The effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents: A meta-analysis of controlled trials

• Published in: Autism 2021-05, Vol.25 (4), p.874-886
• Main Authors: Chan, John SY, Deng, Kanfeng, Yan, Jin H
• Format: Article
• Language: English
• Subjects: Adolescents; Affordability; Aggregate data; Attrition; Autism; Autistic adolescents; Autistic children; Bias; Children; Communication; Communication Problems; Communication Skills; Comparative Analysis; Confidence intervals; Cost analysis; Cost Effectiveness; Early intervention; Efficacy; Exercise; Interpersonal Competence; Intervention; Meta Analysis; Outcomes of Treatment; Pervasive Developmental Disorders; Physical Activities; Physical activity; Research Reports; Risk assessment; Social functioning; Symptoms (Individual Disorders); Teenagers
• ISSN: 1362-3613; 1461-7005
• DOI: 10.1177/1362361320977645

Difficulty with communication and social functioning are two outstanding core symptoms of autism spectrum disorder, and physical activity has long been suggested to improve autism spectrum disorder symptoms. In this meta-analysis of controlled trials, we examined the effects of physical activity interventions compared to controls on communication and social functioning in autistic children and adolescents. Included studies are published articles in English with autism spectrum disorder participants younger than 18 years. Literature search was conducted on MEDLINE, Embase, CINAHL, and related databases through 6 May 2020. Quality of study was assessed with the Cochrane risk-of-bias tool regarding randomization, allocation concealment, blinding, attrition, and selective reporting. We included 12 controlled trials (N = 350) with communication outcomes (k = 8) and/or social functioning outcomes (k = 11). Results show small to moderate intervention benefits on communication (standardized mean change = 0.27, 95% confidence interval (0.06, 0.48)) and social functioning (standardized mean change = 0.39, 95% confidence interval (0.15, 0.63)), but the result for social functioning may be susceptible to publication bias. Better intervention outcomes are observed in younger participants, suggesting the importance of early participation. This study shows the benefits of physical activity interventions, and they could be considered a cost-effective means for autism spectrum disorder management in the future. Lay abstract Difficulty with communication and social functioning are two outstanding core symptoms of autism spectrum disorder, while there is no efficacious pharmacologic treatment available to deal with them. Traditional behavioral therapies usually require specialist therapist and be conducted in specific settings, increasing burdens on families and individuals with autism. Physical activity has long been found to promote physical and mental well-beings, and it is more affordable and versatile than traditional therapies. There is preliminary support for the use of physical activity interventions to improve communication and social functioning in individuals with autism. In this study, we quantitatively aggregate data from existing controlled trials to provide an up-to-date inquiry into the effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents. We included 12 trials involving 350 participants