Prediction of Outcomes in Mini-Basketball Training Program for Preschool Children with Autism Using Machine Learning Models

In recent years evidence has emerged suggesting that Mini-basketball training program (MBTP) can be an effec-tive intervention method to improve social communication (SC) impairments and restricted and repetitive beha-viors (RRBs) in preschool children suffering from autism spectrum disorder (ASD). However, there is a considerable degree if interindividual variability concerning these social outcomes and thus not all preschool chil-dren with ASD profit from a MBTP intervention to the same extent. In order to make more accurate predictions which preschool children with ASD can benefit from an MBTP intervention or which preschool children with ASD need additional interventions to achieve behavioral improvements, further research is required. This study aimed to investigate which individual factors of preschool children with ASD can predict MBTP intervention out-comes concerning SC impairments and RRBs. Then, test the performance of machine learning models in predict-ing intervention outcomes based on these factors. Participants were 26 preschool children with ASD who enrolled in a quasi-experiment and received MBTP intervention. Baseline demographic variables (e.g., age, body, mass index [BMI]), indicators of physical fitness (e.g., handgrip strength, balance performance), performance in execu-tive function, severity of ASD symptoms, level of SC impairments, and severity of RRBs were obtained to predict treatment outcomes after MBTP intervention. Machine learning models were established based on support vector machine algorithm were implemented. For comparison, we also employed multiple linear regression models in statistics. Our findings suggest that in preschool children with ASD symptomatic severity (r = 0.712, p < 0.001) and baseline SC impairments (r = 0.713, p < 0.001) are predictors for intervention outcomes of SC impair-ments. Furthermore, BMI (r = -0.430, p = 0.028), symptomatic severity (r = 0.656, p < 0.001), baseline SC impair-ments (r = 0.504, p = 0.009) and baseline RRBs (r = 0.647, p < 0.001) can predict intervention outcomes of RRBs. Statistical models predicted 59.6% of variance in post-treatment SC impairments (MSE = 0.455, RMSE = 0.675, R-2 = 0.596) and 58.9% of variance in post-treatment RRBs (MSE = 0.464, RMSE = 0.681, R-2 = 0.589). Machine learning models predicted 83% of variance in post-treatment SC impairments (MSE = 0.188, RMSE = 0.434, R-2 = 0.83) and 85.9% of variance in post-treatment RRBs (MSE = 0.051, RMSE = 0.226, R-2 = 0.859), which were better than statistical models. Our findings suggest that baseline characteristics such as symptomatic severity of ASD symptoms and SC impairments are important predictors determining MBTP intervention-induced improvements concerning SC impairments and RBBs. Furthermore, the current study revealed that machine learning models can successfully be applied to predict the MBTP intervention-related outcomes in preschool children with ASD, and performed better than statistical models. Our findings can help to inform which preschool children with ASD are most likely to benefit from an MBTP intervention, and they might provide a reference for the development of personalized intervention programs for preschool children with ASD.

Automated summary

In recent years, evidence has shown that the Mini-basketball training program (MBTP) can effectively improve social communication impairments and repetitive behaviors in preschool children with autism spectrum disorder (ASD). However, not all children with ASD benefit equally from MBTP intervention. This study investigated individual factors that predict intervention outcomes and tested the performance of machine learning models in predicting these outcomes. The findings suggest that symptomatic severity and baseline social communication impairments are important predictors for intervention outcomes. Machine learning models outperformed statistical models in predicting the intervention-related outcomes. These findings can inform personalized intervention programs for preschool children with ASD.