The effect of motor interventions on gross motor skills in children with autism: a systematic review and META analysis

The effect of motor interventions on gross motor skills in children with autism: a systematic review and META analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The effect of motor interventions on gross motor skills in children with autism: a systematic review and META analysis YUANG CAO, LIXIA FAN, XIAOJIN MAO This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3802549/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract OBJECTIVE To systematically and quantitatively evaluate the effects of different forms of interventions on the development of gross motor skills in children with autism and to provide a reference for further enhancing the development of gross skills in children with autism. METHODS Randomised controlled trials (RCTs) on gross motor skill interventions for children with autism were collected according to the criteria developed by searching in China Knowledge Network (CNKI), Wanfang Digital Resources, Wipu database, and web of science database. The Chinese and English search terms included: (autism OR autism spectrum disorder) AND (motor skill OR fundamental motor skill OR fundamental movement skill) AND (pupil OR child). The retrieved literature was screened, data extracted, and the quality of the included literature was evaluated using Cochrane. Meta-analysis and sensitivity analysis, regression analysis, and publication bias were performed using Review Manager 5.4 and Stata 15.1 software. Result Meta-analysis results showed that targeted motor interventions significantly improved the development of gross motor skills in children with autism and were effective in improving the total TGMD scores of children with autism (SMD = 13.61, 95% CI [8.77,18.46]). There was a significant increase in displacement skills (SMD = 7.07, 95% CI [5.20,8.94]) and object control skills (SMD = 6.55, 95% CI [4.98,8.12]). In terms of displacement skills, a certain duration of motor intervention had a good effect on children with autism for fast running, side sliding, single-leg jumping, and straddle jumping, but not for front sliding and standing long jump. In terms of object control skills: the motor intervention significantly improved children with autism's ability to throw the ball underhand, kick the ball, and hit the stationary ball, but not overhand throwing and slapping the ball in place. Conclusion Targeted motor interventions have an important role in promoting gross skills in children with autism spectrum disorders. Further research should be conducted to validate this with larger sample sizes and high-quality RCTs. autism children gross motor skills Meta analysis Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Introduction Autism spectrum disorders (ASD) are complex neurodevelopmental disorders characterized by deficits in social interaction, communication skills, and interests [1]. The prevalence of autism in Chinese children is around 1%, which means that the number of children with autism is increasing at a rate of around 200,000 per year [2], with these results placing a huge burden on society and families with autistic individuals. Therefore, intervention and rehabilitation for children with autism should begin in childhood. It has been well documented that the development of motor skills in adulthood is closely related to the development of basic motor skills in childhood, with gross motor skills being the most fundamental component of basic motor skills, including locomotor skills (LMS) and object control (OC) skills [3]. Research has shown that motor developmental deficits are common in children with autism and are a central factor in the differences in motor skills between children with autism and normal children. Neglecting motor development disorders in the rehabilitation of children with autism can lead to a decline in motor skills, which can lead to increased social impairment, low motor skills, cognitive limitations, and other problems that can hinder the rehabilitation of children with autism [4,5]. Therefore, it is important to adopt a series of timely interventions to promote the development of gross motor skills in children with autism. Most of the research has been conducted on single-motor interventions for children with autism and some qualitative findings have been obtained, but no quantitative synthesis of the results of single-motor interventions using Meta-analysis has been conducted. It is important to explore the impact of different interventions on the development of gross motor skills in children with autism and to provide a scientific basis for further promoting of different interventions in the development of gross motor skills in children with autism. The paper uses the latest version of Review manager 5.4 software and STATA 15.1 software to conduct a Meta-analysis of the relevant literature collected from China Knowledge Network (CNKI), Wanfang data, Vipshop database and web of science on gross motor skill interventions for children with autism, and the experimental results on the development of gross motor skills after the interventions. The evaluation was conducted to provide a basis for illustrating the effectiveness of different interventions. This study not only examined the actual effects of different interventions on the gross motor skills of children with autism but also provided a basis for further research on the development of motor skills in children with autism. 1. Materials and Methods 1.1 The research was searched in China Knowledge Network (CNKI), Wanfang Digital Resources, Wipu database, web of science, and other databases based on PICO (participants, intervention, comparison, outcome) format. The Chinese and English search terms include: (autism OR autism spectrum disorder) AND (motor skill OR fundamental motor skill OR fundamental movement skill) AND (pupil OR child). The search period was from the creation of the database to January 2023, and references to the literature obtained from the search were included in the search for relevant information, and if the literature was not published it was not included in the study. 1.2 Inclusion criteria: (1) Study population: children aged 3 to 12 years with a definite diagnosis of autism spectrum disorder. (2) Type of trial: The included literature used randomized controlled trials (RCT) and clearly described the control and experimental groups. Individual studies were not included. (3) Interventions: The control group had a conventional intervention or no intervention, while the experimental group added a targeted intervention to the conventional intervention, with no restriction on the type of intervention. (4) Outcome indicators: Gross motor skill scores were used as outcome indicators (at least one of the outcome indicators included object control skills or displacement skills), and the length of intervention in the experimental group was more than 4 weeks. 1.3 Exclusion criteria: (1) Unable to provide raw data such as subject information, intervention protocol, and intervention outcome (data subject to availability of LMS and OC) (2) Subjects were not diagnosed as children with autism spectrum disorders. (3) Non-experimental studies, e.g. META analysis, review type, conference type literature. (4) A mixture of movement and recurrent articles in control measures. 1.4 Literature screening and data extraction: A search of literature published before January 2023 was conducted based on the inclusion-exclusion criteria established, and a total of 2095 documents were searched. An initial screening of the literature through Endnote X9 software based on author, year of publication, title, and source yielded 895 documents, followed by a full-text search of those potentially meeting the inclusion criteria, yielding 45 documents. These 45 documents were read in full and screened strictly according to the inclusion and exclusion criteria established, resulting in 15 documents. 1.5 Qualitative evaluation The quality of the nine included studies was evaluated according to the Cocharane Risk Bias Assessment Tool recommended in the Cochrane Handbook for Systematic Reviews, version 5.1, which has a clear and easy-to-use structural framework. The use of this tool for risk bias assessment was the consensus of the Cochrane Collaboration editors and systematic evaluators [6]. Risk bias assessment using Cochrane includes (1) randomization methods, (2) blinding of participants and investigators, (3) allocation concealment, (4) completeness of outcomes, (5) selective reporting of outcomes, and (6) other sources of bias. Each assessed the bias of the included RCTs in terms of low risk of bias (low risk), high risk of bias (high risk), and uncertainty (unclear risk) [7]. Each criterion has three options: low bias, high bias, and unclear. When the number of low bias in the literature is ≥4, it can be classified in category A; when the number of low bias in the literature is ≥2 and <4, it is classified in category B; when the number of low bias in the literature is <2, it is classified in category C. Because sport interventions cannot be double-blinded, most experiments are primarily instrument-based, and evaluators have less subjective influence on the results, the 'blinded approach to outcome assessment' scores are high. 1.6 Statistics and analysis: Meta-analysis of data extracted from the included literature was performed using Review Manager 5.4, Stata 15.1 software. The χ2 (α=0.1) test was used to determine heterogeneity between studies, combined with I² for quantitative evaluation, and heterogeneity was considered to exist when I² > 50% [7], and a random effects model was selected, while I² < 50% resulted in homogeneous study effects and a fixed effects model was selected. Standardized mean difference (SMD) and 95% confidence interval (95% CI) were chosen as the effect scales to combine effect sizes, with small effects when the absolute value of SMD was 0-0.4, moderate effects when 0.4-0.8, and high effects when greater than 0.8. Differences were considered significant when P < 0.05, and subgroup analyses were performed for highly heterogeneous findings. 2. Results 2.1: Literature search and screening: The specific literature screening process is shown in Figure 3. As can be seen from Figure 3, a total of 2908 papers were retrieved based on the inclusion criteria established, and the resulting papers were subsequently cascaded according to the inclusion and exclusion criteria, resulting in the 15 papers included in this paper. 