Implementation, Reach, and Safety of Physical Activity Interventions for Autistic Adults: A Scoping Review

TY - JOUR

T1 - Implementation, Reach, and Safety of Physical Activity Interventions for Autistic Adults

T2 - A Scoping Review

AU - Kennedy, Rachel A.

AU - Archibald, Daryll

AU - Bury, Simon M.

AU - Southby, Alesha

AU - Shrestha, Rena

AU - Hedley, Darren

AU - Taylor, Nicholas F.

AU - Hawke, Lyndon

AU - McKeown, Gilly

AU - Shields, Nora

N1 - Copyright 2025, Mary Ann Liebert, Inc., publishers.

PY - 2025/7/2

Y1 - 2025/7/2

N2 - Background: Despite the known benefits of physical activity—such as better sleep, increased social connection, and reduced psychological distress—autistic adults often do not meet recommended levels. As physical and psychological conditions often co-occur with autism, increasing physical activity represents a potential avenue for improved health and well-being outcomes. Physical activity research to date has primarily focused on autistic children and adolescents. The aim of this study was to understand the implementation, reach, and safety of physical activity programs for autistic adults. Methods: We conducted a scoping review. Reported according to PRISMA-ScR guidelines, our review included studies implementing physical activity interventions in autistic people aged ≥18 years. We searched six databases to June 2024 with keywords, MeSH headings and derivatives relating to autism and physical activity. We extracted data using a standardized template, applying a descriptive analytical approach to map data to categories associated with the review’s aim. Results: Nine studies involving 148 autistic adults (108 male; aged 19–34 years) met inclusion criteria. Physical activity interventions implemented included aerobic exercise, walking or jogging, strength training, motor skills training, soccer, and exer-gaming. Trained instructors, exercise or health professionals, students, coaches, teaching assistants, or residential staff supervised programs conducted in home, school, university, or community settings. Strategies used to support implementation were incorporating appropriate adaptations and scaffolding, using social support strategies and facilitating self-determination. Elements of reach were described variably among the included studies. Reasons for reduced reach and nonparticipation included lack of interest, scheduling, and medical and personal issues. Safety strategies included conducting pre-exercise medical screening and providing physical and psychological training for support people. Conclusion: Safe implementation of physical activity among autistic adults is possible with support. However, there is a lack of research addressing physical activity among autistic women and those with complex needs.

AB - Background: Despite the known benefits of physical activity—such as better sleep, increased social connection, and reduced psychological distress—autistic adults often do not meet recommended levels. As physical and psychological conditions often co-occur with autism, increasing physical activity represents a potential avenue for improved health and well-being outcomes. Physical activity research to date has primarily focused on autistic children and adolescents. The aim of this study was to understand the implementation, reach, and safety of physical activity programs for autistic adults. Methods: We conducted a scoping review. Reported according to PRISMA-ScR guidelines, our review included studies implementing physical activity interventions in autistic people aged ≥18 years. We searched six databases to June 2024 with keywords, MeSH headings and derivatives relating to autism and physical activity. We extracted data using a standardized template, applying a descriptive analytical approach to map data to categories associated with the review’s aim. Results: Nine studies involving 148 autistic adults (108 male; aged 19–34 years) met inclusion criteria. Physical activity interventions implemented included aerobic exercise, walking or jogging, strength training, motor skills training, soccer, and exer-gaming. Trained instructors, exercise or health professionals, students, coaches, teaching assistants, or residential staff supervised programs conducted in home, school, university, or community settings. Strategies used to support implementation were incorporating appropriate adaptations and scaffolding, using social support strategies and facilitating self-determination. Elements of reach were described variably among the included studies. Reasons for reduced reach and nonparticipation included lack of interest, scheduling, and medical and personal issues. Safety strategies included conducting pre-exercise medical screening and providing physical and psychological training for support people. Conclusion: Safe implementation of physical activity among autistic adults is possible with support. However, there is a lack of research addressing physical activity among autistic women and those with complex needs.

KW - Autism spectrum disorder

KW - Medicine, Surgery & Diagnosis

KW - Mental disorders

KW - Nervous system diseases

KW - Neurodevelopmental disorders

U2 - 10.1089/aut.2024.0317

DO - 10.1089/aut.2024.0317

M3 - Article

SN - 2573-9581

JO - Autism in Adulthood

JF - Autism in Adulthood

ER -