Exploring the Effects of Swimming on Sleep Behaviors of Children with Autism Spectrum Disorder Using Single-Subject Design

Evidence suggests physical activity (PA) improves sleep of typical children but benefits for children with autism spectrum disorders (ASD) are not established. We examined the effects of PA, particularly swimming, on the sleep behaviors of three children with ASD using objective and parent-report measures. Children participated in eight weeks of a specialized swim program. Parents completed sleep and behavior measures at the beginning and end of the eight-week program. Parents also completed a sleep log for one week while their child slept on a sleep sensor. Results showed variable response to the Sensory Enhanced Aquatics intervention. One child’s sleep and behavior were stable and/or improved, one child’s outcomes were variable, and one child’s sleep worsened. The sleep sensor revealed children fell asleep more quickly after swimming, but increased times out of bed for one child. Recreational therapists should use caution when recommending physical activity to improve sleep with this population and carefully monitor outcomes.