2.2 Basic characteristics of the included literature The basic characteristics of the 11 pieces of literature are shown in Table 1 and Table 2. A total of 184 people in the experimental group and 197 people in the control group were included in this study. The ratio of the experimental group to the control group and the ratio of males to females are shown in the following table1,2: Table 1:The basic characteristics of the research objects included in the literature Number Author Year Experimental subjects Crowd Age(years) Experimental group (male: female)/ Control group (male: female) 1 Meilin Yan [8] 2020 NC 4-5 6(4:2)/ 6(4:2) 2 Xiaojin Song [9] 2020 NC 7-14 10(7:3)/ 10(8:2) 3 Xuliang Su [10] 2021 NC 5-6 16(Unknown)/ 14(Unknown) 4 Liangshan Dong [11] 2021 NC 5-12 8(7:1)/ 10(8:2) 5 Nan Su [12] 2020 NC 8-10 10(5:5)/ 10(5:5) 6 Xiang Pi [13] 2020 NC 4-6 29(25:4)/ 29(24:5) 7 Ling Li [14] 2022 NC 9-12 8(Unknown)/ 8(Unknown) 8 Yongbin Zheng [15] 2020 NC 5-7 15(11:4)/ 15(11:4) 9 Jiayu Hong [16] 2022 NC 6-12 12(Unknown)/ 12(Unknown) 10 Minting Zhang [17] 2019 NC 6-12 10(7:3)/ 14(11:3) 11 Emily Bremer [18] 2015 NC 3-7 5(Unknown)/ 5(Unknown) 12 Liangshan Dong [19] 2021 NC 6-12 21(17:4)/ 29(25:4) 13 Kim [20] 2020 NC 3-6 6(3:3)/ 8(1:7) 14 Columna [21] 2021 NC 4-11 7(Unknown)/ 8(Unknown) 15 Morales [22] 2022 NC 10-11 21(Unknown)/ 19(Unknown) Note: NC is normally developing children; EG is the experimental group; CG is the control group Table 2 Status of interventions included in the study No. Author Interventions Training content and scale Group:Total time/week frequency/sub-hour Training intensity 1 MeilinYan [8] EG: Targeted exercise program include, mobility exercise, manipulative exercise CG:Unknown EG:16 weeks*3 times*60min CG:16 weeks Unknown 2 Xiaojin Song [9] EG:Ansei Waist Drum Practice CG:Routine exercise activity intervention EG:10 weeks*2 times*60min CG:10 weeks 60-80% HRmax 3 Xuliang Su [10] EG:Sports games CG:Normal PE Course EG: 10 weeks * 3 sessions * 30min; CG:10 weeks Unknown 4 Liangshan Dong [11] EG: Basic motor skills teaching, cooperative games, aerobics CG:Traditional Sports Programme EG:12 weeks*3 times*60min CG:12 weeks Unknown 5 Nan Su [12] EG: Warm-up activities, dynamic balance training, rollerblading CG:Regular balance exercises, daily exercise EG:20 weeks*9 times*50min CG: 20 weeks Unknown 6 Xiang Pi [13] EG:Combined sensory integration training, vestibular balance training Exercises, bounce training, tactile training, sports games CG:Psychotherapy EG:52 weeks*7 times*45min CG:52 weeks Unknown 7 Ling Li [14] EG:Children's Fun Athletics, Sports Games CG:Regular Physical Education Programme EG:12 weeks * 3 sessions * 35min; CG: 12 weeks * 3 sessions * 35min Unknown 8 Yongbin Zheng [15] EG: Structured Teaching, Physical Education Game teaching training CG:Structured Teaching EG:24 weeks*5 times*35min CG:24 weeks*5 times*35min Unknown 9 Jiayu Hong [16] EG:A 12-week dance therapy intervention program that includes three phases of self-exploration, interpersonal and integration development, as well as quality exercises such as running and jumping movement exercises and agility and strength. CG: No intervention EG:12 weeks*3 times*80min CG: None Unknown 10 Minting Zhang [17] EG: displacement and object manipulation skills, basic physical exercises CG:Normal PE Course EG: 10 weeks * 3 sessions * 60min; CG:10 weeks*3 times*60min Unknown 11 Emily Bremer [18] EG: Motor and social skills learning, sports games, obstacle training CG:Normal PE Course EG: 12 weeks * 3 sessions * 45min; CG:12 weeks*3 times*45min Unknown 12 Liangshan Dong [19] EG:Balance exercises, muscle strength exercises, fun exercise instruction CG: No intervention EG: 9 weeks * 3 sessions * 80min; CG:None Unknown 13 Kim [20] EG:FMS skills teaching and fun sports games, social games CG: Social Games EG: 10 weeks * 4 sessions * 15min; CG:10 weeks*4 times*15min Unknown 14 Columna [21] EG: Parent-chaperoned PE lessons, sports games and motor skills learning CG: Regular class sessions EG: 10 weeks * 4 sessions * 15min; CG:10 weeks*4 times*15min Unknown 15 Morales [22] EG: Adaptive Judo exercises, Judo specific exercises and fun games CG: Non-participation in sporting activities EG: 9 weeks * 1 session * 90min; CG:None Unknown 3. Meta-analysis results 3.1: META analysis of the effect of exercise intervention on total gross motor skill (TGMD) scores: The Test of Gross Motor Development (TGMD) has become the world's most widely used tool for measuring children's gross motor skills due to its highly standardized assessment system and has now been updated to its third edition, the TGMD-3. The TGMD total score provides a comprehensive picture of children's gross motor skill development. Scholars such as Bo Li have noted that the use of the TGMD is necessary for screening children with atypical motor development (children with autism and children with intellectual disability) [18]. The acquisition of gross motor skills is beneficial for children's physical fitness and can also improve muscle strength, orientation, and motor dexterity in children with autism [19], and is the basis for the development of many abilities such as self-care in children with autism [20]. A total of 11 studies were included in this study using the total TGMD score as the outcome indicator. As shown in Figure 4, χ² = 60.88, df = 10 (P < 0.00001), I² = 84% between the experimental and control groups, which can be considered as heterogeneity between the two groups, and Meta-analysis was performed using a random effects model. The results showed a combined sample size of 130 cases, SMD = 13.61, 95% CI [8.77,18.46],Z = 5.51, P < 0.00001, the combined effect was statistically significant, and the small diamond-shaped squares fell to the left of the null line and did not intersect, indicating the presence of a medium effect, suggesting that gross motor skill levels of children with autism could be significantly improved by the intervention. 3.2 Meta-analysis of the effect of motor intervention on displacement skills in children with autism: 3.2.1 Total displacement skill score (TGMD score) Horizontal displacement-like motor skills (locomotor skills) such as running, side-stepping, standing long jump, and single-leg jump are important components of large muscle motor skills. The total displacement skill score in the TGMD score was first analyzed. META results showed that χ² = 51.77, df = 11 (P < 0.00001) and I² = 79% between the experimental and control groups, which can be considered as heterogeneity between the two groups. Meta-analysis was conducted using a random effects model. The results showed that the combined sample size was 208 cases, SMD = 7.07, 95% CI [5.20,8.94],Z = 7.41, p < 0.00001, and the combined effect was statistically significant, with the small diamond-shaped squares falling to the left of the null line and not intersecting, indicating a significant increase in the total displacement skill scores of children with autism through the motor intervention. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias. 3.2.2 Running ability Running is a basic skill that humans possess and running ability is analyzed in children with autism using fast running as well as side-sliding and front-sliding steps as tests. A total of five papers in this study contained research on the effect of exercise on the running ability of children with autism, using three main methods to measure children's jumping ability: the fast run, the front glide step, and the side glide step. As seen in Figure 6, there was no high heterogeneity between the experimental and control groups with χ² = 33.46, df = 17 (P = 0.010), I² = 49%, and a fixed effects model was used. SMD = 1.71, 95% CI [1.46,1.95],Z = 13.68, P 0.8 indicates that the motor intervention had a better effect on children's running but there were significant differences between subgroups. In running ability, χ² = 3.08, df = 5 (P = 0.03), I² = 0%, the two groups were homogeneous in fast running, SMD = 2.05, 95% CI [1.67, 2.42],P < 0.001, the small diamond-shaped squares did not intersect with the null line and were farther apart indicating a significant improvement in fast running ability in children with autopathy by the motor intervention. The two groups were homogeneous for lateral glide χ² = 5.43, df = 5 (P = 0.37), I² = 8%, SMD = 1.87, 95% CI [1.42, 2.331],P < 0.001 The small diamond-shaped square did not intersect with the null line, indicating that the motor intervention had an enhancing effect on the lateral glide ability of children with autism. There was heterogeneity between the two groups in the forward glide χ² = 12.44, df = 5 (P = 0.03), I² = 60%, SMD = 0..99, 95% CI [0.42, 1.96],P < 0.001, and the small diamond-shaped squares were close to but did not intersect the null line, suggesting that the motor intervention had some effect on improving the forward glide ability of children with autism, but the enhancement was limited. 3.2.3 Jumping ability A total of five papers in this study included research on children's jumping ability, using three methods: standing long jump, single-leg jump, and straddle jump to measure children's jumping ability. As can be seen in Figure 6, there was high heterogeneity between the experimental and control groups with χ² = 31.68, df = 14 (P < 0.004), I² = 56%, using a random effects model. SMD = 1.62, 95% CI [1.21,2.03],Z = 7.77, P 0.8 indicates that the football intervention had a better facilitation effect on the children's object control ability but there were significant differences between subgroups. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias. There was heterogeneity between the two groups with χ² = 74.28, df = 5 (P 0.8, and the small diamond-shaped square intersected the null line, indicating that the motor intervention did not significantly improve the standing long jump of children with autism. χ² = 5.69, df = 5 (P = 0.34), I² = 2%, there was homogeneity between the two groups for single-leg hopping, SMD = 1.92, 95% CI [1.44, 2.39],P 0.8, and the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was better at improving the single-leg hopping ability of children with autism. χ² = 7.25, df = 5 (P = 0.20), I² = 31%, there was homogeneity between the two groups in the straddle jump, SMD = 1.50, 95% CI [0.96, 2.04],P 0.8, the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was better at improving the straddle jump ability of children with autism. 3.3 Meta-analysis of the effect of motor intervention on object control skills in children with autism 3.3.1 Total score for object control skills: Object control skills are an important component of gross skills, and in this study object control skills were divided into three components: total TGMD control skill scores, throwing skill scores, and ball skill scores. As can be seen from the figure, the combined data heterogeneity of the effect of movement on object control skills in children with autism χ² = 28.65, df = 6 (p < 0.00001), I² = 79%, therefore Meta-analysis using a random effects model, SMD = 7.78, 95% CI [4.93, 10.64], p < 0.0001, the combination was statistically significant, the rhombus squares fell to the left of the null line and did not intersect, indicating that the intervention significantly improved object control in children with autism. