Proposal: A combined intervention for a young adult with low-functioning autism
spectrum disorder who is extremely obese
Emma Gibbons
St. Francis Xavier University
Dr. Amanda Casey
January 24th, 2014
Proposal: A combined intervention for ASD and Obesity
Gibbons
A variety of studies have been conducted on the effects of regular physical
activity for individuals with Autism Spectrum Disorder (ASD), which has produced some
promising results as well as presented some recurrent barriers when implementing
programs. Rimmer found that there is a higher prevalence of obesity and obesity-related
secondary conditions among youths with Intellectual Disability, which makes it a
relevant topic for further research (2009). In reviewing the literature it became evident
that although sample sizes were generally small, motor performance and social skills
children and adults with ASD benefit most from individual exercise interventions (Sowa
& Meaulenbroek, 2011).
Various studies have examined the effects of various types of exercise and it
appears that vigorous exercise has a more pronounced effect than milder less strenuous
exercise. The target range for heart rate’s outlined for children with Down Syndrome is
60-80% (Medlen, 2006). This is a useful guide for children with Autism to determine the
intensity of exercise that will illicit maximal improvements in cardiovascular endurance.
Methods of tracking these changes remain difficult and minimal studies succeeded in
reducing levels of body fat according to preliminary results (Casey & Rasmussen, 2013).
Past studies on people without disabilities have found walking to have the greatest
influence in combating obesity, followed by swimming, biking, and low-intensity
aerobics (Casey & Rasmussen, 2013). This is of significance as it guides the decision to
implement an aquatic program to combat obesity for individuals with intellectual
disabilities.
A study conducted by Pan suggests that a 10 week water exercise swimming
Proposal: A combined intervention for ASD and Obesity
Gibbons
program (WESP) holds great promise for individuals with Autism. Results from this
study indicate that the environment provided by WESP enables individuals to develop
physical skills as well as enhancing their behavioral and social skills (Pan, 2010).
In addition to physical activity, research involving the nutrition of individual’s
with Autism was examined. Nutrition professionals consider individuals with intellectual
or developmental disabilities to be nutritionally vulnerable or at risk for malnutrition. We
are primarily concerned with over nourishment, which may include a pattern of
consumption that leads to becoming overweight or developing some cancers or chronic
conditions such as cardiovascular disease and diabetes (Humphries, 2009).
The primary challenge in the assessment of studies pertaining to individuals with
ASD is the heterogenic nature of the participants. Within these studies, some of the
individuals had severe autism and others were described as high functioning persons. It
is difficult generalize findings to the ASD population; therefore the results should be
interpreted relative to the severity of impairment.
We are proposing a combined intervention for an individual with ASD who is
also obese, addressing both his physical activity levels, as well as his nutritional
behaviors. This is significant for the local community where resources and programming
are limited for individuals with such comorbidities. The individual that we are going to
be working with requires one-on-one assistance, which is challenging in a rural
community. In order for this particular individual to succeed both his autism and obesity
need to be addressed on an individual basis.
Proposal: A combined intervention for ASD and Obesity
Gibbons
This project will develop the question of how to measure the change in
physiological health of this individual with regular aquatic exercise. We also aim to
address the question on how to instill patterns of healthy eating for an individual who is
at risk for diabetes and other obesity related diseases. We hypothesize that the greatest
potential for success will be a combined intervention involving exercise and nutrition.
We are providing this service to one individual (n=1. The exercise component of
the program will involve 2 1-hour pool sessions a week for 10 weeks. The available
facility is the St FX aquatics center. In the pool, the participant will engage in resistance
training exercises as well as activities to improve their aerobic capacities. The nutritional
component of the program will involve individualized teachings in a classroom setting
emphasizing the importance of maintaining a well balanced diet. These will be done in
the classroom of the individual at JH Gillis High School.
The success of this project is heavily dependent on the support of the participant’s
teachers and teacher assistants. It is these people who are responsible for ensuring that the
participant is transported from the High School to the pool. Without their cooperation, he
will not have the opportunity to undergo improvements. For his health to be maintained
long term, the most important support team is his parents. Once he graduates it is
imperative that his parents are willing to continue implementing a weekly exercise
regime as well as providing him with appropriate foods to eat.
Proposal: A combined intervention for ASD and Obesity
Gibbons
This project has many potential barriers. The first are the practical aspects of
ensuring the participant is present to attend all the sessions. The second is the health of
the participant. If he is not well physically, he will be unable to fully perform the tasks in
the water for improvements to be made. His mental health is also of concern, as it could
impede his improvement in the classroom or in the pool. Another barrier is ensuring his
safety in the water while being able to challenge him aerobically. Finally, with the
severity of ASD, it is difficult to assess his potential for success or track his
improvements, as he is non-verbal.
Although many potential barriers exist, this combined intervention holds great promise
for this low functioning individual with ASD who is also obese.
Proposal: A combined intervention for ASD and Obesity
Gibbons
References
Casey, A. F., & Rasmussen, R. (2013). Reduction measures and percent body fat in
individuals with intellectual disabilities: A scoping review. Disability and Health
Journal, 6(1), 2-7. doi:http://dx.doi.org/10.1016/j.dhjo.2012.09.002
Medlen, J. E. G.,. (2006). The down syndrome nutrition handbook : A guide to promoting
healthy lifestyles. Portland, OR.: Phronesis Publishing, LLC.
Obesity and obesity‐ related secondary conditions in adolescents with
intellectual/developmental disabilities. Journal of Intellectual Disability Research,
54(9), 787-794.
Pan, C. (2010). Effects of water exercise swimming program on aquatic skills and social
behaviors in children with autism spectrum disorders. Autism, 14(1), 9-28.
doi:10.1177/1362361309339496
Rimmer, J. A., Wang, E., Yamaki, K., & Davis, B. (2009). Documenting disparities in
obesity and disability. FOCUS Technical Brief (24). Austin, TX: SEDL.
Sowa, M., & Meulenbroek, R. (2012). Effects of physical exercise on autism spectrum
disorders: A meta-analysis. Research in Autism Spectrum Disorders, 6(1), 46-57.
doi:http://dx.doi.org/10.1016/j.rasd.2011.09.001