Judo and karate in primary school as a means for the improvement of social inclusion for autistic children

Judo and karate in primary school as a means for the improvement of social inclusion for autistic children | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Judo and karate in primary school as a means for the improvement of social inclusion for autistic children Nicole Maussier, Emanuela Pierantozzi, Renato Manno, Angela Magnanini This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4836261/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Jun, 2025 Read the published version in Sport Sciences for Health → Version 1 posted 11 You are reading this latest preprint version Abstract Purpose Autistic children are often at risk of isolation. Many studies have demonstrated the effectiveness of sport interventions for autistic children. Martial arts such as judo and karate are among the most recommended sports, but few studies have been conducted to analyze the benefits of sports in inclusive primary school contests. This research was conducted by "KATAUTISM PROJECT" of the Italian Judo, Wrestling, Karate and Martial Arts Federation (FIJLKAM), whose objective is the inclusion of autistic children through the practice of judo and karate in primary schools. Methods The study involves 31 ASD children (n=5 girls n= 26 boys) with different level of autism between 6 and 10 years old who all partook in an inclusive judo (n=16) and karate program (n=15) at school with their classmates. Each program includes 2 weekly sessions for 24 weeks, with each session lasting 1 hour. This study analyzes 3 different areas in autistic children: the level of autism, social compromission and gross motor skills Results. All ASD children completed the program with classmates that yielded statistically significant results (p<0.05) in all 3 areas analyzed. Conclusion Judo and karate in school contest has favored the inclusion of ASD children within the classroom. Through careful monitoring of autistic mannerisms, hetero and self-aggressive behaviors, emotional regulation and a degree of tolerance, all ASD subjects greatly benefitted from the social inclusion. The study also demonstrated that the comparison groups of judo and karate produce similar average percentage improvements in GARS, SRS and TGMD-3. Autism judo karate social inclusion primary school Figures Figure 1 Introduction Autism spectrum disorder (ASD) refers to a range of heterogeneous neurodevelopmental conditions characterized by difficulties in communication and language development, social interaction and the presence of restrictive and repetitive behavior patterns that are defined by American Psychiatric Association (1). The prevalence of ASD is estimated to be at least 1.5% in developed countries (2). Autistic children often find it difficult to be included in inclusive sports contexts (3). In Italy, it is estimated that 1 child out of 77 between the ages of 7-9 has ASD, with a higher prevalence in males, who are 4.4 times more likely to have ASD than females. This national estimate was made as part of the “Observatory Project for Monitoring Autism Spectrum Disorders” coordinated by the National Institute of Health and the Ministry of Health (2021). ASD individuals exhibit a variety of stereotypical motor behaviors such as hand clapping and body rocking (4). Many studies have demonstrated the effectiveness of motor interventions in ASD people, especially if the interventions are intensive and introduced in the early stages of life (5). However, early therapeutic intervention can be extremely expensive for families of ADS children (6), with a high cost placed on individual families and social services. Many pedagogical studies have also shown that sport is one of the many possible paths to inclusion (7; 8). A recent study also shows that raising awareness at school on the topic of diversity is a fundamental element for a more inclusive path (9). Reviews of the impact of physical activity in ASD individuals (10) have highlighted significant benefits. Another review exclusively examines the impact of exercise interventions on a range of behavioral symptoms that include stereotyped behaviors (11) and also examines positive social behaviors that focuses on younger children who are often excluded by other reviews. It has therefore been highlighted that martial arts disciplines are among the most recommended sports for autistic subjects as they produce significant and positive change from a behavioral, communicative and relational point of view (11). There is an association between reduced social functioning and less physical activity in autistic individuals (12; 13). Existing studies have shown that physical activity interventions can influence ASD symptoms, such as reducing stereotyped behaviors in both autistic children and adults (14; 15). Previous meta-analysis has revealed moderate to large effects of physical activity interventions on social functioning (16). Increased exposure to social stimuli through physical activity can induce improvements in communication, social functions and increase self-confidence. Since the 1970s, Italy has passed a series of laws, in particular law n°104 of 5 February 1992, which supports the integration and scholastic inclusion of people with disabilities, with particular attention to the sporting dimension. With law n°66 of 2017, the rules for promoting the educational inclusion of disabled students were defined and the term integration is replaced with inclusion. In 1999 the law n. 17 in Italy sanctioned the right of access to the university to include disabled students. These legislations highlight how Italy has worked according to its own model of inclusion in sport which combines the principles of Universal Design (17; 18). Studies have demonstrated the beneficial effects of exercise and sports training through a wide variety of abilities in ASD children (19). After practicing physical exercises, subjects ASD subjects showed profound improvements in social skills (20;19), cognitive function (21), stereotypical behavior (22), communication (23), attention (20), self- harm behavior (24), aggressiveness (25). Bahrami et al (23) were among the first to examine the effects of karate exercise on communication deficits in ASD. The results of the study confirmed that karate training techniques lead to an improvement in communication deficit in ASD children. In a recent article (26; 27; 28) the benefits of a motor and behavioral judo activity were demonstrated. In another study (29) it was also shown that physical activity with physical contact contributes to a good production of oxytocin in autistic subjects. The concept of sport inclusion is based on the fact that playing sport together, disabled children with non disabled children, has mutual benefits (30); even those with severe disabilities benefit from physical interaction with other groups of children (31; 32). As such, the preparation of physical educators (33; 34) and peers as well as a strategic inclusion in physical education is critical (31). It is proven that sports disciplines offer many social opportunities for disabled students; for example, interactions with non disabled peers, building new friendships and learning appropriate behaviors (35; 36). The optimal solution to a successful inclusion is to provide support to the disable students ties through qualified coaches or peer tutors (30; 37; 38). Studies of which, clearly show that peer tutors can be an effective method of supporting disable students in general physical education but providing them with support from trained coaches is essential (31; 39). Starting from a theoretical background, a scientific study was conducted into the Italian Judo Fight Karate and Martial Arts Federation (FIJLKAM) project “KATAUTISM”, with the aim of including autistic children through practice of judo and karate in a school environment. The study looked at adaptations related to social inclusion, gross motor skills and behavior. Our hypothesis was that by practicing judo and karate in a school environment, behavioral and gross motor improvements could be achieved through promotions of inclusivity. Methods Participants The autistic children involved and analyzed n=31 were n=5 girls and n=26 boys with a mean age of 7,58 (± 0,38) years and with different level of autism. The activity took place twice a week (1 hour each session) for a total of 24 weeks. The involved classes were 31, with a mean number of 18.48 children per class. Materials The intervention program focused on basic judo and karate skills. The research was conducted across 7 italian regions with a total of 573 children of which 31 autistic children. To participate each classroom had to have 1 autistic child. The selection of the classes was entrusted to the school Directors who knew which classes had autistic children. All the participants had been diagnosed ASD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) (1). Procedure The selected classrooms were divided in 2 groups: 1group followed the Katautism Judo Program and 1 group followed the KATAUTISM karate program. The ASD children partook in inclusive activities with their classmates together during curricular school hours. The project used an adapted methodology with specific tools. To ensure predictability for autistic children, images of augmentative communication were used to facilitate understanding of the sequence and duration of individual activities. The images of the augmentative communication were given to coaches and psychologists, with a visual weekly agenda issued in the classroom which allowed the autistic child and his classmates to understand on which day of the week the activity took place. All the staff, made by specialized coaches and psychologists of autism, followed a specific training course of 40 hours where topics concerning autism were treated by psychologists, neuroscience experts, adapted motor activity experts and pediatricians. The focus of the lessons was based on the objective of research into the methodology, specific equipment, reading and management of children on the autistic spectrum in inclusive school contests. Prior to starting the project, meetings were organized with the parents of all the children and teachers in the classes to clearly explain the objectives of the project and clarify any doubts. In addition, individual meetings were held with the parents of autistic children with the coordinator of the research, psychologists and coaches of the staff to gather information on the child, state the objectives and explain the test of the research. There were 2 specialized coaches in ASD during the sessions so, if required, a coach was dedicated to the ASD