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias. 3.3.1 Throwing skill scores: The combined data heterogeneity of the effect of the motor intervention on children's throwing category χ² = 42.66, df = 8 (P < 0.00001), I² = 82.4%, therefore Meta-analysis using a random effects model, SMD = 1.46, 95% CI [0.73, 2.18],P 0.8, indicates that the motor intervention on children with autism's throwing category skill development can be well facilitated and there were significant differences between subgroups. Heterogeneity existed between the two groups for overhand pitching χ² = 14.53, df = 4 (P = 0.14), I² = 72%, SMD = 0.91, 95% CI [0.21, 1.61],P = 0.01, SMD > 0.8, the diamond-shaped cubes did not intersect with the null line but were close together, indicating that the motor intervention did not significantly improve the overhand pitching ability of children with autism. There was heterogeneity between the two groups in the lower hand throw χ² = 42.66, df = 3 (P 0.8, and the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was effective in promoting the development of the lower hand throw in children with apparent autism. 3.3.2 Score for ball games: The combined data heterogeneity of the effect of the motor intervention on the scores of children with autism on ball items χ² = 29.53, df = 14 (P = 0.009), I² = 53%, therefore Meta-analysis using a random effects model, SMD = 1.27, 95% CI [0.82, 1.73],P 0.8, indicates that the motor intervention on autism children's ball skill development can be well facilitated and there were significant differences between subgroups. The funnel plot shows that the included literature is more evenly distributed on both sides of the mean effect value, so there is no significant publication bias. There was homogeneity between the two kicking groups with χ² = 4.78, df = 4 (P = 0.31), I² = 16%, SMD = 1.53, 95% CI [0.99, 2.07],P = 0.31, SMD > 0.8, and the small diamond-shaped squares did not intersect with the null line, suggesting that the football sport intervention had a beneficial effect on children's kicking ability. There was heterogeneity between the two groups for in situ tapping χ² = 8.35, df = 4 (P = 0.08), I² = 52%, SMD = 0.82, 95% CI [0.08, 1.57],P = 0.03, SMD > 0.8, and the small diamond-shaped square intersected with the null line, indicating that the football exercise intervention did not have a significant effect on children's ability to tap the ball in situ. The two groups were homogeneous in terms of χ² = 7.72, df = 4 (P = 0.10), I² = 48%, SMD = 1.59, 95% CI [0.70, 2.47],P = 0.009, SMD > 0.8, and the diamond-shaped cube did not intersect with the null line, indicating that the motor intervention improved the ability of children with autism to hit the fixation ball. 3.4 Subgroup analysis: 3.4.1 Comparison of different total intervention lengths: In this study, the period, number of interventions, and duration of interventions are important factors affecting the results of the experiment. The total intervention duration was divided into two subgroups: above 1800 min and below. The results of the subgroup analysis showed that: |SMD above 1800min｜ > |SMD below 1800min｜, in terms of total TGMD score, both SMD (above 1800min) and SMD (below 1800min) showed a high effect, indicating that the total intervention duration did not have a significant effect on the difference in total TGMD score. In terms of object control and displacement skills: interventions above 1800 min had a moderate, high effect, while below 1800 min had a low effect, so the effect of training above 1800 min was more likely to promote the development of displacement skills and control skills in children with autism. This suggests that a longer training duration can specifically and more comprehensively improve children's gross motor skills. Table 3 Comparison of the effects of different total intervention times Test indicators Subgroup Number of articles Z P SMD 95% CI Total TGMD score 1800min or more 4 2.18 0.0001 18.83 [5.56, 32.11] Under 1800min 7 7.16 0.79 10.26 [7.45, 13.07] Overall 11 5.5 0.0001 13.67 [8.77, 18.46] Displacement skills 1800min or more 6 4.60 0.0001 7.17 [4.12,10.23] Under 1800min 6 10.84 0.45 7.07[5.20,8.94] Overall 12 7.41 0.0001 7.81 [5.29, 10.33] Control skills 1800min or more 5 4.90 0.00001 8.93 [5.03, 11.79] Under 1800min 6 9.37 0.56 5.61 [4.43, 6.78] Overall 11 8.08 0.00001 6.55 [4.98, 5.12] 3.4.2 Comparison of effects by age group The study divided the literature into two subgroups based on age, preschoolers (3-6 years) and children (7-12 years). The results of the subgroup analysis showed that there was a more significant effect of the gross motor skills intervention for both preschoolers and children aged 7-12 years, and in general SMD 7-12 > SMD 3-6 , indicating a better effect of the intervention for children with autism aged 7-12 years. Table 4 Comparison of effects by age Test indicators Subgroup Number of articles Z P SMD 95% CI Total TGMD score 3-6 years 3 3.88 0.0001 11.46 [5.67, 17.26] 7-12 years 5 3.05 0.002 15.31 [5.48, 25.15] Overall 8 4.08 0.0001 14.23 [7.40, 21.06] Displacement skills 3-6 years 4 7.62 0.00001 5.88 [4.37, 7.40] 7-12 years 6 6.12 0.00001 8.32[5.66,10.99] Overall 10 7.50 0.0001 7.60 [5.61, 9.59] Control skills 3-6 years 3 6.26 0.00001 4.58 [3.15, 6.01] 7-12 years 3 4.79 0.00001 8.07 [4.77, 11.38] Overall 6 6.42 0.00001 6.76 [4.69, 8.83] 4. Analysis and discussion The Meta-analysis found that the experimental group had a significant increase in total gross motor skill (TGMD) scores, displacement skill scores and object control skill scores compared to the control group in the 15 included papers. This result is consistent with the general systematic review studies by Van Capelle [21] and Wick [25], as well as with the findings of a study by Meng-Yuan Bai [23] on basic motor skills interventions for preschool children. It suggests that through early and timely intervention, there is a positive effect on the enhancement of gross motor skills in both children with autism and healthy children in general. Displacement is an essential ability in everyday life and the ability to run and jump is an indicator of displacement ability. The subgroup analysis concluded that interventions longer than 1800min were more effective than those below 1800min. However, in terms of the total duration of the exercise, it has been suggested that the exercise intervention did not have better results with longer duration, possibly because the children felt monotonous and disengaged from the experiment due to the long duration of a single session, thus affecting the improvement of basic motor skills [28]. In addition, it has been suggested that children's basic motor skills may stabilize after a certain 'amount' of instruction [29], so longer sessions do not necessarily lead to better results. In the specific displacement skills tested, the motor interventions significantly improved children's ability to run fast, slide sideways, hop on one foot, and jump across the floor, but had limited effect on the front slide and standing long jump. The reason for this is that the front slide and standing long jump are more difficult than other displacement tests, especially the standing long jump, which requires a high level of strength and explosive power, and the front slide, which requires good coordination and balance, and it is difficult to improve the performance of the standing long jump and front slide quickly through a short training. The interventions included in the literature are not specific to the strength and coordination of the children and the results may be different if the corresponding interventions are used. It is also difficult for preschool children with autism to improve in the long jump, and even with interventions, the results are not significant in the short term. Again there was better overall facilitation of object control skills in children with autism through the motor intervention, which in this study was divided into throwing category skills as well as ball item skills. In the throwing category, the motor intervention improved the performance of children with autism on hand throwing more than on overhand throwing, and due to the small amount of literature included, the results for the throwing category should be treated with caution. For ball skills, the motor intervention was better at improving children with autism's ability to kick and hit a stationary ball but did not have a significant effect on children with autism's ability to shoot the ball in place. The reason for the lack of significant improvement in children's ability to tap the ball may be that tapping the ball is more upper limb dominated and requires some ball support, so it is difficult to achieve a significant improvement without targeted ball practice. 5. Limitations of the study There are also limitations to this meta-analysis. These limitations include: (1) The various strategies used in physical education classes do not include research on multiple physical education interventions. (2) Heterogeneity in the number of physical education classes per week and their duration in the intervention and control groups. (3) The role of potential confounding factors. (4) Sports that are not fully integrated. (5) Some children are younger and may have compliance problems. 6. Conclusions and recommendations The motor intervention had a significant effect on the improvement of gross motor skills in children with autism, as evidenced by significant improvements in total TGMD scores, and displacement and object control skills scores. However, for individual items such as the standing long jump the improvement was not significant. In the specific interventions, the best results were obtained for children aged 7-12 years with a simultaneous intervention duration of 1800 min or more. Future studies should focus on the design of the experimental protocol, especially the reasonable control, and evaluation of the motor interventions to ensure the effective implementation of the motor interventions. The effects of different intervention components and the ratio of each component as well as the intensity of the intervention on the gross motor skills of children with autism are lacking in the current study. It is recommended that further exploration of motor intervention programs to promote the development of motor skills in children with autism should be conducted to identify the key features of effective interventions, including the periodicity, frequency, and duration of interventions, as well as the content of interventions to provide a basis and reference for physical education practices for special groups of children This will serve as a basis and reference for the development of gross motor skills in children with autism. Declarations Author Contribution CAO, as the first author, was responsible for compiling the main body of the paper and organizing the data for the paper. FAN was responsible for evaluating the paper in stages and giving advice on writing. MAO was responsible for assisting in organizing the data and formatting the paper. All authors reviewed the manuscript. References Jocelyn J.Le Blanc,Michela Fagiolini.Autism：A“Critical Period” Disorder[J].Neural Plasticity,2011,10(11):17-18. Bhat A N，Landa Ｒ J，Galloway J C． Currentperspectives on motor functioning in infants，Children,and adults with autism spectrum disorders．