Promoting Physical Activity among Young Children with Autism

/Abstract Higher amounts of physical activity (PA) are linked to multiple health benefits, increased cognition, academic success, and improved classroom behavior for children. These relationships begin to emerge early in childhood during the preschool years. Additional research is needed to determine the rates of PA among children with autism spectrum disorder (ASD); however, research suggests that compared to their typically developing peers, children with ASD participate in fewer types of physical activities, often have delays in a range of motor skills, and face PA challenges including behavior problems, social communication challenges, and adults’ uncertainty about how to modify physically active games to include them. Young children need adult guidance and opportunities to be more active, and early care and education programs are a critical setting for PA promotion. Our team developed and pilot tested WE PLAY (Wellness Enhancing Physical Activity for Young Children), a teacher training, that can be accessed online at no cost. WE PLAY was designed to promote PA at the child- level, to promote knowledge, confidence, and skills to lead PA at the teacher-level, and to impact social and environmental challenges at the program-level. Our three pilot studies demonstrated that WE PLAY was efficacious in increasing PA when implemented with preschoolers with and without ASD and it was viewed as feasible, understandable, and acceptable by teachers. The current proposal aims to test the effectiveness of WE PLAY in children with ASD using a properly powered randomized controlled trial (RCT) and to identify malleable teacher factors that moderate and mediate the relationship between WE PLAY and child PA levels. We hypothesize that at post-intervention and 4-month follow up, children in the WE PLAY group will engage in higher levels of PA in school relative to children in the control group. Further, we will explore the effects of malleable teacher and system-level factors between the intervention and child PA. We hypothesize that malleable teacher and system variables will mediate and moderate the relationship between study group and child PA levels. A national sample of teacher-child dyads (N = 148) from preschools across the country will be randomized into two conditions (WE PLAY vs. Control). WE PLAY teachers will be asked to complete the WE PLAY training. Control group teachers will complete a different online training that is not related to PA. Children with ASD (ages 2.9 to 5.11) will wear accelerometers during waking hours for 5 consecutive days at pre-intervention, post-intervention, and 4-month follow up. Teachers will complete online surveys at each data collection period. The proposed study addresses a critical need for young children with ASD. If WE PLAY is determined to be effective on a large scale it would lead to interventions that could be integrated in a variety of settings, including early care and education programs and community settings, which could improve PA levels in young children, setting them up for greater success throughout their lives. Project Number: 1R01HD116726-01A1 | Fiscal Year: 2026 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: JESSICA HOFFMAN | Institution: NORTHEASTERN UNIVERSITY, BOSTON, MA | Award Amount: $457,605 | Activity Code: R01 | Study Section: Psychosocial Development, Risk and Prevention Study Section[PDRP] View on NIH RePORTER: https://reporter.nih.gov/project-details/11292058