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Cited by 157Autism Spectrum Disorder ResearchPhysical Activity and HealthAttention Deficit Hyperactivity Disorder

A meta-analytic review of the efficacy of physical exercise interventions on cognition in individuals with autism spectrum disorder and ADHD

Open access
Tan, Beron W. Z., Pooley, Julie A., Speelman, Craig P.·2016·Journal of Autism and Developmental Disorders
DOI 10.1007/s10803-016-2854-x
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Abstract

This review evaluates the efficacy of using physical exercise interventions on improving cognitive functions in individuals with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD). This review includes a meta-analysis based on a random-effects model of data reported in 22 studies with 579 participants aged 3-25 year old. The results revealed an overall small to medium effect of exercise on cognition, supporting the efficacy of exercise interventions in enhancing certain aspects of cognitive performance in individuals with ASD and/or ADHD. Specifically, similar to the general population literature, the cognitive benefits of exercise are not consistent across all aspects of cognitive functions (i.e., some areas are not improved). The clinical significance of the reported effect sizes is also considered.

AI snapshot

Written from the paper’s full text.

TL;DR

This meta-analysis of 22 studies (579 participants aged 3–25 with ASD and/or ADHD) found a small-to-medium overall effect of physical exercise on cognition, r = .235 (95% CI .131–.335). Effects were selective: larger for on-task/simple learning tasks than executive function tasks, with inhibition and memory showing significant benefits in ADHD.

Key findings

  • Overall random-effects mean effect size was r = .235, 95% CI [.131, .335], z = 4.347, p < .001; 22 studies, 579 participants (ADHD = 451; ASD = 128), based on 125 effect size values.
  • Cognitive task type significantly moderated effects, χ²(1) = 4.08, p = .04: on-task duration/simple learning tasks r = .526 (n = 5) vs EF tasks r = .180 (n = 17).
  • In ADHD, exercise significantly improved inhibition r = .174 and memory r = .286; set shifting was not significant (r = .184, p = .09). ASD studies mostly assessed on-task/simple learning (n = 5), with r = .526.
  • BESD indicated 61.75% of ASD/ADHD individuals improved overall; 76.30% for ASD on-task/learning, 59.05% for ADHD EF, 58.70% for ADHD inhibition, and 64.30% for ADHD memory.

Methods

  • Systematic search of PsychINFO, CINAHL, PubMED, Web of Science, and ERIC plus backward/forward searches; inclusion required diagnosis of ADHD or ASD, exercise intervention, objective cognitive performance, and quantitative studies published 1968–2015.
  • 22 articles included (16 ADHD, 6 ASD); effect sizes calculated as Glass’s delta then converted to r, with a random-effects model (Hedges & Vevea, 1998); one average effect size per article was entered.
  • Moderator analysis used multiple regression with categorical/continuous moderators; sensitivity analysis (Vevea & Woods, 2005) assessed publication bias; binomial effect size display (BESD) was calculated for practical interpretation.

Limitations

  • Paper states: only 22 studies were included, especially few ASD studies (6) and few EF studies; 5 studies (1 ASD, 4 ADHD) did not report non-significant results, indicating reporting bias; 18 studies did not report IQ and 12 did not quantify exercise intensity; results only support ages up to 25; EF tasks often used a single task and cannot isolate specific cognitive processes.
  • Paper states: sensitivity analysis under severe one-tailed selection bias reduced the overall effect from .235 to −.466 and the ADHD effect from .181 to −.452, while ASD changed little (.471 to .439), so confidence in effects may be lower.
  • Evident from the text: heterogeneity was low-to-medium (I² = 27.78%) and Q was non-significant, χ²(21) = 29.08, p = .11; many confidence intervals extended into negative values, and only 3 of 22 papers had confidence intervals entirely in the positive range.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s10803-016-2854-x

Cites

80 of 80 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 57 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Rosenthal's fail-safe N analysis reveals 186 unpublished null papers are needed to invalidate the population effect size of .235.

    “Rosenthal's (1979) fail-safe N analysis reveals 186 unpublished papers (i.e., null effect) are needed to be included in the meta-analysis in order to invalidate the population effect size of small to medium (i.e., .235)found in this review.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rosenthal's (1979) source

      Not checked in the free run.