child. The psychologist was an observational figure who supported the coaches throughout lessons; their role was to observe and provide feedback to the coaches. At the end of each training session, the synergistic work between coaches and psychologists formulated the intervention plan to be able to equally satisfy the needs of both the ASD children and the classmates. Throughout the research project, video and in-person supervision were present to ensure the achievement of the objectives and support the Martial Art Teachers and psychologists in the different phases. This was useful for monitoring the behaviors and relationships of autistic and non-autistic children. The sporting activities of judo and karate aligned with the accessibility criteria as the lessons were held in a spacious and comfortable space so that the safety of the participants was guaranteed. The equipment required for this project included a tatami, a high-density mattresses of 100m2, to help prevent injuries. Judo began with the didactic progression of falls in all its forms (backward, sideways forward), before moving on to individual practice and then gradually in pairs with immobilization techniques on the ground. The individualized program for the autistic child resulted from the synergistic work of the specialized coaches and the expert psychologist in autism who was always present during the lessons. Karate began with teaching the basics of karate, (such as correct posture, breathing and movements fundamentals), before progressing to the first kata (pinan nidan). The importance of how to use these techniques in a controlled and responsible way was also explained to the children. The research design involved the analysis of 3 areas of autistic children at the beginning (T0) and at the end of the project (T1). These areas refer to the level of autism on the Gilliam Autism Ration Scale – GARS (40) which is assessed by psychology experts, the area that relates to social impairment on the Social Responsiveness Scale – SRS (41) which is administered by class teachers, and Test of Gross Motor Development 3 rd edition - TGMD-3 (42) which is evaluated by experts in Adapted Motor Sciences. The tests at the beginning and end of the project were always carried out by the same person to guarantee the reliability of the result. The classroom teachers were instructed on how to administer the test, and a psychologist was made available in case any questions were unclear. The research analyzed the changes determined by a judo and karate protocol in the three specific areas of autistic children at the beginning (T0) and end of the project after 24 weeks (T1) through 3 scientifically validated tests: Level of autism with Gilliam Autism Ration Scale (GARS) compiled by psychologists in autism. Social Compromission with Social Responsiveness Scale (SRS) compiled by the classroom teachers. The classroom teachers were instructed on how to administer the test, and a psychologist was made available in case any questions were unclear. Gross motor development with Test of Gross Motor Development third edition (TGMD-3) administrated by an expert in Adapted Motor Sciences. The "Gilliam Autism Rating Scale " is a checklist developed for use by professionals, educators and rehabilitators both to identify autism and to rate the severity of its symptoms for individuals aged 3 to 22 years. Characteristics of the GARS are grouped into 4 subtests that describe specific, observable and measurable behaviors: 1) stereotyped behavior defined by movement disorders and other unconventional behavior 2) communication which allows for the assessment of verbal and non-verbal communicative behavior; 3) social Interaction which evaluates the subject's ability to interact appropriately with people, situations and objects; 4) developmental disorders which includes developmental questions from the first three years of the subject. SRS is used to measure the degree of social impairment associated with ASD. The SRS is a 65-item questionnaire that assesses the Social Awareness (measures the ability to recognize social cues), Social Cognition (assesses the ability to interpret social cues and understand others' perspectives), Social Communication (evaluates the ability to initiate and sustain social interactions), Social Motivation (measures the interest and motivation for social interactions), Autistic Mannerism (assesses the presence of repetitive behaviors and restricted interests typical of autism spectrum disorders)m that characterize ASD in children or adolescents aged between 4 and 18 years. It can be completed by a teacher, parent, or caregiver who is familiar with the individual's current behavior and developmental history. The elements are the same for teachers or parents, but the score profiles are specific to each group. A total score provides a measure of the scale of the social deficit and allows for comparisons across different contexts and raters. The test measures the degree of social impairment, autism spectrum disorders, can be used for all types of ASD. The TGMD-3 is eligible for special education services in physical education and consists of 13 skills: 6 for locomotor skills (running, gallop, single foot hops, hopping step, standing long jump, lateral canter ) and 7 for ball skills (two-handed hitting of a ball at rest, forehand, dribbling in place with one hand, catching a ball with two hands, kicking a ball at rest, high pass and low pass). The TGMD-3 combines fun activities with a reliable procedure to yield significant results in identifying children with gross motor impairments. The results of this evaluation can be used to develop instructional programs, monitor progress, evaluate treatment, and conduct further research on gross motor development. All analyses are realized using IBM SPSS Statistics software in version 28 and a significance level of 0,05 was used for all the analysis. The research design includes the analysis, following the practice of judo or karate in an inclusive school setting, of three different areas in autistic children: the level of autism (GARS), social impairment (SRS), and gross motor skills (TGMD-3) (Fig.1). Results At the end of the data collection and scoring, a univariate descriptive analysis of the variables will be firstly carried out for the total of 31 observations. Table 1 Results Mean pre/post, delta, variation%, t-tes, Wilcoxon test, Cohen's d, in n=31 ASD children n=31 MEAN PRE MEAN POST DELTA VARIATION % P-value (Paired t-test) Wilcoxon test Cohen's d GARS Stereotyped Behaviors 10.87 8.48 -2.39 -21.99 <0,001 <0,001 -1,100 GARS Comunication 8.58 7.06 -1.52 -17.72 <0,001 <0,001 -1,024 GARS Social Interaction 8.32 6.23 -2.09 -25.12 <0,001 <0,001 -,879 GARS Developmental Disorders 8.13 8.13 0 0.00 GARS Total 35.9 29.9 -6 -16.71 <0,001 <0,001 -1,115 GARS Autism Quotient 93.16 83.32 -9.84 -10.56 <0,001 <0,001 -1,108 SRS CnS (Social Awareness ) 71.19 65.23 -5.96 -8.37 <0,001 <0,001 -,999 SRS CgS (Social Cognition) 79.74 73.55 -6.19 -7.76 <0,001 <0,001 -,710 SRS CmS (Social Communication) 79.13 70.26 -8.87 -11.21 <0,001 <0,001 -1,074 SRS MS (Social Motivation) 75.87 68.42 -7.45 -9.82 <0,001 <0,001 -,877 SRS MA (Autistic Mannerism) 86.87 78.58 -8.29 -9.54 <0,001 <0,001 -,841 SRS TOT Punteggio T 82.9 74.32 -8.58 -10.35 <0,001 <0,001 -1,083 TGMD3 Locomotor 2.48 8.68 6.26 252.42 <0,001 <0,001 2,280 TGMD3 Ball control 2.42 8.68 6.2 256.20 <0,001 <0,001 2,243 TGMD3 Total 4.9 17.68 12.78 260.82 <0,001 <0,001 2,429 TGMD3 Gross Motor Index (GMI) 55.61 92.03 36.42 65.49 <0,001 <0,001 2,480 Paired sample t-tests and Wilcoxon tests will be then performed, for both the samples, to assess if there are statistically significant differences in the mean score of GARS, SRS and TGMD3 scales and subscales before and after the experiment (Table 1). A contingency table is presented to analyze the average variations (Delta) in GARS TGMD3 and SRS scales and subscales(table 1). Each paired t-test conducted on GARS subscales and on Autism Quotient is statistically significant (p<0,05): the differences between average scores before and after practising sport are statistically significant. Wilcoxon Tests lead to the same conclusions for all the tests. The Cohen’ d for all the subscales is in absolute value greater than 0.8, meaning that the effect is great in size. The differences between the SRS scores before and after practicing sports are statistically significant for all the subscales (p<0,05), both considering the paired t-test and the Wilcoxon test: it is possible to conclude that the decrease in scores due to practicing sport is statistically significant. Using Cohen’ d to evaluate the magnitude of the effect on the SRS subscales , it can concluded that the effect is of great size ( absolute value of d>0.8) for all the subscales except for the SRS CgS, for which the effect is of medium size. Cohen’ d, used in TGMD-3 to evaluate the effect size for each pair tested, is in absolute value greater than 0,8 for all the pairs pre-mid and pre-post, meaning that the effect is of great size (table 1). Table 2 Percentage variations of the GARS, SRS, and TGMD-3 averages in the judo and karate comparison groups. Judo Karate Mean Mean GARS Stereotyped Behaviors Standard Variation (%) -23,12 -19,10 GARS Communication Standard Variation (%) -17,65 -19,93 GARS Social Interaction Standard Variation (%) -22,90 -24,39 GARS Developmental Disorders Standard Variation (%) ,00 ,00 GARS Total Standard Variation (%) -16,23 -16,73 Autism Quotient Variation (%) -10,55 -9,94 SRS CgS VARIATION (%) -5,45 -9,71 SRS CnS VARIATION(%) -6,63 -9,93 SRS CmS VARIATION(%) -9,02 -12,91 SRS MS VARIATION(%) -10,97 -7,75 SRS MA VARIATION(%) -9,18 -9,51 SRS TOT T score VARIATION(%) -9,12 -11,27 TGMD3 BALL POST PRE VAR (%) 436,82 339,67 TGMD3 LOCOMOTOR POST PRE VAR (%) 399,38 338,48 TGMD3 TOTAL POST PRE VAR (%) 434,71 307,07 TGMD3 GMI POST PRE VAR(%) 68,73 64,00 Finally, in order to analyze the variations considering the martial art practiced, a contingency table is presented to show variations of GARS, SRS and TGMD3 subscales split up by sport practiced (table 2) Discussion The main hypothesis of the research were to if the practice of judo and karate in an inclusive school context can contribute to improve in all level of ASD children, behaviors, the gross motor development and the social inclusion. Studies with neurotypical people have shown that participating in judo increases empathy, reduces aggressive behavior (43) and contributes to the development of self-discipline, serenity, problem solving efficiency and socio-moral sensitivity (44). Other studies on martial arts that have demonstrated significant adaptations in reducing stereotyping behaviors in ASD person and improving