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A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD
Open accessAbstract
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.
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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.
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33 Not checked yet · 25 Own result · 14 Own interpretation · 8 Own method · 4 No basis given
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
What the sources say
- Not checked yetcites Rosenthal's (1979) source
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
What the sources say
- Not checked yetcites Begg and Mazumdar's (1994) source
plainn = 22- Asserted: passes — The authors put it forward as true.
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In the paper
“Conversely, all ADHD studies (n = 16) investigated aspects of executive functioning.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Moderator Analysis
plainn = 16- Asserted: passes — The authors put it forward as true.
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
What the sources say
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
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In the paper
“Nevertheless, the mean effect size estimates for ASD, ADHD and combined samples have confidence intervals supporting a positive effect of exercise intervention.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Main Findings
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In the paper
“Based on the moderator analysis (see Table 5), only the type of cognitive tasks significantly moderated the population effect size, v 2 (1) = 4.08, p = .04.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Moderator Analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“For the ASD sample, the adjusted population effect size does not result in much attenuation (i.e., .471reduced to .439),indicating that the population effect size remains relatively unaffected by the most severe scenario for one or two-tailed selection bias.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
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In the paper
“Only inhibition and memory functions demonstrated significant small to medium ES following post-exercise intervention, r = .181and r = .286,respectively (see Table 6).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
boosteddirectn = 6- Asserted: passes — The authors put it forward as true.
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In the paper
“The overall effect of exercise intervention has a small to medium effect on ASD/ ADHD individuals, r = .235.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 34
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- Probably not a substantial claim. 17
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Abstract
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- Also stated in: § Efficacy of Exercise Interventions by Cognitive Tasks · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Abstract
plaindirectn = 579- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Main Findings
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Moderator Analysis
What the sources say
- Not checked yetcites Anderson-Hanley et al. (2011) source
plainn = 5 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“Sensitivity analysis revealed a reduced effect size on inhibitory control for severe one-tailed selection bias, r = .097,and memory function, r = -.500.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
plaindirectn = 6- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Main Findings
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Publication Bias and Sensitivity Analysis
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Clinical Implications: Binomial Effect Size Display
What the sources say
- Not checked yetcites Chang et al. 2012a
- Not checked yetcites Tomporowski et al. 2008 source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Executive Functions (ADHD)
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In the paper
“Additionally, similar to conclusions from the typical developing literature, the exercise effect varies among individuals and favours some cognitive functions over others.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Conclusion
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Individual Variations
plaindirect- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Individual Variations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For ADHD individuals, 59.05% reported cognitive benefits on aspects of their EF after exercising; especially on inhibitory control (i.e., 58.70 %).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Clinical Implications: Binomial Effect Size Display
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
- Not checked yetcites Chang et al. 2012a
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
What the sources say
- Not checked yetcites Chang et al. 2012a
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
What the sources say
- Not checked yetcites Joshi et al. 2010 source
hedgedconditionaln = 6- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This finding indicates that exercise interventions are likely to be beneficial to both ASD and ADHD populations.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Individuals with ASD and/or ADHD
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Process of Calculating Effect Sizes
What the sources say
- Not checked yetcites Field and Gillett 2010 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
plaindirectn = 6- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the finding on memory should be interpreted with caution as the number of papers included is limited (n = 6).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
plainn = 6- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
boosted- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“To the authors' knowledge, this is the first meta-analysis that reviews the relationship between exercise and cognition, in both ASD and ADHD populations.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Main Findings
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Sensitivity analysis (Vevea and Woods 2005) was also conducted to evaluate and account for the level of publication bias.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Process of Calculating Effect Sizes
What the sources say
- Not checked yetcites Vevea and Woods 2005 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
- Not checked yetcites Cerrillo-Urbina et al. 2015 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Additionally, the reported positive effect of exercise on global EF was too broad.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
- Not checked yetcites Cerrillo-Urbina et al. 2015 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Introduction
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions by Cognitive Tasks
What the sources say
- Not checked yetcites Cerrillo-Urbina et al. (2015) source
hedgedn = 16- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Clinical Implications: Binomial Effect Size Display
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, recent literature has supported EF as a multifaceted latent construct where various domains are separable but interdependent (e.g., Cassidy 2016).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
What the sources say
- Not checked yetcites Cassidy 2016 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In particular, the number of ASD studies examining exercisecognition relationship is very limited (i.e., six studies), especially on EF.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Executive Functions (ADHD)
What the sources say
- Not checked yetcites Chang et al. 2012a
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions by Cognitive Tasks
What the sources say
- Not checked yetcites Cerrillo-Urbina et al. (2015) source
plaindirectn = 16- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the contrary, memory benefits after exercise may exist but the effect may be much smaller, and varies among different types of memory functions.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Executive Functions (ADHD)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The present meta-analysis bridges the gap in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Limitations/Future Directions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
- Rests on an assumption: A gap exists in the literature regarding the exercise and cognition relationship in the ASD/ADHD and typical developing populations.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the mechanism behind the unique characteristics of the exercise effect on cognition remains inconclusive,”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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.”