  • Findingown data

    Begg and Mazumdar's rank correlation test shows a non-significant correlation between effect sizes and sample size, s(N=22)=.11, p=.46.

    “Furthermore, Begg and Mazumdar's (1994) rank correlation test shows a non-significant correlation between the effect sizes and sample size of the studies included in the meta-analysis, s(N = 22) = .11,p = .46.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Begg and Mazumdar's (1994) source

      Not checked in the free run.

  • Findingown data

    All ADHD studies (n=16) investigated aspects of executive functioning.

    “Conversely, all ADHD studies (n = 16) investigated aspects of executive functioning.”
    Quote in the paperSubstantial claim
  • Findingown data

    Four out of the 16 ADHD articles did not report the results of any non-significant findings.

    “One possible explanation is the issue of reporting bias; 4 out of the 16 ADHD articles did not report the results of any non-significant findings (i.e., Choi et al. 2015;Gawrilow et al. 2016;Pontifex et al. 2013;Ziereis and Jansen 2015).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Choi et al. 2015 source

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    • cites Gawrilow et al. 2016 source

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    • cites Pontifex et al. 2013 source

      Not checked in the free run.

  • Findingown data

    The current finding did not find any significant differences in the impact of aerobic-type versus aerobic and perceptual-motor exercises on cognitive functions.

    “Given that the present review included studies that conducted exercise interventions that involved either aerobic-type or aerobic and perceptual-motor exercises, the current finding did not find any significant differences in their impact on cognitive functions.”
    Quote in the paperSubstantial claim
  • May combine two claims. 34
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 17

  • May combine two claims.

    Findingown data

    The cognitive benefits of exercise are not consistent across all aspects of cognitive functions; some areas are not improved.

    “Specifically, similar to the general population literature, the cognitive benefits of exercise are not consistent across all aspects of cognitive functions (i.e., some areas are not improved).”
    • Also stated in: § Efficacy of Exercise Interventions by Cognitive Tasks · plain
      “The effects of exercise interventions on cognition differ based on the type of cognitive tasks used to evaluate its efficacy.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Exercise interventions have an overall small-to-moderate positive effect on cognition in individuals with ASD and/or ADHD (r = .235, 95% CI .131-.335, p < .001).

    “The results revealed an overall small to medium effect of exercise on cognition, supporting the efficacy of exercise interventions in enhancing certain aspects of cognitive performance in individuals with ASD and/or ADHD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For the ADHD sample, the adjusted population effect size is severely impacted by a one-tailed selection bias, decreasing from .181 to -.452, suggesting the actual effect size estimate may be smaller than the mean effect size.

    “In contrast to this, the adjusted population effect size for the ADHD sample is severely impacted by a one-tailed selection bias, decreasing the effect size from .181 to -.452, suggesting that the actual effect size estimate for this population may be smaller than the mean effect size.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Sample size, age group, type of control group/condition, type of exercise, and number or duration of intervention sessions did not significantly moderate the relationship between exercise and cognition.

    “Similarly, sample size, age group, the type of control group/condition, and the type of exercise and number or duration of intervention sessions did not significantly moderate the relationship between exercise and cognition.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The homogeneity test Q is not significant, v2(21)=29.08, p=.11, but I2=27.78%, suggesting low to medium heterogeneity.

    “The homogeneity test, as denoted by the Q statistic is not significant, v 2 (21) = 29.08,p = .11but the I 2 = 27.78%, suggests that there is a low to medium heterogeneity within the sample of effect sizes included in this analysis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The exercise-cognition effect was more likely to be beneficial across ASD/ADHD individuals aged between 3 and 25 years, contrary to other meta-analyses that found greater benefit in younger children.

    “In addition, other meta-analyses found a greater post-exercise cognitive benefit in younger children (Sibley and Etnier 2003;Fedewa and Ahn 2011), contrary to this finding where the exercise-cognition effect was more likely to be beneficial across ASD/ADHD individuals aged between 3 and 25 years; similar to findings from the general population reported by Verburgh et al. (2013).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Sibley and Etnier 2003 source

      Not checked in the free run.

