Autistic individuals, compared to their non-autistic peers, have an increased likelihood of co-occurring medical conditions such as psychiatric disorders, immune conditions, hypertension, diabetes, and obesity; each of which may unduly impact their ability to engage in movement or may be benefited through regular engagement in physical activity (PA). Indeed, PA may be a key modifiable factor vital to improving the overall health-related quality of life among autistic individuals. Yet, it has been well documented that autistic individuals face increased barriers to their engagement and many opportunities remain inaccessible.
As adolescents on the autism spectrum share a cluster of socially-defined difficulties related to their social communication and stereotyped behavior, interests, and/or activities, developing effective teaching and assessment strategies remains elusive. Moreover, due to limitations of the scientific process, much of the evidence regarding the PA behavior is captured through secondary sources—namely parents, caregivers, or teachers—and prior research has not openly discussed the influence of autistic behavior related to movement outside of deficit-based explanations. For example, self-stimulatory behavior (i.e., stimming) is a common behavior among autistic individuals; yet researchers using wrist-worn fitness monitors such as Actigraph accelerometers or Fitbit/Garmin devices have not accounted for such behaviors nor it’s relation to PA or movement beyond labeling it an impediment.
Therefore, the aim of this scoping review was two-fold: (1) to explore the discourse of direct measures of PA used with autistic youth among and factors related to movement in the published literature; and (2) to investigate measurement-related issues regarding the reliability and validity of objectively collected PA data of autistic youth. A total of 33 studies out of an initially identified 3,521 studies met the inclusion criteria for the scoping review. In addition to standard study characteristics, the authors extracted article information such as: (a) the objective measure of PA; (b) the PA domain assessed; (c) the assessment protocol used; and (d) the PA result.
Three main outcomes were identified in this analysis; findings suggest there exists: (1) a limited scope of tools to measure PA placing an over reliance on interpreting data with little scientific consensus on the necessary accommodations needed; (2) an oversampling of white male participants, thus limiting the overall generalizable interpretations of PA among the broader autistic population; and (3) a lack of critical examination of PA as a construct and an over reliance on expert generated definitions that may not relate to lived experience.