This is the synopsis of the study on the eight weeks of aerobic exercises on selected physical fitness components of children with autism

1. 1
EFFECTS OF EIGHT WEEKS AEROBIC EXERCISES ON SELECTED
PHYSICAL FITNESS COMPONENTS OF CHILDREN WITH AUTISM
SPECTRUM DISORDERS
A Synopsis of
Post Field PhD Thesis Report
By
ADEYEYE, Adeyemi Elijah
03-01-04-303
Submitted to Faculty of Education, Lagos State University, Ojo. In partial
fulfilment of the requirements for the award of Doctor of Philosophy (PhD) in
Exercise Physiology
Prof. Adeogun, J.O.
Supervisor
July, 2019

2. 2
ABSTRACT
Physical fitness is an important health marker both in the early years and later in life.
Physical activity has been found useful to every individual in all ramifications.
Observation revealed that despite the vocational training, Applied Behavioural Analysis
and other programmes designed for children with Autism Spectrum Disorder at National
Orthopaedic Special School Igbobi, Lagos, exercise or physical fitness activities were not
included as part of daily activities for this group of individual. Adopting measures to
increase the physical fitness levels in this population is necessary to reduce the likelihood
of negative health consequences, which form the fulcrum for this study. The two groups of
pretest-posttest experimental design were adopted for this study. The population for the
study consists of all children diagnosed with Autism Spectrum Disorders which the
severities are mildly attending the school between the ages of 9-20 years. All
measurements and treatments were carried out in the school hall and playground.
Standardised instruments were used for data collection for pretest and posttest. The
modified stork standing test was used to measure the static balance of participants. The
test interrater reliability of the stork using a two-point scale showed high levels of
agreement on the weight bearing leg (kappa scores: left κ = 0.67 percentage agreement
91.9%; right κ = 0.77 percentage 89.9%). The Handgrip test was to measure muscular
Strength with an intraclass correlation coefficient of r = 0.79. The modified Sit and reach
test was to measure the flexibility. Reliability estimates for the standard SR are
consistently high (r = 0.96). The ruler Drop test was used to measure reaction time.
Reliability using test-retest was r = 9.75 while the wall Toss Test was used to measure
Neuromuscular coordination. (r = 0.94). The data collected was analysed with statistical
tools of frequency counts, percentage, chart, the mean and standard deviation for
demographic data while inferential statistics of paired t-test was used to test the stated
hypotheses at 0.05 alpha level. Findings from the study revealed that eight-week aerobic
exercises had significant effects on static balance, (t = 4.92; p 0.05; DF =19, muscular
strength (t = 4.83; p < 0.05), flexibility, (t = 4.37; p < 0.05; DF =19), body composition,
(t =-3 404; p < 0.05; DF = 19), neuromuscular coordination, (t = 5.47; p < 0.05; DF
=19) and reaction time ( t = 4.45; p < 0.05; DF =19). It was recommended that aerobic
exercises should be incorporated with other existing programmes, while exercise stress
tests should be conducted for all newly admitted children to reveal contraindication to
exercise among the children and should be conducted by an exercise physiologist.
Words Count: 436.
Keywords: physical fitness, Autism Spectrum Disorder, static balance, muscular strength,
flexibility, reaction time, neuromuscular coordination, body composition.

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CHAPTER ONE
INTRODUCTION
Background to the Study
Health or being healthy is one of the prerequisites for an individual to live a meaningful life.
There are many ways by which an individual can maintain his/her health. One of such ways is to
keep fit or be physically fit. Apparently healthy children have the opportunity of participating in
various physical activities with their peers, age groups and neighbours in every setting when they
have the opportunity and this makes them be active and physically fit. But this is not the case for
most children with disabilities due to many challenges especially those with neuro-development
disorders like Autism Spectrum Disorders. The long term health burden associated with neuro-
developmental disorders can further be complicated due to lack/low level of physical fitness.
This low level of physical activity participation could even be a greater issue for children with
disabilities because they often have to deal with other health issues related to their disability.
Examining the effects of aerobic exercise on the physical fitness levels of these children will
help in designing appropriate exercise that will promote their health and well—beings hence this
study was conducted.
Physical fitness refers to the body's internal processes that allow one to meet the demands of
daily living or that provides the basis for sports performance, or both. Physical activity and
physical fitness are often used interchangeably, with fitness commonly being treated as a more
accurate measure of physical activity (Williams, 2001). Physical fitness is a condition in which
an individual has the ability to carry out the normal and unusual physical activity for daily life
without being fatigued and still have the energy for leisure activities (Okuneye, 1999). Physical
fitness means that the various systems of the body are healthy and function efficiently so as to
enable the person to engage in activities of daily living, as well as in recreation pursuits and
leisure activities without undue stress (Corbin, Welk, Corbin & Welk, 2004; Adeogun, Setonji &
Dansu 2003; Fahey, Insel & Roth, 2001).
Beyond physical development, physical fitness implies efficient performance in exercise or work
and a reasonable measure of motor skill in the performance of selected physical activities.
Physical fitness varies with the individual and with the demands and requirements of a specific
task (Fahey, Insel & Roth, 2001). Regular participation in moderate and vigorous levels of
exercise increases physical fitness, which can lead to many health benefits (Ruiz, Rizzo,

4. 4
Wennlof, Ortega, Harro & Sjostrom, 2006). Physical activity has been found useful to every
individual in all ramifications as it improves physique, emotional stability and enhanced social
interaction. Participation in physical activity provides opportunities to learn teamwork; helps
strengthen bodies, develops coordination, and promotes physical fitness. Exercise provides the
opportunity to spend time with like-minded friends, many forms of exercise help to develop a
physical body that improves self-confidence, which can translate positively into several areas of
life (Livestrong, 2017).
Exercise is healthy for everyone, but it can have a major positive impact on the quality of life for
those on the Autism Spectrum Disorders. Exercise doesn’t just help the child or adult with
autism, it also has a profound impact on his or her family (Srinivasan, Pescatello & Bhat, 2014).
In order to improve physical fitness and health, children and youth aged 5–17 years should
accumulate at least sixty minutes of moderate- to vigorous-intensity physical activity daily,
amounts of physical activity greater than sixty minutes provide additional health benefits. Most
of the daily physical activity should be aerobic and vigorous-intensity activities should be
incorporated, including those that strengthen muscle and bone, at least three times per week
(World Health Organisation, 2014). Observations showed that apparently healthy children have
the opportunity of participating in various physical activities with their peers, age groups and
neighbours in every setting when they have the opportunity and this makes them be active and
physically fit but most children with disabilities especially Autism Spectrum Disorders cannot do
the same nor have the opportunity due to many challenges.
Autism Spectrum Disorders is a neuro-development disorder and/or condition that impair
individual ability to communicate, form a relationship, socially interact and respond
appropriately within a given environment. This condition is a spectrum of closely related
disorders with a shared core of symptoms (American Psychiatric Association, 2000). The
American Psychiatric Association, (2000) published Diagnostic and Statistical Manual of Mental
Disorders-IV manual which categorised neurodevelopment disorder into five categories;
Pervasive Developmental Disorders (PDD): Autistic Disorder, Asperger's Disorder, Rett's
Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not
Otherwise Specified (PDD-NOS).
In 2013, the American Psychiatric Association, (2013) published the Diagnostic and Statistical
Manual of Mental Disorders-V and redefined the previous categorisation into Autism Spectrum

