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RUNNING HEADER: The Effects of Diet and Exercise 1

The Effects of Diet and Exercise on a Child with Autism Spectrum Disorder

Taylor Kilgour, Jenna Kosyla, Pax Manning, Elizabeth Marcone, Elizabeth Nerantzis, Julia
Schwartz

James Madison University


The Effects of Diet and Exercise 2

Abstract

The prevalence of children with Autism Spectrum Disorder continues to grow each year, and

more frequently families are turning to alternative treatment plans. These treatment plans include

risk-free methods such as a change in diet and the implementation of various physical activities.

The purpose of the research is to see if there is a correlation between a healthy diet and adequate

exercise and the behavior of children with autism spectrum disorder (ASD). Even though ASD

does not have a cure, it is important to discover ways to improve the behavior that can be

associated with ASD. Each group member researched and analyzed two articles related to our

topic. Overall, the findings were mixed. Some argued that changing the diet and encouraging

exercise is variable and depends on the particular child. Others argued that altering the lifestyle

will improve behavioral issues and health conditions associated with ASD. In conclusion,

although findings are not significant, there is a correlation between diet, exercise and behavior in

children with ASD. None of the articles showed that these little changes will negatively affect

the child. In the future, larger scale studies with more defined guidelines needs to be completed

in order to find a more significant, positive connection.

Keywords: Autism, behavior, nutrition, exercise

Introduction
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Autism spectrum disorder (ASD) is a developmental delay that appears within the first two to

three years of life that affects a child’s cognitive and behavioral growth (National Institute of

Mental Health, 2018). The nature of this disorder affects individuals in a variety of manners, thus

requiring the individualization of care for each child. The prevalence of autism has grown

substantially in the pediatric care setting and continues to grow annually. 1 in every 68 children

born in the United States are diagnosed with autism spectrum disorder. ASD, when compared to

the prevalence of cancer, diabetes, Down Syndrome, and spina bifida in children, still ranks the

highest as the most common diagnosis (Olin, McFadden, Golem, Pellegrino, Walker, Sanders,

Arent, 2017). Although the widespread diagnosis of autism continues to grow, current medical

approaches still lack research and evidence of causation. However, evidence does show that

early therapeutic and alternative interventions can help to minimize ASD behavioral issues. Due

to the lack of curative treatments, parents have decided to turn to alternative interventions to

improve their child’s behaviors (Mari-Bauset, Llopis-Gonzales, Zazpe, Mari-Sanchis, Suarez-

Valera, 2015). Researching how a healthy lifestyle and exercise influences the behavior of

children with autism will allow nurses and healthcare professionals to implement the best plan of

care that is individualized to each child with ASD.

Synthesis of the Literature

Diet
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When looking at how diet specifically affects behavior in children with autism spectrum

disorder (ASD) multiple articles show there is a strong correlation. Other research studies found

showed the results were significant, but there was not enough scientific evidence to draw a

conclusion. Children with ASD have been shown to experience an increase in GI symptoms that

has been due to dysbiotic gut bacteria. The imbalance of flora and lower overall bacterial

diversity in the gut impairs the behavioral health of the patient (Kang, D.W., Adams, J.B.,

Gregory, A.C., Borody, T., Chittick, L., Fasano, A., et al.. 2017). A study that was performed to

look at how a certain diets are shown to manage chronic digestive impairments such as Crohn’s

disease and irritable bowel syndrome (IRS). The goal of the study was to show how managing

these diseases through diet would affect behavioral problems like irritability, aggression, and self

harm. The research compared two studies. The first study looked at 2,973 records and of those

children with autism 24% of them had at least one digestive issue (ex: constipation, diarrhea,

abdominal pain,. etc.). There was a strong correlation between those 24% of children with GI

problems and the diagnosis of anxiety. The second study found a direct relationship between GI

distress and worsening behavior such as, vocal behavior (Ferro, P. & Prasad, R., 2016). Many

times children with ASD stick to specific diets with the thought that these diets will help manage

symptoms associated with ASD. In another study about the effects of different diets, a gluten and

casein free diet was used to see if it had an affect on the behavioral symptoms of children with

ASD (Sathe, 2017). The study results showed that a significant number of parents reported

behavioral and communication improvement in their children, however evidence was not

sufficient enough to conclude that a gluten and casein free diet actually had beneficial effects on

the gastrointestinal system for children with ASD (Sathe, 2017). All of these studies show that

there is a positive correlation between special diets and behavioral symptoms of ASD, although
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overall results were inconclusive due to the uncertain ability of parents to accurately quantify the

severity of their child’s symptoms and the effectiveness of the diets on those symptoms.

