A quarterly publication of the Autism Research Institute
Fall 2025 | Number 4, Volume 39
While increasing evidence indicates that exercise significantly benefits individuals with autism spectrum disorders (ASD), researchers in the United States say that federally endorsed exercise guidelines—exemplified by the FITT (Frequency, Intensity, Time, Type) principle—“fail to account for neurodevelopmental, motor, and sensory differences across the autism spectrum.”
David Geslak and colleagues say that the frequency of exercise recommended by FITT is unrealistic for many autistic individuals. For instance, they note that children with ASD typically are already involved in other therapies for many hours each week, limiting time for exercise, and that their schools may not have physical education programs equipped to accommodate them. Instead, they recommend creating a flexible schedule that includes one to three days per week of exercise, depending on an individual’s ability and need for support.
Also, rather than relying on standard measurements of intensity, they say that providers should acknowledge that “meaningful outcomes do not require high levels of exertion, and in many cases, lower-intensity movement may be both more accessible and more beneficial.” They stress the importance of individualizing exercise intensity guidelines, noting that stereotypic behaviors, motor coordination challenges, and other issues can make moderate to vigorous activity difficult for individuals with ASD. They also suggest that practitioners working with individuals who have language impairments use pictorial measures rather than standard guidelines when assessing the perceived intensity of exercise.
The researchers add that while standard guidelines recommend fairly long intervals of exercise, “emerging evidence suggests 10 to 15 minutes of exercise provides initial health benefits in autistic individuals and should be considered a realistic introduction to exercise. A starting goal of 10 to 15 minutes is realistic and achievable, not only for the individual but also for caregivers, exercise professionals, and/or PE/APE [adaptive physical education] teachers.”
Noting that standard guidelines focus primarily on aerobic activity, the researchers say this can be problematic for individuals with autism, who often have motor impairments and additional challenges that make aerobic exercise difficult. Instead, they say, “exercises that focus on muscular strength, muscular endurance, and flexibility may offer a more accessible starting point and improve outcomes.”
When developing an exercise program for an individual with ASD, the researchers say, the first step should be to take the interests, abilities, and overall health of the individual into account. Once a program begins, they say, practitioners should continuously evaluate the individual’s response to the type, frequency, intensity, and length of the activities; modify the program to account for sensory sensitivities and other individual needs; and obtain regular feedback from participants or caregivers to determine if the program is meeting their needs or requires revision.
“Exercise as medicine across the autism spectrum: a conceptualized framework,” David S. Geslak, Robyn T. Boudreaux, and Benjamin D. Boudreaux, Current Sports Medicine Reports, August 2025 (online). Address: David S. Geslak, Exercise Connection, Lisle, IL 60532, [email protected].