5. 5
Disorders. Additionally, the Diagnostic and Statistical Manual of Mental Disorders-V also
reduces social-related elements of Autism Spectrum Disorder into social communication
impairment and repetitive/restricted behaviours, though the labels of Asperger's and PDD-NOS
are still in common use. The Diagnostic and Statistical Manual of Mental Disorders-V describes
three levels of increasing severity of Autism Spectrum Disorder, from requiring support to
requiring substantial support and requiring very substantial support (Autism Society, of America,
2016; American Psychiatric Association, 2013).
According to Esposito Venuti, Maestro, and Muratori, (2009) ASD predominantly affects males,
with a male-to-female ratio of approximately 4:1. In children with ASD, the symptoms are
present before three years of age, although a diagnosis can sometimes be made after the age of
three. More boys are diagnosed with the condition than girls (National Health Service Wales,
2018). Estimates of the prevalence of ASD are scarce possibly due to the complexity of the
symptoms and appearance of multiple illnesses associated with the disorders (Kim, Leventhal,
Koh, Fombonne, Laska, Lim & Grinker, 2011). Autism Spectrum Disorders begin in childhood
and tend to persist into adolescence and adulthood. In most cases, the conditions are apparent
during the first 5 years of life (World Health Organisation, 2019).
Studies are not available in addressing the epidemiology of ASD among sub-Saharan African
children. Of the 135 million established cases of Autism Spectrum Disorders globally, it is
worrisome that over one million children and teenagers are suffering from the condition in
Nigeria. The majority of them termed imbeciles, fools, and even witches; an approach that makes
medical and psycho-social help difficult. Unfortunately for autistic persons in Nigerian choose to
believe in superstitions and myths. Diagnosis and management of the condition have been a
major casualty due to the pathetic belief system of the citizens; hence it is one of the most
ignored health issues in the country despite the high number of cases (Ifijeh, 2017).
However, it is in tackling this condition that Guarantee Trust Bank, through its Orange Ribbon
Initiative, an advocacy programme which seeks to support children living with Autism and other
developmental disabilities, has decided to spare head initiatives against the disability, by
providing awareness on the condition, reawaken people's social consciousness about the plight
and requirements of children living with ASD, integrate centres for adults, then sponsor, support
and lobby for legislation that protects the rights of people living with the challenges, among
others. Prior to 2009 when the initiative started, there was little or no information about Autism

6. 6
Spectrum Disorders in Nigeria, as knowledge of the situation was scarce among parents and
medical practitioners. In parents' frustration, they found coping methods which included locking
up the children and not allowing any form of interaction with other children, since they were
supposedly 'abnormal' (Agbonkhese, 2015).
The United Nations in 2008 dedicated the month of April to create awareness on the disorder,
tagging it ‘International Autism Awareness Month. In May 2014, the Sixty-seventh World
Health Assembly adopted a resolution entitled "Comprehensive and coordinated efforts for the
management of Autism Spectrum Disorders (ASD)," which was supported by more than 60
countries. The resolution urges WHO to collaborate with Member States and partner agencies to
strengthen national capacities to address ASD and other developmental disorders. The
Sustainable Development Goals and related strategies (the Global Strategy for Women’s,
Children’s and Adolescents’ Health 2016-30 and the Nurture Care Framework), endorse
disability-inclusive principles. They provide a road map for policy and action to address the
needs of people with disabilities and ensure that people with disabling conditions such as autism
have adequate access to health, inclusive education and optimal well-being and participation
throughout the life course. WHO and partners recognise the need to strengthen countries'
abilities to promote optimal health and well-being of all persons with ASD (Agbonkhese, 2015).
There are no population-based prevalence studies of Autism Spectrum Disorders have been
conducted in Africa to date due to barriers associated with access to "gold standard" diagnostic
tools (Abubakar, Ssewanyana, de Vries, & Newton, 2016; Durkin, Elsabbagh, Barbaro,
Gladstone, Happe, Hoekstra & Shih, 2015). Lack of information available to caregivers and
inadequate skilled manpower often limit early detection and access to the few available under-
resourced services in the community (Oshodi, Olagunju, Oyelohunnu, Campbell, Umeh, Aina,
Oyibo, Lesi & Adeyemi, 2017). Also, there are limited studies on its occurrence, risk factors, and
presentation in developing countries such as Nigeria. (Izuwah, Okoh & Alikor, 2015).
The two available studies that are closely related were focused on children with developmental
disorders conducted in Tunisia and Egypt. The study found that 11.5% and 33.6% of children
had Developmental Disabilities (Seif Eldin, Habib, Noufal, Farrag, Bazaid, Al-Sharbati, Badr,
Moussa, Essali & Gaddour, 2008). A hospital-based population study in South-Eastern Nigeria
on the prevalence of Autism Spectrum Disorders reported that 0.8% of the total population of
children that attended the clinic over a year period (Bakare, & Munir, 2011a). The prevalence of

7. 7
Autism Spectrum Disorders among Nigerian children with intellectual disability in Nigeria was
11.4%. Forty-four children with intellectual disabilities were assessed for a diagnosis of
childhood Autism (Bakare, Ebigbo & Ubochi, 2012).
The exact cause of Autism Spectrum Disorders is currently unknown. It is a complex condition
and may occur as a result of genetic predisposition (a natural tendency), environmental or
unknown factors. Most researchers believe that certain genes a child inherits from their parents
could make them more vulnerable to develop Autism Spectrum Disorders (National Health
Service Wales, 2018). Daniels, Forssen, Hultman, Cnattingius, Savitz, Feychting and Sparen,
2008; Johnson and Myers, 2007; Lawler, Croen, Grether and Van de Water, (2004) found that
persons born with a genetic vulnerability to Autism Spectrum Disorders will develop the
condition if they're exposed to a specific environmental trigger. Possible triggers include being
born prematurely (before 35 weeks of pregnancy), or being exposed in the womb to alcohol or to
certain medication (National Health Service Wales, 2018).
In the past, a number of issues were linked to Autism Spectrum Disorders, which include
measles, Mumps, and Rubella vaccines thiomersal- a compound that contains mercury, which is
used as a preservative in some vaccines and eating gluten or dairy products. But extensive
research found no evidence to suggest that any of these contribute to the condition. Some years
ago, a study reported that Measles, Mumps, and Rubella (MMR) vaccine caused Autism
Spectrum Disorders, but this has been investigated extensively in a number of major studies
around the world, involving millions of children, and researchers found no evidence of a link
between Measles, Mumps and Rubella and Autism Spectrum Disorders. It was found that the
study was filled with methodological flaws (National Health Service Wales, 2018; Maisonneuve
& Floret, 2012; Dyer, 2010).
Many of the key components of a successful physical activity programme for individuals with
autism mirror those that make up some of the most common treatments and behavioural
interventions - Applied Behavioural Analysis (ABA). The most widely used behavioural
intervention programmes focus on developing communication, social, and cognitive skills.
According to Adeogun and Adeyeye, (2010) aerobic dance has a significant effect on the amount
of fat lost by overweight male students of AOCOED International School Otto-Ijanikin, Lagos.
Shimammoto, Adachi, Takahashi, and Tanaka, (1998) reported that low impact dance is a useful

8. 8
exercise mode for weight loss in obese middle-aged women. IloveIndia, (2007) asserts that
aerobic exercise helps in losing weight and body fats.
Dawson and Rosanoff, (2009), Pitetti, Rendoff, Grover and Beets, (2007) study of 9-month
treadmill walking programme on weight reduction in adolescents with severe autism revealed
that the programme significantly decreased Body Mass Index among the participants.
Additionally, as time progressed through the study, the frequency, duration, speed, and elevation
of the treadmill walking all increased, indicating a general rise in exercise capacity and physical
fitness. Yilmaz, Yanarda, Birkan, and Bumin, (2004) studied of swimming training and water
exercise among children with Autism of ten weeks of hydrotherapy 60-minute sessions per week
resulted in a significant increase in fitness levels indicated by changes in balance, speed, agility,
strength, flexibility, and endurance.
Motor therapy, when it is associated with music makes social interaction and communication
easier, as well as several systems that interfere in the perception of movement and are
fundamental for the social-emotional development and for the interconnection of areas that are
responsible for the association of movement. Dance therapy favoured motor and gesture
performance, even in body balance and gait. Besides, it contributed to improving the quality of
life of the teenager with Autism Spectrum Disorders (Srinivasan & Bhat 2013; Hardy &
LaGasse, 2013; Rosenblatt, 2010).
In light of the growing prevalence of Autism Spectrum Disorders in recent years and increased
obesity among children with Autism Spectrum Disorders, it is important to design and
incorporates aerobic exercises programme with other programmes for this group of individuals to
improve their physical fitness and well-being. From the wide range of difficulties that occur to
children with Autism Spectrum Disorders, this study focused on selected physical fitness
components, though low level of physical fitness was not among the primary symptoms of
Autism Spectrum Disorders, but it is one of the main factors that influence or reduces most
symptoms and enhance the performance of activities of daily living, education, and socialisation.