social interactions (22; 19; 27). In this study, conduce in KATAUTISM project, we can confirm that Judo and karate has contributed significantly to the reduction of hetero and self-aggressive behaviors, emotional regulation and has improved the degree of tolerance with respect to the times of expected, which greatly compromised the subject's social inclusion. One study has shown that ASD children have greater difficulties with motor development than their peers (45). They also found a relationship between gross and fine motor skills and ASD severity , specifically they observed that the most severe cases of ASD were associated with lower fine and gross motor skills (46). In this study all ASD children (n=31) completed the 24 weeks of inclusive sports program with their classmates. All autistic children have significantly improved their gross motor skills along with behavior and social inclusion. Conclusion The differences between the GARS, SRS and TGMD-3 scores before and after practicing sports are statistically significant in all levels of autism for all the subscales (p0.8) for all the subscales (GARS, SRS, TGMD-3) except for the SRS CgS, for which the effect is of medium size. The study also compared the results of two groups, judo and karate. The results demonstrated that the comparison groups analyzed, judo and karate, both produce average percentage improvements. This underscores the inclusive potential of both disciplines, confirming their adaptability in inclusive settings. The importance of specific training and coordination allows the coaches, through the support of psychology experts in autism, to recognize the needs of ASD children and provide the right motor proposals. It would be interesting in the future to further analyze, across all levels of autism, the benefits of other inclusive sports, including team sports. In this study we can confirm that the practice of Judo and karate in inclusive school contest has significantly improved in autistic children gross motor skills, behavior and favored the inclusion ASD children Declarations Ethic Committee All interventions by project participants involving data collection for research purposes have been subject to approval by the Ethics Committee of the University of Rome Foro Italico (cod.186/2024), in accordance with the directives set out in the updated version of the Helsinki Declaration. This has ensured the respect of all participants' rights and the full protection of data confidentiality and the right to withdraw from the experiment at any time. Declaration of conflicting interests: None. Community Involvement Statement In the development of the research, in the study design, measures, implementation, interpretation, and dissemination of results, the school community, autistic children, families of autistic children, judo coaches, and psychologists specializing in autism were involved. Funding This project was supported by funds from Sport e Salute SPA CUP - J59I22001590001 Financial interests: The authors declare they have no financial interests. References American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association, D. S. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American psychiatric association. Lyall, K., Croen, L., Daniels, J., Fallin, M.D., Ladd-Acosta, C., Lee, B.K., & Windham, G.C. (2017). The changing epidemiology of autism spectrum disorders. Annual Review of Public Health, 38, 81-102. https://doi.org/10.1146/annurev-publhealth-031816-044318. Cioni, L., & Magnanini, A. (2022). Le barriere ambientali alla pratica sportiva: uno studio di comparazione tra bambini con e senza disabilità. ITALIAN JOURNAL OF SPECIAL EDUCATION FOR INCLUSION , 10 (2), 211-220. Bodfish, J.W., Symons, F.J., Parker, D.E., & Lewis, M.H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of autism and developmental disorders, 30, 237-243. Corsello CM, Christina M. (2005). PhD Early Intervention in Autism, Infants & Young Children. 18 (2). 74-85. Chasson, G., Gerald E., Harris & Wendy J. Neely. (2007). Cost Comparison of Early Intensive Behavioral Intervention and Special Education for Children with Autism. Journal of Child and Family Studies, 16 , 401–417. Magnanini, A. (2018). Pedagogia speciale e sport. Padova , Incontropiede. Cioni, L. (2023). Posso giocare anche io? Sport e disabilità: dalla teoria ai dati sulle pari opportunità in età evolutiva. Padova , Soares. Magnanini, A., Grosu, E.F., Manno, R., Maussier,N. (2023). La percezione della diversità a scuola attraverso l’Avventura di Simone: Uno studio esplorativo, QTimes – webmagazine Anno XV - 3, doi: 10.14668/QTimes_15319. Sorensen, C., Zarrett, N. (2014). Benefits of Physical Activity for Adolescents with Autism Spectrum Disorders: A Comprehensive Review. Rev J Autism Dev Disord 1, 344–353, https://doi.org/10.1007/s40489-014-0027-4. Bremer, E., Crozier, M., & Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20 (8), 899-915. https://doi.org/10.1177/1362361315616002. Reinders, N.J., Branco, A., Wright, K., Fletcher, P.C., & Bryden, P.J. (2019). Scoping review: Physical activity and social functioning in young people with autism spectrum disorder. Frontiers in Psychology, 10 , 120, https://doi.org/10.3389/fpsyg.2019.00120. Zheng, Z., Zhang, L., Li, S., Zhao, F., Wang, Y., Huang, L., & Mu, D. (2017). Association among obesity, overweight and autism spectrum disorder: A systematic review and meta-analysis. Scientific Reports, 7 , https://doi.org/10.1038/s41598-017-12003-4. Ferreira, J.P., Ghiarone, T., Cabral Júnior, C.R., Furtado, G. E., Moreira Carvalho, H., Machado-Rodrigues, A. M., & Andrade Toscano, C.V. (2019). Effects of physical exercise on the stereotyped behavior of children with autism spectrum disorders. Medicina, 55(10): 685. https://doi.org/10.3390/medicina55100685. Lang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576. https://doi.org/10.1016/j.rasd.2010.01.006. Healy, S., Nacario, A., Braithwaite, R.E., & Hopper, C. (2018). The effect of physical activity interventions on youth with autism spectrum disorder: A meta‐analysis. Autism Research, 11(6), 818-833. https://doi.org/10.1002/aur.1955. Magnanini, A. (2021). Pedagogia speciale e sport: Modelli, attività e contesti inclusivi tra scuola ed extrascuola . Soares Editore. De Iulio, R., & Isidori, E. (2021). Sport e spazi umani: dalla forma all’evento. Sport e spazi umani: dalla forma all’evento (6-14). Tuga Edizioni. Movahedi, A., Bahrami, F., Marandi, S. M., & Abedi, A. (2013). Improvement in social dysfunction of children with autism spectrum disorder following long term Kata techniques training. Research in Autism Spectrum Disorders, 7 (9), 1054- 1061. https://doi.org/10.1016/j.rasd.2013.04.012 Bass M.M, Duchowny C.A, & Llabre M.M, (2009). The effect of therapeutic horseback riding on social functioning in children with autism. Journal of Autism and Developmental Disorders, 39 (9), 1261–1267. Anderson-Hanley, C., Turek, K., & Schneiderman, R. L. (2011). Autism and exergaming: Effects on repetitive behaviors and cognitions. Psychology Research and Behavior Management, 1, 129–137. Bahrami, F., Movahedi, A., Marandi, S. M., & Abedi, A. (2012). Kata techniques training consistently decreases stereotypy in children with autism spectrum disorder. Research in Developmental Disabilities , 33 (4), 1183-1193. Bahrami, F., Movahedi, A., Marandi, S. M., & Sorensen, C. (2016). The effect of karate techniques training on communication deficit of children with autism spectrum disorders. Journal of Autism and Developmental Disorders , 46 (3), 978- 986. https://doi.org/10.1007/s10803-015-2643-y. Elliott Jr, R.O., Dobbin, A. R., Rose, G.D., & Soper, H.V. (1994). Vigorous, aerobic exercise versus general motor training activities: Effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation. Journal of autism and developmental disorders , 24 (5), 565-576. Allison, D. B., Basile, V. C., & MacDonald, R. B. (1991). Brief report: Comparative effects of antecedent exercise and lorazepam on the aggressive behavior of an autistic man. Journal of Autism and Developmental Disorders, 21 (1), 89–94. https://doi.org/10.1007/BF02207001 Rivera P., Renziehausen J., Garcia JM., (2020). Effects of an 8-Week Judo Program on Behaviors in Children with Autism Spectrum Disorder: A Mixed-Methods Approach. Child Psychiatry 51 (5). 734-741, doi: 10.1007/s10578-020-00994-7. PMID: 32394411. Morales, J., Pierantozzi, E., Fukuda, D. H., Garcia, V., Guerra-Balic, M., Sevilla-Sánchez, M., & Carballeira, E. (2022). Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program. Frontiers in psychology , 13 , 1067310. https://doi.org/10.3389/fpsyg.2022.1067310. Pierantozzi, E., Morales, J., Fukuda, D.H., Garcia V, Gómez AM, Guerra-Balic M, Carballeira E. (2022). Effects of a Long-Term Adapted Judo Program on the Health-Related Physical Fitness of Children with ASD. International journal of environmental research and public health. 19 (24), 16731. DOI: 10.3390/ijerph192416731. Rassovsky, Y., Harwood, A., Zagoory-Sharon, O., & Feldman, R. (2019). Martial arts increase oxytocin production. Scientific Reports, 9 (1), https://doi.org/10.1038/s41598-019-49620-0. Block, M.E. (2007). A teacher's guide to including students with disabilities in general physical education. Brookes Publishing Company . Klavina, A., & Block, M.E. (2008). The effects of peer tutoring on interaction behaviors in inclusive physical education. Adapted Physical Activity Quarterly, 25, 132-158. Obrusnikova, I., Block, M.E., & Válková, H. (2003). Impact of inclusion in GPE on students without disabilities. Adapted Physical Activity Quarterly, 20, 230-245. Meegan S, MacPhail A. (2006). Irish physical educators’ attitude toward teaching students with special educational needs. European Physical Education Review, 12 (1), 75-97. Vickerman,P., & Coates, J.K., (2009) Trainee and recently qualified physical education teachers' perspectives on including children with special educational needs, Physical Education and Sport Pedagogy, 14:2, 137-153, DOI: 10.1080/17408980802400502. Goodwin, D.L., & Watkinson, E.J. (2000). Inclusive physical education from the perspective of students with physical disabilities. Adapted Physical Activity Quarterly, 17, 144-160. Hutzler, Y., Fliess, O., Chacham, A., & van den Auweele, Y. (2002). Perspectives of children with physical disabilities on inclusion and empowerment: Supporting and limiting factors. Adapted Physical Activity Quarterly, 19, 300-317. Davis, R.W., Kotecki, J.E., Harvey, M., & Oliver, A. (2007). Responsibilities and training needs of paraeducators in physical education. Adapted Physical Activity Quarterly, 24 (1), 70-83. Lieberman, L. J. (2007). Paraeducators in physical education: A training guide to roles and responsibilities. Human Kinetics. Lieberman, L.J., Dunn, J.M., van der Mars, H., & McCubbin, J. (2000). Peer tutors effects on activity levels of deaf students in inclusive elementary physical education. Adapted Physical Activity Quarterly, 17, 20-39. Gilliam, J. E. (2006). Gilliam autism rating scale: GARS 2 . Pro-ed. Constantino, J. N., & Gruber, C. P. (2012). Social responsiveness scale: SRS-2. Ulrich, D. A. (2019). TGMD-3: Test of Gross Motor Development: Examiner’s Manual. 