Summary: A systematic review of clinical trials finds that structured, organized sports programs can meaningfully improve motor skills in children with Autism Spectrum Disorder (ASD). Across 11 studies, martial arts (notably Tai Chi Chuan and kata) and aquatic training produced the most consistent and largest improvements in balance, overall motor performance, and object control.
Other sports-based programs — including gymnastics, trampoline, table tennis, and Australian football — also produced targeted gains, particularly in bilateral coordination, locomotion, and specific object control tasks. Overall, balance emerged as the motor domain most responsive to these interventions across sports types.
Key Facts
- High prevalence of motor impairment: More than half of children with ASD experience motor challenges affecting gait, posture, and fine and gross motor coordination.
- Martial arts show strong results: Martial arts interventions, especially Tai Chi Chuan and kata programs, yielded consistently large effect sizes for balance, total motor scores, and object control.
- Aquatic training is effective: Hydrotherapy and organized swimming programs produced sizable and consistent improvements in balance, locomotion, and object manipulation.
- Balance is the most responsive domain: Across every sport category examined, balance showed the most reliable improvement.
- Sport-specific benefits: Gymnastics and trampoline training supported bilateral coordination and balance; table tennis contributed to generalized gross motor gains; Australian football showed strong improvements in object control with moderate effects on balance and total motor scores.
- Need for stronger evidence: Study authors stress the need for larger, more rigorous randomized controlled trials to strengthen confidence in recommendations and to inform clinical guidelines.
Source: Wiley
Clinical and research evidence indicates that motor impairments are common among children diagnosed with autism spectrum disorder, a neurodevelopmental condition characterized primarily by differences in social communication and restricted or repetitive behaviors. These motor differences frequently affect day-to-day function and participation in physical activities.
A systematic review published in Developmental Medicine & Child Neurology examined organized sports-based interventions and their effects on motor outcomes for children with ASD. The review highlights martial arts and aquatic training as particularly promising modalities for improving key motor domains.
The review synthesized findings from 11 clinical trials that tested organized sports interventions. Martial arts programs consistently produced large improvements in balance, total motor skill assessments, and object control measures, with particularly robust effects reported in Tai Chi Chuan and kata-based training. Aquatic programs similarly showed large, consistent gains across balance, locomotor abilities, and object manipulation tasks.
Gymnastics and trampoline-based interventions were associated with notable improvements in balance and bilateral coordination, while trampoline studies additionally reported positive changes in composite motor scores. Table tennis was linked to broad improvements in gross motor function, and Australian football yielded strong gains in object control plus moderate improvements in balance and overall motor ability.
Across all trial types and sports categories, balance was the motor skill domain that improved most consistently, suggesting that balance-focused activities may provide a common pathway for motor gains in children with ASD.
However, the review also highlights methodological limitations across many included studies. Several trials carried elevated risk of bias, small sample sizes, or non-randomized designs. The authors call for larger randomized controlled trials with standardized outcome measures to better establish the efficacy and clinical utility of sports-based interventions.
“Organized sports-based interventions may offer benefits beyond recreation for children with autism by supporting motor skill development,” said corresponding author Sonia Khurana, PT, PhD, of Old Dominion University. “While our review identified promising effects, particularly for martial arts and aquatic training, larger and more rigorous studies are needed to confirm these benefits and guide evidence-based recommendations.”
Key Questions Answered:
A: Martial arts such as Tai Chi and kata use slow, repetitive, and deliberate movement sequences that reinforce postural control, coordination, and spatial awareness. Aquatic settings provide buoyancy and constant hydrodynamic resistance, which can improve proprioceptive feedback and lessen the impact of gravity on movement, helping children practice motor skills with greater ease and confidence.
A: Balance was the most consistently improved motor domain across the 11 clinical trials and across all sports disciplines evaluated in the review.
A: No. The review suggests that organized sports can be effective adjuncts to therapeutic care, offering structured opportunities to practice motor skills, but they are not replacements for individualized physical or occupational therapy that addresses specific clinical needs.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by the editorial team.
- Additional context was added by staff to summarize the research findings and implications.
About this autism and motor skills research news
Author: Sara Henning-Stout
Source: Wiley
Contact: Sara Henning-Stout – Wiley
Image: Image credited to Neuroscience News
Original Research: Open access. “Organized sports-based interventions and motor outcomes in children diagnosed with autism spectrum disorder: A systematic review” by Kailash Ram, Maeren Hill, Caitlyn Stewart, Kaitlin Hardy, Sonia Khurana. Developmental Medicine & Child Neurology. DOI: 10.1111/dmcn.70385
Abstract
Organized sports-based interventions and motor outcomes in children diagnosed with autism spectrum disorder: A systematic review
Aim
To evaluate the effectiveness of organized sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).
Method
Researchers searched four databases from inception through November 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) that reported motor outcomes following organized sports interventions in children with ASD. Risk of bias was assessed using ROB-2 for RCTs and ROBINS-I for NRCTs.
Results
Eleven studies met inclusion criteria (six RCTs and five NRCTs) and were grouped into martial arts (n = 5), aquatic training (n = 2), gymnastics and trampoline (n = 3), and other sports (n = 2); one study was classified as both martial arts and aquatic. Interventions most reliably improved balance (d = 0.18–4.99), locomotor skills (d = 0.63–2.02), total motor scores (d = 0.61–3.90), and object control skills (d = 1.10–3.83). Effects were generally moderate to large, particularly for martial arts and aquatic programs. Risk of bias was rated high for five RCTs and of some concern for one RCT; among NRCTs, four had serious risk and one had critical risk of bias.
Interpretation
Organized sports-based interventions show potential to improve gross motor skills in children with ASD, with martial arts and aquatic training demonstrating the most consistent benefits. However, the overall strength of the evidence is limited by methodological concerns, and higher-quality trials are needed to establish firm clinical recommendations.