Abstract
The aim of this study was to examine the effect of Physical Activity Program (PAP) on psychomotor and psychosocial characteristics of autistic children. In this study, a mixed-methods sequential exploratory design consisting of two stages, quantitative and qualitative, was used. The research group consisted of a total of 40 participants (girls n = 20, boys n = 20), aged between 8 and 12 years, with 20 in the control group (CG) and 20 in the experimental group (EG). EG participated in the PAP for 60 min a day, 3 days a week for 10 weeks. Gilliam Autistic Disorder Rating Scale-2 (GARS-2), Bruininks-Oseretsky motor competence test-2 short form (BOT-2 SF), Eurofit Test Battery, Pediatric Quality of Life Form and Social Skills Rating System Parent Form were used in the study. Mann Whitney U test was used for two-group comparisons of parameters that did not show normal distribution, and Wilcoxon signed-rank test was used to examine the changes between pretest and posttest measurements. Significance was evaluated at p < 0.05 level. The thematic analysis method was used for the focus group interview, one of the qualitative research methods.After PAP, a statistically significant difference was found in favor of EG in all subtests of GARS-2 and in total standard scores (p < 0.05). The increase in all subtests and total scores of the BOT-2 was higher in favor of the EG (p < 0.05), and an increase in performance in all subtests of the Eurofit test battery was detected (p < 0.05). The positive effects of PAP on social skills and quality of life were supported by qualitative findings, but quantitative findings did not reveal a significant change (p > 0.05). Effect size analyses showed that the program produced moderate effects on autistic symptoms (r = 0.3–0.5), very large effects on motor skills (r = 0.8–1.5), and large effects on physical fitness variables (r = 0.6–0.9). 10 weeks of PAP applied to autistic children seems to be sufficient to provide positive effects on motor skills, physical fitness and autistic disorder index, but longer programs are needed for more striking effects on quality of life and social skills.
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The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th edn (American Psychiatric Association, 2013).
Hatipoğlu Özcan, G., Özer, D. F. & Pınar, S. Effects of motor intervention program on academic skills, motor skills and social skills in children with autism spectrum disorder. J. Autism Dev. Disord. 55, 1–15. https://doi.org/10.1007/s10803-024-06384-5 (2025).
Liu, T., Capistran, J. & ElGarhy, S. Fine and gross motor competence in children with autism spectrum disorder. Phys. Educ. 78, 227–241. https://doi.org/10.18666/TPE-2021-V78-I3-9644 (2021).
Sansi, A., Nalbant, S. & Ozer, D. Effects of an inclusive physical activity program on the motor skills, social skills and attitudes of students with and without autism spectrum disorder. J. Autism Dev. Disord. 51, 2254–2270. https://doi.org/10.1007/s10803-020-04693-z (2021).
Mohd Nordin, A., Ismail, J. & Kamal Nor, N. Motor development in children with autism spectrum disorder. Front. Pediatr. 9, 598276. https://doi.org/10.3389/fped.2021.598276 (2021).
Wang, L. A., Petrulla, V., Zampella, C. J., Waller, R. & Schultz, R. T. Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychol. Bull. 148, 273. https://doi.org/10.1037/bul0000358 (2022).
Ohara, R., Kanejima, Y., Kitamura, M. & Izawa, K. P. Association between social skills and motor skills in individuals with autism spectrum disorder: a systematic review. Eur. J. Investig Health Psychol. Educ. 10, 276–296. https://doi.org/10.3390/ejihpe10010022 (2019).
De Greeff, J. W., Bosker, R. J., Oosterlaan, J., Visscher, C. & Hartman, E. Effects of physical activity on executive functions, attention and academic performance in preadolescent children: a meta-analysis. J. Sci. Med. Sport. 21, 501–507. https://doi.org/10.1016/j.jsams.2017.09.595 (2018).
Tan, B. W., Pooley, J. A. & Speelman, C. P. A meta-analytic review of the efficacy of physical exercise interventions on cognition in individuals with autism spectrum disorder and ADHD. J. Autism Dev. Disord. 46, 3126–3143. https://doi.org/10.1007/s10803-016-2854-x (2016).
Ferreira, J. P. et al. Effects of a physical exercise program (PEP-Aut) on autistic children’s stereotyped behavior, metabolic and physical activity profiles, physical fitness, and health-related quality of life: a study protocol. Front. Public. Health. 6, 47. https://doi.org/10.3389/fpubh.2018.00047 (2018).
Kashi, A., Dawes, H., Mansoubi, M. & Sarlak, Z. The effect of a physical exercise package on motor proficiency of children and adolescents with autism spectrum disorder. J. Exerc. Health Sci. 1, 15–34. https://doi.org/10.22089/jehs.2022.11442.1036 (2021).