3rd Edn, Austin, TX: Pro-Ed, Inc. Ennigkeit, F., & Beek, F.L. (2019). The effect of judo on social behavior with special consideration of periods of reflection. Journal of Martial Arts Research , 2 (2), 7-7. Sterkowicz-Przybycień, K., Kłys, A., & Almansba, R. (2014). Educational judo benefits on the preschool children’s behaviour. J. Combat Sports Martial Arts , 5 , 23-26. Miyahara, M. (2013). Meta review of systematic and meta-analytic reviews on movement differences, effect of movement based interventions, and the underlying neural mechanisms in autism spectrum disorder. Frontiers in integrative neuroscience, 7, 16. MacDonald, M., Lord, C., & Ulrich, D. A. (2014). Motor skills and calibrated autism severity in young children with autism spectrum disorder. Adapted physical activity quarterly, 31(2), 95-105. Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterial.docx Cite Share Download PDF Status: Published Journal Publication published 18 Jun, 2025 Read the published version in Sport Sciences for Health → Version 1 posted Editorial decision: Revision requested 22 Mar, 2025 Reviews received at journal 20 Mar, 2025 Reviews received at journal 20 Mar, 2025 Reviewers agreed at journal 17 Mar, 2025 Reviewers agreed at journal 13 Mar, 2025 Reviewers agreed at journal 13 Mar, 2025 Reviewers agreed at journal 25 Jan, 2025 Reviewers invited by journal 25 Jan, 2025 Editor assigned by journal 31 Jul, 2024 Submission checks completed at journal 31 Jul, 2024 First submitted to journal 31 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4836261","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":343313135,"identity":"62f91b5a-5aac-420c-a056-5c4c6f1f8aea","order_by":0,"name":"Nicole Maussier","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYPACCTkDMG1gwcBGrBZjAwZmkBYJBjZi9SRuAGthkGAgaI252OFnkj/+WKRvZ+8/uuFHgQQDn3wDfi2Ws9PMpHnbJHJ39hxmu9lDjMMMbieYSTM2SORuuJHMdoOHOC3p34AOk0g3AGq5+Yc4LTlmEjxsEgkgLbeJtCWn2BroF8MNZw6b3ZYxAGpnSyDosI03f/ypkzc43vjs5ps/NnLyzQcIWIMOeEhUPwpGwSgYBaMAGwAAPPo56QCVupEAAAAASUVORK5CYII=","orcid":"","institution":"University “Foro Italico”","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Nicole","middleName":"","lastName":"Maussier","suffix":""},{"id":343313136,"identity":"94593c88-2f8d-45a2-893b-bcc1d347dc0c","order_by":1,"name":"Emanuela Pierantozzi","email":"","orcid":"","institution":"University of Genoa","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Emanuela","middleName":"","lastName":"Pierantozzi","suffix":""},{"id":343313137,"identity":"d4d6e915-b48e-4306-8a95-5e6de4240704","order_by":2,"name":"Renato Manno","email":"","orcid":"","institution":"San Raffaele University of Rome","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Renato","middleName":"","lastName":"Manno","suffix":""},{"id":343313138,"identity":"b5e8c88e-0887-4643-ad73-ec65040f7237","order_by":3,"name":"Angela Magnanini","email":"","orcid":"","institution":"University “Foro Italico”","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Angela","middleName":"","lastName":"Magnanini","suffix":""}],"badges":[],"createdAt":"2024-07-31 14:16:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4836261/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4836261/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11332-025-01461-3","type":"published","date":"2025-06-18T15:57:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":64006176,"identity":"ffad7d89-9617-4b4c-a13f-f943d779ae1f","added_by":"auto","created_at":"2024-09-04 21:47:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":20157,"visible":true,"origin":"","legend":"\u003cp\u003eDesign of the research\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4836261/v1/f1c2bddc83d3c79bb6ac2767.png"},{"id":85231278,"identity":"75edd2f3-ca38-4e32-b1c5-c7c5d67390ac","added_by":"auto","created_at":"2025-06-23 16:04:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":536797,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4836261/v1/28cee8bb-1065-4b24-b296-c70c18814ee7.pdf"},{"id":64006179,"identity":"0a03f4cd-3dd3-4c67-af4b-768384203b06","added_by":"auto","created_at":"2024-09-04 21:47:38","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":67481,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-4836261/v1/baf068d8a9aacf8a2a08a3d3.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Judo and karate in primary school as a means for the improvement of social inclusion for autistic children","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAutism spectrum disorder (ASD) refers to a range of heterogeneous neurodevelopmental conditions characterized by difficulties in communication\u0026nbsp;and language development,\u0026nbsp;social interaction and the presence of restrictive and repetitive behavior patterns that are defined by American Psychiatric Association (1). The prevalence of ASD is estimated to be at least 1.5% in developed countries (2).\u0026nbsp;Autistic children often find it difficult to be included in inclusive sports contexts (3). In Italy, it is estimated that 1 child out of 77 between the ages of 7-9 has ASD, with a higher prevalence in males, who are 4.4 times more likely to have ASD than females. This national estimate was made as part of the “Observatory Project for Monitoring Autism Spectrum Disorders” coordinated by the National Institute of Health and the Ministry of Health (2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eASD individuals exhibit a variety of stereotypical motor behaviors such as hand clapping and body rocking (4). Many studies have demonstrated the effectiveness of motor interventions in ASD people, especially if the interventions are intensive and introduced in the early stages of life (5). However, early therapeutic intervention can be extremely expensive for families of ADS children (6), with a high cost placed on individual families and social services.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMany pedagogical studies have also shown that sport is one of the many possible paths to inclusion (7; 8). A recent study also shows that raising awareness at school on the topic of diversity is a fundamental element for a more inclusive path (9). Reviews of the impact of physical activity in ASD individuals (10) have highlighted significant benefits. Another review exclusively examines the impact of exercise interventions on a range of behavioral symptoms that include stereotyped behaviors (11) and also examines positive social behaviors that focuses on younger children who are often excluded by other reviews.\u0026nbsp;It has therefore been highlighted\u0026nbsp;that martial arts disciplines are among the most recommended sports for autistic subjects as they produce significant and positive change from a behavioral, communicative and relational point of view (11).\u003c/p\u003e\n\u003cp\u003eThere is an association between reduced social functioning and less physical activity in autistic individuals (12; 13). Existing studies have shown that physical activity interventions can influence ASD symptoms, such as reducing stereotyped behaviors in both autistic children and adults (14; 15). Previous meta-analysis has revealed moderate to large effects of physical activity interventions on social functioning (16). Increased exposure to social stimuli through physical activity can induce improvements in communication, social functions and increase self-confidence.\u003c/p\u003e\n\u003cp\u003eSince the 1970s, Italy has passed a series of laws, in particular law n°104 of 5 February 1992,\u0026nbsp;which supports the integration and scholastic inclusion of people with disabilities, with particular attention to the sporting dimension. With law n°66 of 2017, the rules for promoting the educational inclusion of\u0026nbsp;disabled students\u0026nbsp;were defined and the\u0026nbsp;term integration is replaced with inclusion. In 1999 the law n. 17 in Italy sanctioned the right of access to the university to include\u0026nbsp;disabled students. These legislations highlight how Italy has worked according to its own model of inclusion in sport which combines the principles of Universal Design (17; 18).\u003c/p\u003e\n\u003cp\u003eStudies have demonstrated the beneficial effects of exercise and sports training through a wide variety of abilities in ASD children (19). After practicing physical exercises, subjects ASD subjects showed profound improvements in social skills (20;19), cognitive function (21), stereotypical behavior (22), communication (23), attention (20), self- harm behavior (24), aggressiveness (25).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBahrami et al (23) were among the first to examine the effects of karate exercise on communication deficits in ASD. The results of the study confirmed that karate training techniques lead to an improvement in communication deficit in ASD children. In a recent article (26; 27; 28) the benefits of a motor and behavioral judo activity were demonstrated. In another study (29)\u0026nbsp;it was also shown that physical activity with physical contact contributes to a good production of oxytocin in autistic subjects.\u003c/p\u003e\n\u003cp\u003eThe concept of sport inclusion is based on the fact that playing sport together,\u0026nbsp;disabled children with non disabled\u0026nbsp;children, has mutual benefits (30); even those with severe disabilities benefit from physical interaction with other groups of children (31; 32).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;As such, the preparation of physical educators (33; 34) and peers as well as a strategic inclusion in physical education is critical (31).\u003c/p\u003e\n\u003cp\u003eIt is proven that sports disciplines offer many social opportunities for\u0026nbsp;disabled\u0026nbsp;students; for example, interactions with non disabled peers, building new friendships and learning appropriate behaviors (35; 36). The optimal solution to a successful inclusion is to provide support to the disable students ties through qualified coaches or peer tutors (30; 37; 38). Studies of which, clearly show that peer tutors can be an effective method of supporting disable students in general physical education but providing them with support from trained coaches is essential (31; 39).