The effect of SPARK exercises combined with pivotal response treatment on balance and executive function in children with high-functioning autism spectrum disorder: A follow-up study

Résumé fourni par la source

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and interaction, repetitive behaviors, and strong genetic associations. Objective: This study examines the impact of SPARK exercises combined with pivotal response treatment (PRT) on enhancing executive function and balance in children with high-functioning ASD, who are faced with challenges in communication, cognition, and motor skills. Methods: A total of 24 boys aged 7-10 years with high-functioning ASD were randomly divided into two groups of 12. The experimental group participated in 18 sessions of SPARK exercises using child-led, interest-based PRT over a period of six weeks (3 sessions/week, 45 min/session), while the control group was provided with SPARK exercises with instructor training under the same schedule. Static balance was measured by the stork test, modified dynamic balance by the heel-to-toe walk test, cognitive flexibility by the Wisconsin Card Sorting Test, and working memory by the n-back test. Pretest, posttest, and 2-month follow-up tests were conducted. Results: Cognitive flexibility revealed a statistically significant improvement for the experimental group (p = .026, ηp2 = .15), which was maintained at follow-up two months later. The group time interaction for static balance, dynamic balance, and working memory were not significant for the pretest, posttest, or follow-up (all ps > .05). Conclusions: The effectiveness of the PRT intervention, when used in conjunction with SPARK-based activities, was substantial for the improvement of cognitive flexibility for children with high-functioning ASD. Such improvements could explain the enhanced behavioral adaptability of this group. However, the effectiveness of the intervention was limited for balance and working memory, suggesting specific rather than general benefits. Further studies with larger and more diverse samples are needed to increase external validity, replicate these findings, and improve the intervention protocol.

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