Autonomy-Supportive Circuit Training Program: Differential effects on adaptive behavior and emotional symptoms in children with and without autism spectrum disorder.

Abstract

Aim: This prospective non-randomized controlled study examined the Autonomy-Supportive Circuit Training Program (ASCTP), a structured physical activity intervention. The primary objective was to assess and compare changes in internalizing (emotional symptoms) and externalizing (behavioral difficulties) traits between children with autism spectrum disorder (ASD) and those with subthreshold ASD following ASCTP participation.

Methods: A total of 28 boys (aged 4-10 years) were divided into an ASD (n = 14) and a non-ASD group (n = 14). The ASCTP intervention was developed and implemented in an exercise-focused daycare center for children with disabilities in Japan. The intervention consisted of a structured 45-min exercise program conducted once a week for 6 months. It emphasized an autonomy-supportive and standardized session structure, implemented by trained facilitators, and was specifically designed to support children's self-regulation and individualized activity selection. Emotional and behavioral traits were assessed pre- and post-intervention using the Strengths and Difficulties Questionnaire, completed by the parents. Additionally, the children's lifestyle habits (sleep, screen time, and breakfast consumption) were recorded pre- and post-intervention through parental reports.

Results: The ASD group showed a significant reduction in behavioral difficulties, whereas the non-ASD group exhibited an increase in behavioral difficulties (-1 [-2 to 0] vs. 1 [-1 to 1], adjusted p = 0.034, r = 0.45). Although no significant changes in emotional symptoms were present in either group, a decreasing trend was observed.

Conclusion: Participation in the ASCTP was associated with a reduction in behavioral difficulties in children with ASD, which may reflect the potential benefits of the structured framework of the program. Conversely, the increased behavioral difficulties observed in the non-ASD group may indicate the need for more flexible intervention approaches.