9. 9
The conceptual framework for the study
The framework that was adopted for the study was presented below:
Fig 1: Conceptual framework for the study
Adapted from (Rimmer, Rowland & Yamaki, 2007).
Children with Autism Spectrum Disorders between the ages of 9-20 years are likely to be
overweight, obese, lack/low level of physical fitness, difficulty in motor skills and low level of
independence. These can be due to contributory factors of low physical activity levels, poor
nutrition, medication use, and metabolic abnormalities. To promote the well-being, physical
fitness, motor skills, functional capacity and to complement other available programmes for
these children, there is a need to incorporate exercise (aerobic exercise) intervention to other
Improved level
of physical
fitness.
Improved level
of independence.
Improved motor
skills
Reduced body
composition
Long and short
term outcomes of
aerobic exercises
intervention
Overweight
Obese
Lack/Low
level of
physical
fitness
Difficulty in
motor skills
Low level of
independence
Brisk walk
Aerobic Dance
Jumping on ropes
activities
Low level of
physical
activity
Poor nutrition
Medication use
and
metabolism
abnormalities
Children with
Autism Spectrum
Disorders
between the ages
of 9-20 years.
Contributory
factors to the
low level of
physical fitness
components
8-week
aerobic
exercises
intervention

10. 10
programmes. The aerobic exercises include; brisk walk, aerobic dance and jumping on ropes
activities. The short and long term of aerobic exercise intervention programme includes;
improved levels of physical fitness, improved level of independence, improved motor skills and
reduced Body Mass Index among the children with Autism Spectrum Disorders. This study,
therefore, investigated the effects of eight weeks aerobic exercises on selected physical fitness
components of children with Autism Spectrum Disorders at National Orthopaedic Special
School, Igbobi Lagos.
Statement of the Problem
Despite the enormous health benefits that can be attained from regular physical activity, most
children with disabilities are not achieving the recommended goal of 30 minutes a day or more
days of the week as recommended by the World Health organisation, American Heart
Association and American College of Sports Medicine. This low level of physical activity
participation could even be even greater issue for people with disabilities compared to a
relatively sedentary population without existing illnesses because people with disabilities often
have to deal with other health issues related to their disability such as pain, fatigue, de-
conditioning, depression, weight gain and associated conditions (Staples & Reid, 2010). Georgia
Department of Health, (2019) asserts that childhood and adolescence are critical periods for
developing movement skills, learning healthy habits, and establishing a firm foundation for
lifelong health and well-being. Regular physical activity in children and adolescents promotes
health and fitness. School-aged children can achieve substantial health benefits by participating
in moderate or vigorous-intensity physical activity.
It has been observed over the years that most children with disability in regular Physical
Education class and those in special schools and homes were not receiving the normal physical
activity levels as American Heart Association recommends that aerobic activity should be done
at 50-85 percent of the child's maximum target heart rate (US Department of Health and Human
Services, 1996). Physical activity and sports programmes for typical pupils are not compatible
with children with disabilities and thus they were left to sit down during Physical Education and
sports programmes. In most settings including school, there are no physical education
programmes designed for this population.
In Physical Education classes in most schools in Nigeria especially in Lagos State, children with
disabilities including Autism Spectrum Disorders are often left wondering. The unisensory-

11. 11
friendly environment, variety of learning styles, lack of qualified personnel, lack of appropriate
physical activity programme and lack of visual supports have made the typical Physical
Education class a missed opportunity. Instead of using exercise to increase the child's focus, self-
esteem, and relationships, this well-intended attempt to exercise results in more frustration,
failure, and ridicule due to many factors. School administrators are also conflicted about how
exercise fits into a student with Autism Spectrum Disorder's daily routine. Administrators and
their teachers are evaluated on the progress students make in the areas of reading, Writing, and
Arithmetic which are included in their learning goals but they have not evaluated on fitness goals
hence this study.
It was observed that programmes designed for children with Autism Spectrum Disorders at
National Orthopaedic Special School Lagos, mainly target their core social, communication and
academic impairments. The programmes include Applied Behavioural Analysis (ABA),
Teaching and Education of Autistic and Related Communication Handicapped Children
(TEACHH), and Picture Exchange Communication System (PECS). These programmes
primarily involve sedentary, tabletop activities where children with ASDs practice social
communication skills in highly structured and confined environments.
Exercise or physical fitness activities were not included as part of daily activities for these
children. Although movement and Physical activity deficits are not central to the disorder,
addressing the motor deficiencies and Physical fitness levels may indirectly impact the core
social and communication impairments of children with ASDs by providing greater opportunities
for socialisation with peers, better attentional focus, and improved motor performance. Also,
research and anecdotal evidence suggest that some alternative therapeutic choices that include
sports, exercise, and physical activity can be a useful adjunct to traditional behavioural
interventions, leading to improvement in symptoms, behaviours, and quality of life for
individuals with Autism Spectrum Disorders (Dawson & Rosanoff, 2009).
To achieve one of the objectives of National Orthopaedic Special School, Igbobi Lagos which is
to make the pupils independent to some extent which cannot be achieved only with the teaching
of communication, social and cognitive skills but with other programmes. There is the need to
include physical activity and exercise programme that can cater for motor deficits of this group
of children, so as to reduce the likelihood of negative health consequences like overweight,
obesity and cardiorespiratory diseases, many of which exercise has shown to effectively prevent

12. 12
which form the fulcrum for this study. This study, therefore, examined the effects of eight weeks
aerobic exercises on selected physical fitness components of children with Autism Spectrum
Disorders at National Orthopaedic Special School, Igbobi, Lagos.
Purpose of the Study
The study examined the effects of eight weeks aerobic exercises on selected physical fitness
components of children with Autism Spectrum Disorders at National Orthopaedic Special
School, Igbobi, Lagos. Other objectives of the study were to:
1. Find out the effects of eight weeks aerobic exercises on the static balance of children with
Autism Spectrum Disorders.
2. Examine the effects of eight weeks of aerobic exercises on the muscular strength of
children with Autism Spectrum Disorders.
3. Find out the effects of eight weeks aerobic exercises on the flexibility of children with
Autism Spectrum Disorders.
4. Examine the effects of eight-week aerobic exercises on body composition of children
with Autism Spectrum Disorders.
5. Examine the effect of eight weeks aerobic exercises on neuromuscular coordination of
children with Autism Spectrum Disorders.
6. Find out the effect of eight weeks aerobic exercises on the reaction time of children with
Autism Spectrum Disorders.
Research Questions
The following questions were answered in the course of the study:
1. What is the effect of eight weeks aerobic exercise on the static balance of children with
Autism Spectrum Disorders?
2. Will eight weeks of aerobic exercise have an effect on the muscular strength of children
with Autism Spectrum Disorders?
3. What is the effect of eight weeks aerobic exercise on the flexibility of children with
Autism Spectrum Disorders?
4. Is there any effect of eight weeks aerobic exercise on body composition of children with
Autism Spectrum Disorders?
5. Will eight weeks of aerobic exercise has effects on neuromuscular coordination of
children with Autism Spectrum Disorders?

