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      Physical activity, sedentary behavior and their correlates in children with Autism Spectrum Disorder: A systematic review

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          Abstract

          Autism Spectrum Disorder affects up to 2.5% of children and is associated with harmful health outcomes (e.g. obesity). Low levels of physical activity and high levels of sedentary behaviors may contribute to harmful health outcomes. To systematically review the prevalence and correlates of physical activity and sedentary behaviors in children with Autism Spectrum Disorder, electronic databases (PsycINFO, SPORTDiscus, EMBASE, Medline) were searched from inception to November 2015. The review was registered with PROSPERO (CRD42014013849). Peer-reviewed, English language studies were included. Two reviewers screened potentially relevant articles. Outcomes of interest were physical activity and sedentary behaviour levels and their potential correlates. Data were collected and analysed in 2015. Of 35 included studies, 15 reported physical activity prevalence, 10 reported physical activity correlates, 18 reported sedentary behavior prevalence, and 10 reported sedentary behavior correlates. Estimates of children’s physical activity (34–166 mins/day, average 86 mins/day) and sedentary behavior (126–558 mins/day in screen time, average 271 mins/day; 428–750 mins/day in total sedentary behavior, average 479 mins/day) varied across studies. Age was consistently inversely associated, and sex inconsistently associated with physical activity. Age and sex were inconsistently associated with sedentary behavior. Sample sizes were small. All but one of the studies were classified as having high risk of bias. Few correlates have been reported in sufficient studies to provide overall estimates of associations. Potential correlates in the physical environment remain largely unexamined. This review highlights varying levels of physical activity and sedentary behavior in children with Autism Spectrum Disorder. Research is needed to consistently identify the correlates of these behaviors. There is a critical need for interventions to support healthy levels of these behaviors.

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          Most cited references64

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          Motor coordination in autism spectrum disorders: a synthesis and meta-analysis.

          Are motor coordination deficits an underlying cardinal feature of Autism Spectrum Disorders (ASD)? Database searches identified 83 ASD studies focused on motor coordination, arm movements, gait, or postural stability deficits. Data extraction involved between-group comparisons for ASD and typically developing controls (N = 51). Rigorous meta-analysis techniques including random effects models, forest and funnel plots, I (2), publication bias, fail-safe analysis, and moderator variable analyses determined a significant standardized mean difference effect equal to 1.20 (SE = 0.144; p <0.0001; Z = 10.49). This large effect indicated substantial motor coordination deficits in the ASD groups across a wide range of behaviors. The current overall findings portray motor coordination deficits as pervasive across diagnoses, thus, a cardinal feature of ASD.
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            Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0-5 years.

            This paper reviews the evidence behind the methodological decisions accelerometer users make when assessing habitual physical activity in children aged 0-5 years. The purpose of the review is to outline an evidence-guided protocol for using accelerometry in young children and to identify gaps in the evidence base where further investigation is required. Studies evaluating accelerometry methodologies in young children were reviewed in two age groups (0-2 years and 3-5 years) to examine: (i) which accelerometer should be used, (ii) where the accelerometer should be placed, (iii) which epoch should be used, (iv) how many days of monitoring are required, (v) how many minutes of monitoring per day are required, (vi) how data should be reduced, (vii) which cut-point definitions for identifying activity intensity should be used, and (viii) which physical activity outcomes should be reported and how. Critique of the available evidence provided a basis for the development of a recommended users protocol in 3-5-year olds, although several issues require further research. Because of the absence of methodological studies in children under 3 years, a protocol for the use of accelerometers in this age range could not be specified. Formative studies examining the utility, feasibility and validity of accelerometer-based physical activity assessments are required in children under 3 years of age. Recommendations for further research are outlined, based on the above findings, which, if undertaken, will enhance the accuracy of accelerometer-based assessments of habitual physical activity in young children.
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              • Article: not found

              Physical activity and physical self-concept in youth: systematic review and meta-analysis.

              Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                28 February 2017
                2017
                : 12
                : 2
                : e0172482
                Affiliations
                [1 ]Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
                [2 ]Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
                [3 ]Deakin University, Deakin Child Study Centre, School of Psychology, Burwood, Victoria, Australia
                [4 ]Deakin University, School of Health and Social Development, Burwood, Victoria, Australia
                [5 ]University of Melbourne, Department of Paediatrics, Parkville, Victoria, Australia
                [6 ]Murdoch Childrens Research Institute, Parkville, Victoria, Australia
                [7 ]Deakin University, Centre of Social and Early Emotional Development, School of Psychology, Burwood, Victoria, Australia
                Vanderbilt University, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: NJR LMB TM JM NVP HS AT TH.

                • Data curation: RAJ KD TM TH.

                • Formal analysis: RAJ KD TH.

                • Funding acquisition: NJR LMB TM JM NVP HS AT TH.

                • Investigation: RAJ KD.

                • Methodology: RAJ NJR TH.

                • Project administration: TH.

                • Resources: RAJ KD TH.

                • Supervision: NJR TH.

                • Validation: RAJ TH.

                • Visualization: RAJ KD TM TH.

                • Writing – original draft: RAJ KD TM TH.

                • Writing – review & editing: RAJ KD NJR LMB TM JM NVP HS AT TH.

                ‡ These authors also contributed equally to this work.

                Author information
                http://orcid.org/0000-0003-2742-8579
                Article
                PONE-D-16-31002
                10.1371/journal.pone.0172482
                5330469
                28245224
                2ee9c532-cdfe-477b-aee5-bc75e23660e7
                © 2017 Jones et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 August 2016
                : 6 February 2017
                Page count
                Figures: 1, Tables: 5, Pages: 23
                Funding
                Funded by: National Health and Medical Research Council (AU)
                Award ID: GNT1092876
                Award Recipient :
                Funded by: Deakin University (AU)
                Award ID: Alfred Deakin Postdoctoral research Fellowship
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100001030, National Heart Foundation of Australia;
                Award ID: 100046
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: APP1070571
                Award Recipient :
                Funded by: Deakin University (AU)
                Award ID: Faculty of Health
                Funded by: Deakin University Faculty of Health Postdoctoral Research Fellowship
                Award Recipient :
                KD is funded by a National Health and Medical Research Council Postgraduate Scholarship (GNT1092876); LMB is funded by an Alfred Deakin Postdoctoral Research Fellowship; AT is funded by a National Heart Foundation of Australia Future Leader Fellowship (Award ID 100046); TH is funded by an NHMRC ECF (APP1070571). The study was funded by Deakin University’s Faculty of Health. NVP is funded by a Deakin University Faculty of Health Postdoctoral Research Fellowship. None of the funding bodies had any role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Social Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Behavior
                Biology and Life Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Autism
                Social Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Autism
                Biology and Life Sciences
                Neuroscience
                Developmental Neuroscience
                Neurodevelopmental Disorders
                Autism
                Medicine and Health Sciences
                Neurology
                Neurodevelopmental Disorders
                Autism
                Biology and Life Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Asperger Syndrome
                Social Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Asperger Syndrome
                Research and Analysis Methods
                Database and Informatics Methods
                Database Searching
                Medicine and Health Sciences
                Diagnostic Medicine
                Custom metadata
                All data are available from published studies which are publicly available. Details of each study from which data were drawn for this review are included within the paper and supporting information files.

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