Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Abstract

<p id="d3438758e283"> <div class="list"> <a class="named-anchor" id="celist0001"> <!-- named anchor --> </a> <ul class="so-custom-list" style="list-style-type: none"> <li id="celistitem0001"> <div class="so-custom-list-label so-ol">•</div> <div class="so-custom-list-content so-ol"> <p id="para0003">A focus on lifestyle interventions for improving quality of life among children and adolescents with autism spectrum disorder may be particularly warranted as children with autism spectrum disorder are known to engage in poorer health behaviors, including low levels of physical activity, high levels of sedentary behaviors, and inadequate sleep patterns. </p> </div> </li> <li id="celistitem0002"> <div class="so-custom-list-label so-ol">•</div> <div class="so-custom-list-content so-ol"> <p id="para0004">Overall, 452 participants (45.34%) met 1 of the 3 recommendations, 216 (22.65%) met 2 recommendations, whereas only 39 participants (5.04%) met all 3 recommendations. </p> </div> </li> <li id="celistitem0003"> <div class="so-custom-list-label so-ol">•</div> <div class="so-custom-list-content so-ol"> <p id="para0005">Importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the quality of life (greater learning interest/curiosity and adaptive ability, whereas lower odds of repeating grades, being bullied, and presenting behavioral problems) of children and adolescents with autism spectrum disorder. </p> </div> </li> </ul> </div> </p><div class="section"> <a class="named-anchor" id="d3438758e301"> <!-- named anchor --> </a> <h5 class="section-title" id="d3438758e302">Background</h5> <p id="d3438758e304">The Canadian 24-hour movement behavior (24-HMB) guidelines suggest that a limited amount of screen time use, an adequate level of physical activity (PA), and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life (QoL) of children and adolescents. However, this topic has yet to be examined for children and adolescents with autism spectrum disorder (ASD) specifically. The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoL-related indicators among a national sample of American children and adolescents with ASD. </p> </div><div class="section"> <a class="named-anchor" id="d3438758e306"> <!-- named anchor --> </a> <h5 class="section-title" id="d3438758e307">Methods</h5> <p id="d3438758e309">Data were taken from the 2020 U.S. National Survey of Children's Health dataset. Participants ( <i>n</i> = 956) aged 6–17 years and currently diagnosed with ASD were included. The exposure of interest was adherence to the 24-HMB guidelines. Outcomes were QoL indicators, including learning interest/curiosity, repeating grades, adaptive ability, victimization by bullying, and behavioral problems. Categorical variables were described with unweighted sample counts and weighted percentages. Age, sex, race, preterm birth status, medication, behavioral treatment, household poverty level, and the educational level of the primary caregivers were included as covariates. Odds ratio (OR) and 95% confidence interval (95%CI) were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators. </p> </div><div class="section"> <a class="named-anchor" id="d3438758e314"> <!-- named anchor --> </a> <h5 class="section-title" id="d3438758e315">Results</h5> <p id="d3438758e317">Overall, 452 participants (45.34%) met 1 of the 3 recommendations, 216 (22.65%) met 2 recommendations, whereas only 39 participants (5.04%) met all 3 recommendations. Compared with meeting none of the recommendations, meeting both sleep duration and PA recommendations (OR = 3.92, 95%CI: 1.63–9.48, <i>p</i> &lt; 0.001) or all 3 recommendations (OR = 2.11, 95%CI: 1.03–4.35, <i>p</i> = 0.04) was associated with higher odds of showing learning interest/curiosity. Meeting both screen time and PA recommendations (OR = 0.15, 95%CI: 0.04–0.61, <i>p</i> &lt; 0.05) or both sleep duration and PA recommendations (OR = 0.24, 95%CI: 0.07–0.87, <i>p</i> &lt; 0.05) was associated with lower odds of repeating any grades. With respect to adaptive ability, participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing (OR = 0.11, 95%CI: 0.02–0.66, <i>p &lt;</i> 0.05) than those who did not. For participants who met all 3 recommendations (OR = 0.38, 95%CI: 0.15–0.99, <i>p</i> = 0.05), the odds of being victimized by bullying was lower. Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems (OR = 0.17, 95%CI: 0.04–0.71, <i>p &lt;</i> 0.05) than those who did not meet those guidelines. </p> </div><div class="section"> <a class="named-anchor" id="d3438758e341"> <!-- named anchor --> </a> <h5 class="section-title" id="d3438758e342">Conclusion</h5> <p id="d3438758e344">Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators. These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD. </p> </div><p id="d3438758e349"> <div class="fig panel" id="fig0001"> <a class="named-anchor" id="fig0001"> <!-- named anchor --> </a> <div class="figure-container so-text-align-c"> <img alt="" class="figure" src="/document_file/ce82758b-ff24-4737-999a-f275a7d17ed0/PubMedCentral/image/ga1"/> </div> <div class="panel-content"/> </div> </p>