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6. Is there any effect of eight weeks aerobic exercise on the reaction time of children with
Autism Spectrum Disorders?
Hypotheses
The following hypotheses were formulated and tested in the course of the study:
1. There is no significant effect of eight weeks of aerobic exercises on the static balance of
children with Autism Spectrum Disorders.
2. Eight weeks of aerobic exercise have no significant effect on the muscular strength of
children with Autism Spectrum Disorders.
3. There is no significant effect of eight weeks of aerobic exercises on the flexibility of
children with Autism Spectrum Disorders.
4. There is no significant effect of eight weeks aerobic exercise on body composition of
children with Autism Spectrum Disorders.
5. Eight weeks aerobic exercises have no significant effect on neuromuscular coordination
of children with Autism Spectrum Disorders.
6. There is no significant effect of eight weeks of aerobic exercises on the reaction time of
children with Autism Spectrum Disorders.
Significance of the study
The long term burden associated with neuro-developmental disorders can further be complicated
due to lack/low level of physical fitness. This study, therefore, will be of health benefit to
children with Autism Spectrum Disorders by enhancing their physical fitness levels and motor
skills.
This study will also expose the children to varieties of activities that they might not receive in
their regular Physical Education class/daily activities. The study can also motivate the children to
develop an interest in participation in physical activities. This study will promote social
interaction among the children as they will have the opportunity to perform aerobic exercise
together.
This study might promote interagency/organisational partnerships with National Orthopaedic
Special School to incorporate regular aerobic exercise into the school programme to reduce
atypical behaviours and enhance social skills that can improve their health and well-being. This
study could assist the National Orthopaedic Special School in including exercise stress tests as
part of screening during admission to reveal contraindications to exercise among the children.

14. 14
The study of this topic can enhance the physical functioning of the special children by improving
their strength and power that will help in maintaining correct posture, supporting balance, and
prevent lower back injuries.
This study could help overweight and obese children to reduce fat and thus reduce weight.
Findings from this study can be used by NGOs, homes and other allied health professionals in
charge of providing care for children with disabilities/challenges.
The outcome of this study can be used by the Lagos State Basic Education Board as a baseline
for developing a Physical Education programme for special children in Lagos state Public
schools.
The outcome of this study can serve as a guide and inform practitioners/educators in developing
school and residential exercise programmes for individuals with Autism Spectrum Disorders.
Since obesity is significant comorbidity among individuals with ASD, this study can be used by
Physical and Health Educators, and exercise physiologist to design effective exercise
intervention to help children with ASD to lose body fat and keep fit.
This study might shed additional light on how special students react to the stimulus presented to
them which has a broader implication on teaching motor skills to these children.
This study might provide guidance with regard to the type of preferred exercise programme that
is beneficial for this population and the components that should be included.
Findings from this study may serve as references for other researchers working on related topics.
Delimitation of the study
This study was delimited to the following:
Two group pre-test posttest experimental design.
1. A total of 40 participants between the ages of 9-20 years.
2. The use of a simple random sampling technique to select the sample.
3. Independent variable of aerobic exercises.
4. Dependent variables of selected physical fitness components: Static balance, muscular
strength, flexibility, body composition, neuromuscular coordination and reaction time.
5. The use of standardised instruments for data collection.

15. 15
Limitations of the study
The following were the limitations of the study:
Most of the participants were frightened of the exercise environment: This was due to the fact
that children with Autism Spectrum Disorders relate to their environment differently than other
children. This was resolved by conducting the programme in the school hall and playground at
National Orthopaedic Special School, Igbobi, Lagos.
Characteristics of the participants: Characteristics of the participants in terms of their
impairments was a limitation in the course of the study. This was resolved by soliciting the
services of the assistant Headteacher and other trained teachers who helped to train the research
assistants on how to handle and cope with the participants.
Severity level of Autism Spectrum Disorders among participants: The severity level of Autism
Spectrum Disorder was a problem during the selection of participants. This was resolved by
assessing the case file of each participant and the American Psychiatric Association's Diagnostic
and Statistical Manual of Mental Disorders, DSM-5 was used to categorise the participants and
those within severity levels 1 were part of the sample.
Inability to measure the Blood pressure of participants: There was a challenge in measuring the
blood pressure of participants due to their inability to maintain a stable position. This challenge
was resolved by collecting the health record of participants from the school record and individual
health files.
The inability of participants to maintain a static balance on a base: It was also a challenge to
measure the static balance of participants using the stork balance test because of the inability of
the participants to stand on a base. This was resolved by removing the base and modified the
stork balance test.
Operational Definition of Terms
These are terms as used in the study:
Autism Spectrum Disorders: Autism Spectrum Disorders is used here to cover five different
disorders from Autism, Disintegrative Disorder, Pervasive Development Disorder, Aspergers
Syndrome and Rett syndrome.
Children with Autism Spectrum Disorders children: These are children that have been diagnosed
with Autism Spectrum Disorders between the ages of 9-20 years attending National Orthopaedic
Special School Igbobi, Lagos.

16. 16
Physical Fitness: Ability of children with Autism Spectrum Disorders to perform various basic
movements without undue fatigue.
Aerobic exercises: The aerobic exercises are aerobic dance, brisk walk and jumping on ropes
activities.
Aerobic Dance: This is a continuous series of steps or movements to aerobic/popular music.
Body Mass Index (BMI): BMI is a screening tool that can indicate whether a person is
underweight or if they have a healthy weight, excess weight, or obesity. If a person's BMI is
outside of the healthy range, their health risks may increase significantly.
Adult Body Mass Index: This is the BMI used for adults.
Underweight: This is when the BMI is less than 18.5
Normal/healthy weight: This is when the BMI is between the ranges of 18.5–24.9.
Overweight: This is when the BMI is between the ranges of 25–29.9.
Obese: This is when the BMI of over 30.
BMI of children and Teens: This is the MBI used for children and teens.
Normal weight: This is when the BMI is between 5th
-85th
percentage for children and teens of
the same age and sex.
Overweight: This when the BMI at or above the 85th
percentage for children and teens of the
same age and sex on the BMI graph.
Obese: This is when the BMI is greater than or equal to the 95th
percentage on the BMI graph.
Severity levels of Autism Spectrum Disorders: These are the severity levels of Autism Spectrum
Disorders which can be in level 1 which require support, level 2 substantial supports and level 3
require very substantial support.

17. 17
CHAPTER TWO
REVIEW OF RELATED LITERATURE
In this chapter, literature that was related to the problem under investigation was reviewed. It
covers the following sub-headings:
Theoretical frameworks of motor control theories.
Theories of motor control
Overview of Neuro-Developmental Disorders.
Anatomy and physiology of the nervous system.
Brief History of National Orthopaedic Special School, Igbobi Lagos.
Overview of ASD.
Autism Spectrum Disorders Treatment and Management
Prevalence of Obesity in Individuals with Autism Spectrum Disorders.
Factors contributing to obesity among children and adolescents with disabilities
Concept of physical fitness and physical activity.
Benefits of physical exercise for individuals with Neurodevelopmental Disorders.
Concept of aerobic exercise.
Factors that affect motor skills in children with Autism Spectrum Disorders.
Recommendations for personnel providing exercise for Individuals with Autism Spectrum
Disorders.
Physical activity and exercise prescription for children with Autism Disorders
Effects of aerobics exercises on the physical fitness level of children with ASD
Helping students with Neurodevelopmental Disorders in Physical Education lessons.
Empirical studies on physical activity and exercise on individuals with Autism Spectrum
Disorders.
Summary of the review.