\u003c/p\u003e\n\u003cp\u003eStarting from a theoretical background, a scientific study was conducted into the Italian Judo Fight Karate and Martial Arts Federation (FIJLKAM) project “KATAUTISM”, with the aim of including autistic children through practice of judo and karate in a school environment. The study looked at adaptations related to social inclusion, gross motor skills and behavior. Our hypothesis was that by practicing judo and karate in a school environment, behavioral and gross motor improvements could be achieved through promotions of inclusivity.\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe autistic children involved and analyzed n=31 were n=5 girls and n=26 boys with a mean age of 7,58 (± 0,38) years and with different level of autism.\u0026nbsp;The activity took place twice a week (1 hour each session) for a total of 24 weeks. The involved classes were 31, with a mean number of 18.48 children per class.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMaterials\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe intervention program focused on basic judo and karate skills. The research was conducted across 7 italian regions with a total of 573 children\u0026nbsp;of which\u0026nbsp;31 autistic children.\u0026nbsp;To participate\u0026nbsp;each classroom had to have 1 autistic child.\u0026nbsp;The selection of the classes was entrusted to the school Directors who knew which classes had autistic children. All the participants had been diagnosed ASD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) (1).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eProcedure\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe selected classrooms were divided in 2 groups: 1group followed the Katautism Judo Program and 1 group followed the\u0026nbsp;KATAUTISM\u0026nbsp;karate program. The ASD children partook in inclusive activities with their classmates together during curricular school hours. The project used an adapted methodology with specific tools. To ensure predictability for autistic children, images of augmentative communication were used to facilitate understanding of the sequence and duration of individual activities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe images of the augmentative communication were given to coaches and psychologists, with a visual weekly agenda issued in the classroom which allowed the autistic child and his classmates to understand on which day of the week the activity took place.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll the staff,\u0026nbsp;made by specialized coaches and psychologists of autism, followed a specific training course of 40 hours where topics concerning autism were treated by psychologists, neuroscience experts, adapted motor activity experts and pediatricians.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe focus of the lessons was based on the objective of research into the methodology, specific equipment, reading and management of children on the autistic spectrum in inclusive school contests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePrior to starting the project, meetings were organized with the parents of all the children and teachers in the classes to clearly explain the objectives of the project and clarify any doubts. In addition, individual meetings were held with the parents of autistic children with the coordinator of the research, psychologists and coaches of the staff to gather information on the child, state the objectives and explain the test of the research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were 2 specialized coaches in ASD during the sessions so, if required, a coach was dedicated to the ASD child. The psychologist was an observational figure who supported the coaches throughout lessons; their role was to observe and provide feedback to the coaches.\u0026nbsp;At the end of each training session,\u0026nbsp;the synergistic work between coaches and psychologists formulated the intervention plan to be able to equally satisfy the needs of both the ASD children and the classmates. Throughout the research project, video and in-person supervision were present to ensure the achievement of the objectives and support the Martial Art Teachers and psychologists in the different phases. This was\u0026nbsp;useful for monitoring the behaviors and relationships of autistic and non-autistic children.\u003c/p\u003e\n\u003cp\u003eThe sporting activities of judo and karate aligned with the accessibility criteria as the lessons were held in a spacious and comfortable space so that the safety of the participants was guaranteed. The equipment required for this project included a tatami, a high-density mattresses of 100m2, to help prevent injuries.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eJudo\u003c/u\u003e began with the didactic progression of falls in all its forms (backward, sideways forward), before moving on to individual practice and then gradually in pairs with immobilization techniques on the ground. The individualized program for the autistic child resulted from the synergistic work of the specialized coaches and the expert psychologist in autism who was always present during the lessons.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u0026nbsp;Karate\u0026nbsp;\u003c/u\u003ebegan with teaching the basics of karate, (such as correct posture, breathing and movements fundamentals), before progressing to the first kata (pinan nidan). The importance of how to use these techniques in a controlled and responsible way was also explained to the children.\u003c/p\u003e\n\u003cp\u003eThe research design involved the analysis of 3 areas of autistic children at the beginning (T0) and at the end of the project (T1). These areas refer to the level of autism on the Gilliam Autism Ration Scale – GARS (40) which is assessed by psychology experts, the area that relates to social impairment on the Social Responsiveness Scale – SRS (41)\u0026nbsp;which is administered by class teachers, and\u0026nbsp;Test of Gross Motor Development 3\u003csup\u003erd\u003c/sup\u003e edition -\u0026nbsp;TGMD-3 (42) which is evaluated by experts in Adapted Motor Sciences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe tests at the beginning and end of the project were always carried out by the same person to guarantee the reliability of the result. The classroom teachers were instructed on how to administer the test, and a psychologist was made available in case any questions were unclear.\u003c/p\u003e\n\u003cp\u003eThe research analyzed the changes determined by a judo and karate protocol in the three specific areas of autistic children at the beginning (T0) and end of the project after 24 weeks (T1) through 3 scientifically validated tests:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eLevel of autism with Gilliam Autism Ration Scale (GARS) compiled by psychologists in autism.\u003c/li\u003e\n \u003cli\u003eSocial Compromission with Social Responsiveness Scale (SRS) compiled by the classroom teachers. The classroom teachers were instructed on how to administer the test, and a psychologist was made available in case any questions were unclear.\u003c/li\u003e\n \u003cli\u003eGross motor development with Test of Gross Motor Development third edition (TGMD-3) administrated by an expert in Adapted Motor Sciences.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cu\u003eThe \"Gilliam Autism Rating Scale\u003c/u\u003e\" is a checklist developed for use by professionals, educators and rehabilitators both to identify autism and to rate the severity of its symptoms for individuals aged 3 to 22 years.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCharacteristics\u0026nbsp;of the GARS are grouped into 4 subtests that describe specific, observable and measurable behaviors:\u003c/p\u003e\n\u003cp\u003e1) stereotyped behavior defined by movement disorders and other unconventional behavior\u003c/p\u003e\n\u003cp\u003e2) communication which allows for the assessment of verbal and non-verbal communicative behavior;\u003c/p\u003e\n\u003cp\u003e3) social Interaction which evaluates the subject's ability to interact appropriately with people, situations and objects;\u003c/p\u003e\n\u003cp\u003e4) developmental disorders which includes developmental questions from the first three years of the subject.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eSRS\u003c/u\u003e is used to measure the degree of social impairment associated with ASD. The SRS is a 65-item questionnaire that assesses the Social Awareness (measures the ability to recognize social cues), Social Cognition (assesses the ability to interpret social cues and understand others' perspectives), Social Communication (evaluates the ability to initiate and sustain social interactions), Social Motivation (measures the interest and motivation for social interactions), Autistic Mannerism (assesses the presence of repetitive behaviors and restricted interests typical of autism spectrum disorders)m that characterize ASD in children or adolescents aged between 4 and 18 years. \u0026nbsp;It can be completed by a teacher, parent, or caregiver who is familiar with the individual's current behavior and developmental history. The elements are the same for teachers or parents, but the score profiles are specific to each group. \u0026nbsp;A total score provides a measure of the scale of the social deficit and allows for comparisons across different contexts and raters. The test measures the degree of social impairment, autism spectrum disorders, can be used for all types of ASD.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eThe TGMD-3\u003c/u\u003e is eligible for special education services in physical education and consists of 13 skills: 6 for locomotor skills (running, gallop, single foot hops, hopping step, standing long jump, lateral canter ) and 7 for ball skills (two-handed hitting of a ball at rest, forehand, dribbling in place with one hand, catching a ball with two hands, kicking a ball at rest, high pass and low pass). The TGMD-3 combines fun activities with a reliable procedure to yield significant results in identifying children with gross motor impairments. The results of this evaluation can be used to develop instructional programs, monitor progress, evaluate treatment, and conduct further research on gross motor development.\u003c/p\u003e\n\u003cp\u003eAll analyses are realized using IBM SPSS Statistics software in version 28 and a significance level of 0,05 was used for all the analysis.\u003c/p\u003e\n\u003cp\u003eThe research design includes the analysis, following the practice of judo or karate in an inclusive school setting, of three different areas in autistic children: the level of autism (GARS), social impairment (SRS), and gross motor skills (TGMD-3) (Fig.1).