Exercise

Exercise in children with autism spectrum disorder seemed to have a positive effect on

their behavior, according to multiple studies. One study looked at the correlation between

swimming and the behavior of 16 boys. Eight of the boys were in phase one and participated in

water exercises for 10 weeks, while the second group did not participate. After 10 weeks the two

groups switched, and the second group of boys participated in water exercises. (Pan, 2010).

After the 10 weeks, group B had shown significant improvements in social behavior. Group A

had barely maintained the improvements they had achieved in the first phase after the ten weeks

of the second phase. This indicates that the swimming exercise program did in fact help with the

behavior of children with autism spectrum disorder. Another article looked at multiple studies

focusing on the effects that exercising has on the behavior of kids with autism spectrum disorder

(Shrinivasan, Pescatllo, Bhat, 2014). Based on the findings of the 16 studies that were done,

exercise interventions led to a 37% improvement in overall symptoms of autism, specifically in

behavior and academics (Shrinivasan, Pescatllo, Bhat, 2014). In another study looking at the

effects that exercise has on behavior, results showed that 20 minutes of high intensity, aerobics

produced significantly worse self-stimulating behaviors than all other conditions (Olin,

McFadden, Golem, Pellegrino, Walker, Sanders, Arent, 2017). Behaviors post exercise at the

thirty-minute mark with kids who had 10 minutes of low intensity exercise were significantly

better than kids who exercised for 20 minutes low or high intensity. Overall, there was a

reduction in self-stimulating behavior (SSB) with children who exercised in a shorter duration

and lower intensity when compared to baseline data and children who didn’t exercise at all. The
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10 L (10 minutes of exercise at a low intensity) yielded the best results in decreased SSB

whereas 20 H (20 minutes of high intensity exercise) led to an increase in SSB (Olin, McFadden,

Golem, Pellegrino, Walker, Sanders, Arent, 2017). All of the studies found concluded that

exercise can improve the behavior of a child with ASD.

Limitations/Implications

There are many limitations to drawing a clear conclusion on the benefits of diet and

exercise on the behavior of children with ASD. The sample sizes of the study were too small and

there was not a specific clinical trait that directly compared nutrition and an active lifestyle to

behavior. Another limitation to the results of the studies is that each child is different and has

different factors that play into their everyday lives that could also affect their behavior. The

results however were encouraging. The positive correlation allows health professionals, social

workers and parents of children with ASD to plan an individualized care plan for the child by

encouraging an active lifestyle, promoting a balanced diet and evaluating adequate nutritional

levels. As the results show no negative implications on the child’s behavior, the methods shown

prove at minimum, a maintenance of behavior and overall improvement of health status

concurrently.

Conclusion

In conclusion, through the research conducted, the findings on the effects of diet and

exercise on children with Autism Spectrum Disorder are diverse. Though the effects of diet on

children with Autism are promising, there was not enough quantitative data collected to confirm

a definitive correlation. However, in most studies the parents of the children with ASD did
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confirm a positive change in behavior with certain dietary changes. Our research does indicate

that exercise can help children with ASD if done in a shorter frame of time, such as exercising

for 10 minutes at a low intensity level. In the end, there were no studies that reported that diet

and exercise negatively affected children with Autism. For best practice, staying educated on

proper nutrition and exercise regimens for children with ASD can be beneficial in implementing

a care plan to benefit the child’s behavior.

Recommendations

There are many ways to improve studies about the effects of nutrition and exercise on

autism spectrum disorders. All of the studies have limited sample sizes, many times with

children of different ages who live in different home life situations. In order to truly get an

accurate study a larger sample would need to be taken with children who have similar home life

and financial situations. Of these children in the sample there would need to be a control group

and an experimental group in which the experimental group eats the same foods in about the

same quantities (according to their nutritional needs). To have the most accurate results it would

be beneficial to follow these children from a young age to an adult to compare if the children on

a special diet have more or less behavioral symptoms of autism as compared to the control

group. In order to measure behavioral changes adequately, it is important to evaluate the

precicity of behavioral changes such as tantrums and agitation.

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