Date Presented 04/04/19
Leisure activity participation is important for health and well-being. This study examined differences between children with autism spectrum disorders and controls from 6 to 17 years old in a large national database. An increasing disparity among many types of leisure participation was seen as age increased. This reinforces the importance of intervention at an early age to increase participation in these activities to promote development of skills that contribute to adult competencies.
Primary Author and Speaker: Claudia Hilton
Additional Authors and Speakers: Karen Ratcliff, Ickpyo Hong
PURPOSE: Participation in leisure activities is important for physical health, mental health and well-being (Potvin et al., 2013). For the purpose of this study, we defined leisure as time spent without demands of survival activities, outside of school and sleep. Engagement in leisure activities is significantly correlated with quality of life (QOL) in individuals with autism spectrum disorders (ASD; Billstedt et al., 2011). QOL among individuals with ASD has been consistently found to be lower than that of typically developing individuals in studies across the age span from childhood to adulthood (Ikeda et al., 2014; Potvin et al., 2015). Previous studies have found lower participation in leisure in children, adolescents and adults with ASD with various strategies for categorizing leisure activities among studies. No studies have examined participation changes across the age range from elementary school through high school or have examined a database as large or as broad as in this study.
RESEARCH QUESTION: How does the trajectory of leisure participation from age 5 to 17 compare between children with and without autism spectrum disorders?
DESIGN: We used a cross-sectional design to examine data from the National Survey of Children’s Health 2016 (NSCH). Data consisted of parent/caregiver responses, was representative of the entire United States population (all 50 states) of non-institutionalized children ages 0-17 years. Data were collected between June 2016 and February 2017.
METHOD: Participants included children between age 5 and 17 without intellectual disability, separated into five age groups: 6-8, 9-11, 12-13, 14-15, 16-17.
Nine survey items were included in the analysis, separated into five activity categories:
1. Physical –exercised, played a sport, or participated in physical activity for at least 60 minutes
2. Recreational –TV watching, videos, playing video games, computers, cell phones
3. Social - ate a meal together with family, participated in clubs or organizations
4. Skill – participated in organized activities or lessons or sports team
5. Jobs/Chores – participated in paid work, community service or volunteer work
We used multivariate regression models for the five categories to examine the differences between ASD and controls across the five age groups by accounting for covariates, including sex, race/ethnicity, having attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (ADHD), having current health insurance, having low income, highest level of educational attainment of adult in household, overall health status of parents, and neighborhood supportiveness and safety. Data were weighted to reflect US population estimations.
RESULTS: The sample size was 35,280, 823 (2.33%) with an ASD diagnosis and 34,457 controls. While participation was generally lower in children with ASD, physical activities, skill activities and jobs/chores showed no significant differences from age 6 to 10, but were significant from age 11 to 17. Social activities were only significantly lower than controls for age 16-17. Recreational activities were not significantly different at any age.
CONCLUSION: Participating in a range of leisure occupations is important for well-being. Children with ASD participate less in most leisure activities than children without ASD. The gap becomes greater in adolescence and may eventually lead to limited participation in adult activities, such as employment, living independently, and attending college.
IMPACT STATEMENT: Intervention at an early age is important for children with ASD to facilitate participation in physical, social, skill-based, and jobs/chores activities for overall well-being and to promote development of skills that contribute to adult competencies.
References
Billstedt, E., Gillberg, I. C., & Gillberg, C. (2011). Aspects of quality of life in adults diagnosed with autism in childhood. Autism, 15(1), 7-20. http://dx.doi.org/10.1177/1362361309346066
Ikeda, E., Hinckson, E., & Krageloh, C. (2014). Assessment of quality of life in children and youth with autism spectrum disorder: A critical review. Quality of Life Research, 23, 1069-1085. http://dx.doi.org/10.1007/s11136-013-0591-6
Potvin, M. C., Snider, L., Prelock, P., Kehayia, E., & Wood-Dauphinee, S. (2013). Recreation participation of children with high functioning autism. Journal of Autism Developmental Disorder, 43, 445-457. http://dx.doi.org/10.1007/s10803-012-1589-6
Potvin, M. C., Snider, L., Prelock, P. A., Wood-Dauphinee, S., & Kehayia, E. (2015). Health-related quality of life in children with high-functioning autism. Autism, 19(1), 14-19. http://dx.doi.org/10.1177/136236131509730
