PURPOSE:

Motor impairments are prominent in individuals with autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs), and these impairments often impact the individual’s ability to engage in organized physical activity (OPA) programs. While many studies have identified dance and creative movement to be retrospectively and anecdotally therapeutic in multiple areas of development and function, there remains a paucity of literature regarding evidence-based outcomes associated with these programs, and specifically their impact on (1) perceived and objective gross and fine motor skills, (2) self-efficacy, or the perceived ability to accomplish both related (movement) and unrelated (academic or social) goals, and (3) quality of life for affected individuals and their caregivers. This study is designed to objectively evaluate the impact of organized dance classes across these three domains.

STUDY DESIGN:

This study is a prospective randomized controlled study with a waitlist control. Participants include 34 children (ages 4-16 years) with NDDs and their caregivers. Outcome measures consist of caregiver surveys, direct questionnaires, and remote direct assessments conducted pre and post intervention. The intervention consists of either a wait period or a series of ten weekly 1-hour dance classes held virtually via Zoom. The dance classes are provided by the Expressive Movement Initiative at UCLA and contain seven core components: 1) a group warm-up, 2) an across-the-floor series, 3) a challenge series, 4) an aerobic series, 5) a choreographed variation, 6) a game, and 7) a group closing. Participants are each paired with a volunteer teacher who caters classes in a way that is appropriate for their individual developmental and skill level.

SURVEY SELECTION AND DESIGN:

Systematic review of existing literature yielded a limited number of validated surveys available to assess our intended metrics. Specifically, very few surveys exist to measure self-efficacy (defined as the perceived ability to attain goals and known to be key component in the development of resilience), which may be of particular value to a population of children met with challenges regularly. Although specific scales chosen for this study address core features of self-efficacy such as hope and self-concept, they do not directly address goal setting and attainment in a variety of contexts. From the literature review, the study team designed a set of surveys purposefully designed to measure perception of the child’s self-efficacy from the perspective of both the child and their caregiver. In addition, direct measures of social communication and adaptive skills were included in the study to better measure change in these developmental domains.

RESULTS:

241 individuals responded with interest in study enrollment, indicating a strong desire among caregivers to enroll their children with NDDs in dance classes. 18 children were ultimately randomized to the intervention (dance class) group and 16 children to the control (wait period) group, for a total of 34 participants. Participants range in age from 4 to 16 years (M 8.81, SD 3.21) with a plurality diagnosis of autism. The first cohort is currently underway with anticipated effects of dance classes as follows: improved objective and perceived motor skill, higher levels of self-efficacy, and improved quality of life for children and their caregivers.

CONCLUSIONS:

Motor impairments are a prevalent and pervasive co-occurring neurologic condition in individuals with NDDs. These impairments can lead to barriers in access and participation in OPA.  In addition to improving objective physical ability, participation in dance classes may also improve perceived physical ability, which is thought to play a large role in the extent to which children participate in future physical activity. Engagement in physical activity is further known to play primary and secondary roles in the prevention of cardiovascular disease, diabetes, cancer, obesity, depression, and premature death among numerous other benefits. Improved perception of personal physical ability may also contribute to improved perception of goal attainability, otherwise referred to as generalized self-efficacy. Successfully recognizing improved physical competence through dance classes may help children perceive themselves as capable of making improvements in other domains, which might reasonably be applied to psychosocial and behavioral goals.

Self-efficacy is highly desired in all children as a component of resilience, with resilience itself being essential for healthy development in adverse settings, and therefore of particular benefit to a population defined by developmental adversity. This study both evaluates the effect of dance classes on self-efficacy and introduces a newly developed tool for the evaluation of self-efficacy as perceived by participants and caregivers.