ORIGINAL PAPER
Effect of an indoor climbing program on selective attention of children with
autism spectrum disorder (ASD)
1
Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
2
Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
Submission date: 2025-02-18
Acceptance date: 2025-09-20
Publication date: 2025-12-22
Corresponding author
Alexandra Eleftheria Broupi
Department of Physical Education and Sport Science, University of Thessaly, Karyes, Trikala, Greece
Department of Physical Education and Sport Science, University of Thessaly, Karyes, Trikala, Greece
Hum Mov. 2025;26(4):120-129
KEYWORDS
TOPICS
ABSTRACT
Purpose:
Children with autism spectrum disorder (ASD) focus their attention more easily through visual support. Indoor climbing requires focus and motor planning that enhance the cognitive functions and attention of children with ASD to follow specific routes differentiated by tape colours that act as clear visual prompts. Cancellation tests in mobile apps are frequently used to assess the selective attention of children with ASD using visual stimuli. The purpose of this study was to examine the effect of an indoor climbing program on the selective attention of children with ASD, using mobile apps featuring a cancellation test.
Methods:
The sample consisted of 34 children with ASD (7 to 13 years of age) randomly assigned into an experiment group (EG) and a control group (CG). EG followed a 10-week indoor climbing program structured on visual cues provided throughout the sessions, whereas the CG did not participate in the program.
Results:
Wilcoxon analysis revealed statistically significant differences between pre- and post- measures only for the EG group on selective attention concerning time (p < 0.001) and mistakes (p < 0.001). No differences were observed for the CG. Mann–Whitney analysis revealed significant differences between the EG and CG in post-cancelation test measures, in favour of the EG participants (p < 0.001 and p < 0.002 for time and mistakes, respectively).
Conclusions:
The findings support that indoor climbing is effective in promoting the selective attention of children with ASD through visual cues. Future studies could focus on climbing interventions using visual prompts to promote selective attention and other cognitive functions of children with ASD and other neurodevelopmental conditions.
Children with autism spectrum disorder (ASD) focus their attention more easily through visual support. Indoor climbing requires focus and motor planning that enhance the cognitive functions and attention of children with ASD to follow specific routes differentiated by tape colours that act as clear visual prompts. Cancellation tests in mobile apps are frequently used to assess the selective attention of children with ASD using visual stimuli. The purpose of this study was to examine the effect of an indoor climbing program on the selective attention of children with ASD, using mobile apps featuring a cancellation test.
Methods:
The sample consisted of 34 children with ASD (7 to 13 years of age) randomly assigned into an experiment group (EG) and a control group (CG). EG followed a 10-week indoor climbing program structured on visual cues provided throughout the sessions, whereas the CG did not participate in the program.
Results:
Wilcoxon analysis revealed statistically significant differences between pre- and post- measures only for the EG group on selective attention concerning time (p < 0.001) and mistakes (p < 0.001). No differences were observed for the CG. Mann–Whitney analysis revealed significant differences between the EG and CG in post-cancelation test measures, in favour of the EG participants (p < 0.001 and p < 0.002 for time and mistakes, respectively).
Conclusions:
The findings support that indoor climbing is effective in promoting the selective attention of children with ASD through visual cues. Future studies could focus on climbing interventions using visual prompts to promote selective attention and other cognitive functions of children with ASD and other neurodevelopmental conditions.
REFERENCES (50)
1.
Sultana OF, Bandaru M, Islam MA, Reddy PH. Unraveling the complexity of human brain: Structure, function in healthy and disease states. Ageing Res Rev. 2024;100:102414; doi: 10.1016/j. arr.2024.102414.
2.
de Souza Almeida R, Faria-Jr A, Klein RM. On the origins and evolution of the Attention Network Tests. Neurosci Biobehav Rev. 2021;126:560–72; doi: 10.1016/j.neubiorev.2021.02.028.
3.
Posner MI. The evolution and future development of attention networks. J Intell. 2023;11(6):98; doi: 10.3390/jintelligence11060098.
4.
