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Dropout From Exercise Interventions in Autistic Youth: A Systematic Review and Meta-analysis
Tine Van Damme1,2, Isabel Zwahlen3, Jênifer de Oliveira4
1Department of Rehabilitation Sciences, KU Leuven, Herestraat 49 box 1510, Leuven, 3000, Belgium. Tine.vandamme@kuleuven.be.
Journal of Autism and Developmental Disorders
|July 20, 2026
Summary
Exercise interventions are well-tolerated by autistic youth, with dropout rates comparable to control groups. Factors like intervention type, intensity, and duration influence dropout in exercise randomized controlled trials (RCTs).
Area of Science:
- Autism Spectrum Disorder Research
- Exercise Science
- Clinical Trials Methodology
Background:
- Exercise offers significant physical and mental health benefits for autistic youth.
- Dropout rates in randomized controlled trials (RCTs) for autistic youth vary, impacting evidence validity.
Purpose of the Study:
- To determine the prevalence and predictors of dropout rates in exercise RCTs involving autistic youth.
- To analyze factors influencing participant attrition in exercise interventions for autism.
Main Methods:
- A systematic literature search was conducted on major electronic databases up to April 2025.
- A random effects meta-analysis and meta-regression were employed to analyze dropout data from 21 RCTs (25 interventions, 565 participants).
- Dropout prevalence in exercise groups and comparisons between exercise and control groups were calculated, exploring moderators of dropout.
Main Results:
- The overall trim-and-fill-adjusted dropout prevalence was 24.4% (95% CI: 18.1%–32.1%).
- Dropout rates were significantly associated with exercise intervention type (p < 0.001), intensity (p = 0.003), and duration (p = 0.032).
- No significant difference in dropout rates was observed between exercise and control groups (OR = 1.0, p = 0.90).
Conclusions:
- Exercise interventions are generally well-tolerated by autistic children and adolescents.
- Dropout rates in exercise RCTs for autistic youth are comparable to control conditions, indicating feasibility.
- Shorter intervention durations, aerobic exercise, and specific intensities may reduce dropout rates.
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