18. 18
Theoretical frameworks of motor control theories
A theoretical framework can be thought of as a map or travel plan. When planning a journey in
an unfamiliar country, people seek as much knowledge as possible about the best way to travel,
using previous experience and the accounts of others who have been on similar trips. ‘Survival
advice' and ‘top tips' enable them to ascertain the abilities, expectations, and equipment that may
help them to have a successful journey with good outcomes, to achieve their objectives and
return to base safely (Sinclair, 2007). Theories are formulated to explain, predict, and understand
phenomena and, in many cases, to challenge and extend existing knowledge within the limits of
critical bounding assumptions. The theoretical framework is the structure that can hold or
support a theory of a research study. The theoretical framework introduces and describes the
theory that explains why the research problem under study exists (Abend, 2008).
Within the field of Neurology, many textbooks and researchers recommend the adoption of a
systems model of motor control incorporating neurophysiology, biomechanics, and motor
learning principles which also considers learning solutions based on the interaction between the
clients, the task and the environment. As an exercise physiologist/therapist it is these key areas
that we need to be aware of when planning our interventions. There are different theories on
motor control reflecting existing ideas of how movement is controlled by the brain. This study
was based on two of such theories:
Reflex theory
In 1906, the neurophysiologist Sir Charles Sherrington established the basis for the reflex theory
of motor control, according to which reflexes were the building blocks of complex behaviour
intended to achieve a common objective. According to reflex theory, movement is controlled by
stimulus-response and reflexes are the basis for movement. Reflexes are combined into actions
that create behaviour.

19. 19
Overview of a stimulus-response pathway
Ecological theory or perspective
Gibson and Walk, (1960) explored the way in which our motor systems allow us to interact more
effectively with our surroundings in order to develop goal-oriented behaviour. The individual
actively explores his or her environment, and the environment promotes the performance of
activities that are environmentally appropriate. The ecological theory emphasises the
organisation of movement as a result of interactions of the environment and goal-directed
actions. The interaction of the person with any given environment provides perceptual
information used to control movement.

20. 20
CHAPTER THREE
RESEARCH METHODOLOGY
This study examined the effects of eight weeks aerobic exercises on selected physical fitness
components of children with Autism Spectrum Disorders at National Orhopaedic Special School
Igbobi, Lagos. In this chapter, the research methodology adopted in the study were discussed
under the following sub-headings:
Research Design
The population of the Study
Sample and Sampling technique
Instruments
Measurement and Performance Test
Procedure for Data Collection
Procedure for Data Analysis
Research design
Two groups of Pre-test Post-test experimental design was adopted for this study.
Table 2: Graphical representation of two groups pre-test post experimental design
Random assignment
of participants
Pre-test Treatment-8-week
aerobic exercises/No
treatment
Post-test
R O1 X O2
R O1 - 02
In this design, subjects were randomly assigned into two groups, (experimental group and
control group), the experimental group was given treatment and the results are gathered at the
end. The advantage here is the randomisation, so that any differences that appear in the posttest
should be the result of the experimental variable rather than the possible difference between the
two groups. This is the classical type of experimental design and has good internal validity
(Creswell, 2012). The control group received no treatment, over the same period of time, but
undergoes exactly the same tests. This design is appropriate for this study because it is the
simplest and most common of the pretest-posttest designs, and is a useful way of ensuring that an
experiment has a strong level of internal validity. The principle behind this design involves

21. 21
randomly assigning subjects between two groups, a test group, and a control. Both groups are
pre-tested, and both are post-tested, the ultimate difference being that one group was
administered the treatment. This test allows a number of distinct analyses, giving researchers the
tools to filter out experimental noise and confounding variables. The internal validity of this
design is strong because the pretest ensures that the groups are equivalent. This design allows
researchers to compare the final posttest results between the two groups, giving them an idea of
the overall effectiveness of the intervention or treatment. The researcher can see how both
groups changed from pretest to posttest, whether one, both or neither improved over time. If the
control group also showed a significant improvement, then the researcher must attempt to
uncover the reasons behind this. The researchers can compare the scores in the two pretest
groups, to ensure that the randomisation process was effective (Shuttleworth, 2009).
The population of the Study
The population for the study consists of all children diagnosed with Autism Spectrum Disorder
attending National Orthopaedic Hospital Special School, Igbodi, Lagos between the ages of 9-20
years.
Sample and Sampling technique
The participants for this study were 40 children who have been diagnosed and confirmed to have
Autism Spectrum Disorder and which the severities are mild. The American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-5 was used to
categorised the participants and those within severity levels 1 were part of the sample. A total of
20 participants completed the aerobic exercises programme. The simple random sampling
technique was used to select the sample. Precisely, the random numbers method was used
involving the numbering of population members. Then, the sample size of N has to be
determined by selecting numbers randomly (Gravetter & Forzano, 2011). This technique was
suitable for this study because each participant was chosen entirely by chance and each member
of the population had an equal chance, or probability, of being selected. This sampling technique
was chosen because it is free of classification error, and it requires minimum advance knowledge
of the population other than the frame. Its simplicity also makes it relatively easy to interpret
data collected in this manner. For these reasons, simple random sampling best suits situations
where not much information is available about the population and data collection can be
efficiently conducted on randomly distributed items (Meng, 2013).

22. 22
Instruments
The following equipment was used for data collection:
1. Weighing Scale: Weighing scale Model 2650KL Health- O - Metre digital electronic platform
scale was used to measure the weight of the participants in a kilogramme.
2. Stadiometre: Stadiometre SECA-213 model was used to measure the height of participants.
3. Whistle: The Champion Whistle model Fox- 40 Classic was used to motivate the participants
during the brisk walking exercise.
4. Stopwatch: Kadio Electronic Stopwatch Model KD -1063 was used for taking the time during
aerobics dance and brisk walk exercise.
5. Child BMI calculator software: The Child BMI calculator software was used to rank each
child's raw BMI score relative to age- and sex-specific national norms using the criteria
established by the Centre for Disease Control and Prevention Growth Charts for ages 2-20 years
(Centre for Disease Control and Prevention, 2000).
6. Sit and reach bench.
The sit and reach bench is a piece of 3/4" plywood, sturdy wood cut into the following sizes:
8. Takei Hand Grip Dynamometer: The Takei Hand Grip Dynamometer model SKU 5401-C
model is a simple and popular test for general strength level.
Measurement.
Height:
Equipment: Stadiometre.
Purpose: To measure the height of participants (International Society for the Advancement of
Kinanthropometry, 2001; Lohman, Roche & Martorell, 1988).
The height was recorded to the nearest 0.1 centimetre
Weight
Equipment: Weighing scale.
Purpose: To measure participants weight.
Body Mass Index: The Body Mass Index was measured with Child BMI calculator software
(Centre for Disease Control and Prevention, 2000).
Performance Tests
The following performance tests were conducted on all participants.

