Impaired Motor Competence in Children and Adolescents With Autism Spectrum Disorder: Evidence From a Systematic Review and Meta-Analysis.

Autism spectrum disorder (ASD) is frequently associated with motor difficulties that may affect daily functioning, participation in physical activity, and developmental outcomes. Although motor impairments have been widely reported in this population, comparative evidence against typically developing (TD) peers remains fragmented across studies and assessment tools. This systematic review and meta-analysis aimed to examine whether children and adolescents with ASD show lower motor competence than TD peers and to identify the most affected motor domains. A systematic search was conducted in Scopus, Web of Science, PubMed, and SPORTDiscus up to December 10, 2025. Studies were eligible if they included children or adolescents with ASD and TD controls and assessed motor competence using standardized instruments. A total of 42 studies involving 3142 participants were included. The most frequently used tools were the Movement Assessment Battery for Children, the Bruininks-Oseretsky Test of Motor Proficiency, and the Test of Gross Motor Development. Across studies, children and adolescents with ASD consistently showed poorer performance than TD peers in manual dexterity, aiming and catching, balance, locomotor skills, and object control. Meta-analytic findings also indicated that participants with ASD had greater odds of presenting motor difficulty and being classified within the at-risk range. Despite heterogeneity and methodological limitations, the overall evidence supports a broad pattern of lower motor competence in ASD. These findings reinforce the importance of early motor assessment and targeted intervention in clinical and educational contexts.