Physical Therapy 2011，91:1116-1129 GregPayne. Introduction to human action development [M]. People's Education Press,2008,09:121-124. Colombo-Dougovito A M，Ｒeeve Ｒ E． Exploring the interaction of motor and social skills with autism severity using the SFAＲI dataset．Perceptual＆ Motor Skills，2017，124: 413-424 Macdonald M，Lord C，Ulrich D A．The relationship of motor skills and social communicative skills in school- aged children with autism spectrum disorder.Adapted Physical Activity Quarterly，2013，30: 271-282 Wu Zijing, Zeng Hui. A meta-analysis-based assessment of the value of forest ecosystem services in China[J]. Journal of Ecology,2021,41(14):5533-5545. Wei LJ, Dong HJ. Identification and treatment of heterogeneity in Meta-analysis [J]. Journal of the Second Military Medical University, 2006 Yan Meilin. A study on the design of a gross motor development exercise program for children with moderate autism aged 4-5 years [D]. Hebei Normal University,2022. Song Xiaojin. A study on the effect of 10 weeks of Ansai waist drum practice on the motor ability of children with autism[D]. Beijing Sports University,2020. Su XG. Study on the effect of 10-week motor intervention on the motor development level of children with moderate autism and related mechanisms[D].Tianjin Institute of Physical Education,2021. Dong L.S., Bu J., Shen B., Pang Y.L., Song Y., Xing Y. Effects of 10-week motor intervention on basic motor skills and social interaction ability in children with autism [J]. Chinese Journal of Sports Medicine,2021,40(03):171-180. Su Nan. The effect of dynamic balance training on the physical and mental conditions of children with autism[D]. Northeast Normal University, 2022. Pi Xiang. The effect of sensory integration training in the cognitive ability and motor development ability of children with autism[J].China Contemporary Medicine,2020,27(12):103-106. Li Ling. Research on the effect of children's fun athletics on the development of gross motor development of children with autism[D]. Xi'an Institute of Physical Education, 2022. Zheng YB. Research on the intervention of sports games in the rehabilitation training of children with autism spectrum disorders[D]. Liaoning Normal University, 2020. Hong Jia Yu. A study on the effect of dance therapy on the motor and social communication skills of children with autism[D]. Jiangxi Normal University, 2022. Zhang M-T. An intervention study of basic motor skills for children with autism spectrum disorders [D]. Huazhong Normal University,2019. Bremer, E., & Lloyd, M. (2016). School-Based Fundamental-Motor-Skill Intervention for Children With Autism-Like Characteristics: An Exploratory Study, Adapted Physical Activity Quarterly, 33(1), 66-88. Dong L, Shen B, Pang Y L, et al. FMS effects of a motor program for children with autism spectrum disorders[J]. Perceptual and Motor Skills, 2021, 128(4): 1421-1442. Felzer-Kim I T, Hauck J L. How much instructional time is necessary? Mid-intervention results of fundamental movement skills training within ABA early intervention centers[J]. Frontiers in Integrative Neuroscience, 2020, 14: 24. Columna L, Prieto L A, Beach P, et al. A randomized feasibility trial of a fundamental motor skill parent-mediated intervention for children with autism spectrum disorders[J]. International journal of environmental research and public health, 2021, 18(23): 12398. Morales J, Pierantozzi E, Fukuda D H, et al. Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program[J]. Frontiers in Psychology, 2022, 13: 1067310. Li B, Diao YC, Li J, Hong JT, Sun JG, Liu Y. Analysis and insight of the Test of Gross Motor Development (TGMD) in the United States[J]. Journal of Chengdu Institute of Physical Education,2021,47(02):58-64. Yang Qingxuan. Experimental interventions on large muscle movement development of preschool children in the perspective of movement development [J]. Journal of Xi'an Sports College,2017,34(3):341. AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and statistical manual of mental disorders［M］. 5th ed. Arlington: American Psychiatric Publishing, 2013:936-937. VAN CAPELLE A, BRODERICK C R, VAN DOORN N,et al. Interventions to improve fundamental motor skills in pre-school aged children: A systematic review and metaanalysis [J ]. Journal of Science and Medicine in Sport,2017, 20(7):658-666. WICK K, LEEGER-ASCHMANN C S, MONN N D,et al.Interventions to promote fundamental movement skills in childcare and kindergarten : A systematic review andmeta-analysis[J]. Sports Medicine, 2017,47:2045-2068. DONATH L, FAU DE O, HAGMANN S, et al., Fundamental movement skills in preschoolers: A randomized controlled trial targeting object control proficiency[J]. Child:Care, Health and Development, 2015. 41(6):1179-1187. LOGAN S W, ROBINSON L E, WILSON A E, et al.Getting the fundamentals of movement: A meta-analysis of the effectiveness of motor skill interventions in children [J]. Child: Care, Health and Development, 2012,38(3):305-315. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3802549","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":263383268,"identity":"a266ad66-0072-4188-813f-0599721571f1","order_by":0,"name":"YUANG CAO","email":"","orcid":"","institution":"Shandong Normal University","correspondingAuthor":false,"prefix":"","firstName":"YUANG","middleName":"","lastName":"CAO","suffix":""},{"id":263383269,"identity":"058f4028-d114-4588-bef9-9839366e5bd4","order_by":1,"name":"LIXIA FAN","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIie3QIQvCQBTA8SfCVg5XnyD6FWYZFtlXuWPGKSZZEBlM3oL4GfwKJjHeEJbOvrh1i02bm0Zlzma4f7pwv3vcA9Dp/jAzhJbkgGCYUZLzYPmdMAnwJB2Wenau0oakOvTRd7rFut2AmGcpCxoNDKacQIQGWPGG1xM245IrHJJJi0wce4DqvK8lLvi25AG2iJ0OmVAG2DitJ8y6lMRGl5A7c0HtBgRfUwThxIGGpJqi0KNyychVyr7+hVn+sLjTaryLo+R6C5Z9K97Wk/c3fruu0+l0uo89ABLaSlj5L04hAAAAAElFTkSuQmCC","orcid":"","institution":"Shandong Normal University","correspondingAuthor":true,"prefix":"","firstName":"LIXIA","middleName":"","lastName":"FAN","suffix":""},{"id":263383270,"identity":"c8e6037d-3fdb-4748-b01d-223472edfa26","order_by":2,"name":"XIAOJIN MAO","email":"","orcid":"","institution":"Shandong Normal University","correspondingAuthor":false,"prefix":"","firstName":"XIAOJIN","middleName":"","lastName":"MAO","suffix":""}],"badges":[],"createdAt":"2023-12-25 01:29:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3802549/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3802549/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49081991,"identity":"3edb0ef4-c22f-4354-8a4e-596e8681eb65","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":15935,"visible":true,"origin":"","legend":"\u003cp\u003eIncluded data bias evaluation map\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/37cc27ef02a60fa5aa984ca4.png"},{"id":49081990,"identity":"c8bb52fc-9797-4ade-9f90-bd7446fe54d8","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":15634,"visible":true,"origin":"","legend":"\u003cp\u003eSummary of bias of included literature\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/183d59f849e000c055184fcc.png"},{"id":49081993,"identity":"a549e212-0d73-4b31-8dfd-8ac969eb65d4","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":29887,"visible":true,"origin":"","legend":"\u003cp\u003eLiterature selection flow diagram\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/453ecc070bfbf0222dd639ec.png"},{"id":49083359,"identity":"b37b6765-f99b-4c41-94b7-22610ffd5f9c","added_by":"auto","created_at":"2024-01-02 20:26:33","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":24276,"visible":true,"origin":"","legend":"\u003cp\u003eMeta-analysis forest plot of the effect of motor intervention on the total TGMD score of children with autism\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/a7c45ddd9c410bc53ba13917.png"},{"id":49081995,"identity":"8f25bb37-c3a8-4c2d-af28-4b8efd9010aa","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":307804,"visible":true,"origin":"","legend":"\u003cp\u003eMeta-analysis forest plot of the effect of motor intervention on displacement scores of children with autism\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/52fcbd25d2c83b2008ff7efc.png"},{"id":49083136,"identity":"7b07c66b-d806-4880-983e-4c8c64b62c74","added_by":"auto","created_at":"2024-01-02 20:18:33","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":46131,"visible":true,"origin":"","legend":"\u003cp\u003eMeta-analysis forest plot of the effect of motor intervention on running ability in children with autism\u003c/p\u003e","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/b661caf326116ed8a92267fb.png"},{"id":49081998,"identity":"307d97ad-702a-4b1f-ad65-4204ebfa5968","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":154410,"visible":true,"origin":"","legend":"\u003cp\u003eFunnel plot of Meta-analysis of the effect of motor intervention on running ability in children with autism\u003c/p\u003e","description":"","filename":"floatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/f3f3f9be19b9468291d17e2e.png"},{"id":49083138,"identity":"44389149-33ca-4906-9e8a-c48a85be8e13","added_by":"auto","created_at":"2024-01-02 20:18:33","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":47686,"visible":true,"origin":"","legend":"\u003cp\u003eMeta-analysis forest plot of the effect of motor intervention on jumping ability in children with autism\u003c/p\u003e","description":"","filename":"floatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/237846c7705fdc5db7a4531b.png"},{"id":49083488,"identity":"7ee2b69f-f8e4-4a48-a54c-4a7fc32c31e3","added_by":"auto","created_at":"2024-01-02 20:34:33","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":14282,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 8: Funnel plot of Meta-analysis of the effect of motor intervention on jumping ability in children with autism\u003c/p\u003e","description":"","filename":"floatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/a0d7f6c350c1e0168bfd7102.png"},{"id":49083360,"identity":"1677c076-a736-4fec-9ace-3c11debc190f","added_by":"auto","created_at":"2024-01-02 20:26:33","extension":"png","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":355544,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 9: Meta-analysis forest plot of the effect of motor interventions on total scores of object control skills in children with autism\u003c/p\u003e","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/4d0652f6d6390036c12b27cc.png"},{"id":49082001,"identity":"f30ef4ff-1d2d-490e-bd55-76ddd68c0aa7","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":423981,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 10: Meta-analysis forest plot of the effect of motor interventions on scores in throwing category skills for children with