The Efficacy of Contingent Reinforcement on Compliance with a Stationary Cycling Activity by Adolescent Boys with Autism Spectrum Disorder

ABSTRACT
Studies have reported that youth with Autism Spectrum Disorder (ASD),when compared to typically developing children as well as youth with other disabilities had (a) higher levels of obesity (Broder-Fingert, Brazauskas, Lindgren, Iannuzzi, & Van Cleave, 2014; Curtin, Anderson, Must, & Bandini, 2010; Rimmer, Yamaki, Lowry, Wang, & Vogel, 2010), (b) lower levels of physical activity (PA) (MacDonald, Esposito, & Ulrich, 2011; Pan & Frey, 2005) and (c) higher levels of sedentary behavior (especially screen time [ST]) (Mazurek & Wenstrup, 2013; Shane & Albert, 2008). The short- and long-term disadvantages of these three conditions are well documented. However, the complex, heterogeneous nature of ASD, often coupled with other concurrent conditions, as well as particular individual idiosyncrasies has resulted in this population reportedly experiencing difficulty in motivation for and complying with physical activity (Lang et al., 2010; Sherrill, 2004).
The purpose of this study was to assess the efficacy of the contingent use of screen time (watching DVDs) on the compliance with a stationary cycling activity by three adolescent males (ages 17 to 18 years) with mild to moderate ASD for 5 days a week over a period of 5 weeks (20+ sessions). Participants pedaled a regular bicycle mounted on an indoor trainer connected to a microprocessor that displayed information on time pedaled (TP) and revolutions per minute (RPM) to the participants, as well as controlled the portable DVD player. These sessions were 20 to 30 minutes long in total. During each session, TP and RPM data collected were used to calculate total output per session (TOS) and percentage compliance. In addition, heart rate (HR) was monitored prior to, during, and after exercise using a wristband monitor. Phase A (baseline) required the participants to pedal the stationary bicycle for 15 minutes while the DVD (reinforcement) played continuously (thus non-contingent). Once predictability was established
for the dependent variables (TP and RPM), phase B (several brief learning/orienting task sessions) was implemented during which participants were afforded the opportunity to learn/understand the task (i.e., DVD paused when pedaling within 5 RPM outside the set RPM criterion zone, and shut off when pedaling > 5RPM outside the criterion zone). Phase C (treatment) was then introduced during which the DVD played normally (i.e., was made contingent on the participants’ ability to pedal within a predetermined set RPM zone [range of 10 RPM] for a duration of 15 min).
Results indicated that all three participants pedaled the full 15 min throughout all treatment sessions. The participants all showed increased compliance in terms of RPM changes during each criterion change phase (whether the change was an increase or a decrease), as well as increased HR values across treatment sessions. Two of the subjects pedaled within their individualized HR levels equaling moderate PA (40% to 70% heart rate reserve [HRR]), while the third participant’s data showed a slow and gradual, but definite upward slope. In addition, TOS (work output) for each participant increased from baseline to treatment, and within treatment. These results demonstrated the efficacy of the contingent use of screen time (watching a DVD) on the compliance of these three participants with a stationary cycling activity.
The discussion involved an interpretation of the findings with regard to the dependent variables, and incorporated the findings of additional measures (DVD actions taken, enjoyment ratings, body composition measures, and social validity).