Salza· Massimilia no Conson 2018, Italy Effectiveness of a multisystem aquatic therapy on behavioural, social and swimming skills sample size was 26 (17 males and nine females): 13 participants in the CI-MAT group (two females) and 13 participants in the control group (seven females). 1.Standardized tests assessing behavioural, 2.Socialcommunicative and emotional abilities, 3.Autism symptomatology, 4.Functional adaptation and 5.Swimming skills. 10 month program 1.Vineland adaptive behavior scales, 2.Childhood Autism Rating Scale The aquatic therapy group show significant improvements relative to control on functional adaptation Limitation : The study does not allow solving the issue of whether aquatic therapy is fully effective in treating social impairments in autism it suggests that the CIMAT programme is a viable approach for enhancing relevant skills in children with ASD. Future study: 1.Further investigation is needed to verify effectiveness of CI-MAT with respect to other aquatic training programmes, 2.To evaluate whether CI-MAT can represent a stand-alone intervention. 3.Suggest that the CIMAT, as a multisystem treatment embedded in social contexts, could be included. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 12 1.Benefit of swimming 2.Children with ASD James G. Hall, 2013 Canada identify learn-toswim program strategies and techniques that will benefit children with ASD. 6 subject with ASD a qualitative study was conducted to explore strategies and techniques that may prove beneficial to children with ASD Multiple method to gain an in-depth perspective on the implementation of strategies an techniques NO INTERVENTION Thematic analysis from interviews the parent with observational data collected 1.There are key strategies and techniques that can be implemented to swimming lesson program 2.This study was based on previous literature, grounded in readily available teaching tools, and was easily implemented. Indications from the parents, instructors and the observer believed the strategies and techniques were beneficial for the children. Limitation 1.The sample size of six (6) participants, which could be construed as small. 2.Lack of female participants. Future study: 1.Even though ASD is more prominent in males, having female participants would have allowed for a broader analysis for this research. 2.Having a more expansive age range could have resulted in varying results to the data. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 13 1.Video prompting 2.Children with ASD 3.Aquatic play therapy 4.Motor performance Yanardag 2013 Turkey Examine effectiveness of video prompting on teaching aquatic play skills and the effect on motor performance 3 chidren with ASD 1.A multiple probe design across behaviours was used and replicated across subjects for the instructional part of this study. 2.Pretest–posttest design was applied for the exercise training part of this study 12 weeks Swimming prog, 3 session per week 60 min per session Aquatic play skill observation, Motor skill : MABC-2 1.Increase in correct target skills and maintenance observe 2.Aquatic training improved motor performance skills Limitation 1.The number of participants. Three children with autism were included in the study. 2.The aquatic play skills. Additional research should investigate the effects of video prompting on more complex chained aquatic skills such as the basic phases of swimming administered by parents, physical education teachers and preservice educators. Future study : 1.Other forms of videobased instruction should be conducted to teach simple play skills on land such as bowling, boccia, darts, frisbee and compared in terms of effectiveness and efficiency using handheld devices. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 14 1.Aquatic 2.Children with ASD 3.Water safety and social skills Michele L. Alaniz, Sheila S. R osenberg, Nicole R. B eard, Emily R. R osario 2017, USA Examine the feasibility and effectiveness of an aquatic therapy program on water safety and social skills in children with mild to severe ASD 7 children with ASD Swim skills were assessed using the Aquatic Skills Checklist (ASC), a tool developed by the researchers (Table 3) and based on the American Red Cross Water Safety Instructor Manual (2009). Testing was videotaped and the ASC was completed by video review. Video review was completed by an occupational therapist and a research assistant, independent of one another 8, 16, or 24 h of group intervention provided in 1-h increments, once a week 1.The aquatic skills data was analyzed using a repeated measure ANOVA 2.Wilcoxon signed rank to compare differences between pre and post intervention variables. 3.The GAS data was assessed using the Wilcoxon signed rank for the difference pre and post the intervention. 4.JMP was used for all data analysis (JMP Statistical Discovery from SAS, Cary, NC). 1.Provide preliminary evidence that children with ASD can improve water safety skills (p=0.0002), 2.Social skills did not respond to intervention (p=0.6409) Limitations 1.Small sample size 2.Lack of socioeconomic data on participants makes generalization of these findings limited. 3.The lack of control group or a treatment as usual group. Future study : 1.Should conduct follow up after cessation of intervention to determine skill maintenance. Nama Pelajar : Zakiah Binti Md Yusof / No Matrik : M20201000642 / Kursus GRU 60104 Kaedah Penyelidikan Dalam Pendidikan (Tugasan 1)/ Semester : M201 / Tarikh : 30 Disember 2020 15 1.Hydrotherapy 2.Children with ASD 3.Social interaction and behaviors treatment Rachel Mortimer Melinda Privopoulo s Saravana Kumar, 2014 Australia To examine the effectiveness of hydrotherapy on social interactions and behaviors in the treatment of children with ASDs 3-18 years with ASD high functioning level A systematic search of Cochrane. McMaster Critical Review Form for Quantitative Studies, was performed to assess methodological quality Systematic Review NO INTERVENTION The data was extracted by the two reviewers and collated into excel spread sheets, including information related to: study design; participants’ information (age, sex, and diagnosis); intervention components; intervention duration; dose and frequency of the intervention; experimental design and method randomization; outcome measures; statistical analyses; and the results of preand postanalysis Showed some improvements in social interactions or behaviors following a Halliwick-based hydrotherapy intervention. Few studies have investigated the effect of hydrotherapy on the social interactions and behaviors of children with ASDs. While there is an increasing body of evidence for hydrotherapy for children with ASDs, this is constrained by small sample size, lack of comparator, crude sampling methods, and the lack of standardized outcome measures. Hydrotherapy shows potential as a treatment method for social interactions and behaviors in children with ASDs.