    • cites Fedewa and Ahn 2011 source

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    • cites Verburgh et al. (2013) source

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  • May combine two claims.

    Findingown data

    The majority of ASD studies evaluated on-task duration or simple learning tasks (n=5), except Anderson-Hanley et al. (2011), which examined executive functions.

    “Indeed, the majority of the ASD studies evaluated on-task duration or simple learning tasks (n = 5), except for Anderson-Hanley et al. (2011), which examined executive functions.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Anderson-Hanley et al. (2011) source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Sensitivity analysis revealed a reduced effect size on inhibitory control for severe one-tailed selection bias, r=.097, and memory function, r=-.500.

    “Sensitivity analysis revealed a reduced effect size on inhibitory control for severe one-tailed selection bias, r = .097,and memory function, r = -.500.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Only 3 out of 22 papers had their confidence intervals within the range of positive effect size values, with the majority having confidence intervals extending into negative values.

    “The figure identified that only 3 out of 22 papers had their confidence intervals within the range of positive effect size values, with the majority of the papers having confidence intervals extending into the range of negative values.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Under a severe one-tailed selection model, the population effect size reduced from .235 to -.466, suggesting lower confidence in the effects of exercise on cognition in this neurodevelopmental population.

    “When applied under a severe selection (i.e., one-tailed) model, the population effect size reduced from .235 to -.466; this suggests a lower level of confidence is appropriate in the effects of exercise on cognition in this neurodevelopmental population.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Exercise interventions mostly only account for a small variance in cognitive improvements, supporting the consensus that the relationship between exercise and cognition is complex and is moderated by many other factors such as individual differences.

    “Based on Table 7, it is evident that exercise interventions mostly only account for a small variance on cognitive improvements, supporting the consensus in the literature that the relationship between exercise and cognition is complex and is moderated by many other factors such as individual differences (e.g., Chang et al. 2012a;Tomporowski et al. 2008).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Chang et al. 2012a

      Not checked in the free run.

    • cites Tomporowski et al. 2008 source

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  • May combine two claims.

    Findingown data

    Exercise interventions have specific beneficial effects on inhibitory and memory functions (r=.174 and r=.286, respectively), but there are unclear effects on set shifting performance.

    “The meta-analysis indicates that exercise interventions have specific beneficial effects on inhibitory and memory functions (r = .174and r = .286,respectively), but there are unclear effects on set shifting performance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    The exercise effect varies among individuals and favours some cognitive functions over others.

    “Additionally, similar to conclusions from the typical developing literature, the exercise effect varies among individuals and favours some cognitive functions over others.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Not all executive function domains were improved by exercise interventions; the effect of exercise is selective and affects some areas of cognition more than others.

    “it is apparent that there is a wide range of cognitive tasks that measures various aspects of EF, and most importantly, not all functions were improved by exercise interventions.”
    • Also stated in: § Individual Variations · plain
      “Further, the effect of exercise is selective and affects some areas of cognition more than others.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For ADHD individuals, 59.05% reported cognitive benefits on aspects of their executive function after exercising, especially on inhibitory control (58.70%).

    “For ADHD individuals, 59.05% reported cognitive benefits on aspects of their EF after exercising; especially on inhibitory control (i.e., 58.70 %).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Individual differences such as fitness level moderate the magnitude of the effect of exercise on cognition, with greater improvements among those who are fitter.

    “For instance, it has been reported that individual differences such as fitness level moderate the magnitude of the effect of exercise on cognition; with greater improvements among those who are fitter (e.g., Chang et al. 2012a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chang et al. 2012a

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The effect of exercise varies among individuals, and not every study reported cognitive improvements.

    “Secondly, the effect of exercise varies among individuals (e.g., Kramer and Erickson 2007;Tomporowski et al. 2008) and not every study reported cognitive improvements (e.g., Audiffren 2009;Kramer and Erickson 2007).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Kramer and Erickson 2007 source

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    • cites Tomporowski et al. 2008 source

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    • cites Audiffren 2009

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  • May combine two claims.

    Premisecitation

    ADHD studies generally report positive findings of the effects of exercise interventions on aspects of EF, but the efficacy remains unclear.