\u003c/p\u003e"},{"header":" Results","content":"\u003cp\u003eAt the end of the data collection and scoring, a univariate descriptive analysis of the variables will be firstly carried out for the total of 31 observations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;1\u0026nbsp;Results Mean pre/post, delta, variation%, t-tes, Wilcoxon test, Cohen\u0026apos;s d, in n=31 ASD children\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"97%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\" valign=\"bottom\"\u003e\n \u003cp\u003en=31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eMEAN PRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eMEAN POST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"bottom\"\u003e\n \u003cp\u003eDELTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"bottom\"\u003e\n \u003cp\u003eVARIATION %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eP-value (Paired t-test)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eWilcoxon test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"bottom\"\u003e\n \u003cp\u003eCohen\u0026apos;s d\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Stereotyped Behaviors \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e10.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-21.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Comunication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e7.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-1.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-17.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Social Interaction \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e6.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-25.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-,879\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Developmental Disorders\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e29.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-16.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,115\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eGARS Autism Quotient \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e93.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e83.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-9.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-10.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS CnS (Social Awareness )\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e71.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e65.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-5.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-8.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-,999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS CgS (Social Cognition)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e79.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e73.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-6.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-7.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-,710\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS CmS (Social Communication)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e79.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e70.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-8.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS MS (Social Motivation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e75.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e68.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-7.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-9.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-,877\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS MA (Autistic Mannerism)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e86.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e78.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-8.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-9.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-,841\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eSRS TOT Punteggio T\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e82.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e74.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e-8.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e-10.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e-1,083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eTGMD3 Locomotor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e2.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e6.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e252.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e2,280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eTGMD3 Ball control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e8.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e256.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e2,243\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eTGMD3 Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e17.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e12.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e260.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e2,429\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.375%\"\u003e\n \u003cp\u003eTGMD3 Gross Motor Index (GMI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e55.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e92.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\"\u003e\n \u003cp\u003e36.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e65.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e2,480\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003ePaired sample t-tests and Wilcoxon tests will be then performed, for both the samples, to assess if there are statistically significant differences in the mean score of GARS, SRS and TGMD3 scales and subscales before and after the experiment (Table 1).\u003c/p\u003e\n\u003cp\u003eA contingency table is presented to analyze the average variations (Delta) in GARS \u0026nbsp;TGMD3 and SRS scales and subscales(table 1).\u003c/p\u003e\n\u003cp\u003eEach paired t-test conducted on GARS subscales and on Autism Quotient is statistically significant (p\u0026lt;0,05): the differences between average scores before and after practising sport are statistically significant. Wilcoxon Tests lead to the same conclusions for all the tests. The Cohen\u0026rsquo; d for all the subscales is in absolute value greater than 0.8, meaning that the effect is great in size. The differences between the SRS scores before and after practicing sports are statistically significant for all the subscales (p\u0026lt;0,05), both considering the paired t-test and the Wilcoxon test: it is possible to conclude that the decrease in scores due to practicing sport is statistically significant. Using Cohen\u0026rsquo; d to evaluate the magnitude of the effect on \u0026nbsp;the SRS subscales , it can concluded that the effect is of great size ( absolute value of d\u0026gt;0.8) for all the subscales except for the SRS CgS, \u0026nbsp;for which the effect is of medium size. Cohen\u0026rsquo; d, used in TGMD-3 to evaluate the effect size for each pair tested, is in absolute value greater than 0,8 for all the pairs pre-mid and pre-post, meaning that the effect is of great size (table 1).\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;2\u0026nbsp;Percentage variations of the GARS, SRS, and TGMD-3 averages in the judo and karate comparison groups.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"64%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" rowspan=\"3\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.323232323232325%\" colspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\" height=\"12\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"65.625%\" valign=\"bottom\"\u003e\n \u003cp\u003eJudo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eKarate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"65.625%\" valign=\"bottom\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.375%\" valign=\"bottom\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eGARS Stereotyped Behaviors Standard Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-23,12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-19,10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eGARS Communication Standard Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-17,65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-19,93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eGARS Social Interaction Standard Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-22,90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-24,39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eGARS Developmental Disorders Standard Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eGARS Total Standard Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-16,23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-16,73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eAutism Quotient Variation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-10,55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-9,94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS CgS VARIATION (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-5,45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-9,71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS CnS VARIATION(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-6,63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-9,93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS CmS VARIATION(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-9,02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-12,91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS MS VARIATION(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-10,97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-7,75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS MA VARIATION(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-9,18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-9,51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eSRS TOT T score VARIATION(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e-9,12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-11,27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eTGMD3 BALL POST PRE VAR (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e436,82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e339,67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eTGMD3 LOCOMOTOR POST PRE VAR (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e399,38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e338,48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eTGMD3 TOTAL POST PRE VAR (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e434,71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e307,07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"67.67676767676768%\" valign=\"top\"\u003e\n \u003cp\u003eTGMD3 GMI POST PRE VAR(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e68,73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e64,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFinally, in order to analyze the variations considering the martial art practiced, a contingency table is presented to show variations of GARS, SRS and TGMD3 subscales split up by sport practiced (table 2)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe main hypothesis of the research were to if the practice of judo and karate in an inclusive school context can contribute to improve in all level of ASD children, behaviors, the gross motor development and the social inclusion.