Adolescents with Autism Spectrum Disorder (ASD) typically engage less in physical activities than their typically developing peers, influenced by intrinsic and extrinsic factors. Modified sports interventions, like Sports Stars Brazil, can improve motor skills and promote lifelong participation in sports by enhancing physical, social, and cognitive abilities. However, adolescents often face barriers to engaging in community sports and recreational activities after completing the program. PREP is an approach designed to address these barriers by modifying environments and empowering families. To date, no study has explored this combination in adolescents with ASD. Objective: This protocol assesses the effectiveness of combining Sports Stars Brazil with PREP to enhance participation and physical literacy in adolescents with ASD and explores participant and family perceptions. Method: A mixed-methods study with two phases: 1) a randomized controlled trial to investigate combined intervention's effects; and 2) evaluation of participant and family perceptions.
Diagnosis of Autism Spectrum Disorder (ASD).
Level I of functioning (able to maintain interaction and adapt to changes).
Level II of functioning (able to communicate with others but faces difficulties when changes occur) according to the Autism Spectrum Disorder Social Communication Functioning Classification System.
Cognitive limitations
Behavioral limitations
Clinical limitations (e.g., severe cardiorespiratory disease)
Parallel
Sports Stars Brazil
BehavioralModified sports interventions promote physical activity participation in individuals with ASD by addressing intrinsic factors, however they do not address contextual barriers, such as environmental and interpersonal factors, which also influence participation. Factors like bullying, parents' perceptions often prioritizing therapy intervention, and challenges faced in community programs (as the lack of adaptations in existing programs to meet their needs) are some of these obstacles, which reduce adherence to physical activities (Jachyra et al., 2021). Therefore, it may be necessary to combine interventions targeting intrinsic factors, such as Sports Stars, with those that address the extrinsic contextual factors impacting the participation of adolescents with ASD in their community.
context-centered therapy
BehavioralThe complimentary approach of combining intrinsic (Sports Stars) and extrinsic (PREP) interventions aligns with the relationships between the person, their environment, and the quantity and quality of their participation proposed in the "family of participation related constructs (Imms et al., 2017)." By recognizing that participation depends on both the individual's abilities and the contexts and conditions in which it occurs, professionals can adopt a more holistic and tailored approach to individual needs (Imms et al., 2015).
Physical Literacy Profile Questionnaire
As an outcome measure, the Physical Literacy Profile Questionnaire will be used, currently being validated by our research group. Developed in Portuguese, this instrument assesses the level of Physical Literacy in children, adolescents, and adults (ages 6-21), focusing on the individual's perception of their participation in the Sports Stars (SS) program. The questionnaire consists of two parts: the first, with 5 questions, evaluates the participant's perception of their experience in the modified sports program; the second, composed of 24 multiple-choice items, examines the individual's performance in physical, social, and cognitive skills. Each item is rated on a scale of 0 to 2 (0: does not perform, 1: performs partially, 2: fully performs). Higher scores (closer to 2) indicate better physical literacy and greater engagement, while lower scores (closer to 0) suggest poorer outcomes.
Goal Attainment Scale
Goal Attainment Scale : A scale used to assess and quantify the achievement of goals previously established in collaboration with the patient/family. This allows for the evaluation of goal attainment and comparison of the interventions used in the process. The scores range from (+2) for the best outcomes to (-2) for the worst, in accordance with the expected results. It is recommended to set at least two goals and a maximum of four to be achieved within the same period. Higher scores (closer to +2) represent better outcomes, indicating that the goal was successfully achieved or even exceeded. Conversely, lower scores (closer to -2) indicate worse outcomes, suggesting that the goal was not achieved as planned.
Canadian Occupational Performance Measure
Canadian Occupational Performance Measure: A widely used assessment tool designed to measure a person's perceived performance and satisfaction with their daily activities (occupations). It allows individuals to identify and prioritize the areas in which they want to see improvement. The COPM uses a 10-point scale for both performance and satisfaction, with scores ranging from 1 to 10. A score of 1 indicates "not able to perform" or "extremely dissatisfied," while a score of 10 indicates "able to perform at the desired level" or "extremely satisfied." Higher scores indicate better outcomes, meaning greater satisfaction and higher perceived performance in the selected activities.
Family Empowerment Scale
The Family Empowerment Scale is an assessment tool used to measure the empowerment of families with children who have disabilities. It evaluates how well families feel they can influence decisions regarding their child's care and the services they receive. The scale focuses on key areas such as family support, decision-making, and advocacy. The FES uses a 5-point Likert scale, with scores ranging from 1 to 5. A score of 1 indicates strong disagreement or low empowerment, while a score of 5 indicates strong agreement or high empowerment. Higher scores represent better outcomes, indicating greater family empowerment, with families feeling more confident and capable in managing their child's needs and advocating for services.
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