Yao Y, De Swaef W, Geirnaert S, Bertrand A. EEGbased decoding of selective visual attention in superimposed videos. IEEE J Biomed Health Inform. 2025;29(10):7248–61; doi: 10.1109/JBHI.2025. 3580261.
5.
American Psychiatric Association. Neurodevelopmental disorders. In: Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). Arlington: American Psychiatric Association; 2022; doi: 10.1176/appi.books.9780890425787.x01_ Neurodevelopmental_Disorders.
6.
Wang Q, Chang J, Chawarska K. Atypical valuedriven selective attention in young children with autism spectrum disorder. JAMA Netw Open. 2020;3(5):e204928; doi: 10.1001/jamanetworkopen. 2020.4928.
7.
Sabag M, Geva R. Hyper and hypo attention networks activations affect social development in children with autism spectrum disorder. Front Hum Neurosci. 2022;16:902041; doi: 10.3389/ fnhum.2022.902041.
8.
Dupuis A, Mudiyanselage P, Burton CL, Arnold PD, Crosbie J, Schachar RJ. Hyperfocus or flow? Attentional strengths in autism spectrum disorder. Front Psychiatry. 2022;13:886692; doi: 10.3389/ fpsyt.2022.886692.
9.
Mallory C, Keehn B. Implications of sensory processing and attentional differences associated with autism in academic settings: an integrative review. Front Psychiatry. 2021;12:695825; doi: 10.3389/ fpsyt.2021.695825.
10.
Sanku BS, Li YJ, Jung S, Mei C, He JS. Enhancing attention in autism spectrum disorder: comparative analysis of virtual reality-based training programs using physiological data. Front Comput Sci. 2023;5:1250652; doi: 10.3389/fcomp.2023. 1250652.
11.
Spaniol MM, Mevorach C, Shalev L, Teixeira MCTV, Lowenthal R, De Paula CS. Attention training in children with autism spectrum disorder improves academic performance: a double-blind pilot application of the computerized progressive attentional training program. Autism Res. 2021;14(8): 1769–76; doi: 10.1002/aur.2566.
12.
Bled C, Guillon Q, Mottron L, Soulieres I, Bouvet L. Evaluation of a visual cognitive style in autism: a cluster analysis. J Autism Dev Disord. 2024; doi: 10.1007/s10803-024-06616-8.
13.
Rutherford M, Baxter J, Grayson Z, Johnston L, O’Hare A. Visual supports at home and in the community for individuals with autism spectrum disorders: a scoping review. Autism. 2020;24(2): 447–69; doi: 10.1177/1362361319871756.
14.
Hokken MJ, Krabbendam E, Van Der Zee YJ, Kooiker MJG. Visual selective attention and visual search performance in children with CVI, ADHD, and dyslexia: a scoping review. Child Neuropsychol. 2023;29(3):357–90; doi: 10.1080/09297049. 2022.2057940.
15.
Vu NN, Hung BP, Van NTT, Lien NTH. Theoretical and instructional aspects of using multimedia resources in language education: a cognitive view. In: Kumar R, Sharma R, Pattnaik PK (eds.) Multimedia Technologies in the Internet of Things Environment. Vol. 2. Studies in Big Data. Vol. 93. Singapore: Springer Singapore; 2022, pp. 165–94; doi: 10.1007/978-981-16-3828-2_9.
16.
Cohen A, Demchak M. Use of visual supports to increase task independence in students with severe disabilities in inclusive educational settings. Educ Train Autism Dev Disabil. 2018;53(1):84–99.
17.
Hardy JK, Mere-Cook Y, Yang H-W. Critical issues in measuring and teaching social problemsolving in early childhood research. In: Topics in Early Childhood Special Education. 2024, p. 02 711214241288214; doi: 10.1177/027112142412 88214.
18.
Bogdashina O. Communication Issues in Autism and Asperger Syndrome. Do we speak the same language? 2nd ed. London: J. Kingsley; 2022.
19.
Holyfield C, Light J, Nieder D, Preece J. External challenges for individuals who need or use AAC who are learning language: lived experiences, key research findings, and future directions. Augment Altern Commun. 2025;41(3):267–79; doi: 10.1080/ 07434618.2025.2508485.