    “Despite conflicting findings, ADHD studies generally report positive findings of the effects of exercise interventions on aspects of EF (e.g., Choi et al. 2015;Pontifex et al. 2013) but the efficacy remains unclear.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Choi et al. 2015 source

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    • cites Pontifex et al. 2013 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    The memory tasks included a range of memory functions (e.g., visual/verbal working memory), and thus it is possible that the exercise effect varies for different aspects of memory.

    “Moreover, the memory tasks included a range of memory functions (e.g., visual/verbal working memory), and thus it is also possible that the exercise effect varies for different aspects of memory (Chang et al. 2012a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chang et al. 2012a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The non-significant diagnosis moderation may be due to the small number of ASD studies (n=6) or high comorbidity shared between both disorders.

    “Although this may be due to the small number of ASD studies (n = 6), it may also be due to high-comorbidity shared between both disorders (e.g., Joshi et al. 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Joshi et al. 2010 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Exercise interventions are likely to be beneficial to both ASD and ADHD populations.

    “This finding indicates that exercise interventions are likely to be beneficial to both ASD and ADHD populations.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    A random-effects model was selected because variability in effect sizes should be assumed in psychological research and it allows generalisation beyond the included studies.

    “A random-effects model was selected as it was recommended that variability in effect sizes should be assumed in psychological research and that this model allowed generalisation of the findings beyond the studies included in the meta-analysis (Field and Gillett 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Field and Gillett 2010 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The attenuated effect size for memory function reduced drastically and reversed the positive effect of exercise (i.e., exercise has a negative impact on memory functions).

    “Interestingly, the attenuated effect size for memory function reduced drastically and reversed the positive effect of exercise (i.e., exercise has a negative impact on memory functions).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The finding on memory should be interpreted with caution as the number of papers included is limited (n=6).

    “However, the finding on memory should be interpreted with caution as the number of papers included is limited (n = 6).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Studies investigating EF between individuals with ASD and ADHD have demonstrated difficulty in establishing a distinct executive dysfunction profile; EF deficits can overlap in both disorders such as aspects of working memory, sustained attention and even inhibition.

    “Nevertheless, studies that investigated EF between individuals with ASD and ADHD have demonstrated the difficulty in establishing a distinct executive dysfunction profile (e.g., Corbett et al. 2009;Geurts et al. 2004;Goldberg et al. 2005); in that EF deficits can sometimes overlap in both disorders such as aspects of working memory, sustained attention and even inhibition.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Corbett et al. 2009 source

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    • cites Geurts et al. 2004 source

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    • cites Goldberg et al. 2005 source

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  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    This is the first meta-analysis that reviews the relationship between exercise and cognition in both ASD and ADHD populations.

    “To the authors' knowledge, this is the first meta-analysis that reviews the relationship between exercise and cognition, in both ASD and ADHD populations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    EF in general tend to be more impaired in individuals with ASD than those with ADHD.

    “There are also findings that EF in general tend to be more impaired in individuals with ASD than those with ADHD (e.g., Corbett et al. 2009;Goldberg et al. 2005;Pennington and Ozonoff 1996).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Corbett et al. 2009 source

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    • cites Goldberg et al. 2005 source

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    • cites Pennington and Ozonoff 1996 source

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  • May combine two claims.

    Interpretationreasoning

    The positive effects of exercise on cognition are likely to exist in these populations but the exact magnitude could not be confidently established.

    “These results indicate that the positive effects of exercise on cognition are likely to exist in these populations but the exact magnitude could not be confidently established.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Sensitivity analysis was conducted to evaluate and account for the level of publication bias.

    “Sensitivity analysis (Vevea and Woods 2005) was also conducted to evaluate and account for the level of publication bias.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Vevea and Woods 2005 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Exercise may be particularly beneficial to individuals with learning difficulties, such as those with ADHD or ASD.

    “One of the implications provided by the literature from the typical developing population is that exercise may be particularly beneficial to individuals with learning difficulties (e.g., Fedewa and Ahn 2011;Sibley and Etnier 2003), such as those with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Fedewa and Ahn 2011 source

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    • cites Sibley and Etnier 2003 source

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  • Classified as probably not a substantial claim.

    Premisecitation

    A recent meta-analysis of eight studies reported moderate to large effect sizes (standardised mean differences of 0.58 and 0.84) on measures of EF and attention, respectively, in ADHD children.