23. 23
Modified Stork Standing Test
Variable measured: Balance
Equipment: Stopwatch
Purpose: The stork standing test was used to measure the static balance of participants. The
stork test was modified due to balance deficits among this population (Mackenzie, 2000;
Johnson & Nelson, 1979). The test interrater reliability of the stork test using a two-point scale
showed high levels of agreement on the pattern of pelvic movement on the weight bearing leg
(kappa scores: left κ = 0.67 percentage agreement 91.9%; right κ = 0.77 percentage 89.9%).
(Hungerford, Gilleard, Moran & Emmerson, 2007).
Scoring: This test was executed twice and the best time was recorded.
Hang grip Test
Variable measured: Muscular Strength
Equipment: Handgrip dynamometre and a recording sheet.
Purpose: The purpose of this test was to measure the maximum isometric strength of the hand
and forearm muscles (Winnick & Short, 2001; Mathiowetz, Wiemer & Federman, 1986).
Within-session reliability was high with an intraclass correlation coefficient of r = 0.79 for all
muscle groups, and there was acceptable between-session reliability ICC > 0.70 (Crompton,
Galea, & Phillips, 2007). Intraclass correlation coefficients ranged from .76-.93 for within-
session, intratester reliabilities, .67-.84, for between-session intratester reliabilities, and .30-.83
for within-session, intertester reliabilities (McMahon, Burdett & Whitney, 1992). The inter-tester
reliability of strength measurement using the 30-sec RM was acceptable with intraclass
correlation coefficients values ranging from 0.91 -0.96. (Verschuren, Ketelaar, Takken, Van
Brussel, Helders & Gorter, 2008).
Scoring: The best of three trials was recorded, with at least 15 seconds recovery between each
effort.
Modified Sit and reach test
Variable measured: Flexibility.
Equipment: A ruler, sit and reach the bench.
Purpose: The purpose of this test was to measure the flexibility of the lower back and hamstring
muscles. (Australian College of Sport & Fitness, 2013). The sit and reach test is an important
functional measure of hip region flexibility, including the lower back and hamstring muscles (the

24. 24
back of the legs). The sit and reach (SR) test is a field test used to measure hamstring and low
back flexibility (Baumgartner & Jackson, 1995). Reliability estimates for the standard Sit and
reach are consistently high (r = 0.96) (Shaulis, Golding & Tandy, 1994; Jackson & Langford,
1989; Jackson & Baker, 1986).
Ruler Drop Test
Variable measured: Reaction Time
Equipment: Ruler, stopwatch, recording sheet
Purpose: The purpose of this test was to measure the time it takes the participant to catch a ruler
dropped by the researcher. The ruler drop test was used to measure the reaction time of
participants (Wood, 2008). The Ruler Drop Test has acceptable reliability and criterion validity
(Aranha, Sharma, Joshi, & Samuel, 2015; Eckner, Whitacre, Kirsch, & Richardson, 2009), and
Ruler Drop Test reliability in preschool children. Reliability using test-retest, descriptive results
(i.e., mean and standard deviation for pretest and retest were 38.43 7.86 and 37.56 9.75 cm,
respectively Intraclass correlation coefficient (ICC) equal to 0.744 (95% confidence interval
[0.836, 0.602] (Latorre Roman, Lopez, Sanchez, Sanchez, Coronas, & Garcıa-Pinillos, 2015).
Scoring: Record the time it took for the subject to react and catch the falling ruler and the
distance.
Wall Toss Test
Variable measured: Neuromuscular coordination.
Equipment: Smooth surface wall, tennis ball, paper tape, recording sheet.
Purpose: This was used to measure the hand-eye coordination of the participants.
Neuromuscular coordination is typically measured using tests of hand-eye or foot-eye
coordination such as throwing, catching or bouncing a ball, or hitting an object. Manual dexterity
tests or tests of hand-eye coordination also fall into this category (Wood, 2008). Luz, Rodrigues,
Almeidac, and Cordovilf, (2016) reported r = 0.94 indicating good reliability of the model to
reproduce Motor competence concluding for its overall validity for interpreting Motor
competence in children and adolescents. Motor competence can be used by researchers, PE
teachers, and health and sports training professionals, in order to objectively monitor motor
development.
Scoring: Record the number of successful catches in 60 seconds.

25. 25
Ethical considerations
Studies involving interaction with a human sample usually have some ethical implications and
this study was not an exemption. To resolve this implication, letter of reference was collected
from the Department of Human Kinetics, Sports and Health Education to Lagos State Universal
Basic Board via National Orthopaedic Hospital special and Igbobi for permission to conduct the
study. A copy of the study proposal was attached to the permission letter. Willingness to take
part in the exercise programme was obtained from the participant's parents/guardian at the start
of the programme while participants/parent/guardian was given informed consent and their
anonymity was maintained.
Pilot Study
The pilot study was conducted to enable the researcher and assistants to be acquitted with the
procedures involved in the test and measurements and any challenges with the instrumentation or
other elements in the data collection technique. A pilot study that lasted for six days was
conducted at Agbeke Homes at Araromi-Ale, Badagry. The home was selected because it has
children with Autism Spectrum Disorders. A total of eight children from the homes participated
in the pilot study to collect data on the selected variables of physical fitness and bio-data of
participants. The pilot study revealed the difficulty in measuring children with Autism Spectrum
Disorders blood pressure due to their inability to maintain a stable position. Also, the children
were unable to stand on a base to perform the Stork balance test. In view of this, the base was
removed and the Stork balance test was performed on the floor. Information gathered from the
pilot study provided a base for modifying the instrument for data collection.
Procedure for Data Collection
The researcher and four research assistants moved to National Orthopaedic Special School,
Igbobi, Lagos to collect pre-test and post-test data. The purpose of the study was explained to all
participants parents/guardians, head and other teaching and non-teaching staff. All measurements
and treatments were carried out in the school hall and playground. The participant's
parents/guardians filled and submitted the informed consent form to show their support and
permission of their children/wards to take part in the study.

26. 26
Inclusion criteria
To be included in the study, participants met the following criteria:
 Participants must have been diagnosed with Autism Spectrum Disorders in accordance
with the criteria of the DSM-V.
 Participants in severity level 1 that required support
 The participant that can move on their own without support
 Participants who were willing to follow instructions
Exclusion criteria
The following criteria were used for exclusion:
 The participant that displayed a high level of aggression.
 The participant whose motor ability is not adequate for physical exercises.
 The participant with a severe physical disability and those in a wheelchair.
 Participant in severity level 2 and 3 that required substantial very substantial support.
 The participant that did not return the parents/guardian consent form.
 Participants above the ages of 20 years.
Measurements of selected physical fitness componets as presented below:
Table 5: Pre-test and posttest of selected physical fitness components.
Selected physical fitness
components
Instruments used for
measurement
Measuring equipment
Static balance Modified stork standing test Stopwatch
Flexibility Sit and reach Sit and reach bench
Muscular strength Hand grip dynamometre Hand grip dynamometre
Neuromuscular Coordination Wall toss test Wall, tape and tennis ball
Reaction Balance Ruler Drop Test Ruler and stopwatch
Body Composition Weight and height measurement Weighing scale, stadiometre
and BMI software
Table 5 showed the selected physical fitness components, instruments and measuring
equipments. The two groups performed the selected physical fitness components as stated above

27. 27
before and after the treatment. The sit and reach was used to test for flexibility of each
participant in each group; hand grip dynamometre was used to test for hand and forehand
muscles, modified stork standing test was used to test for static balance, ruler drop test was used
to measure reaction time while the wall toss test was used to measure neuromuscular
coordination, weighing scale was used to measured weight, stadiometre was used to measured
height while BMI software was used to Body Mass Index of each of the participants.
Treatment for the experimental group
Activities selected for the eight weeks programmes are:
The sequence of the exercises in the programme was low impact and was not rigid to maintain
high levels of interest and fun. Different motivational strategies were used to maintain
motivation and adherence to the programme using different equipment materials, music, and
refreshment. The strategies helped to reduced or eliminate barriers/ mortality throughout the
duration of the study.
Table 6: Eight weeks of treatment for the experimental group
Days Events Duration Intensity
Monday Aerobic
dance
Warm-up = 5 minutes Aerobic dance -30 minutes, Warm-
down =30 minutes Total = 40 Minutes
Low impact
Tuesday Brisk
walk
Warm-up = 5 minutes, brisk walk -30 minutes, Warm-down
= 30 minutes Total = 40 Minutes
Low Impact
Friday Jumping
on rope
Warm-up = 5 minutes Jumping on rope -30 minutes, Warm-
down = 30 minutes Total = 40 Minutes
Low Impact
Procedure for Data Analysis
The data collected were analysed with statistical tools of frequency counts, percentage, the mean,
standard deviation and chart for demographic data while inferential statistics of paired t-test was
used to test the stated hypotheses at 0.05 alpha level.

