Optimal dosage of group-based organized physical activity for enhancing social abilities in autistic children: insights from a multilevel meta-analysis.

Background: In response to current research trends emphasizing training programs to develop daily living skills in autistic children, this study employs a meta-analysis to explore the impact of group-based organized physical activity (GBOPA) on the social abilities of autistic children from multiple perspectives and further investigates its dose‒response relationship to define the "optimal" dose.

Methods: We searched the PubMed, Web of Science, Embase, and Cochrane Library databases to identify relevant studies and screen their references. The effect size was calculated via Hedges' g, and three-level random effects models were constructed via the metafor package in R. Moderation and regression analyses were conducted to explore significant influencing factors.

Results: This study included 24 articles from ten countries and included 1,042 participants (aged 4.56-11.11 years). The meta-analysis results clearly show that GBOPA can significantly improve social abilities (g = 0.48, Q = 114.84), including social functioning (g = 0.50, Q = 62.97) and communication (g = 0.37, Q = 48.07), in autistic children. Moderation analysis indicated that different age groups and training frequencies significantly affected social ability (between-group difference: p < 0.05). Specifically, interventions for early childhood children (g = 0.65) and a frequency of five sessions per week (g = 0.69) significantly enhanced the training effects on social ability. The multivariate meta-regression analysis results suggest that the optimal intervention for improving social ability in autistic children consists of 40 training sessions, each lasting 50 min.

Conclusions: GBOPA can improve the social abilities of autistic children, including social functioning and communication. On the basis of existing evidence, GBOPA should be prioritized for early childhood autistic children (5 sessions per week, 50 min per session), followed by a transition to a maintenance intervention strategy (1-2 sessions per week) after completing the 8-week foundational cycle (a total of 2,000 min of exercise).