autism\u003c/p\u003e","description":"","filename":"floatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/34de7c1b968a325bf0a9bfe1.png"},{"id":49083140,"identity":"b0014ed1-9284-47a1-a808-6bad91ed7c5e","added_by":"auto","created_at":"2024-01-02 20:18:33","extension":"png","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":13761,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 11: Meta-analysis funnel plot of the effect of motor interventions on scores in throwing category skills for children with autism\u003c/p\u003e","description":"","filename":"floatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/6d698a91e818d9caf0d91642.png"},{"id":49082002,"identity":"ccd15091-bcde-4b3e-a40a-507ea660f7dc","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":13,"title":"Figure 13","display":"","copyAsset":false,"role":"figure","size":537898,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 12: Meta-analysis forest plot of the effect of motor interventions on scores in ball events for children with autism\u003c/p\u003e","description":"","filename":"floatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/5aa4c9f6aa6cc2f6be506bba.png"},{"id":49082003,"identity":"a23fa6f8-ab40-407a-b5a7-06163254b8cb","added_by":"auto","created_at":"2024-01-02 20:10:33","extension":"png","order_by":14,"title":"Figure 14","display":"","copyAsset":false,"role":"figure","size":14202,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 13: Meta-analysis funnel plot of the effect of motor interventions on scores in ball events for children with autism\u003c/p\u003e","description":"","filename":"floatimage14.png","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/4e619adcd26327e6aceba5b4.png"},{"id":49437839,"identity":"306a27f9-edea-4311-8a71-1813091d8e9b","added_by":"auto","created_at":"2024-01-10 20:53:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1559313,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3802549/v1/5982650b-7213-41da-93e4-b60fc2ef3168.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of motor interventions on gross motor skills in children with autism: a systematic review and META analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAutism spectrum disorders (ASD) are complex neurodevelopmental disorders characterized by deficits in social interaction, communication skills, and interests [1]. The prevalence of autism in Chinese children is around 1%, which means that the number of children with autism is increasing at a rate of around 200,000 per year [2], with these results placing a huge burden on society and families with autistic individuals. Therefore, intervention and rehabilitation for children with autism should begin in childhood. It has been well documented that the development of motor skills in adulthood is closely related to the development of basic motor skills in childhood, with gross motor skills being the most fundamental component of basic motor skills, including locomotor skills (LMS) and object control (OC) skills [3]. Research has shown that motor developmental deficits are common in children with autism and are a central factor in the differences in motor skills between children with autism and normal children. Neglecting motor development disorders in the rehabilitation of children with autism can lead to a decline in motor skills, which can lead to increased social impairment, low motor skills, cognitive limitations,\u0026nbsp;and other problems that can hinder the rehabilitation of children with autism [4,5]. Therefore, it is important to adopt a series of timely interventions to promote the development of gross motor skills in children with autism.\u003c/p\u003e\n\u003cp\u003eMost of the research has been conducted on single-motor interventions for children with autism and some qualitative findings have been obtained, but no quantitative synthesis of the results of single-motor interventions using Meta-analysis has been conducted. It is important to explore the impact of different interventions on the development of gross motor skills in children with autism and to provide a scientific basis for further promoting of different interventions in the development of gross motor skills in children with autism. The paper uses the latest version of Review manager 5.4 software and STATA 15.1 software to conduct a Meta-analysis of the relevant literature collected from China Knowledge Network (CNKI), Wanfang data, Vipshop database and web of science on gross motor skill interventions for children with autism, and the experimental results on the development of gross motor skills after the interventions. The evaluation was conducted to provide a basis for illustrating the effectiveness of different interventions. This study not only examined the actual effects of different interventions on the gross motor skills of children with autism but also provided a basis for further research on the development of motor skills in children with autism.\u003c/p\u003e"},{"header":"1. Materials and Methods","content":"\u003cp\u003e1.1 The research was searched in China Knowledge Network (CNKI), Wanfang Digital Resources, Wipu database, web of science, and other databases based on PICO (participants, intervention, comparison, outcome) format. The Chinese and English search terms include: (autism OR autism spectrum disorder) AND (motor skill OR fundamental motor skill OR fundamental movement skill) AND (pupil OR child). The search period was from the creation of the database to January 2023, and references to the literature obtained from the search were included in the search for relevant information, and if the literature was not published it was not included in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.2 Inclusion criteria:\u003c/p\u003e\n\u003cp\u003e(1) Study population: children aged 3 to 12 years with a definite diagnosis of autism spectrum disorder.\u003c/p\u003e\n\u003cp\u003e(2) Type of trial: The included literature used randomized controlled trials (RCT) and clearly described the control and experimental groups. Individual studies were not included.\u003c/p\u003e\n\u003cp\u003e(3) Interventions: The control group had a conventional intervention or no intervention, while the experimental group added a targeted intervention to the conventional intervention, with no restriction on the type of intervention.\u003c/p\u003e\n\u003cp\u003e(4) Outcome indicators: Gross motor skill scores were used as outcome indicators (at least one of the outcome indicators included object control skills or displacement skills), and the length of intervention in the experimental group was more than 4 weeks.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.3 Exclusion criteria:\u003c/p\u003e\n\u003cp\u003e(1) Unable to provide raw data such as subject information, intervention protocol, and intervention outcome (data subject to availability of LMS and OC)\u003c/p\u003e\n\u003cp\u003e(2) Subjects were not diagnosed as children with autism spectrum disorders.\u003c/p\u003e\n\u003cp\u003e(3) Non-experimental studies, e.g. META analysis, review type, conference type literature.\u003c/p\u003e\n\u003cp\u003e(4) A mixture of movement and recurrent articles in control measures.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.4 Literature screening and data extraction:\u003c/p\u003e\n\u003cp\u003eA search of literature published before January 2023 was conducted based on the inclusion-exclusion criteria established, and a total of 2095 documents were searched. An initial screening of the literature through Endnote X9 software based on author, year of publication, title, and source yielded 895 documents, followed by a full-text search of those potentially meeting the inclusion criteria, yielding 45 documents. These 45 documents were read in full and screened strictly according to the inclusion and exclusion criteria established, resulting in 15 documents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.5 Qualitative evaluation\u003c/p\u003e\n\u003cp\u003eThe quality of the nine included studies was evaluated according to the Cocharane Risk Bias Assessment Tool recommended in the Cochrane Handbook for Systematic Reviews, version 5.1, which has a clear and easy-to-use structural framework. The use of this tool for risk bias assessment was the consensus of the Cochrane Collaboration editors and systematic evaluators [6]. Risk bias assessment using Cochrane includes (1) randomization methods, (2) blinding of participants and investigators, (3) allocation concealment, (4) completeness of outcomes, (5) selective reporting of outcomes, and (6) other sources of bias. Each assessed the bias of the included RCTs in terms of low risk of bias (low risk), high risk of bias (high risk), and uncertainty (unclear risk) [7]. Each criterion has three options: low bias, high bias, and unclear. When the number of low bias in the literature is\u0026nbsp;\u0026ge;4, it can be classified in category A; when the number of low bias in the literature is\u0026nbsp;\u0026ge;2 and \u0026lt;4, it is classified in category B; when the number of low bias in the literature is \u0026lt;2, it is classified in category C. Because sport interventions cannot be double-blinded, most experiments are primarily instrument-based, and evaluators have less subjective influence on the results, the \u0026apos;blinded approach to outcome assessment\u0026apos; scores are high.\u003c/p\u003e\n\u003cp\u003e1.6 Statistics and analysis:\u003c/p\u003e\n\u003cp\u003eMeta-analysis of data extracted from the included literature was performed using Review Manager 5.4, Stata 15.1 software. The \u0026chi;2 (\u0026alpha;=0.1) test was used to determine heterogeneity between studies, combined with I\u0026sup2; for quantitative evaluation, and heterogeneity was considered to exist when I\u0026sup2; \u0026gt; 50% [7], and a random effects model was selected, while I\u0026sup2; \u0026lt; 50% resulted in homogeneous study effects and a fixed effects model was selected. Standardized mean difference (SMD) and 95% confidence interval (95% CI) were chosen as the effect scales to combine effect sizes, with small effects when the absolute value of SMD was 0-0.4, moderate effects when 0.4-0.8, and high effects when greater than 0.8. Differences were considered significant when P \u0026lt; 0.05, and subgroup analyses were performed for highly heterogeneous findings.\u003c/p\u003e"},{"header":"2. Results","content":"\u003cp\u003e2.1: Literature search and screening: The specific literature screening process is shown in Figure 3. As can be seen from Figure 3, a total of 2908 papers were retrieved based on the inclusion criteria established, and the resulting papers were subsequently cascaded according to the inclusion and exclusion criteria, resulting in the 15 papers included in this paper.