28. 28
CHAPTER FOUR
RESULTS AND DISCUSSION OF FINDINGS
Discussion of findings
Hypothesis one which postulated that eight weeks aerobic exercises have no significant effects
on the static balance of children with Autism Spectrum Disorders was rejected (t = 4.92; p <
0.05; df = 19) indicating that eight weeks aerobic exercises have significant effects on the static
balance of children with Autism Spectrum Disorders. This finding corroborates the study of
Neophytou, (2016) who found a significant difference between the control and intervention
groups in the second trial of the two board balance activity, yet for all the other balance
parameters there were no significant differences between the groups. The intervention group did,
however, perform better in all of the balance activities compared to the control group. The
intervention group was able to hold their balance for a mean 10.5 ± 9.2s during the two-board
balance test, while the control group could hold their balance for 6.8 ± 6.0s. The intervention
group performed worse in their second trial of the test (compared to their first), maintaining their
balance for a mean 16.9 ± 11.2s, while the control group maintained their balance for 6.7 ± 8.8s.
Casey, Quenneville-Himbeault, Normore, Davis and Martell, (2015) investigated the use of
dancing as a means of rehabilitation in a 15-year-old girl with Autism Spectrum Disorder. The
participant participated in 30-minute sessions of dance therapy twice a week for a year, totaling
120 sessions. Results showed marked improvement in her balance where her overall balance
score improved from 68% to 75%, and her overall motor function measure improved by 27.1%.
Following dance therapy, the participant moved from a "severe" ASD diagnosis to a "moderate"
Autism Spectrum Disorders diagnosis according to the childhood autism rating scale for the
before mentioned parameters, thus making dance therapy an effective physical activity tool in
rehabilitating this participant with Autism Spectrum Disorders. Ahmadi, Sokhanguei and
Memar, (2013) study of aerobic exercise showed significant improvement in static and dynamic
balance's triple tests among experimental and control groups. Pan, 2010; Wuang, Wang, Huang,
and Su, (2010) found that recreational pool exercises and horseback riding have been used to
facilitate gross motor coordination and balance in children with Autism Spectrum Disorders.
Waleed, Moronkola, and Oladipo, (2002); Paterno and Mmyer, (2004); Young, Jordan, and

29. 29
Waren, (2010) studies found that that strength exercises cause a significant increase in static and
dynamic balance.
Hypothesis two which states that eight weeks of aerobic exercises have no significant effects on
the muscular strength of children with Autism Spectrum Disorders was rejected (t = 4. 83; p <
0.05; DF = 19). This implies that eight weeks of aerobic exercise had significant effects on the
muscular strength of children with Autism Spectrum Disorders. This finding is in line with that
of Neophytou, (2016) who found significant mean improvement seen in the intervention group
for handgrip strength in the non-dominant hand. The result further showed that mean handgrip
strength in the intervention group increased from 19.0 ± 11.8kg to 20.0 ± 11.0kg for the
dominant hand and from 17.2 ± 10.3kg to 18.8 ± 10.4kg for the non-dominant hand, while in the
control group it decreased from 13.4 ± 9.6kg to 12.8 ± 9.1kg for the dominant hand. Pan, 2011;
Rogers, Hemmeter and Wolery, 2010; Fragala-Pinkham, Haley and O'Neil, 2008; Pitetti,
Rendoff, Grover and Beets, 2007; Yilmaz, Yanarda, Birkan and Bumin, 2004; Lochbaum and
Crews, (2003) who reported that physical benefits of exercise for children with Autism Spectrum
Disorders include improvements in cardiorespiratory functioning, motor skill performance, and
muscular strength, as well as a reduction in Body Mass Index.
Hypothesis three which states that eight weeks of aerobic exercises have no significant effects on
the flexibility of children with Autism Spectrum Disorders is hereby rejected (t = 4.37; p < 0.05;
df = 19). This implies that eight weeks of aerobic exercise had significant effects on the
flexibility of children with Autism Spectrum Disorders. This finding corroborates that of
Neophytou, (2016) study who found no significant differences between the groups for all
flexibility parameters; however, the control group (n=10) had greater hip flexion in the dominant
limb as compared to the intervention group (n=15): 10.6 ± 8.60 vs 5.3 ± 4.70 respectively. In the
intervention group flexibility increased for the dominant leg (from 24.8 ± 8.9cm to 27.3 ±
8.6cm), and for the non-dominant leg (from 24.0 ± 8.8cm to 27.8 ± 8.7cm) for the sit and reach
test, yet in the control group flexibility decreased in the sit and reach test for both the dominant
(from 22.1 ±7.2cm to 19.6 ± 5.8cm) and the non-dominant leg (from 23.6 ± 8.1cm to 20.5 ± 6.2).
Srinivasan, Pescatello and Bhat, (2014) who recommended an exercise programme combining
components of aerobic, resistance, flexibility, and neuromuscular training for maximum gains in
fitness and body composition. Lloyd, MacDonald and Lord, 2013; Yilmaz, Yanarda, Birkan and

30. 30
Bumin, 2004; Elliott, Dobbin, Rose and Soper, 1994; Powers, Thibadeau and Rose, (1992) who
reported that as to the assumed beneficial effects on different health domains (motor
coordination, balance, flexibility, and etc.) of ASD it was found that apart from improving
balance and flexibility aerobic exercise also reduced the stereotypical behavioural patterns of
children with ASD, as well as their self-stimulation behaviours. Verret, Guay, Berthiaume,
Gardiner and Béliveau, (2012) who study the effects of a moderate- to high-intensity physical
activity programme showed that fitness level and motor skills, assessed by standardised tests, as
well as behaviour reports by parents and teachers, and level of information processing were all
improved in children with Attention-Deficit-Hyperactivity Disorder after a 10-week training
compared to a control period. Lang, et.al. (2010) who reviewed physical activity with Autism
Spectrum Disorder individuals reported improvements across many domains. Watemberg,
Waiserberg, Zuk, and Lerman-Sagie, (2007) who reported improvements in motor competence
after their intervention with children with combined Attention-Deficit-Hyperactivity Disorder
(ADHD).
Hypothesis four which states that eight weeks aerobic exercise have no significant effects on
body composition of children with Autism Spectrum Disorders was rejected t = -3.404; p <
0.05; df = 19) indicating that eight weeks aerobic exercise had significant effects on body mass
index of children with Autism Spectrum Disorders. This finding is in line with that of
Neophytou, (2016) study reported that the intervention groups weight decreased from 68.3 ±
22.3kg to 67.7 ± 20.5kg, while the control groups' weight significantly increased (p=0.0284)
from pre-intervention from 53.5 ± 17.6kg to post-intervention 54.8 ± 18.1kg. The intervention
groups' BMI significantly decreased (p=0.0130) from pre to post intervention from 25.8 ±
6.0m/kg2 to 24.8± 5.3 m/kg2 and their body fat percentage also decreased from 31.9 ± 12.0% to
31.6% ± 11.4. Pan, 2011; Rogers, Hemmeter and Wolery, 2010; Fragala-Pinkham, Haley and
O'Neil, 2008; Pitetti, Rendoff, Grover and Beets, 2007; Yilmaz, Yanarda, Birkan and Bumin,
2004; Lochbaum and Crews, (2003) who reported the physical benefits of exercise for children
with Autism Spectrum Disorders include improvements in cardiorespiratory functioning, motor
skill performance, and muscular strength, as well as a reduction in body mass index. Kimura and
Hozumi, (2012) who posits aerobic dance exercises have typically been developed as an aerobic
exercise to reduce body compositions as well as improve physical fitness and performance.