    “A recent meta-analysis of eight studies reviewed the effects of exercise on various symptoms of ADHD children and provided the first indication of the magnitude of the effect on cognition (Cerrillo-Urbina et al. 2015).The authors reported moderate to large effect sizes (standardised mean differences of 0.58 and 0.84) on measures of EF and attention, respectively.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cerrillo-Urbina et al. 2015 source

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The reported positive effect of exercise on global EF in Cerrillo-Urbina et al. (2015) was too broad.

    “Additionally, the reported positive effect of exercise on global EF was too broad.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cerrillo-Urbina et al. 2015 source

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  • May combine two claims.

    Premisecitation

    The relationship between exercise and cognition in the neurodevelopmental population appears to be less clear, with ASD studies focusing more on behavioural symptoms compared to ADHD studies that specifically examine EF.

    “Unlike in the literature from the general population, however, the relationship between exercise and cognition in the neurodevelopmental population appears to be less clear, with studies on ASD samples focusing more on behavioural symptoms (e.g., Petrus et al. 2008;Sowa and Meulenbroek 2012) compared to ADHD studies that specifically examine EF (e.g., Chang et al. 2012b;Smith et al. 2013).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Petrus et al. 2008 source

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    • cites Sowa and Meulenbroek 2012 source

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    • cites Chang et al. 2012b

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  • May combine two claims.

    Interpretationreasoning

    This ADHD EF effect is smaller than the effect size reported by Cerrillo-Urbina et al. (2015), d=0.58 (r=.28), possibly due to a smaller number of articles included in their analysis (n=3).

    “This is a smaller effect compared to the effect size reported by Cerrillo-Urbina et al. ( 2015), d = 0.58 (equivalent to r = .28),possibly due to a smaller number of articles included in their analysis (n = 3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cerrillo-Urbina et al. (2015) source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Five studies (one ASD and four ADHD articles) did not report non-significant results, and this reporting bias is consistent with the results of the sensitivity analysis.

    “Secondly, five studies (one ASD and four ADHD articles) did not report non-significant results.This reporting bias is consistent with the results of the sensitivity analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Most studies included in the meta-analysis examined each executive function domain with a single neuropsychological task, making it difficult to ascertain whether an improvement (or not) on a single task after exercise intervention reflects an actual change in that particular executive function.

    “Moreover, most studies included in the meta-analysis examined each EF domain with a single neuropsychological task, making it difficult to ascertain whether an improvement (or not) on a single task after exercise intervention is indeed a reflection of an actual change in that particular EF.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The implications of utilising exercise interventions with individuals with ASD and/or ADHD should not be underestimated, as exercise is likely to be particularly useful in addressing areas of their cognitive function in which they typically do not perform well (e.g., inhibition).

    “Nonetheless, it should be noted that the implications of utilising exercise interventions with individuals with ASD and/or ADHD should not be underestimated, as it is likely to be particularly useful in addressing areas of their cognitive function in which they typically do not perform well (e.g., inhibition).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Recent literature supports executive function as a multifaceted latent construct in which various domains are separable but interdependent.

    “In addition, recent literature has supported EF as a multifaceted latent construct where various domains are separable but interdependent (e.g., Cassidy 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cassidy 2016 source

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  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The overall findings of the meta-analysis should be regarded as a tentative conclusion, and future large-scale randomised-controlled trials would be required to validate the current findings.

    “Although the overall findings are encouraging, it should be regarded as a tentative conclusion in guiding future research and future large-scale randomised-controlled trials would be required to validate the current findings.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The number of ASD studies examining the exercise-cognition relationship is very limited (six studies), especially on executive function.

    “In particular, the number of ASD studies examining exercisecognition relationship is very limited (i.e., six studies), especially on EF.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Eighteen of the included studies did not report IQ levels and 12 studies did not provide quantification of their exercise interventions.

    “however, 18 studies did not report IQ levels and 12 studies did not provide quantification of their exercise interventions (e.g., heart rate, oxygen consumption).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Visual short-term memory improves following exercise (d = 0.49, equivalent to r = .24), but exercise has a negative impact on other aspects of memory including sequential and auditory-verbal memory.

