Autism Spectrum Disorder Clinical Trial
Official title:
Adapted Judo for Children With Autistic Spectrum Disorders
The project is aligned with one of the overall: To promote social inclusion and equal
opportunities, encouraging participation in sport and physical activity. With this goal in
mind, the following specific objectives for this project were established:
1. To develop an adapted judo programme for children with ASD.
2. To demonstrate the impact of the participation in adapted judo on the quality of life of
people with ASD.
3. To validate instruments for use among the population with ASD.
4. To establish a set of coherent pedagogical principles that can be applied throughout the
EU to ensure the effectiveness of adapted judo programmes for children with ASD.
5. To establish a coherent set of pedagogical principles to promote good habits in the
participation in judo by children with ASD.
6. To consolidate and disseminate a systematic approach to adapted judo participation and
competition for people with ASD around the EU.
Our hypothesis is that the participants will show improved behaviour after the adapted judo
intervention
The children were recruited via a number of associations of families with children with ASD
and special education schools. All participants had been diagnosed with ASD according to the
criteria of the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition,
(DSM-V). Individuals who had been advised against physical activity for medical reasons were
excluded, as were those who had previously taken judo classes. The participants were invited
to take part in the study voluntarily, and along with their parents were informed verbally
and in writing as to the characteristics of the programme. Parents or legal guardians signed
informed consent forms, and the children signed a consent document that explained the
objectives and planned activities of the programme. The study was approved by the Research
Ethics Committee of (blinded for review). All protocols applied in this research (including
the management of the personal data of the participants) complied with the requirements
specified in the Declaration of Helsinki of 1975 and its subsequent revisions.
The adapted judo programme is aimed at children of between 8 and 15 years of age who have
been diagnosed with ASD and who being introduced to judo. All the project partners will
contact institutions and organisations involved in the education of people with ASD in their
respective localities and countries. The partners will explain the project and enlist the
help of these institutions to recruit participants. All the study participants will be asked
to sign an informed consent document that will be drafted in keeping with all applicable
research ethics protocols, including a guarantee of the confidentiality of personal data and
an assurance that participants can choose to abandon the study at any time.
The judo programme will be carried out over the course of two academic years (2020-21,
2021-22). The first school year will allow for pilot testing of the methods and point toward
any necessary adaptations in the assessment techniques used. The design of this first phase
will take into account prior experiences, expert input and information gleaned from focus
groups in order to arrive at an initial proposal, which will then be subject to modification
in accordance with results. The conclusions drawn from this initial experience will form the
scientific and pedagogical basis for the definitive version of the programme.
The judo sessions will be offered in a large and well-ventilated space suitable for athletic
activity in general and for judo in particular, such that the safety of the participants can
be guaranteed. The judo equipment required for this project will include a tatami mat with a
minimum surface area of 90 m2, made using high-density cushions that help prevent injuries
and ensure that a wide range of activities can be carried out safely. Each participant will
be outfitted with a judogui (a traditional uniform consisting of a cotton jacket and trousers
and a belt that indicates the participant's level of technical skill).
The sessions will be an hour in length and will be held twice a week. Two instructors will
lead each session, and at least four volunteers will have to be present to lend support. The
sessions will be divided into three parts in accordance with the physiological principles of
exercise: warm-up, main exercise and cool-down. The main content of the sessions will
include:
- Judo analytical techniques and judo games
- Different types of movements and falling techniques.
- Ground control techniques and throws. The instruction methodology will always apply the
principle of gradual progression, featuring practice to consolidate the concepts learned
in the initial lessons before moving on to more complex material. Each participant will
be allowed to progress at his or her own pace. Learning will be largely based on
imitation and guided modelling of techniques.
This adapted judo programme for children with ASD will have broader scientific and
pedagogical applications. Each project partner will be responsible for some data collection
tasks. All the partners will gather pedagogical data throughout the process using a common
methodology. Meanwhile, the scientific data will be gathered under stricter conditions by
only some of the project partners. These data will then be handled and analysed by the
research teams of the participating universities.
The judo sessions will be accompanied by the constant management and refining of the
assessment and monitoring instruments that will be needed to gather the data that will inform
the final results. Some of these instruments will be used pending a process of adaptation and
validation for use with individuals with ASD, while others have already been tested and
validated for use with this population. The following instruments will be administered during
the programme:
- Test of Gross Motor Development (TGMD-2). Evaluates two components: a) Locomotor:
Measures gross motor skills that require movements made with a fluid coordination
(running, galloping, jumping with one foot, stride, jump with two feet slide). b) Object
control: This subtest measures the gross motor skills that require efficiency when
throwing, hitting and receiving (hitting a static ball, static jump, reception,
shooting, throwing over the head and throwing below the head).
- Gilliam Autism Rating Scale (GARS-3). It consists of three subscales: Stereotypical
behaviours, communication and social interaction. The instrument consists of 56 clearly
stated items describing the characteristic behaviours of persons with autism. The items
are grouped into six subscales: Restrictive/Repetitive Behaviours, Social Interaction,
Social Communication, Emotional Responses, Cognitive Style, and Maladaptive Speech.
- Physical Activity Enjoyment Scale (PACES). It is a short questionnaire that asks about
the degree of satisfaction when it comes to practicing physical activity.
- Battery ALPHA-FITNESS. It consists of the following variables: weight, height, body
composition (abdominal perimeter, triceps sheet, subscapular fold), hand strength, leg
strength, agility and aerobic endurance.
- Forms to record the participants' technical progress in judo (created for this study)
The pedagogical data will be collected by all the adapted judo instructors. In the collection
of the research data, standard (blinded study) research protocols will be followed, and
researchers will not be provided with information about the participants or the process
carried out.
The two kinds of data described above will be handled differently. First, the pedagogical
information will be subjected to qualitative analysis. These data will include expert
opinion, the participants' level of satisfaction with the process and their degree of
technical progress in judo. These qualitative data will be used to inform the drafting of the
manuals for instructors of adapted judo for children with ASD, texts that will be produced
within the framework of this project. Second, the scientific data will be subjected to
quantitative analysis, including the use of more complex statistical methodology and of
statistical analysis software. This quantitative analysis represents an opportunity validate
some of the instruments applied in the study (PACES, ALPHA-FITNESS) for use among members of
the autistic population. Also measured will be the performance of the participants in adapted
judo competitions, the benefits of judo for individuals with ASD and the prevalence of
injuries among participants in adapted judo.
Baseline data are collected at timepoint 1 (T1-Baseline), at the start of the programme and
eight weeks later, scores are recorded for timepoint 2 (T2-Control), which represents a
control period. During the control period, part of which includes the winter break from
classes, the students not participate in any extracurricular physical activities, as their
organised physical exercise is limited to their regular physical education classes at school.
Between this second measurement and timepoint 3 (T3-Judo), The choice was made to include the
control period at the start of the process because we did not have a control group willing to
submit to all the measurements over the course of the project. In the absence of a control
group, it was decided to take the second measurement after which the participants only took
part in the compulsory physical education activities at their schools.
All descriptive data from the dependent variables are presented as mean ± standard deviation
(SD). The normal distribution of each variable was checked with a Shapiro-Wilks test. In
order to test the study hypotheses, comparisons between the four different timepoints.
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