The effects of a physical exercise program, LEGOR and Minecraft activities on anxiety in underserved children with autism spectrum disorder

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BackgroundAnxiety is a frequent comorbidity in children with autism spectrum disorder (ASD). Physical exercise is a low cost and easy-to-access intervention with therapeutic benefits for reducing anxiety in adults and adolescents. There are currently no randomized controlled trials on the feasibility and efficacy of a physical exercise intervention to reduce anxiety in younger children with ASD. Method148 children (6–12 years old) with ASD were randomized into a clinical trial to evaluate the efficacy of an 8-week exercise protocol designed to reduce anxiety specifically in younger children with ASD. Participants were randomized to an exercise intervention group (N = 76) or sedentary activity LEGO/Minecraft group (N = 72). Both programs were administered 1–3 times weekly for 8 weeks. Anxiety was assessed via parent ratings with the Child Behavior Checklist DSM-5 anxiety subscale (CBCL DSM-5) at weeks 1, 3, 6, and 8 as well as follow up at weeks 12 and 16. Secondary outcome measures included child self-reported anxiety (Screen for Child Anxiety Related Disorders; SCARED), sleep (Child’s Sleep Habits Questionnaire, CSHQ-ATN), physical activity level (Physical Activity Questionnaire, PAQ-C), and salivary cortisol measured at weeks 1, 3, 6, and 8. ResultsParent-rated (CBCL DSM-5) and self-reported (SCARED) anxiety scores showed improvements at weeks 3, 6 and 8 in both groups with no significant differences between the physical exercise and sedentary activity (LEGO/Minecraft) groups. In addition, the CBCL DSM-5 anxiety scores decreased only in the physical exercise group at weeks 12 and 16 compared to baseline with no significant difference from LEGO/Minecraft group. Sleep also showed improvements during weeks 6 and 8 in the physical exercise group but not in the LEGO/Minecraft group with no significant differences between the groups. Physical activity level was significantly increased in the physical exercise group compared to the LEGO/Minecraft group at week 8. Salivary cortisol did not show any significant changes from weeks 1–8 or differences between groups. ConclusionEight-week physical exercise and sedentary LEGO/Minecraft interventions reduced parent-rated and self-reported anxiety in 6–12-year-old underserved children with ASD with no significant difference between the intervention groups.