20.
Leung PWS, Li SX, Tsang CSO, Chow BLC, Wong WCW. Effectiveness of using mobile technology to improve cognitive and social skills among individuals with autism spectrum disorder: systematic literature review. JMIR Ment Health. 2021;8 (9):e20892; doi: 10.2196/20892.
21.
Al-Saadi AM, Al-Thani D. Mobile application to identify and recognize emotions for children with autism: a systematic review. Front Child Adolesc Psychiatry. 2023;2:1118665; doi: 10.3389/frcha. 2023.1118665.
22.
Ntalindwa T, Nduwingoma M, Karangwa E, Soron TR, Uworwabayeho A, Uwineza A. Development of a mobile app to improve numeracy skills of children with autism spectrum disorder: participatory design and usability study. JMIR Pediatr Parent. 2021;4(3):e21471; doi: 10.2196/21471.
23.
Cascaes R, Lameira K, Sarmanho R, Pinheiro K, Mota MP, Pereira A, Neto NCS. Adaptation and automation of a cancellation test for evaluation of exploratory visual behavior. In: Proceedings of the 17th Brazilian Symposium on Human Factors in Computing Systems; 2018 Oct; Belem Brazil; pp. 1–9; doi: 10.1145/3274192.3274197.
24.
Krieger V, Amador-Campos JA. Clinical presentations of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents: comparison of neurocognitive performance. Child Neuropsychol. 2021;27(8):1024–53; doi: 10.1080/092970 49.2021.1917530.
25.
Lee EK, Huh H, Kim WY, Lee H, Yoo H. Validity of the simplified computerized comprehensive learning ability screening test for the early detection of learning disabilities. Psychiatry Int. 2025; 6(2):60; doi: 10.3390/psychiatryint6020060.
26.
Jackson B. The Neural Basis of Aging. Life Sci. 2025; doi: 10.33774/coe-2025-fcg76-v3.
27.
Cascaes R, Lameira K, Sarmanho R, Santos S, Pinheiro K, Pereira MM, Pereira A, Neto CS. An empirical study on the adaptation and automation of a cancellation test for children. J Interact Syst. 2919;10(2):82–95; doi: 10.5753/jis.2019.555.
28.
Lima M, Baeta E, Duro D, Tabuas-Pereira M, Valerio D, Freitas S, Simoes MR, Santana I. Toulouse- Pieron Cancellation Test: normative scores for the Portuguese population. Appl Neuropsychol Adult. 2023;30(2):169–75; doi: 10.1080/23279095.2021. 1918694.
29.
Knobel SEJ, Kaufmann BC, Gerber SM, Cazzoli D, Muri RM, Nyffeler T, Nef T. Immersive 3D virtual reality cancellation task for visual neglect assessment: a pilot study. Front Hum Neurosci. 2020; 14:180; doi: 10.3389/fnhum.2020.00180.
30.
Gassner L, Dabnichki P, Langer A, Pokan R, Zach H, Ludwig M, Santer A. The therapeutic effects of climbing: a systematic review and meta-analysis. PM R. 2023;15(9)1194–1209; doi: 10.1002/pmrj. 12891.
31.
Langer K, Simon C, Wiemeyer J. Physical performance testing in climbing – a systematic review. Front Sports Act Living. 2023;5:1130812; doi: 10.3389/fspor.2023.1130812.
32.
Kokaridas D, Demerouti I, Margariti P, Krommidas C. The Effect of an indoor climbing program on improving handgrip strength and traverse speed of children with and without Autism Spectrum Disorder. Palaestra. 2018;32(3):39–44.
33.
Bibro MA, Żarow R. The influence of climbing activities on physical fitness of people with intellectual disabilities. Int J Disabil Dev Educ. 2023;70(4): 530–9; doi: 10.1080/1034912X.2021.1895085.
34.
Weinstock-Zlotnick G. Wolff A, Potter G, Robbins L. Children with cerebral palsy’s experiences with adaptive climbing: a qualitative study on parents’ perspectives. HSS J. 2024;20(3):377–82; doi: 10.1177/15563316241249912.
