Effect of Combined Music and Taekwondo Training for Children With Autism Spectrum Disorder

Effect of Combined Music and Taekwondo Training on the Psychological and Physical Condition of Children With Autism Spectrum Disorder: A Randomized Controlled Trial

The goal of this randomized controlled trial is to evaluate the effect of combined music and taekwondo training on the mental and physical condition of children with autism spectrum disorder. Participants will be asked to do combined music and taekwondo training or taekwondo training alone to evaluate if the combined training is better than the taekwondo training alone on mental and physical performance for children with autism spectrum disorder.

Study Overview

• Status: Not yet recruiting
• Conditions: Autism Spectrum Disorder
• Intervention / Treatment: Other: Taekwondo training with music therapy; Other: Taekwondo training alone

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Clare CW YU, PhD; Phone Number: +85234003251; Email: clare-chung-wah.yu@polyu.edu.hk
• Study Contact Backup: Name: Kam-Ming Mok, PhD; Email: kmmok2@ln.edu.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Chinese children aged 7 to 9 years who have been clinically diagnosed as ASD by developmental paediatricians or clinical psychologists based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for ASD.

Exclusion Criteria:

• children who have experience in Taekwondo training;
• children who have received music therapy within the previous 12 months;
• those who have severe sensory disorders (blindness or deafness);
• those who have underlying congenital abnormalities or other diseases that limit their ability to engage in physical activities.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Taekwondo training with music therapy; the participating children will attend 20 sessions of Taekwondo training with the presence of music.	Other: Taekwondo training with music therapy; Taekwondo training with music therapy
Sham Comparator: Taekwondo training alone; the participating children will attend 20 sessions of Taekwondo training alone.	Other: Taekwondo training alone; Taekwondo training without music therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engagement in the Training Sessions	the Revised Individual Child Engagement Record (ICER); The ICER-R uses a 15-second momentary time sampling approach and involves the coding of types of engagement, the occurrence of interaction and the interaction partner (coach or peers), and whether the child was physically prompted. The types of engagement being coded at each 15-second interval are active engagement, passive engagement, active non-engagement, and passive non-engagement.	Through training completion, an average of 20 sessions over 10 consecutive weeks
Gross Motor Skills	Motor skills will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2	Baseline, 10 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical Activity Level	Participants will wear an optical heart rate monitor on their forearm to measure their exercise heart rate as a reflection of the physical activity level during the training. Continuous heart rate data will be recorded for every record and expressed as the mean heart rate per min.	Through training completion, an average of 20 sessions over 10 consecutive weeks
Enjoyment State	The Children's Emotional Manifestation Scale (CEMS) will be used to assess the children's emotional state. It classifies observable emotional behaviours into five categories: 'Facial expression', 'Vocalization', 'Activity', 'Interaction', and 'Level of cooperation'. Each category is scored from 1 to 5. The numbers obtained for each category are added together to obtain the total score, which will be between 5 and 25. High scores indicate the manifestation of more negative emotional behavior.	Through training completion, an average of 20 sessions over 10 consecutive weeks
Rate of Perceived Exertion	Children will be asked to rate their exertion level using the Borg 6-to-20 Scale, in which "6" indicates "no exertion at all" and "20" indicates "maximal exertion".	Through training completion, an average of 20 sessions over 10 consecutive weeks
Taekwondo skills performance	A scoring system was modified for use in this project with reference to the international Taekwondo referee scoring standard. Children's performance for a set of selected Taekwondo moves and kicks will be observed and scored by two qualified referees. The performance will be scored out of 8 marks, with 3 marks for presentation, 2 marks for cognitive ability, 2 marks for basic skills, and 1 mark for social interaction. Higher scores indicate better performance.	Baseline, 10 weeks
Conners' Continuous Performance Test II	This test will be used to measure the children's selective attention, that is, their ability to maintain a consistent focus on some continuous stimuli.	Baseline, 10 weeks
Comprehensive Trail-Making Test (CTMT)	The test consists of five visual search and sequencing tasks that are heavily influenced by attention, concentration, resistance to distraction, and cognitive flexibility (or set-shifting). The child is required to connect a series of stimuli (numbers, expressed as numerals or in word form, and letters) in a specified order as fast as possible in each trial. The time scores for the five CTMT trials will be converted to standardized T-scores according to the reference tables in the testing manual, and be summed up to produce a global performance level score, the CTMT Composite Index (CI), which can then be converted into a percentile score according to the participant's chronological age. Higher T score and CTMT CI correspond to better performance.	Baseline, 10 weeks
Social Responsiveness Scale, second edition (SRS-2)	This scale will be completed by the parents. It is a 65-item autism rating scale widely use to identify a spectrum of deficits in reciprocal social behavior, ranging from absent to severe, based on observations of a child's behavior in various social settings. Scoring is on a four-point Likert Scale with five subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerism). Higher T-scores correspond to poorer social functioning.	Baseline, 10 weeks
Childhood Autism Spectrum Test	This is a 39-item, yes-or-no questionnaire of children's social behavior and communication tendencies as reported by their parents. The questionnaire has been translated into Chinese and is being validated. The cut-off score of 15 marks indicates possible autism spectrum disorder (ASD) or related social-communication difficulties.	Baseline, 10 weeks
Strength and Difficulties Questionnaires (SDQ)	The questionnaire will be completed by parents. There are 25 items in the SDQ, which consists of five scales, each with five items, for assessing children's mental health status in terms of emotional, conduct, hyperactivity, peer problems, and prosocial behavior.	Baseline, 10 weeks
Clinical Global Improvement (CGI) score	The CGI-I will be completed by parents to evaluate children's functional changes in daily life after completion of the 10-week program, and at 2-month follow-up. The CGI-I consisted of 12 questions developed by our research team, which are focused on all core symptoms of ASD and covered the following aspects: (1) motor functioning; (2) children's capability to follow instructions; (3) social, communication, and language understanding and expression; and (4) children's capabilities for attention shifting, attention to complete a task, attention to details, and imagination.	10 weeks, 2 months follow-up

Collaborators and Investigators

• Sponsor: The Hong Kong Polytechnic University
• Investigators: Principal Investigator: Clare CW YU, PhD, Assistant Professor

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2024
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: January 14, 2024
• First Submitted That Met QC Criteria: February 18, 2024
• First Posted (Actual): February 26, 2024

Study Record Updates

• Last Update Posted (Actual): February 26, 2024
• Last Update Submitted That Met QC Criteria: February 18, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: music; Autism Spectrum Disorder; taekwondo
• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
• Other Study ID Numbers: HSEARS20211117003-03

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No