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Exercise interventions significantly improve overall, gross, and fine motor skills in children with autismExercise improves motor skills for children with autism

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Key Takeaway
Consider exercise interventions to improve overall, gross, and fine motor skills in children with autism.

This meta-analysis evaluated the impact of exercise interventions on motor skills in a population of 1,082 children with autism spectrum disorder. The analysis synthesized data on overall, gross, and fine motor skills to determine the efficacy of physical activity as a therapeutic intervention.

The meta-analysis found significant improvements across all primary and secondary motor outcomes. Overall motor skills showed an effect size of Hedges' g = 0.95 (95% CI [0.67, 1.23]). Gross motor skills showed a larger effect size of Hedges' g = 0.99 (95% CI [0.67, 1.30]), while fine motor skills showed a significant but more modest improvement of Hedges' g = 0.40 (95% CI [0.14, 0.66]).

Exploratory dose-response patterns were identified for both overall motor skills, with peak effects at approximately 46 sessions of 45 min each, and gross motor skills, with peak effects at approximately 44 sessions of 47 min each. The authors noted that these dose-response patterns are exploratory. Immediate testing of motor skills showed a greater effect size than delayed testing (P = 0.044). These findings suggest that exercise is a viable intervention for improving motor skills in children with autism, though specific optimal dosing remains to be fully established.

How this fits prior evidence

This meta-analysis extends prior evidence showing that exercise improves executive function in children with autism. It specifically adds data regarding motor skill improvements, which complements the finding that structured ball sports significantly improve core symptoms in children with autism. While the current findings confirm the benefit of physical activity, the specific dose-response patterns for motor skills are noted as exploratory.

Moving your body can do more than just build strength. For children with autism spectrum disorder, regular exercise may play a key role in developing physical coordination. A large review of data from over 1,000 children found that exercise programs led to significant improvements in overall motor skills.

These improvements were seen in both gross motor skills, like running or jumping, and fine motor skills, which involve smaller movements like grasping objects. While the data is still exploratory, researchers noticed a pattern regarding how much exercise is needed. They saw peak effects for overall motor skills around 46 sessions of 45 minutes each, and for gross motor skills, around 44 sessions of 47 minutes each.

It is important to note that these specific patterns for how many sessions are needed are still being explored by researchers. However, the overall finding remains clear: exercise is a meaningful way to support motor development in children with autism.

What this means for you:
Exercise programs significantly improve both large and small motor skills in children with autism.

Common questions

What kind of motor skills did exercise improve?

Exercise improved both gross motor skills and fine motor skills in children with autism. Gross motor skills involve large movements, while fine motor skills involve smaller, more precise movements. The study showed significant improvements in both areas for the children involved.

How many exercise sessions are most effective?

The study found exploratory patterns for how many sessions are most effective. They saw peak effects for overall motor skills at about 46 sessions of 45 minutes each, and for gross motor skills at about 44 sessions of 47 minutes each.

Is this a proven treatment for autism?

The study shows that exercise significantly improves motor skills for children with autism. However, because the dose-response patterns are still being explored by researchers, you should talk to a doctor to determine the best exercise plan for a specific child.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
UNLABELLED: Autism spectrum disorder (ASD) is a significant public health concern, with most ASD children suffering from motor skill impairments. This study aimed to explore the dose-response relationship between exercise interventions and motor skill outcomes in children with ASD, thereby identifying the exercise dose associated with the largest intervention effects. Four databases (PubMed, Web of Science, Embase, and the Cochrane Library) were systematically searched from database inception to April 2026. Experimental studies evaluating the effects of exercise interventions on motor skills in children with ASD were included. The outcomes included overall motor skills, gross motor skills, and fine motor skills. Effect sizes were calculated as Hedges' g, and multilevel random-effect models were fitted using the metafor package. The multilevel meta-analysis and dose-response analysis were used to assess the dose-response relationship between exercise and motor skills. Moderation analyses were conducted to explore significant influencing covariates. A total of 34 studies from 12 countries were included, involving 1,082 children with ASD within the eligible age range of 3-12 years. Results of three-level meta-analysis showed that exercise interventions significantly improved motor skills in children with ASD (Hedges' g = 0.95, 95% CI [0.67, 1.23]), including gross motor skills (Hedges' g = 0.99, 95% CI [0.67, 1.30]) and fine motor skills (Hedges' g = 0.40, 95% CI [0.14, 0.66]). Dose-response analyses indicated an exploratory dose-response pattern, with the estimated effects reaching their highest values at approximately 46 sessions of 45 min each for overall motor skills and 44 sessions of approximately 47 min each for gross motor skills. Moderator analyses indicated that the time point of the test significantly influenced the effect of exercise on overall motor skills, with the immediate test showing a greater effect size than the delayed test (P = 0.044). No significant moderators were identified for gross motor skills or fine motor skills. CONCLUSION: Exercise significantly improved overall, gross, and fine motor skills in children with ASD. Dose-response relationships were identified for overall and gross motor skills. WHAT IS KNOWN: • Motor impairments are prevalent in children with ASD and represent an important barrier to functional independence and participation. WHAT IS NEW: • This is the first multilevel and dose-response meta-analysis evaluating exercise effects on overall, gross, and fine motor skills in children with ASD. • Dose-response analyses identified exploratory dose-response patterns for overall and gross motor skills, with estimated peak effects at approximately 46 sessions (45 min/session) and 44 sessions (47 min/session), respectively. • Assessment time point moderated effects on overall motor skills, with larger effects observed immediately after intervention than at delayed assessment.
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