\u003c/p\u003e\n\u003cp\u003e2.2 Basic characteristics of the included literature\u003c/p\u003e\n\u003cp\u003eThe basic characteristics of the 11 pieces of literature are shown in Table 1 and Table 2. A total of 184 people in the experimental group and 197 people in the control group were included in this study. The ratio of the experimental group to the control group and the ratio of males to females are shown in the following table1,2:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Table 1:The basic characteristics of the research objects included in the literature\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"661\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" rowspan=\"2\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" rowspan=\"2\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eAuthor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" rowspan=\"2\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003eYear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.57337367624811%\" colspan=\"3\" valign=\"top\" style=\"width: 31.7904%;\"\u003e\n \u003cp\u003eExperimental subjects\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.25061425061425%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eCrowd\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.832923832923832%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"53.31695331695332%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003eExperimental group (male: female)/\u003c/p\u003e\n \u003cp\u003eControl group (male: female)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eMeilin Yan \u003csup\u003e[8]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e6(4:2)/\u003c/p\u003e\n \u003cp\u003e6(4:2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eXiaojin Song \u003csup\u003e[9]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e7-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e10(7:3)/\u003c/p\u003e\n \u003cp\u003e10(8:2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eXuliang Su \u003csup\u003e[10]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e16(Unknown)/\u003c/p\u003e\n \u003cp\u003e14(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eLiangshan Dong\u003csup\u003e[11]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e5-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e8(7:1)/\u003c/p\u003e\n \u003cp\u003e10(8:2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eNan Su \u003csup\u003e[12]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e8-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e10(5:5)/\u003c/p\u003e\n \u003cp\u003e10(5:5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eXiang Pi \u003csup\u003e[13]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e4-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e29(25:4)/\u003c/p\u003e\n \u003cp\u003e29(24:5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eLing Li \u003csup\u003e[14]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e9-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e8(Unknown)/\u003c/p\u003e\n \u003cp\u003e8(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eYongbin Zheng\u003csup\u003e[15]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e5-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e15(11:4)/\u003c/p\u003e\n \u003cp\u003e15(11:4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eJiayu Hong \u003csup\u003e[16]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e6-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e12(Unknown)/\u003c/p\u003e\n \u003cp\u003e12(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eMinting Zhang \u003csup\u003e[17]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e6-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e10(7:3)/\u003c/p\u003e\n \u003cp\u003e14(11:3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eEmily Bremer \u003csup\u003e[18]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e3-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e5(Unknown)/\u003c/p\u003e\n \u003cp\u003e5(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eLiangshan Dong \u003csup\u003e[19]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e6-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e21(17:4)/\u003c/p\u003e\n \u003cp\u003e29(25:4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eKim \u003csup\u003e[20]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e3-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e6(3:3)/\u003c/p\u003e\n \u003cp\u003e8(1:7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eColumna \u003csup\u003e[21]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e4-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e7(Unknown)/\u003c/p\u003e\n \u003cp\u003e8(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.27231467473525%\" style=\"width: 20.5545%;\"\u003e\n \u003cp\u003eMorales\u003csup\u003e[22]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.07715582450832%\" style=\"width: 9.2495%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.774583963691377%\" style=\"width: 14.3881%;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.674735249621785%\" style=\"width: 24.0781%;\"\u003e\n \u003cp\u003e10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.829046898638424%\" style=\"width: 15.4158%;\"\u003e\n \u003cp\u003e21(Unknown)/\u003c/p\u003e\n \u003cp\u003e19(Unknown)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: NC is normally developing children; EG is the experimental group; CG is the control group\u003c/p\u003e\n\u003cp\u003eTable 2 Status of interventions included in the study\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"766\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" rowspan=\"2\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003eNo.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" rowspan=\"2\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eAuthor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"78.45953002610966%\" colspan=\"3\" style=\"width: 67.0604%;\"\u003e\n \u003cp\u003eInterventions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.76372712146423%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eTraining content and scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.108153078202996%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eGroup:Total time/week frequency/sub-hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.803660565723792%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eTraining intensity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;MeilinYan\u003csup\u003e\u0026nbsp;[8]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Targeted exercise program include, mobility exercise, manipulative exercise\u003c/p\u003e\n \u003cp\u003eCG:Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:16 weeks*3 times*60min\u003c/p\u003e\n \u003cp\u003eCG:16 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Xiaojin Song\u003csup\u003e[9]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:Ansei Waist Drum Practice\u003c/p\u003e\n \u003cp\u003eCG:Routine exercise activity intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:10 weeks*2 times*60min\u003c/p\u003e\n \u003cp\u003eCG:10 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003e60-80% HRmax\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eXuliang Su \u003csup\u003e[10]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:Sports games\u003c/p\u003e\n \u003cp\u003eCG:Normal PE Course\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 10 weeks * 3 sessions * 30min;\u003c/p\u003e\n \u003cp\u003eCG:10 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eLiangshan Dong \u003csup\u003e[11]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Basic motor skills teaching, cooperative games, aerobics\u003c/p\u003e\n \u003cp\u003eCG:Traditional Sports Programme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:12 weeks*3 times*60min\u003c/p\u003e\n \u003cp\u003eCG:12 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Nan Su \u003csup\u003e[12]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Warm-up activities, dynamic balance training, rollerblading\u003c/p\u003e\n \u003cp\u003eCG:Regular balance exercises, daily exercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:20 weeks*9 times*50min\u003c/p\u003e\n \u003cp\u003eCG: 20 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eXiang Pi\u003csup\u003e[13]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:Combined sensory integration training, vestibular balance training\u003c/p\u003e\n \u003cp\u003eExercises, bounce training, tactile training, sports games\u003c/p\u003e\n \u003cp\u003eCG:Psychotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:52 weeks*7 times*45min\u003c/p\u003e\n \u003cp\u003eCG:52 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Ling Li\u003csup\u003e[14]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:Children\u0026apos;s Fun Athletics, Sports Games\u003c/p\u003e\n \u003cp\u003eCG:Regular Physical Education Programme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:12 weeks * 3 sessions * 35min;\u003c/p\u003e\n \u003cp\u003eCG: 12 weeks * 3 sessions * 35min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Yongbin Zheng\u003csup\u003e[15]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Structured Teaching, Physical Education\u003c/p\u003e\n \u003cp\u003eGame teaching training\u003c/p\u003e\n \u003cp\u003eCG:Structured Teaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:24 weeks*5 times*35min\u003c/p\u003e\n \u003cp\u003eCG:24 weeks*5 times*35min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Jiayu Hong\u003csup\u003e[16]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:A 12-week dance therapy intervention program that includes three phases of self-exploration, interpersonal and integration development, as well as quality exercises such as running and jumping movement exercises and agility and strength.