    “For instance, another metaanalytic study reported that visual short-term memory improves following exercise, d = 0.49 (equivalent to r = .24),but exercise has a negative impact on other aspects of memory including sequential and auditory-verbal memory (Chang et al. 2012a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chang et al. 2012a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    This review extended the findings of Cerrillo-Urbina et al. (2015) by including the original 3 articles in their paper that examined EF, further reinforcing the conclusion that exercise interventions have positive effects on EF in ADHD individuals.

    “Furthermore, this review extended the findings of Cerrillo-Urbina et al. ( 2015) by including the original 3 articles in their paper that examined EF, further reinforcing the conclusion that exercise interventions have positive effects on EF in ADHD individuals.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cerrillo-Urbina et al. (2015) source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Memory benefits after exercise may exist, but the effect may be much smaller than for other functions and varies among different types of memory functions.

    “On the contrary, memory benefits after exercise may exist but the effect may be much smaller, and varies among different types of memory functions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    The present meta-analysis bridges the gap in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.

    “The present meta-analysis bridges the gap in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: A gap exists in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The mechanism behind the unique characteristics of the exercise effect on cognition remains inconclusive.

    “Although the mechanism behind the unique characteristics of the exercise effect on cognition remains inconclusive,”
    Quote in the paperNot a substantial claim
46 of 46

  • The paper relies on this without support.

    A gap exists in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.

    “The present meta-analysis bridges the gap in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In autism spectrum disorder, Tan and colleagues reported a small-to-moderate effect, Hedges' g of 0.47, for improvement in some aspects of cognition.

    “In autism spectrum disorder (ASD), Tan et al. (41) reported a small-to-moderate effect (Hedges’ g = 0.47) for improvement in some aspects of cognition.”

    From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [41]

  • In ADHD, effect sizes for physical activity improving cognitive performance ranged from Hedges' g of 0.18 to 0.77, with attention and executive function most commonly affected.

    “In studies examining effects of PA in ADHD, the effect sizes (Hedges’ g) ranged from 0.18 to 0.77 in favor of PA improving cognitive performance (39–41). The cognitive domains most commonly affected included attention and executive function (e.g., inhibition, impulsivity) (39, 41).”

    From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [41]

  • The meta-analysis by Tan and colleagues included children with autism spectrum disorder, ADHD, or both, with an overall Hedges' g of 0.24, making effects of physical activity on autism spectrum disorder alone difficult to interpret.

    “However, the meta-analysis included children with ASD, ADHD, or both disorders (overall Hedges’ g = 0.24) and, as such, it is difficult to interpret effects of PA on ASD alone (41).”

    From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [41]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Inhibition effect size differs between results and discussion

    Minor

    The results section reports an inhibition effect size of r = .181, while the discussion reports r = .174. The latter is also the value shown for inhibition in Table 6; .181 is the table's value for executive functions overall.

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Authors
Tan, B. W. Z., Pooley, J. A., & Speelman, C. P.
Affiliations
Edith Cowan University (AU)
Corresponding author
Tan, Beron W. Z.
ORCID
Venue
Journal of Autism and Developmental Disorders
Publisher
Springer Science and Business Media LLC
Published
2016-07-13
Volume
46
Issue
9
Pages
3126-3143
ISSN
  • 0162-3257 (ISSN-L)
  • 1573-3432
DOI
10.1007/s10803-016-2854-x
OpenAlex
W2461048406
Semantic Scholar
63277ca195d3cbe19399b009b52ca0c68295626e
Cited by
157
References
80
Citations by year
2026: 16 · 2025: 19 · 2024: 15 · 2023: 17 · 2022: 16 · 2021: 23 · 2020: 18 · 2019: 20 · 2018: 6 · 2017: 6 · 2016: 1
FWCI
1.16
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Autism and Developmental Disorders (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Australasian Journal of Paramedicine (submittedVersion, cc-by)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords
physical exercise intervention, cognitive function, autism spectrum disorder, attention deficit hyperactivity disorder, exercise and cognition, children and adolescents, effect size
MeSH terms
Autism Spectrum Disorder, Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Cognition, Exercise Therapy, Humans, Young Adult

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