Expanded Game Squad for Neurodiverse Youth

The significant health disparities that exist among people with mental health conditions (MH)
and developmental disabilities (DD), including autism spectrum disorder (ASD), have been
documented through research and clinical practice. The majority of studies have focused on
adults with these conditions, but due to the efforts of agencies such as the Maternal Child
Health Bureau, the health disparities experienced by youth with MH and DD are increasingly
recognized. These youth are more likely to be overweight and obese than their typically
developing (TD) counterparts, have higher cardio-metabolic risk factors, and have lower
levels of health-related fitness. These conditions can be partly attributed to the low
physical activity levels and poor diet quality that have been observed in these populations.
Multiple barriers that operate at the individual, community, and societal levels limit
opportunities for these youth to achieve good health, and thus there is an urgent need for
health promotion interventions to address these disparities. One novel way to address these
barriers is to explore the use of virtual methods adapted specifically for this population to
reach these children and families in their homes, while also investigating viable venues
through which such interventions can be delivered and supported if necessary.

This study seeks to pilot a virtual health coaching and exercise program aimed at addressing
modifiable lifestyle factors that can lead to improved health and well-being for youth with
MH and DD. The Game Squad Home Exergaming program, originally developed by the Pennington
Biomedical Research Center, is a theoretically-guided and evidence-based intervention that
has shown effectiveness at engaging parents and children with overweight/obesity in regular
physical activity and virtual health counseling. Game Squad utilizes home exergaming consoles
(i.e., Kinect for Xbox video games that require physical activity for gameplay) for both
caregiver and child exercise sessions, as well as to deliver virtual health counseling
sessions to participants. These virtual health counseling sessions were aimed at improving
non-exergame related physical activity. Importantly, during a recent RCT involving a
socio-economically and racially diverse population over a six-month period, the intervention
yielded clinically significant reductions in BMI z-score and cardiovascular disease risk
factors, as well as increased moderate to vigorous physical activity (MVPA).

The proposed project seeks to determine whether the Game Squad intervention is acceptable and
engaging to children and adolescents with MH and DD, adapt the health counseling sessions to
encompass additional health behaviors and meet the needs of this population, as well as to
assess feasibility of implementation through both a school-based program and a specialized
clinic for children with MH/DD. This is achieved through innovative partnerships with several
key collaborators: Merrimack College; the Pennington Biomedical Research Center; the
Therapeutic Intervention Designed for Educational Success Program (TIDES) program, a public
school special education collaborative in several north shore communities in Massachusetts;
and the developmental-behavioral pediatrics clinic at Boston Medical Center (BMC-DBP), a
clinical site associated with the MCHB-funded Developmental Pediatrics Research Network
(DBP-NET).

Inclusion Criteria:

- Receiving services either through the BMC-DBP or TIDES programs

- Wi-Fi and TV available in their home environment

Exclusion Criteria:

- Intellectual disability

- Chronic or physically disabling conditions for which strenuous physical activity is
contra-indicated or not feasible