Sarabzadeh, M., Azari, B. & Helalizadeh, B. The effect of six weeks of Tai Chi Chuan training on the motor skills of children with autism spectrum disorder. J. Bodyw. Mov. Ther. 23, 284–290. https://doi.org/10.1016/j.jbmt.2019.01.007 (2019).
Pan, C. Y. et al. Objectively measured physical activity and health-related physical fitness in secondary school-aged male students with autism spectrum disorders. Phys. Ther. 96, 511–520. https://doi.org/10.2522/ptj.20140353 (2016).
Rios, P. C. & Scharoun Benson, S. M. Exploring caregiver perspectives of social and motor skills in children with autism spectrum disorder and the impact on participation. Front. Psychol. 11, 1260. https://doi.org/10.3389/fpsyg.2020.01260 (2020).
Yu, C. C., Wong, S. W., Lo, F. S., So, R. C. & Chan, D. F. Study protocol: a randomized controlled trial study on the effect of a game-based exercise training program on promoting physical fitness and mental health in children with autism spectrum disorder. BMC Psychiatry. 18, 1–10. https://doi.org/10.1186/s12888-018-1635-9 (2018).
Zhao, M. & Chen, S. The effects of structured physical activity program on social interaction and communication for children with autism. Phys Act. Child. Health Cogn. Article ID. 1825046. https://doi.org/10.1155/2018/1825046 (2018).
López, J. M., Moreno-Rodríguez, R., Alcover, C. M., Garrote, I. & Sánchez, S. Effects of a program of sport schools on development of social and psychomotor skills of people with autistic spectrum disorders: a pilot project. J. Educ. Train. Stud. 5, 167–177. https://doi.org/10.11114/jets.v5i8.2555 (2017).
McCoy, S. M. & Morgan, K. Obesity, physical activity, and sedentary behaviors in adolescents with autism spectrum disorder compared with typically developing peers. Autism 24, 387–399. https://doi.org/10.1177/1362361319861579 (2020).
Du, R. Y., Yiu, C. K. & King, N. M. Oral health behaviours of preschool children with autism spectrum disorders and their barriers to dental care. J. Autism Dev. Disord. 49, 453–459. https://doi.org/10.1007/s10803-018-3708-5 (2019).
Tomaszewski, B., Savage, M. N. & Hume, K. Examining physical activity and quality of life in adults with autism spectrum disorder and intellectual disability. J. Intellect. Disabil. 26, 1075–1088. https://doi.org/10.1177/17446295211033467 (2022).
Kong, C. et al. Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder. J. Sport Health Sci. 12, 73–86. https://doi.org/10.1016/j.jshs.2022.08.003 (2023).
Hamm, J. & Yun, J. Influence of physical activity on the health-related quality of life of young adults with and without autism spectrum disorder. Disabil. Rehabil. 41, 763–769. https://doi.org/10.1080/09638288.2017.1408708 (2019).
Greco, G. & De Ronzi, R. Effect of karate training on social, emotional, and executive functioning in children with autism spectrum disorder. J. Phys. Educ. Sport. 20, 1637–1645. https://doi.org/10.7752/jpes.2020.04223 (2020).
Najafabadi, M. G. et al. The effect of SPARK on social and motor skills of children with autism. Pediatr. Neonatol. 59, 481–487. https://doi.org/10.1016/j.pedneo.2017.12.005 (2018).
Redquest, B., Bryden, P. & Fletcher, P. Social and motor skills of children and youth with autism from the perspectives of caregivers. Adv. Autism. 6, 259–275. https://doi.org/10.1108/AIA-01-2020-0008 (2020).
Creswell, J. W. & Plano Clark, V. L. Designing and Conducting Mixed Methods Research 2nd edn (SAGE, 2011).
Büyüköztürk, Ş., Kılıç Çakmak, E., Akgün, Ö. E., Karadeniz, Ş. & Demirel, F. Scientific Research Methods (in Turkish) (Pegem Publishing, 2008).
Haghighi, A. H. et al. Combined physical training strategies improve physical fitness, behavior, and social skills of autistic children. J. Autism Dev. Disord. 53, 4271–4279. https://doi.org/10.1007/s10803-022-05731-8 (2023).
Grenier, M. & Weiner, B. Physical education and sport for students with autism spectrum disorder. In Physical Education and Sport for Students with Special Needs (in Turkish, transl. L. E.) 6th edn (ed. Özer, D.) 37–45 (Nobel Publishing, 2020).
Goodway, J. D., Ozmun, J. C. & Gallahue, D. L. Understanding Motor Development: Infants, Children, Adolescents, Adults (Jones & Bartlett Learning, 2019).
Gilliam, J. E. GARS: Gilliam Autism Rating Scale (Pro-ed, 2006).
Diken, I. H., Ardıç, A., Diken, Ö. & Gilliam, J. E. Validity and reliability study of the Turkish version of the Gilliam autism rating Scale-2 (GARS-2-TV): A standardization study in Turkey. Education Science 37, (166) (2012).
