WED-030 - Comparing Physical Activity and Weight Outcomes in Children with and Without Autism Spectrum Disorder

Brief Abstract Summary: This study examined differences in physical activity and weight status between youth with autism spectrum disorder (ASD) and their typically developing peers using data from the 2023 National Survey of Children’s Health (n = 33,449). Children with ASD (4.6%) were significantly less likely to engage in daily physical activity (14.5% vs. 20.0%) and more likely to report no activity (21.1% vs. 8.3%). Weight disparities were also evident; children with ASD were less often of normal weight (50.6% vs. 60.5%) and more frequently obese (20.5% vs. 13.2%). Logistic regression analyses showed that ASD was associated with higher odds of inactivity and abnormal weight status. However, after adjusting for physical activity, children with ASD had reduced odds of overweight and obesity, suggesting that physical activity partly mediates this relationship. Findings highlight the importance of inclusive physical activity interventions to promote healthier outcomes among youth with ASD.

Detailed abstract description:

Background: Children with autism spectrum disorder (ASD) often experience health disparities, including lower participation in physical activity and higher rates of unhealthy weight. This study examined national-level differences in physical activity engagement and weight status between children and adolescents with ASD and their typically developing peers.

Methods: Data were drawn from the 2023 National Survey of Children’s Health (n = 33,449), which collects parent-reported information on child health and well-being. Autism diagnosis, physical activity frequency, and BMI-based weight classifications were analyzed. Group differences were assessed using chi-square tests, and associations were examined using Goodman and Kruskal’s gamma and logistic regression models adjusted for relevant covariates.

Results: Of all participants, 1,546 (4.6%) had ASD. Compared to typically developing children, those with ASD were more likely to report no physical activity (21.1% vs. 8.3%) and less likely to engage in daily activity (14.5% vs. 20.0%). Significant differences were also observed in weight status: 50.6% of children with ASD were classified as normal weight compared to 60.5% of peers, while 20.5% of children with ASD were obese versus 13.2% of typically developing youth. Regression analyses indicated that children with ASD had greater odds of inactivity (OR = 3.53, 95% CI [2.96, 4.21]) and increased odds of being underweight, overweight, or obese. When physical activity was included in the multinomial model, higher activity levels were associated with lower odds of overweight (OR = 0.89, 95% CI [0.86, 0.92]) and obesity (OR = 0.72, 95% CI [0.70, 0.75]). After adjustment, children with ASD had reduced odds of being classified in any non-normal weight category.

Conclusion: Youth with ASD exhibit both lower levels of physical activity and higher prevalence of unhealthy weight compared to their peers. Physical activity appears to mediate part of this relationship, underscoring its critical role in promoting healthy weight trajectories among children with ASD. Interventions that address barriers to physical activity participation, such as sensory sensitivities, limited program accessibility, and social challenges, may help reduce obesity risk and improve overall health outcomes in this population.