Research finds video games improve mobility for children with autism

University of Delaware professor Anjana Bhat has a long history of finding creative ways to keep autistic children engaged with the added benefit of improving their flexibility and gross motor skills. She’s used dance and play in the past but is now testing video games to see if they’re a viable intervention to promote movement in this population.

Bhat and her team in the Move to 2 Learn Innovation Lab at UD's STAR Campus have been using Ring Fit on Nintendo Switch to help children with autism get their daily dose of exercise.

“Children love video games, and they’re fun,” said Bhat, professor of physical therapy in UD's College of Health Sciences. “But there’s also a lot of evidence that video games with an exercise component have positive effects on cognition, social interactions and general physical activity levels.”

She added that children with autism have a predilection for technology with a love of computers and robots, but exergaming hasn’t been studied in this population.

“Technologies that have been tested and studied in children with autism mainly target sedentary functions that look at improvement in executive function and decision-making, but not necessarily exergaming,” Bhat said. “Exergaming has been studied in older populations and healthy children, but not so much in children with autism, so this study is unique.”

After testing the intervention on a dozen children with autism over eight weeks, the consensus is that it works.

“I’ve never seen anything grab their attention so much. Across the board, this tool is far more engaging than any other tool we’ve used before, including music and movement, yoga, general exercise, and outdoor play, which do not always work for every child,” Bhat said. “With exergaming and the variety of content that exists, most children remain engaged, and that’s what’s so unusual about this intervention compared to past interventions.”

Games like tennis, volleyball, badminton, golf, sword fighting and bowling focus on the upper extremities, while soccer focuses on the lower extremities. Bhat receives accurate measures of improvement in a child’s ability through accelerometers in the video game controllers.

“This is one place where children with autism shine,” Bhat said. “Their visual learning and sensory enhancements help them excel. This gives them a sense of self-efficacy and self-assurance that — they’re good at this,” she said. “It also gives them a sense of connection to the community because they can make friends and feel empowered. Video games are a great equalizer.”

Bhat’s innovative pilot study was funded through a $50,000 award from the donor-created Maggie E. Neumann Health Sciences Research Fund, which targets research and innovation that aims to improve the lives of people with disabilities. Equipped with data from this study, Bhat hopes to expand access to the intervention and test it in the community. It’s already available at D-Fit Plus, an inclusive fitness center in New Castle that aims to help those with special needs explore fitness to build social skills and confidence, grow cognition, and manage stress.

“It’s relatively low cost,” Bhat said. “Another advantage of this intervention is that you don’t need a highly skilled person present to work the intervention because the game leads the activity, making it accessible if embedded in the community.”

This also provides a social outlet for the child’s parents.

“Community settings bring a sense of connection for the child’s parents, who are always looking for community-based activities, and many environments aren’t suitable for children with autism,” Bhat said. “Many environments are too noisy or distracting. Exergaming removes those barriers and allows the child to engage with the game and maybe another partner.”

Bhat’s previously published research has shown that 80% of people with autism face motor challenges. Her research is so compelling that she’s made a case to change the definition of autism to include motor impairments so those on the spectrum can get the proper physical therapy or gross motor interventions that could dramatically improve their quality of life.