\u003c/p\u003e\n \u003cp\u003eCG: No intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG:12 weeks*3 times*80min\u003c/p\u003e\n \u003cp\u003eCG: None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eMinting Zhang\u003csup\u003e[17]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: displacement and object manipulation skills, basic physical exercises\u003c/p\u003e\n \u003cp\u003eCG:Normal PE Course\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 10 weeks * 3 sessions * 60min;\u003c/p\u003e\n \u003cp\u003eCG:10 weeks*3 times*60min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eEmily Bremer\u003csup\u003e[18]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Motor and social skills learning, sports games, obstacle training\u003c/p\u003e\n \u003cp\u003eCG:Normal PE Course\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 12 weeks * 3 sessions * 45min;\u003c/p\u003e\n \u003cp\u003eCG:12 weeks*3 times*45min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eLiangshan Dong\u003csup\u003e[19]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:Balance exercises, muscle strength exercises, fun exercise instruction\u003c/p\u003e\n \u003cp\u003eCG: No intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 9 weeks * 3 sessions * 80min;\u003c/p\u003e\n \u003cp\u003eCG:None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eKim \u003csup\u003e[20]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG:FMS skills teaching and fun sports games, social games\u003c/p\u003e\n \u003cp\u003eCG: Social Games\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 10 weeks * 4 sessions * 15min;\u003c/p\u003e\n \u003cp\u003eCG:10 weeks*4 times*15min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003e\u0026nbsp;Columna\u003csup\u003e[21]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Parent-chaperoned PE lessons, sports games and motor skills learning\u003c/p\u003e\n \u003cp\u003eCG: Regular class sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 10 weeks * 4 sessions * 15min;\u003c/p\u003e\n \u003cp\u003eCG:10 weeks*4 times*15min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.483028720626632%\" style=\"width: 4.4569%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.057441253263708%\" style=\"width: 13.2502%;\"\u003e\n \u003cp\u003eMorales\u003csup\u003e[22]\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.76762402088773%\" style=\"width: 32.4027%;\"\u003e\n \u003cp\u003eEG: Adaptive Judo exercises, Judo specific exercises and fun games\u003c/p\u003e\n \u003cp\u003eCG: Non-participation in sporting activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.54569190600522%\" style=\"width: 32.2823%;\"\u003e\n \u003cp\u003eEG: 9 weeks * 1 session * 90min;\u003c/p\u003e\n \u003cp\u003eCG:None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.968668407310705%\" style=\"width: 8.7933%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"3. Meta-analysis results","content":"\u003cp\u003e3.1:\u0026nbsp;META analysis of the effect of exercise intervention on total gross motor skill (TGMD) scores:\u003c/p\u003e\n\u003cp\u003eThe Test of Gross Motor Development (TGMD) has become the world\u0026apos;s most widely used tool for measuring children\u0026apos;s gross motor skills due to its highly standardized assessment system and has now been updated to its third edition, the TGMD-3. The TGMD total score provides a comprehensive picture of children\u0026apos;s gross motor skill development. Scholars such as Bo Li have noted that the use of the TGMD is necessary for screening children with atypical motor development (children with autism and children with intellectual disability) [18]. The acquisition of gross motor skills is beneficial for children\u0026apos;s physical fitness and can also improve muscle strength, orientation, and motor dexterity in children with autism [19], and is the basis for the development of many abilities such as self-care in children with autism [20].\u003c/p\u003e\n\u003cp\u003eA total of 11 studies were included in this study using the total TGMD score as the outcome indicator. As shown in Figure 4,\u0026nbsp;\u0026chi;\u0026sup2;\u0026nbsp;= 60.88, df = 10 (P \u0026lt; 0.00001), I\u0026sup2;\u0026nbsp;= 84% between the experimental and control groups, which can be considered as heterogeneity between the two groups, and Meta-analysis was performed using a random effects model. The results showed a combined sample size of 130 cases, SMD = 13.61, 95% CI [8.77,18.46],Z = 5.51, P \u0026lt; 0.00001, the combined effect was statistically significant, and the small diamond-shaped squares fell to the left of the null line and did not intersect, indicating the presence of a medium effect, suggesting that gross motor skill levels of children with autism could be significantly improved by the intervention.\u003c/p\u003e\n\u003cp\u003e3.2 Meta-analysis of the effect of motor intervention on displacement skills in children with autism:\u003c/p\u003e\n\u003cp\u003e3.2.1 Total displacement skill score (TGMD score)\u003c/p\u003e\n\u003cp\u003eHorizontal displacement-like motor skills (locomotor skills) such as running, side-stepping, standing long jump, and single-leg jump are important components of large muscle motor skills. The total displacement skill score in the TGMD score was first analyzed. META results showed that \u0026chi;\u0026sup2; = 51.77, df = 11 (P \u0026lt; 0.00001) and I\u0026sup2; = 79% between the experimental and control groups, which can be considered as heterogeneity between the two groups. Meta-analysis was conducted using a random effects model. The results showed that the combined sample size was 208 cases, SMD = 7.07, 95% CI [5.20,8.94],Z = 7.41, p \u0026lt; 0.00001, and the combined effect was statistically significant, with the small diamond-shaped squares falling to the left of the null line and not intersecting, indicating a significant increase in the total displacement skill scores of children with autism through the motor intervention. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias.\u003c/p\u003e\n\u003cp\u003e3.2.2 Running ability\u003c/p\u003e\n\u003cp\u003eRunning is a basic skill that humans possess and running ability is analyzed in children with autism using fast running as well as side-sliding and front-sliding steps as tests. A total of five papers in this study contained research on the effect of exercise on the running ability of children with autism, using three main methods to measure children\u0026apos;s jumping ability: the fast run, the front glide step, and the side glide step. As seen in Figure 6, there was no high heterogeneity between the experimental and control groups with \u0026chi;\u0026sup2; = 33.46, df = 17 (P = 0.010), I\u0026sup2; = 49%, and a fixed effects model was used. SMD = 1.71, 95% CI [1.46,1.95],Z = 13.68, P \u0026lt; 0.00001, the combined effect was statistically significant and the small diamond-shaped squares fell to the SMD \u0026gt; 0.8 indicates that the motor intervention had a better effect on children\u0026apos;s running but there were significant differences between subgroups.\u003c/p\u003e\n\u003cp\u003eIn running ability, \u0026chi;\u0026sup2; = 3.08, df = 5 (P = 0.03), I\u0026sup2; = 0%, the two groups were homogeneous in fast running, SMD = 2.05, 95% CI [1.67, 2.42],P \u0026lt; 0.001, the small diamond-shaped squares did not intersect with the null line and were farther apart indicating a significant improvement in fast running ability in children with autopathy by the motor intervention.\u003c/p\u003e\n\u003cp\u003eThe two groups were homogeneous for lateral glide \u0026chi;\u0026sup2; = 5.43, df = 5 (P = 0.37), I\u0026sup2; = 8%, SMD = 1.87, 95% CI [1.42, 2.331],P \u0026lt; 0.001 The small diamond-shaped square did not intersect with the null line, indicating that the motor intervention had an enhancing effect on the lateral glide ability of children with autism.\u003c/p\u003e\n\u003cp\u003eThere was heterogeneity between the two groups in the forward glide \u0026chi;\u0026sup2; = 12.44, df = 5 (P = 0.03), I\u0026sup2; = 60%, SMD = 0..99, 95% CI [0.42, 1.96],P \u0026lt; 0.001, and the small diamond-shaped squares were close to but did not intersect the null line, suggesting that the motor intervention had some effect on improving the forward glide ability of children with autism, but the enhancement was limited.\u003c/p\u003e\n\u003cp\u003e3.2.3 Jumping ability\u003c/p\u003e\n\u003cp\u003eA total of five papers in this study included research on children\u0026apos;s jumping ability, using three methods: standing long jump, single-leg jump, and straddle jump to measure children\u0026apos;s jumping ability. As can be seen in Figure 6, there was high heterogeneity between the experimental and control groups with \u0026chi;\u0026sup2; = 31.68, df = 14 (P \u0026lt; 0.004), I\u0026sup2; = 56%, using a random effects model. SMD = 1.62, 95% CI [1.21,2.03],Z = 7.77, P \u0026lt; 0.0001, the combined effect was statistically significant, and the diamond-shaped squares fell to the left of the null line The SMD \u0026gt; 0.8 indicates that the football intervention had a better facilitation effect on the children\u0026apos;s object control ability but there were significant differences between subgroups. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias.\u003c/p\u003e\n\u003cp\u003eThere was heterogeneity between the two groups with \u0026chi;\u0026sup2; = 74.28, df = 5 (P \u0026lt; 0.00001), I\u0026sup2; = 93%, SMD = 1.52, 95% CI [-0.03, 3.08], P = 0.05, SMD \u0026gt; 0.8, and the small diamond-shaped square intersected the null line, indicating that the motor intervention did not significantly improve the standing long jump of children with autism.\u003c/p\u003e\n\u003cp\u003e\u0026chi;\u0026sup2; = 5.69, df = 5 (P = 0.34), I\u0026sup2; = 2%, there was homogeneity between the two groups for single-leg hopping, SMD = 1.92, 95% CI [1.44, 2.39],P \u0026lt; 0.00001, SMD \u0026gt; 0.8, and the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was better at improving the single-leg hopping ability of children with autism.\u003c/p\u003e\n\u003cp\u003e\u0026chi;\u0026sup2; = 7.25, df = 5 (P = 0.20), I\u0026sup2; = 31%, there was homogeneity between the two groups in the straddle jump, SMD = 1.50, 95% CI [0.96, 2.04],P \u0026lt; 0.00001, SMD \u0026gt; 0.8, the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was better at improving the straddle jump ability of children with autism.\u003c/p\u003e\n\u003cp\u003e3.3 Meta-analysis of the effect of motor intervention on object control skills in children with autism\u003c/p\u003e\n\u003cp\u003e3.3.1 Total score for object control skills:\u003c/p\u003e\n\u003cp\u003eObject control skills are an important component of gross skills, and in this study object control skills were divided into three components: total TGMD control skill scores, throwing skill scores, and ball skill scores. As can be seen from the figure, the combined data heterogeneity of the effect of movement on object control skills in children with autism \u0026chi;\u0026sup2; = 28.65, df = 6 (p \u0026lt; 0.00001), I\u0026sup2; = 79%, therefore Meta-analysis using a random effects model, SMD = 7.78, 95% CI [4.93, 10.64], p \u0026lt; 0.0001, the combination was statistically significant, the rhombus squares fell to the left of the null line and did not intersect, indicating that the intervention significantly improved object control in children with autism. The funnel plot shows that the literature included in the study was relatively evenly distributed on either side of the mean effect value, so there was no significant publication bias.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3.3.1 Throwing skill scores:\u003c/p\u003e\n\u003cp\u003eThe combined data heterogeneity of the effect of the motor intervention on children\u0026apos;s throwing category \u0026chi;\u0026sup2; = 42.66, df = 8 (P \u0026lt; 0.00001), I\u0026sup2; = 82.4%, therefore Meta-analysis using a random effects model, SMD = 1.46, 95% CI [0.73, 2.18],P \u0026lt; 0.0001, SMD \u0026gt; 0.8, indicates that the motor intervention on children with autism\u0026apos;s throwing category skill development can be well facilitated and there were significant differences between subgroups.