35.
Horst E. Learning to Climb Indoors. Blue Ridge Summit (PA): Rowman and Littlefield; 2019.
36.
Mangan K, Andrews K, Miles B, Draper N. The psychology of rock climbing: a systematic review. Psychol Sport Exerc. 2025;76:102763; doi: 10.1016/ j.psychsport.2024.102763.
37.
Isomura T, Ito H, Ogawa S, Masataka N. Absence of predispositional attentional sensitivity to angry faces in children with autism spectrum disorders. Sci Rep. 2014;4(1):7525; doi: 10.1038/srep07525.
38.
Drummond A, Popinga A. Bayesian inference of the climbing grade scale. 2021;arXiv; 10.48550/ ARXIV.2111.08140.
39.
Garrido-Palomino I, Fryer S, Giles D, Gonzalez- Rosa JJ, Espana-Romero V. Attentional differences as a function of rock climbing performance. Front Psychol. 2020;11:1550; doi: 10.3389/fpsyg.2020. 01550.
40.
Whitaker MM, Pointon GD, Tarampi MR, Rand KM. Expertise effects on the perceptual and cognitive tasks of indoor rock climbing. Mem Cogn. 2020;48(3):494–510; doi: 10.3758/s13421-019- 00985-7.
41.
Angelini E, Oriel KN, Myers GM, Cook KDA, Drawbaugh RM, Price J. The impact of an adapted climbing program on children with attentiondeficit/ hyperactivity disorder. Int J Phys Educ Fitness Sports. 2020;9(4):60–9; doi: 10.34256/ ijpefs2047.
42.
Hamilton J, Lape JE, Lee AL. Use of an adaptive climbing program to improve social skills in children with developmental delays: a feasibility study. Int J Allied Health Sci Pract. 2023;21(1); doi: 10.46743/1540-580X/2023.2253.
43.
Oriel KN, Kanupka JW, Fuehrer AT, Klumpp KM, Stoltz KN, Willey DW, Decvalcante ML. The impact of a rock climbing program for adolescents with autism spectrum disorder: a pilot study. Int J Kinesiol Higher Educ. 2018;2(4):113–26; doi: 10.1080/24711616.2018.1425601.
44.
Sarang SP, Telles S. Immediate effect of two yogabased relaxation techniques on performance in a letter-cancellation task. Percept Mot Skills. 2007; 105(2):379–85; doi: 10.2466/pms.105.2.379-385.
45.
Pradhan B, Nagendra HR. Normative data for the letter-cancellation task in school children. Int J Yoga. 2008;1(2):72–5; doi: 10.4103/0973-6131. 43544.
46.
Langner R, Scharnowski F, Ionta S, Salmon CEG, Piper BJ, Pamplona GSP. Evaluation of the reliability and validity of computerized tests of attention. PLOS ONE. 2023;18(1):e0281196; doi: 10.1371/journal.pone.0281196.
47.
Bouyer C, Gimenes M, Dickert J, Vicente S, Stal V, Wager M, Baudiffier V. Validation of the BLOC test: a computerized oral line bisection task in French healthy participants. App Neuropsychol Adult. 2023; 32(6):1576–84; doi: 10.1080/232 79095.2023.2290190.
48.
di Cesare F, di Carlo C, di Cesare L. Development of a symbol cancellation test to evaluate attention in a school-aged Zambian Population. Innov Clin Neurosci. 2023;20(1–3):46–52.
49.
Garrido-Palomino I, Giles D, Fryer S, Gonzalez- Montesinos JL, Espana-Romero V. Cognitive function of climbers: an exploratory study of working memory and climbing performance. Span J Psychol. 2024;27:e24; doi: 10.1017/SJP.2024.25.
50.
Vasile I, Stănescu M, Pelin F, Bejan R. Cognitive factors that predict on-sight and red-point performance in sport climbing at youth level. Front Psychol. 2022;13:1012792; doi: 10.3389/fpsyg.2022. 1012792.
| eISSN: | 1899-1955 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