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 the citing paper
“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 the citing paper
“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]
In the citing paper
“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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Meta-Analysis by EF Domains
“Only inhibition and memory functions demonstrated significant small to medium ES following post-exercise intervention, r = .181and r = .286,respectively (see Table 6).”
§ A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD > Efficacy of Exercise Interventions on Executive Functions (ADHD)
“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.”
Citations
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“Conversely, deficits are commonly found in aspects of inhibition (e.g., Willcutt et al. 2005) and working memory (e.g., Schreiber et al. 2014) in individuals with ADHD.”
BackgroundExecutive functions and developmental psychopathology.
Pennington, B. F., & Ozonoff, S. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01380.x · Cited by 3,150 · cited 5×
“Due to the complex nature of EF, an EF task is usually unable to provide an isolated measure of a specific cognitive process that it intends to measure and invariably also captures other aspects of EF and non-EF processes (e.g., Pennington and Ozonoff 1996; Suchy 2009).”
BackgroundInfluentialFixed-and random-effects models in meta-analysis.
Hedges, L. V., & Vevea, J. L. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.4.486 · Cited by 2,977 · cited 1×
“Furthermore, each effect size was transformed using Fisher’s (1921) r-to-z conversion before running the meta-analysis using a random-effects model described by Hedges and Vevea (1998), and the obtained overall Zr was transformed back to r for interpretation.”
MethodEllis, P. D. (2010) · doi:10.1017/cbo9780511761676 · Cited by 2,461 · cited 2×
“Nevertheless, what seems to be lacking is also a practical interpretation of effect size (Ellis 2010) that would be useful for clinicians and parents.”
Background
Cited by
Sorted by citations
Items 101–154 of 154
La actividad física como estrategia de intervención en trastornos del espectro autista
Castaño, P. R. L., & Suárez, D. P. M. (2019) · Revista de Investigación e Innovación en Ciencias de la Salud · doi:10.46634/riics.7 · Cited by 2
Transition-Age Youth with Autism Spectrum Disorder
Gwynette, M., Marrus, N., & Vasa, R. (2021) · Springer eBooks · doi:10.1007/978-3-030-62113-1_11 · Cited by 1
Guía para la promoción de actividad física en personas con trastorno del espectro del autismo
Simón-Montañes, L. (2020) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-16723-92-8 · Cited by 2
Petrusenko, O., & Боднар, І. (2021) · Scientific Journal of National Pedagogical Dragomanov University Series 15 Scientific and pedagogical problems of physical culture (physical culture and sports) · doi:10.31392/npu-nc.series15.2021.11(143).23 · Cited by 2
Türk, N., & Gökçen, C. (2022) · Çocuk ve Gençlik Ruh Sağlığı Dergisi / Turkish Journal of Child and Adolescent Mental Health · doi:10.4274/tjcamh.galenos.2021.07269 · Cited by 2
Motor intervention and autism: one way, several domains of effectiveness
Flori, V., & Angeli, B. (2021) · Journal of Advanced Health Care · doi:10.36017/jahc2107-007 · Cited by 2
Benson, S. (2017) · Libraries and Cultural Resources (University of Calgary) · doi:10.11575/prism/24915 · Cited by 2
Min, Y., Chen, Y., & Liu, J. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02904-5 · Cited by 1
“In addition, variation in the types of PA may require different optimal frequencies to achieve cognitive benefits [ 14, 38 ].”
Tai, L., & Cui, Y. (2026) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2026.2628973 · Cited by 1
Lan, W., Zhong, J., Li, Y., Shen, Y., Gong, J., Zou, Z., & Hou, X. (2026) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2026.101208 · Cited by 2
“With the growing recognition of the idea that “ exercise is medicine ” , an increasing body of research suggests that exercise therapy is an effective approach to improving ASD symptoms (Tan et al., 2016; Bremer et al., 2016).”
Dai, X., Shen, H., Guan, Y., & Bao, J. (2026) · Adolescent Research Review · doi:10.1007/s40894-026-00282-w · Cited by 1
Richter, M., Taylor, M. K., Åkerlund, S., Backman, S., Krili, S., Johansson, B. A., Rask, O., & Ekdahl, C. T. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1726809 · Cited by 2
Rozaini, M. A. N., Sariman, S., Rashed, A. A., & Shari, N. B. (2022) · Nutrition & Food Science · doi:10.1108/nfs-02-2022-0038 · Cited by 1
Assessment of Motor Skills in Autism Spectrum Disorders
Gad, E. F., Attwa, S., & Ali, D. T. M. (2023) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2023.279950 · Cited by 2
Chão Interativo e Jogos Sérios Ativos para Autistas: A Plataforma T-TEA e o Jogo RepeTEA
Trindade, A. B., Pereira, G. B., & Hounsell, M. D. S. (2022) · doi:10.5753/sbgames_estendido.2022.224667 · Cited by 1
Bentholm, A., & Ramskov, D. (2023) · European Journal of Adapted Physical Activity · doi:10.5507/euj.2022.014 · Cited by 1
EXERCISE IN AUTISM SPECTRUM DISORDERS: A PROMISING INTERVENTION
Dong, R. (2022) · Journal Of Healthcare In Developing Countries · doi:10.26480/jhcdc.01.2022.15.19
Rahman, N. H. A., & Dzulkifli, M. A. (2022) · IIUM JOURNAL OF HUMAN SCIENCES · doi:10.31436/ijohs.v4i1.231
Aranas, K. (2020) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r3-sszt-t778 · Cited by 1
Stockley, C. (2020) · UEL Research Repository (University of East London) · doi:10.15123/uel.892xq · Cited by 1
Lang, R. B., Liu, T., & Ledbetter‐Cho, K. (2017) · Springer eBooks · doi:10.1007/978-1-4614-6435-8_102189-1 · Cited by 2
Rönngren, Y. (2018) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
The chance to give it a go: sport participation for developmentally vulnerable children
Stevenson, S. W. (2018) · Figshare
Autismus oder ADHS – oder Autismus und ADHS?
