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

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.

conclusionsThis 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. WHAT IS KNOWN: • 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. WHAT IS NEW: • 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.