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudies with neurotypical people have shown that participating in judo increases empathy, reduces aggressive behavior (43) and contributes to the development of self-discipline, serenity, problem solving efficiency and socio-moral sensitivity (44). Other studies on martial arts that have demonstrated significant adaptations in reducing stereotyping behaviors in ASD person and improving social interactions (22; 19; 27). In this study, conduce in KATAUTISM project, we can confirm that Judo and karate has contributed\u0026nbsp;significantly\u0026nbsp;to the reduction of hetero and self-aggressive behaviors, emotional regulation and has improved the degree of tolerance with respect to the times of expected, which greatly compromised the subject's social inclusion.\u003c/p\u003e\n\u003cp\u003eOne study has shown that ASD children have greater difficulties with motor development than their peers (45). They also found a relationship between gross and fine motor skills and ASD severity , specifically they observed that the most severe cases of ASD were associated with lower fine and gross motor skills (46). \u0026nbsp;In this study all ASD children (n=31) completed the 24 weeks of inclusive sports program\u0026nbsp;with their classmates.\u0026nbsp;All autistic children have significantly improved their gross motor skills along with behavior and social inclusion.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe differences between the GARS, SRS and TGMD-3 scores before and after practicing sports are statistically significant in all levels of autism for all the subscales (p\u0026lt;0,05) and the effect is of great size (absolute value of d\u0026gt;0.8) for all the subscales (GARS, SRS, TGMD-3) except for the SRS CgS, for which the effect is of medium size.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study also compared the results of two groups, judo and karate. The results demonstrated that the comparison groups analyzed, judo and karate, both produce average percentage improvements. This underscores the inclusive potential of both disciplines, confirming their adaptability in inclusive settings.\u003c/p\u003e\n\u003cp\u003eThe importance of specific training and coordination allows the coaches, through the support of psychology experts in autism, to recognize the needs of ASD children and provide the right motor proposals.\u003c/p\u003e\n\u003cp\u003eIt would be interesting in the future to further analyze, across all levels of autism, the benefits of other inclusive sports, including team sports.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn this study we can confirm that the practice of Judo and karate in inclusive school contest has significantly improved in autistic children gross motor skills, behavior and favored the inclusion ASD children\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthic Committee\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll interventions by project participants involving data collection for research purposes have been subject to approval by the Ethics Committee of the University of Rome Foro Italico (cod.186/2024), in accordance with the directives set out in the updated version of the Helsinki Declaration. This has ensured the respect of all participants' rights and the full protection of data confidentiality and the right to withdraw from the experiment at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflicting interests:\u0026nbsp;\u003c/strong\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCommunity Involvement Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the development of the research, in the study design, measures, implementation, interpretation, and dissemination of results, the school community, autistic children, families of autistic children, judo coaches, and psychologists specializing in autism were involved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003eThis project was supported by funds from Sport e Salute SPA CUP\u0026nbsp;- J59I22001590001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial interests:\u003c/strong\u003e The authors declare they have no financial interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmerican Psychiatric Association, D. S. M. T. F., \u0026amp; American Psychiatric Association, D. S. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American psychiatric association.\u003c/li\u003e\n\u003cli\u003eLyall, K., Croen, L., Daniels, J., Fallin, M.D., Ladd-Acosta, C., Lee, B.K., \u0026amp; Windham, G.C. (2017). The changing epidemiology of autism spectrum disorders. \u003cem\u003eAnnual Review of Public Health, 38,\u003c/em\u003e 81-102. https://doi.org/10.1146/annurev-publhealth-031816-044318.\u003c/li\u003e\n\u003cli\u003eCioni, L., \u0026amp; Magnanini, A. (2022). Le barriere ambientali alla pratica sportiva: uno studio di comparazione tra bambini con e senza disabilit\u0026agrave;. \u003cem\u003eITALIAN JOURNAL OF SPECIAL EDUCATION FOR INCLUSION\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(2), 211-220.\u003c/li\u003e\n\u003cli\u003eBodfish, J.W., Symons, F.J., Parker, D.E., \u0026amp; Lewis, M.H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. \u003cem\u003eJournal of autism and developmental disorders, 30,\u003c/em\u003e 237-243.\u003c/li\u003e\n\u003cli\u003eCorsello CM, Christina M. (2005). PhD Early Intervention in Autism, Infants \u0026amp; Young Children. \u003cem\u003e18\u003c/em\u003e(2). 74-85.\u003c/li\u003e\n\u003cli\u003eChasson, G., Gerald E., Harris \u0026amp; Wendy J. Neely. (2007). Cost Comparison of Early Intensive Behavioral Intervention and Special Education for Children with Autism. \u003cem\u003eJournal of Child and Family Studies, 16\u003c/em\u003e, 401\u0026ndash;417.\u003c/li\u003e\n\u003cli\u003eMagnanini, A. (2018). Pedagogia speciale e sport. \u003cem\u003ePadova\u003c/em\u003e, Incontropiede.\u003c/li\u003e\n\u003cli\u003eCioni, L. (2023). Posso giocare anche io? Sport e disabilit\u0026agrave;: dalla teoria ai dati sulle pari opportunit\u0026agrave; in et\u0026agrave; evolutiva. \u003cem\u003ePadova\u003c/em\u003e, Soares.\u003c/li\u003e\n\u003cli\u003eMagnanini, A., Grosu, E.F., Manno, R., Maussier,N. (2023). La percezione della diversit\u0026agrave; a scuola attraverso l\u0026rsquo;Avventura di Simone: Uno studio esplorativo, QTimes \u0026ndash; webmagazine Anno XV - 3, doi: 10.14668/QTimes_15319.\u003c/li\u003e\n\u003cli\u003eSorensen, C., Zarrett, N. (2014). Benefits of Physical Activity for Adolescents with Autism Spectrum Disorders: A Comprehensive Review. \u003cem\u003eRev J Autism Dev Disord 1,\u003c/em\u003e 344\u0026ndash;353, https://doi.org/10.1007/s40489-014-0027-4.\u003c/li\u003e\n\u003cli\u003eBremer, E., Crozier, M., \u0026amp; Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. \u003cem\u003eAutism, 20\u003c/em\u003e(8), 899-915. https://doi.org/10.1177/1362361315616002.\u003c/li\u003e\n\u003cli\u003eReinders, N.J., Branco, A., Wright, K., Fletcher, P.C., \u0026amp; Bryden, P.J. (2019). Scoping review: Physical activity and social functioning in young people with autism spectrum disorder. \u003cem\u003eFrontiers in Psychology, 10\u003c/em\u003e, 120, https://doi.org/10.3389/fpsyg.2019.00120. \u003c/li\u003e\n\u003cli\u003eZheng, Z., Zhang, L., Li, S., Zhao, F., Wang, Y., Huang, L., \u0026amp; Mu, D. (2017). Association among obesity, overweight and autism spectrum disorder: A systematic review and meta-analysis. \u003cem\u003eScientific Reports, 7\u003c/em\u003e, https://doi.org/10.1038/s41598-017-12003-4.\u003c/li\u003e\n\u003cli\u003eFerreira, J.P., Ghiarone, T., Cabral J\u0026uacute;nior, C.R., Furtado, G. E., Moreira Carvalho, H., Machado-Rodrigues, A. M., \u0026amp; Andrade Toscano, C.V. (2019). Effects of physical exercise on the stereotyped behavior of children with autism spectrum disorders. Medicina, 55(10): 685. https://doi.org/10.3390/medicina55100685.\u003c/li\u003e\n\u003cli\u003eLang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., \u0026amp; Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576. https://doi.org/10.1016/j.rasd.2010.01.006.\u003c/li\u003e\n\u003cli\u003eHealy, S., Nacario, A., Braithwaite, R.E., \u0026amp; Hopper, C. (2018). The effect of physical activity interventions on youth with autism spectrum disorder: A meta‐analysis. Autism Research, 11(6), 818-833. https://doi.org/10.1002/aur.1955.\u003c/li\u003e\n\u003cli\u003eMagnanini, A. (2021). \u003cem\u003ePedagogia speciale e sport: Modelli, attivit\u0026agrave; e contesti inclusivi tra scuola ed extrascuola\u003c/em\u003e. Soares Editore.\u003c/li\u003e\n\u003cli\u003eDe Iulio, R., \u0026amp; Isidori, E. (2021). Sport e spazi umani: dalla forma all\u0026rsquo;evento. \u003cem\u003eSport e spazi umani: dalla forma all\u0026rsquo;evento\u003c/em\u003e (6-14). Tuga Edizioni.\u003c/li\u003e\n\u003cli\u003eMovahedi, A., Bahrami, F., Marandi, S. M., \u0026amp; Abedi, A. (2013). Improvement in social dysfunction of children with autism spectrum disorder following long term Kata techniques training. \u003cem\u003eResearch in Autism Spectrum Disorders, 7\u003c/em\u003e(9), 1054- 1061. https://doi.org/10.1016/j.rasd.2013.04.012 \u003c/li\u003e\n\u003cli\u003eBass M.M, Duchowny C.A, \u0026amp; Llabre M.M, (2009). The effect of therapeutic horseback riding on social functioning in children with autism. \u003cem\u003eJournal of Autism and Developmental Disorders, 39\u003c/em\u003e(9), 1261\u0026ndash;1267.\u003c/li\u003e\n\u003cli\u003eAnderson-Hanley, C., Turek, K., \u0026amp; Schneiderman, R. L. (2011). Autism and exergaming: Effects on repetitive behaviors and cognitions. \u003cem\u003ePsychology Research and Behavior Management, 1,\u003c/em\u003e 129\u0026ndash;137.