31. 31
Pitetti, Rendoff, Grover and Beets, (2007) who implemented a graded treadmill training protocol
for 9 months in adolescents with developmental disabilities including autism and found a
significant increase in calorie expenditure and a decrease in BMI in the group of children
receiving treadmill training compared to the children in the control group.
Hypothesis five which postulated that eight weeks of aerobic exercises have no significant
effects on neuromuscular coordination of children with Autism Spectrum Disorders was rejected
(t = 5.45; p < 0.05; df =19). This implies that 8-week aerobic exercises had significant effects
on neuromuscular coordination of children with Autism Spectrum Disorder. This finding
supports that of Srinivasan, Pescatello, and Bhat, (2014) recommend an exercise programme
combining components of aerobic, resistance, flexibility, and neuromuscular training for
maximum gains in fitness and body composition. Pan, 2011; Rogers, Hemmeter and Wolery,
2010; Fragala-Pinkham, Haley and O’Neil, 2008; Pitetti, Rendoff, Grover and Beets, 2007;
Yilmaz, Yanarda, Birkan and Bumin, 2004; Lochbaum and Crews, (2003) who reported the
physical benefits of exercise for children with ASD include improvements in cardiorespiratory
functioning, motor skill performance, and muscular strength, as well as a reduction in body mass
index. Pan, 2010; Wuang, Wang, Huang, and Su, (2010) who found that recreational pool
exercises and horseback riding have been used to facilitate gross motor coordination and balance
in children with autism.
Hypothesis six which states that eight weeks of aerobic exercises have no significant effects on
the reaction time of children with Autism Spectrum Disorders was rejected (t = 5.446; p ≤ 0.05;
df =19) indicating that eight weeks aerobic exercises had significant effects on the reaction time
of children with Autism Spectrum Disorders. This finding agrees with that of Srinivasan,
Pescatello and Bhat, (2014) who recommend an exercise programme combining components of
aerobic, resistance, flexibility, and neuromuscular training for maximum gains in fitness and
body composition. Pan, 2011; Rogers, Hemmeter and Wolery, 2010; Fragala-Pinkham, Haley
and O’Neil, 2008; Pitetti, Rendoff, Grover and Beets, 2007; Yilmaz, Yanarda, Birkan and
Bumin, 2004; Lochbaum and Crews, (2003) who reported the physical benefits of exercise for
children with ASD include improvements in cardiorespiratory functioning, motor skill
performance, and muscular strength, as well as a reduction in body mass index.

32. 32
CHAPTER FIVE
SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Findings from the study revealed that:
 Eight weeks aerobic exercises had significant effects on static balance of children with
Autism Spectrum Disorders (t = 4.92; p < 0.05; DF =19).
 Eight weeks aerobic exercises had effects on the muscular strength of children Autism
Spectrum Disorders (t = 4.83; p < 0.05; DF =19).
 Eight weeks aerobic exercises had significant effects on flexibility of children Autism
Spectrum Disorders. (t = 4.37; p < 0.05; DF =19).
 Eight weeks aerobic exercises had significant effects on body composition of children
Autism Spectrum Disorders (t = -3.404; p < 0.05; DF = 19).
 Eight weeks aerobic exercises had significant effects on neuromuscular coordination of
children with Autism Spectrum Disorders (t = 5.47; p < 0.05; DF =19).
 Eight weeks aerobic exercises had significant effects on the reaction time of children
Autism Spectrum Disorders (t = 5.45; p < 0.05; DF =19).
Conclusion
Based on the findings, it was concluded that:
1. Aerobic exercise improved the static balance of children with Autism Spectrum
Disorders at the National Orthopaedic special school. Igbobi Lagos.
2. Aerobic exercise improved the muscular strength of Children with Autism Spectrum
Disorders at National Orthopaedic Special School, Igbobi Lagos.
3. Aerobic exercise improved the flexibility of children with Autism Spectrum Disorders of
National Orthopaedic Special School, Igbobi Lagos.
4. Aerobic exercise reduced body composition of children with Autism Spectrum Disorders
at National Orthopaedic Special School Igbobi Lagos
5. Aerobic exercise improved neuromuscular coordination of children with Autism
Spectrum Disorders at National Orthopaedic Special School, Igbobi Lagos.
6. Aerobic exercise improved the reaction time of children with Autism Spectrum Disorders
at National Orthopaedic Special School, Igbobi Lagos.

33. 33
Recommendations
Based on the findings, the following recommendations were made:
1. Physical activity should be incorporated with other existing programmes for children
with ASD at National Orthopaedic Special School Igbobi, Lagos.
2. Aerobic dance should be included in Physical Education programmes of children with
Autism Spectrum Disorders at National Orthopaedic Special School Igbobi, Lagos on a
daily basis to enhance their physical fitness level.
3. The exercise stress test should be conducted for all newly admitted children to reveal
contraindication to exercise among the children and should be conducted by an exercise
physiologists.
4. Flexibility exercise/activities should be part of daily physical activities programmes for
children with Autism Spectrum Disorders to improve their physical fitness level.
5. The brisk walk should be included in Physical Education programmes for children with
Autism Spectrum Disorders at National Orhopaedic Special School, Igbobi, Lagos to
reduce their body composition.
6. Physical fitness variables of balance, neuromuscular coordination, flexibility, muscular
strength and reaction time of children with ASD should be measured at the beginning and
the end of the term for evaluation.
Suggestions for further studies
1. The study can be conducted in collaboration with neuropsychiatric, physiotherapist and
neurophysiologist on the effects of exercises on negative behaviours and motor issues
common among children with Autism Spectrum Disorders.
2. The population-based study can be conducted on the effect of physical activity on motor
domains of children with Autism Spectrum Disorders.
3. The study can be conducted to determine the type of exercise, dose, intensity, duration,
and frequency of the exercise that can enhance the physical fitness of children with
Autism Spectrum Disorders.
4. Further study is needed to demonstrate whether early exercise intervention can reduce the
Body fats of overweight children with Autism Spectrum Disorder.
5. The study can be conducted to determine the preferred physical activity among children
with Autism Spectrum Disorders.

34. 34
Contributions to Knowledge
1. This study has revealed that exercise physiologist can integrate the knowledge of motor
control theories to design physical fitness activities for children with neuro-development
disorders (Autism Spectrum Disorders).
2. This study has built upon the existing database so as to stimulate future research efforts
aimed at using exercise to improve the physical fitness level of individuals with Autism
Spectrum Disorders.
3. The study has provided added value to existing theories of motor control that project the
importance of knowledge and understanding of various theories to assist exercise
physiologist in planning and designing exercise intervention for children with Autism
Spectrum Disorders.
4. Most importantly, the study has been able to establish that appropriate exercise
programme can also be incorporated with other programmes to enhance the general well-
being and assist them in reducing atypical behaviours.
5. This study has also revealed that physical fitness activities should be incorporated into
National Orthopaedic Special School Physical Education and sports programme to
promote the physical fitness of children with Autism Spectrum Disorder.
6. The study has revealed that an eclectic approach can be adopted in managing individuals
with Autism Spectrum Disorders.

35. 35
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