Effects of physical activity on motor, communication, social, and executive function in children with autism spectrum disorder: a meta-analysis of randomized controlled trials.

This large research review looked at 33 studies involving over 1,000 autistic children to see how physical activity helps different skills. Results showed physical activity significantly improved movement skills, social skills, and thinking skills like planning and focus. Communication skills also improved but not as much. The best results came from shorter exercise sessions (under 60 minutes) done 3 or more times per week for up to 10 weeks, though thinking skills improved more with longer programs.

This 2025 meta-analysis examined 33 randomized controlled trials involving 1,083 children with autism spectrum disorder to evaluate physical activity interventions across multiple functional domains. Results showed significant improvements in motor ability (SMD = 2.28), social ability (SMD = 1.52), and executive function (SMD = 0.88). Communication improvements were observed but not statistically significant (SMD = 0.82, p > 0.05). Subgroup analyses revealed optimal intervention parameters: sessions under 60 minutes, delivered three or more times per week for no more than 10 weeks were generally most effective.

However, executive function specifically benefited from longer durations and periods, while motor ability favored lower frequencies, indicating a nonlinear dose-response relationship across different functional domains.

Physical activity interventions should be implemented as evidence-based treatments for autistic children, particularly targeting motor and social skills. Practitioners should consider shorter, more frequent sessions initially, while adapting duration and intensity based on specific functional goals. Executive function improvements may require longer intervention periods for optimal benefits.

The abstract does not specify study quality assessment results, participant age ranges, types of physical activities examined, or control group conditions. Heterogeneity between studies and potential publication bias are not discussed. The nonlinear dose-response relationship suggests complexity that may require individual tailoring.

Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by deficits in social communication and restricted, repetitive behaviors. Although physical activity has shown promise as a nonpharmacological intervention, evidence across multiple functional domains remains limited. A systematic search was conducted in March 2024 and updated in May 2025. Thirty-three randomized controlled trials involving 1083 participants were included.

Two reviewers independently performed the study selection, data extraction, quality assessment, and meta-analysis. The meta-analysis revealed significant effects of physical activity on motor ability (SMD = 2.28, 95% CI 1.61-2.95), social ability (SMD = 1.52, 95% CI 0.97-2.07), and executive function (SMD = 0.88, 95% CI 0.58-1.19; all p < 0.05). The ability to communicate also improved (SMD = 0.82, 95% CI 0.50-1.13), although not significantly (p > 0.05). Subgroup analyses suggested that sessions under 60 min, delivered three or more times per week for no more than 10 weeks, were generally more effective.

However, longer durations and periods benefited executive function, whereas lower frequencies favored motor ability. This study found that physical activity has a positive effect on increasing communication, social, motor, and executive function capabilities in children with ASD. However, disparities in optimal effects observed across communication, social, motor, and executive functioning outcomes are contingent upon intervention duration, frequency, and period. • The physical and psychological benefits of physical activity are well established. • Previous meta-analyses have failed to demonstrate the impact of physical activity on the motor ability and characteristic impairments of children with ASD. • Physical activity has a positive effect on augmenting communication, social, motor, and executive function capabilities in children with ASD. • Subgroup analyses revealed a nonlinear dose-response relationship, with shorter sessions, higher frequency, and shorter intervention periods yielding better outcomes for most domains, while executive function benefited from longer, sustained interventions.