\u003c/li\u003e\n\u003cli\u003eBahrami, F., Movahedi, A., Marandi, S. M., \u0026amp; Abedi, A. (2012). Kata techniques training consistently decreases stereotypy in children with autism spectrum disorder. \u003cem\u003eResearch in Developmental Disabilities\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(4), 1183-1193.\u003c/li\u003e\n\u003cli\u003eBahrami, F., Movahedi, A., Marandi, S. M., \u0026amp; Sorensen, C. (2016). The effect of karate techniques training on communication deficit of children with autism spectrum disorders. \u003cem\u003eJournal of Autism and Developmental Disorders\u003c/em\u003e, \u003cem\u003e46\u003c/em\u003e(3), 978- 986. https://doi.org/10.1007/s10803-015-2643-y.\u003c/li\u003e\n\u003cli\u003eElliott Jr, R.O., Dobbin, A. R., Rose, G.D., \u0026amp; Soper, H.V. (1994). Vigorous, aerobic exercise versus general motor training activities: Effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation. \u003cem\u003eJournal of autism and developmental disorders\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(5), 565-576.\u003c/li\u003e\n\u003cli\u003eAllison, D. B., Basile, V. C., \u0026amp; MacDonald, R. B. (1991). Brief report: Comparative effects of antecedent exercise and lorazepam on the aggressive behavior of an autistic man. \u003cem\u003eJournal of Autism and Developmental Disorders, 21\u003c/em\u003e(1), 89\u0026ndash;94. https://doi.org/10.1007/BF02207001\u003c/li\u003e\n\u003cli\u003eRivera P., Renziehausen J., Garcia JM., (2020). Effects of an 8-Week Judo Program on Behaviors in Children with Autism Spectrum Disorder: A Mixed-Methods Approach. \u003cem\u003eChild Psychiatry\u003c/em\u003e \u003cem\u003e51\u003c/em\u003e(5). 734-741, doi: 10.1007/s10578-020-00994-7. PMID: 32394411.\u003c/li\u003e\n\u003cli\u003eMorales, J., Pierantozzi, E., Fukuda, D. H., Garcia, V., Guerra-Balic, M., Sevilla-S\u0026aacute;nchez, M., \u0026amp; Carballeira, E. (2022). Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program. \u003cem\u003eFrontiers in psychology\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e, 1067310. https://doi.org/10.3389/fpsyg.2022.1067310.\u003c/li\u003e\n\u003cli\u003ePierantozzi, E., Morales, J., Fukuda, D.H., Garcia V, G\u0026oacute;mez AM, Guerra-Balic M, Carballeira E. (2022). Effects of a Long-Term Adapted Judo Program on the Health-Related Physical Fitness of Children with ASD. \u003cem\u003eInternational journal of environmental research and public health. 19\u003c/em\u003e(24), 16731. DOI: 10.3390/ijerph192416731.\u003c/li\u003e\n\u003cli\u003eRassovsky, Y., Harwood, A., Zagoory-Sharon, O., \u0026amp; Feldman, R. (2019). Martial arts increase oxytocin production. \u003cem\u003eScientific Reports, 9\u003c/em\u003e(1), https://doi.org/10.1038/s41598-019-49620-0.\u003c/li\u003e\n\u003cli\u003eBlock, M.E. (2007). A teacher\u0026apos;s guide to including students with disabilities in general physical education. \u003cem\u003eBrookes Publishing Company\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eKlavina, A., \u0026amp; Block, M.E. (2008). The effects of peer tutoring on interaction behaviors in inclusive physical education. \u003cem\u003eAdapted Physical Activity Quarterly, 25,\u003c/em\u003e 132-158.\u003c/li\u003e\n\u003cli\u003eObrusnikova, I., Block, M.E., \u0026amp; V\u0026aacute;lkov\u0026aacute;, H. (2003). Impact of inclusion in GPE on students without disabilities. \u003cem\u003eAdapted Physical Activity Quarterly, 20,\u003c/em\u003e 230-245.\u003c/li\u003e\n\u003cli\u003eMeegan S, MacPhail A. (2006). Irish physical educators\u0026rsquo; attitude toward teaching students with special educational needs. \u003cem\u003eEuropean Physical Education Review, 12\u003c/em\u003e (1), 75-97.\u003c/li\u003e\n\u003cli\u003eVickerman,P., \u0026amp; Coates, J.K., (2009) Trainee and recently qualified physical education teachers\u0026apos; perspectives on including children with special educational needs, Physical Education and Sport Pedagogy, 14:2, 137-153, DOI: 10.1080/17408980802400502.\u003c/li\u003e\n\u003cli\u003eGoodwin, D.L., \u0026amp; Watkinson, E.J. (2000). Inclusive physical education from the perspective of students with physical disabilities. \u003cem\u003eAdapted Physical Activity Quarterly, 17,\u003c/em\u003e 144-160.\u003c/li\u003e\n\u003cli\u003eHutzler, Y., Fliess, O., Chacham, A., \u0026amp; van den Auweele, Y. (2002). Perspectives of children with physical disabilities on inclusion and empowerment: Supporting and limiting factors. Adapted Physical Activity Quarterly, 19, 300-317.\u003c/li\u003e\n\u003cli\u003eDavis, R.W., Kotecki, J.E., Harvey, M., \u0026amp; Oliver, A. (2007). Responsibilities and training needs of paraeducators in physical education. \u003cem\u003eAdapted Physical Activity Quarterly, 24\u003c/em\u003e(1), 70-83.\u003c/li\u003e\n\u003cli\u003eLieberman, L. J. (2007). Paraeducators in physical education: A training guide to roles and responsibilities. Human Kinetics.\u003c/li\u003e\n\u003cli\u003eLieberman, L.J., Dunn, J.M., van der Mars, H., \u0026amp; McCubbin, J. (2000). Peer tutors effects on activity levels of deaf students in inclusive elementary physical education. \u003cem\u003eAdapted Physical Activity Quarterly, 17, \u003c/em\u003e20-39.\u003c/li\u003e\n\u003cli\u003eGilliam, J. E. (2006). \u003cem\u003eGilliam autism rating scale: GARS 2\u003c/em\u003e. Pro-ed.\u003c/li\u003e\n\u003cli\u003eConstantino, J. N., \u0026amp; Gruber, C. P. (2012). Social responsiveness scale: SRS-2.\u003c/li\u003e\n\u003cli\u003eUlrich, D. A. (2019). TGMD-3: Test of Gross Motor Development: Examiner\u0026rsquo;s Manual. 3rd Edn, Austin, TX: Pro-Ed, Inc.\u003c/li\u003e\n\u003cli\u003eEnnigkeit, F., \u0026amp; Beek, F.L. (2019). The effect of judo on social behavior with special consideration of periods of reflection. \u003cem\u003eJournal of Martial Arts Research\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(2), 7-7.\u003c/li\u003e\n\u003cli\u003eSterkowicz-Przybycień, K., Kłys, A., \u0026amp; Almansba, R. (2014). Educational judo benefits on the preschool children\u0026rsquo;s behaviour. \u003cem\u003eJ. Combat Sports Martial Arts\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e, 23-26.\u003c/li\u003e\n\u003cli\u003eMiyahara, M. (2013). Meta review of systematic and meta-analytic reviews on movement differences, effect of movement based interventions, and the underlying neural mechanisms in autism spectrum disorder. Frontiers in integrative neuroscience, 7, 16.\u003c/li\u003e\n\u003cli\u003eMacDonald, M., Lord, C., \u0026amp; Ulrich, D. A. (2014). Motor skills and calibrated autism severity in young children with autism spectrum disorder. Adapted physical activity quarterly, 31(2), 95-105.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Autism, judo, karate, social inclusion, primary school","lastPublishedDoi":"10.21203/rs.3.rs-4836261/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4836261/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003ePurpose\u003c/em\u003e Autistic children are often at risk of isolation. Many studies have demonstrated the effectiveness of sport interventions for autistic children. Martial arts such as judo and karate are among the most recommended sports, but few studies have been conducted to analyze the benefits of sports in inclusive primary school contests. This research was conducted by \"KATAUTISM PROJECT\" of the Italian Judo, Wrestling, Karate and Martial Arts Federation (FIJLKAM), whose objective is the inclusion of autistic children through the practice of judo and karate in primary schools.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMethods\u003c/em\u003e The study involves 31 ASD children (n=5 girls n= 26 boys) with different level of autism between 6 and 10 years old who all partook in an inclusive judo (n=16) and karate program (n=15) at school with their classmates. Each program includes 2 weekly sessions for 24 weeks, with each session lasting 1 hour. This study analyzes 3 different areas in autistic children: the level of autism, social compromission and gross motor skills\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResults. \u003c/em\u003eAll ASD children completed the program with classmates that yielded statistically significant results (p\u0026lt;0.05) in all 3 areas analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConclusion\u003c/em\u003e Judo and karate in school contest has favored the inclusion of ASD children within the classroom. Through careful monitoring of autistic mannerisms, hetero and self-aggressive behaviors, emotional regulation and a degree of tolerance, all ASD subjects greatly benefitted from the social inclusion. The study also demonstrated that the comparison groups of judo and karate produce similar average percentage improvements in GARS, SRS and TGMD-3.\u003c/p\u003e","manuscriptTitle":"Judo and karate in primary school as a means for the improvement of social inclusion for autistic children","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-04 21:47:34","doi":"10.21203/rs.3.rs-4836261/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-22T19:19:12+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-20T10:58:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-20T08:01:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"255335754166746579750854070921648526434","date":"2025-03-17T17:53:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"215019214918763623241538379503399385666","date":"2025-03-14T03:42:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"270564543779137246653720071620242981525","date":"2025-03-13T10:29:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17130603775512404420339434825055337907","date":"2025-01-25T19:54:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-25T19:47:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-01T03:29:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-01T03:28:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"Sport Sciences for Health","date":"2024-07-31T14:14:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4be9cb1c-e46f-4d13-b6a7-8cb4b817fd62","owner":[],"postedDate":"September 4th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-06-23T15:58:50+00:00","versionOfRecord":{"articleIdentity":"rs-4836261","link":"https://doi.org/10.1007/s11332-025-01461-3","journal":{"identity":"sport-sciences-for-health","isVorOnly":false,"title":"Sport Sciences for Health"},"publishedOn":"2025-06-18 15:57:07","publishedOnDateReadable":"June 18th, 2025"},"versionCreatedAt":"2024-09-04 21:47:34","video":"","vorDoi":"10.1007/s11332-025-01461-3","vorDoiUrl":"https://doi.org/10.1007/s11332-025-01461-3","workflowStages":[]},"version":"v1","identity":"rs-4836261","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4836261","identity":"rs-4836261","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}