Gresham, F. M. & Elliot, S. N. Social skills rating system manual. PsycTESTS Dataset Circle Pines, MN: American Guidance Service. (1990).
Tekinarslan, İ. Ç., Pınar, E. S. & Sucuoğlu, B. Evaluation of the psychometric properties of the social skills rating System–Parent form in mothers of children with intellectual disabilities. Egitim Ve Bilim. 38, 170 (2013).
Memik, N. C., Agaoglu, B., Coskun, A., Uneri, O. S. & Karakaya, I. The validity and reliability of the Turkish pediatric quality of life inventory for children 13–18 years old. Turk. Psikiyatri Derg. 18, 353 (2007).
Bruininks, R. H. & Bruininks, B. D. Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) (Pearson Clinical Assessment, 2005).
Pace, M. & Bricout, V. A. Low heart rate response of children with autism spectrum disorders in comparison to controls during physical exercise. Physiol. Behav. 141, 63–68. https://doi.org/10.1016/j.physbeh.2015.01.011 (2015).
Braun, V. & Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 3, 77–101. https://doi.org/10.1191/1478088706qp063oa (2006).
Huang, J., Du, C., Liu, J. & Tan, G. Meta-analysis on intervention effects of physical activities on children and adolescents with autism. Int. J. Environ. Res. Public. Health. 17, 1950. https://doi.org/10.3390/ijerph17061950 (2020).
Liu, T., Fedak, A. T. & Hamilton, M. Effect of physical activity on the stereotypic behaviors of children with autism spectrum disorder. Int. J. Sch. Health. 3, e28674. https://doi.org/10.17795/intjsh-28674 (2015).
Scattone, D. Social skills interventions for children with autism. Psychol. Sch. 44, 717–726. https://doi.org/10.1002/pits.20260 (2007).
Liang, X., Li, R., Wong, S. H., Sum, R. K. & Sit, C. H. Accelerometer-measured physical activity levels in children and adolescents with autism spectrum disorder: A systematic review. Prev. Med. Rep. 19, 101147. https://doi.org/10.1016/j.pmedr.2020.101147 (2020).
Toscano, C. V., Carvalho, H. M. & Ferreira, J. P. Exercise effects for children with autism spectrum disorder: metabolic health, autistic traits, and quality of life. Percept. Mot Skills. 125, 126–146. https://doi.org/10.1177/0031512517743823 (2018).
Shahane, V., Kilyk, A. & Srinivasan, S. M. Effects of physical activity and exercise-based interventions in young adults with autism spectrum disorder: A systematic review. Autism 28, 276–300. https://doi.org/10.1177/13623613231169058 (2024).
Iliadis, I. & Apteslis, N. The role of physical education and exercise for children with autism spectrum disorder and the effects on socialization, communication, behavior, fitness, and quality of life. Dialogues Clin. Neurosci. Ment Health. 3, 71–81. https://doi.org/10.26386/obrela.v3i1.178 (2020).
Özer, D. & Özer, K. Motor Development in Children 7th edn (Nobel Publishing, 2012).
Lee, J., Chang, S. H. & Jolin, J. Developing social skills of children with autism spectrum disorder for physical activity using a movement-based program. J. Mot Learn. Dev. 9, 95–108. https://doi.org/10.1123/jmld.2020-0017 (2020).
Shanker, S. & Pradhan, B. Effect of yoga on the motor proficiency of children with autism spectrum disorder and the feasibility of its inclusion in special school environments. Adapt. Phys. Act. Q. 39, 247–267. https://doi.org/10.1123/apaq.2021-0108 (2022).
Hynes, J. & Block, M. Effects of physical activity on social, behavioral, and cognitive skills in children and young adults with autism spectrum disorder: A systematic review of the literature. Rev. J. Autism Dev. Disord. 10, 749–770. https://doi.org/10.1007/s40489-022-00319-5 (2023).
Acknowledgements
This research was completed within the scope of Istanbul University-Cerrahpasa PhD program. We would like to thank all students and parents who participated in the research, Bayrampaşa RAM directorate, Anka special education and rehabilitation center directorate, Ay Autism sports and life center directorate, Şahinler special education and rehabilitation center directorate, and all teachers working in these institutions for their support.
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The first author carried out the procedures of reaching the participants, obtaining the consent forms, collecting the pre-test and post-test data, and entering the data into the computer. He also reported the method section and implemented the intervention program. The second author conducted the literature review and wrote the introduction, discussion, and reference sections. The third author performed the statistical analyses and reported the findings section. The fourth author designed and managed the study and guided the first researcher. He wrote the conclusion section. All authors reviewed the manuscript from beginning to end and contributed to its finalization.
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Ayaz, E., Özcan, G.H., Şahin, M. et al. Effects of physical activity program on psychomotor and psycho-social characteristics of autistic children. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35228-8
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DOI: https://doi.org/10.1038/s41598-026-35228-8


