The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

Executive functions, the mental skills involved in planning, switching between tasks, and controlling impulses, are often affected in children and adolescents with autism spectrum disorder (ASD). This systematic review and meta-analysis asked whether exercise interventions can improve these skills. Researchers searched multiple databases through January 2021 and identified 259 articles, narrowing these to 14 studies for systematic review and 7 studies for meta-analysis. Pooled results showed that chronic (ongoing, repeated) exercise interventions had a small to moderate statistically significant positive effect on overall executive functions (g = 0.342).

Looking at specific domains, there were small to moderate significant improvements in cognitive flexibility (g = 0.312) and inhibitory control (g = 0.492), but the effect on working memory was not statistically significant (g = 0.212). The review does not specify the total number of participants pooled, and the relatively small number of studies included in the meta-analysis limits how confident we can be in these findings.

If you're a parent or clinician wondering whether exercise might help with thinking skills in children and teens with autism spectrum disorder (ASD), this review looked specifically at executive functions, the mental abilities that help with planning, switching between tasks, and controlling impulses. Researchers combined data from 7 studies (out of 14 reviewed overall) that tested exercise programs in children and adolescents with ASD. The combined results showed that ongoing exercise programs were linked to small to moderate improvements in overall executive function skills, particularly in cognitive flexibility (the ability to switch between tasks or ideas) and inhibitory control (the ability to resist impulses).

However, the effect on working memory, the ability to hold and use information in mind, was not statistically significant, meaning the evidence didn't clearly show improvement in that specific skill. Because only a small number of studies were pooled, these findings should be seen as an early but useful signal rather than a definitive answer. The review didn't report the total number of children involved across the pooled studies.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis synthesized evidence on chronic and acute exercise interventions for executive functions in children and adolescents with ASD, following PRISMA guidelines and using the PEDro scale for risk-of-bias assessment. From 259 identified articles, 14 underwent systematic review and 7 were included in meta-analysis, a relatively small pooled sample size that constrains statistical power and generalizability. Chronic exercise interventions showed a small to moderate statistically significant effect on overall executive functions (g = 0.342, 95% CI 0.084-0.600), with similar small to moderate effects for cognitive flexibility (g = 0.312, 95% CI 0.053-0.570) and inhibitory control (g = 0.492, 95% CI 0.188-0.796).

Working memory showed a non-significant effect (g = 0.212, 95% CI -0.088 to 0.512), indicating the evidence does not currently support a benefit in this domain. The abstract does not report participant totals across pooled studies, heterogeneity statistics, or detailed risk-of-bias findings beyond mentioning the PEDro scale was used, which limits appraisal of study quality and consistency. These domain-specific differences suggest that any benefits of exercise on executive function in this population may not be uniform, and the modest number of pooled trials warrants caution in drawing firm conclusions.