Hermann, I., van Elst, L. T., & Matthies, S. (2020) · PiD - Psychotherapie im Dialog · doi:10.1055/a-0987-5204
“Veröffentlicht ist darüber hinaus auch ein metaanalytischer Review zu Wirksamkeit von Sport auf kognitive Variablen bei Individuen mit ASS und ADHS [20], der kleine bis mittlere Effekte von körperlicher Aktivität auf kognitive Funktionen bei dieser Patientengruppe fand.”
BackgroundLang, R. B., Liu, T., & Ledbetter‐Cho, K. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_102189
Exercise as an Intervention for Individuals With Attention Problems
Brenner, S. B., Hartshorne, T. S., Klunejko, S., & Jaklic, J. (2022) · Journal of Education · doi:10.1177/00220574221097368 · Cited by 2
Xu, J., Zhou, D., & Xu, F. (2022) · doi:10.2196/preprints.45401
Aksay, E. (2023) · European Journal of Education Studies · doi:10.46827/ejes.v10i2.4649
Motor intervention and autism: one way, several domains of effectiveness
Flori, V., & Angeli, B. (2021) · Journal of Advanced Health Care · doi:10.36017/jahc202132132
Physical Exercise to Treat ADHD
Deutsch, J., Waldera, R., Lothes, J. E., II, Hartmann, J., & McDaniel, A. (2023) · Autism and child psychopathology series · doi:10.1007/978-3-031-41709-2_22
behavioral and mental health problems
Volkmar, F. R., & Wiesner, L. (2021) · doi:10.1002/9781394259007.ch12
Volkmar, F. R., & Wiesner, L. (2021) · doi:10.1002/9781394259007.ch6
Grossi, E. (2024) · Qeios · doi:10.32388/p5eirp · Cited by 2
Grossi, E. (2024) · Qeios · doi:10.32388/p5eirp.2
“Previous studies and reviews have highlighted the positive benefits of physical activity and exercise on people with ASD [21][22][23][24][25][26] regarding the motor deficits [27] , and improvements in cognitive, [28] , behavioural and social-emotional skills [29][30][31] .”
BackgroundHill, L. J. B., Boom, S., Bingham, D. D., Daly-Smith, A., Llewellyn, B., & Davison, J. (2024) · doi:10.31234/osf.io/upk2z
Medical Care and Common Medical Comorbidities in ASD
Zillo, C., & Volkmar, F. R. (2024) · Springer eBooks · doi:10.1007/978-3-031-46463-8_12 · Cited by 1
АНАЛІЗ ПСИХОЛОГІЧНИХ МЕТОДІВ ДИФЕРЕНЦІАЛЬНОЇ ДІАГНОСТИКИ РДУГ У ДИТЯЧОМУ ВІЦІ
Rudenko, L. M. (2024) · Науковий часопис НПУ імені М П Драгоманова Серія 12 Психологічні науки · doi:10.31392/udu-nc.series12.2024.23(68).11
Giagazoglou, P., Kannas, T., Dampa, A., Iliopoulou, S., Alivizatou, I., & Chalatzoglidis, G. (2024) · Advances in Autism · doi:10.1108/aia-10-2023-0067 · Cited by 1
Considering Emerging, Complementary, and Alternative Treatments
Øien, R. A., Nordahl‐Hansen, A., Skarbek, S., Tolkin, S., & Volkmar, F. R. (2025) · Springer eBooks · doi:10.1007/978-3-031-78143-8_15
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“9,10 .”
Belizário, G. O., Espíndola, F. M. D. M., Duarte, C. C., Ferreira, Y. R., Pinto, S. R., Amaral, T., Keller, N. G., & Lafer, B. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122591
Metadata
- Authors
- Tan, B. W. Z., Pooley, J. A., & Speelman, C. P.
- Affiliations
- Edith Cowan University (AU)
- Corresponding author
- Tan, Beron W. Z.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2016-07-13
- Volume
- 46
- Issue
- 9
- Pages
- 3126-3143
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- 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
- hybrid
- doi.org
- 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 › Public Health, Environmental and Occupational Health › 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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