Introduction
Engaging in physical activity (PA) is essential for the physical, mental, and social well-being of children and youth. However, for individuals with Autism Spectrum Disorder (ASD), participation in PA can be particularly challenging. Many factors—ranging from individual characteristics to societal barriers—affect their ability to participate in activities that can enhance their overall health. To shed light on this important issue, the scoping review titled “Barriers and Facilitators for Physical Activity Among Children and Youth with Autism,” published in September 2024 in the Journal of Physical Activity and Health, synthesizes the available literature on this topic. This review explores both the obstacles and the opportunities that influence PA participation across multiple environments and social levels.
Objectives of the Review
The purpose of the review was to systematically identify and analyze the barriers and facilitators to PA participation for children and youth with ASD. Using the socioecological model as a framework, the review explored how factors at the individual, interpersonal, community, and societal levels influence PA engagement. The review also aimed to distinguish between the unique barriers and facilitators specific to children with ASD and those that overlap with typically developing children or children with other disabilities.
Methodology: Mapping the Existing Evidence
The researchers searched five electronic databases in March 2022 and conducted an updated search in April 2024. They selected studies published between 2008 and 2024 that specifically examined PA among children and youth with ASD. In total, 54 studies were included in the final review. These studies spanned multiple perspectives, with 57% of them including direct insights from children and youth with ASD, either alone or in conjunction with proxies such as parents, teachers, or coaches. The remaining 43% of the studies relied solely on the perspectives of these proxies.
By employing the framework synthesis method, the authors mapped their findings across different levels of the socioecological model: intrapersonal, interpersonal, community, and societal. This approach allowed for a nuanced understanding of how various factors work together to either promote or hinder PA participation among children with ASD.
Key Findings Across Multiple Levels of Influence
1. Intrapersonal Barriers and Facilitators
At the intrapersonal level, individual characteristics such as motor skill deficits, sensory sensitivities, and motivation were found to significantly affect PA participation. Many children with ASD struggle with motor coordination, making physical tasks more challenging. Additionally, sensory sensitivities, such as an aversion to loud noises or certain textures, can create discomfort during activities like gym classes or sports events. These issues often lead to anxiety, withdrawal, and a lack of motivation to participate in PA.
On the other hand, some children with ASD have strong preferences for certain activities and find great enjoyment in them, which can act as a facilitator. When PA is tailored to align with their interests—such as incorporating favorite characters or games—participation increases. Personal enjoyment of activities like swimming, trampolining, or even structured play can enhance their engagement.
2. Interpersonal Barriers and Facilitators
Relationships with family, peers, educators, and coaches play a critical role in PA participation for children with ASD. A strong facilitator is the involvement and support of family members, particularly parents, who often act as advocates and mediators to ensure their child has access to inclusive programs. Parents may encourage PA by providing transportation, finding suitable programs, or even participating in activities alongside their children.
Conversely, a lack of understanding or awareness about ASD among teachers, coaches, and peers can create a social barrier to participation. Misunderstandings about behaviors associated with ASD may lead to exclusion from group activities, further reinforcing social isolation. Social challenges, such as difficulty communicating or interacting with others, also make it harder for children with ASD to engage in team sports or group exercises. For these children, the fear of failure, bullying, or misunderstanding from peers can discourage participation.
3. Community-Level Barriers and Facilitators
Community programs, schools, and sports clubs are important environments where PA opportunities arise. The review found that inclusive programs designed to accommodate children with ASD can be strong facilitators of participation. These programs often provide adapted activities, specialized instruction, and supportive environments that cater to the unique needs of children with ASD.
However, access to such programs is often limited. Many communities lack the resources or trained staff to provide inclusive PA opportunities, making it difficult for children with ASD to find suitable activities. The absence of dedicated facilities and equipment designed for children with disabilities further exacerbates this problem. Schools, in particular, are pivotal spaces for PA, and when they lack inclusive physical education (PE) programs, children with ASD are likely to be left out.
4. Societal Barriers and Facilitators
On a broader societal level, policies and societal attitudes toward inclusion play a major role in determining the extent to which children with ASD can participate in PA. The review highlighted that while awareness of the importance of inclusion in education and sports is growing, there is still much work to be done in terms of funding and policy development. Many programs are underfunded, and there is a need for more comprehensive strategies to ensure that PA opportunities are made available to all children, regardless of their abilities.
Advocacy for inclusive PA environments is a critical facilitator at the societal level. Public awareness campaigns, legislation promoting accessibility, and increased funding for inclusive sports and recreation programs are all necessary steps toward breaking down societal barriers. The review also emphasizes the need for a shift in societal attitudes, where inclusion is seen as the norm rather than the exception.
Unique Barriers and Facilitators Specific to Autism
While many of the barriers and facilitators identified in the review apply to children with and without disabilities, several factors are specific to the ASD population. Sensory sensitivities, motor coordination difficulties, and social communication challenges are unique characteristics of ASD that directly impact PA participation. These issues require specialized support, including adapted equipment, sensory-friendly environments, and the presence of staff trained to work with children with ASD. Without these accommodations, many children with ASD find it difficult to participate in PA.
General Barriers and Facilitators Shared with Other Populations
In addition to the unique factors associated with ASD, the review also identified several general barriers and facilitators that are common across all children, including those with other disabilities. For example, a lack of time, limited access to facilities, and insufficient support from schools or communities are barriers that affect children across the board. Facilitators such as family support, enjoyable activities, and access to well-designed programs were also found to be common across different populations.
Implications for Practice and Policy
The findings from this review have important implications for schools, community organizations, policymakers, and parents. To increase PA participation among children with ASD, it is crucial to address both the unique challenges faced by this population and the broader societal issues that limit access to inclusive opportunities.
Schools should prioritize the development of inclusive PE programs that consider the sensory, social, and motor challenges of children with ASD. This can be achieved by providing specialized training for teachers and coaches, adapting equipment and activities, and creating sensory-friendly environments.
Policymakers and community leaders should also work together to increase funding for inclusive sports programs and recreational facilities. By promoting policies that mandate inclusive practices and provide the necessary resources, they can create more equitable opportunities for children with ASD to participate in PA.
Conclusion
The scoping review highlights the complexity of factors influencing PA participation among children and youth with ASD. By mapping out the barriers and facilitators at different levels of the socioecological model, the authors offer a comprehensive understanding of how individual, social, and environmental factors interact to either promote or hinder PA engagement.
The review emphasizes the importance of tailored interventions that address the unique needs of children with ASD while also advocating for broader societal changes that promote inclusion in all aspects of life. Schools, families, and communities must collaborate to create a more inclusive environment where all children, regardless of their abilities, can experience the benefits of physical activity.
Future Directions
Future research should focus on gaining more direct input from children with ASD about their experiences with PA. Additionally, long-term studies that examine the impact of inclusive PA programs on the physical and mental health of children with ASD would provide valuable insights into how these interventions can be optimized. As technology continues to advance, researchers should also explore how digital tools and virtual platforms can be leveraged to create more accessible and engaging PA opportunities for children with ASD.
Source:
https://journals.humankinetics.com/view/journals/jpah/21/10/article-p965.xml