\u003c/p\u003e\n\u003cp\u003eHeterogeneity existed between the two groups for overhand pitching \u0026chi;\u0026sup2; = 14.53, df = 4 (P = 0.14), I\u0026sup2; = 72%, SMD = 0.91, 95% CI [0.21, 1.61],P = 0.01, SMD \u0026gt; 0.8, the diamond-shaped cubes did not intersect with the null line but were close together, indicating that the motor intervention did not significantly improve the overhand pitching ability of children with autism.\u003c/p\u003e\n\u003cp\u003eThere was heterogeneity between the two groups in the lower hand throw \u0026chi;\u0026sup2; = 42.66, df = 3 (P \u0026lt; 0.00001), I\u0026sup2; = 81%, SMD = 2.23, 95% CI [1.40, 3.06],P = 0.02, SMD \u0026gt; 0.8, and the small diamond-shaped square did not intersect with the null line, indicating that the motor intervention was effective in promoting the development of the lower hand throw in children with apparent autism.\u003c/p\u003e\n\u003cp\u003e3.3.2 Score for ball games:\u003c/p\u003e\n\u003cp\u003eThe combined data heterogeneity of the effect of the motor intervention on the scores of children with autism on ball items \u0026chi;\u0026sup2; = 29.53, df = 14 (P = 0.009), I\u0026sup2; = 53%, therefore Meta-analysis using a random effects model, SMD = 1.27, 95% CI [0.82, 1.73],P \u0026lt; 0.00001, SMD \u0026gt; 0.8, indicates that the motor intervention on autism children\u0026apos;s ball skill development can be well facilitated and there were significant differences between subgroups. The funnel plot shows that the included literature is more evenly distributed on both sides of the mean effect value, so there is no significant publication bias.\u003c/p\u003e\n\u003cp\u003eThere was homogeneity between the two kicking groups with \u0026chi;\u0026sup2; = 4.78, df = 4 (P = 0.31), I\u0026sup2; = 16%, SMD = 1.53, 95% CI [0.99, 2.07],P = 0.31, SMD \u0026gt; 0.8, and the small diamond-shaped squares did not intersect with the null line, suggesting that the football sport intervention had a beneficial effect on children\u0026apos;s kicking ability.\u003c/p\u003e\n\u003cp\u003eThere was heterogeneity between the two groups for in situ tapping \u0026chi;\u0026sup2; = 8.35, df = 4 (P = 0.08), I\u0026sup2; = 52%, SMD = 0.82, 95% CI [0.08, 1.57],P = 0.03, SMD \u0026gt; 0.8, and the small diamond-shaped square intersected with the null line, indicating that the football exercise intervention did not have a significant effect on children\u0026apos;s ability to tap the ball in situ.\u003c/p\u003e\n\u003cp\u003eThe two groups were homogeneous in terms of \u0026chi;\u0026sup2; = 7.72, df = 4 (P = 0.10), I\u0026sup2; = 48%, SMD = 1.59, 95% CI [0.70, 2.47],P = 0.009, SMD \u0026gt; 0.8, and the diamond-shaped cube did not intersect with the null line, indicating that the motor intervention improved the ability of children with autism to hit the fixation ball.\u003c/p\u003e\n\u003cp\u003e3.4 Subgroup analysis:\u003c/p\u003e\n\u003cp\u003e3.4.1 Comparison of different total intervention lengths:\u003c/p\u003e\n\u003cp\u003eIn this study, the period, number of interventions, and duration of interventions are important factors affecting the results of the experiment. The total intervention duration was divided into two subgroups: above 1800 min and below. The results of the subgroup analysis showed that: |SMD above 1800min｜ \u0026gt; |SMD below 1800min｜, in terms of total TGMD score, both SMD (above 1800min) and SMD (below 1800min) showed a high effect, indicating that the total intervention duration did not have a significant effect on the difference in total TGMD score. In terms of object control and displacement skills: interventions above 1800 min had a moderate, high effect, while below 1800 min had a low effect, so the effect of training above 1800 min was more likely to promote the development of displacement skills and control skills in children with autism. This suggests that a longer training duration can specifically and more comprehensively improve children\u0026apos;s gross motor skills.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 Comparison of the effects of different total intervention times\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\"\u003e\n \u003cp\u003eTest indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003eSubgroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003eNumber of articles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003eSMD 95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal TGMD score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e1800min or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003e2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003e18.83 [5.56, 32.11]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eUnder 1800min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e7.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e10.26 [7.45, 13.07]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e13.67 [8.77, 18.46]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eDisplacement skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e1800min or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\" valign=\"top\"\u003e\n \u003cp\u003e4.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\" valign=\"top\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\" valign=\"top\"\u003e\n \u003cp\u003e7.17 [4.12,10.23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eUnder 1800min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e10.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e7.07[5.20,8.94]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e7.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e7.81 [5.29, 10.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eControl skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e1800min or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003e4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003e8.93 [5.03, 11.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eUnder 1800min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e9.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e5.61 [4.43, 6.78]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e8.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e6.55 [4.98, 5.12]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3.4.2 Comparison of effects by age group\u003c/p\u003e\n\u003cp\u003eThe study divided the literature into two subgroups based on age, preschoolers (3-6 years) and children (7-12 years). The results of the subgroup analysis showed that there was a more significant effect of the gross motor skills intervention for both preschoolers and children aged 7-12 years, and in general SMD\u003csub\u003e7-12\u003c/sub\u003e \u0026gt; SMD\u003csub\u003e3-6\u003c/sub\u003e , indicating a better effect of the intervention for children with autism aged 7-12 years.\u003c/p\u003e\n\u003cp\u003eTable 4 \u0026nbsp;Comparison of effects by age\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\"\u003e\n \u003cp\u003eTest indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003eSubgroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003eNumber of articles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003eSMD 95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal TGMD score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e3-6 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003e3.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003e11.46 [5.67, 17.26]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003e7-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e15.31 [5.48, 25.15]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e4.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e14.23 [7.40, 21.06]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eDisplacement skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e3-6 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\" valign=\"top\"\u003e\n \u003cp\u003e7.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\" valign=\"top\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\" valign=\"top\"\u003e\n \u003cp\u003e5.88 [4.37, 7.40]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003e7-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e6.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e8.32[5.66,10.99]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e7.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e7.60 [5.61, 9.59]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.611615245009075%\" rowspan=\"3\"\u003e\n \u003cp\u003eControl skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.693284936479127%\"\u003e\n \u003cp\u003e3-6 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.52994555353902%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.978221415607985%\"\u003e\n \u003cp\u003e6.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.874773139745916%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.312159709618875%\"\u003e\n \u003cp\u003e4.58 [3.15, 6.01]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003e7-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e4.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e8.07 [4.77, 11.38]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.638655462184875%\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.873949579831933%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.865546218487395%\"\u003e\n \u003cp\u003e6.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.84873949579832%\"\u003e\n \u003cp\u003e0.00001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.773109243697476%\"\u003e\n \u003cp\u003e6.76 [4.69, 8.83]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"4. Analysis and discussion","content":"\u003cp\u003eThe Meta-analysis found that the experimental group had a significant increase in total gross motor skill (TGMD) scores, displacement skill scores and object control skill scores compared to the control group in the 15 included papers. This result is consistent with the general systematic review studies by Van Capelle [21] and Wick [25], as well as with the findings of a study by Meng-Yuan Bai [23] on basic motor skills interventions for preschool children. It suggests that through early and timely intervention, there is a positive effect on the enhancement of gross motor skills in both children with autism and healthy children in general.\u003c/p\u003e\n\u003cp\u003eDisplacement is an essential ability in everyday life and the ability to run and jump is an indicator of displacement ability. The subgroup analysis concluded that interventions longer than 1800min were more effective than those below 1800min. However, in terms of the total duration of the exercise, it has been suggested that the exercise intervention did not have better results with longer duration, possibly because the children felt monotonous and disengaged from the experiment due to the long duration of a single session, thus affecting the improvement of basic motor skills [28]. In addition, it has been suggested that children\u0026apos;s basic motor skills may stabilize after a certain \u0026apos;amount\u0026apos; of instruction [29], so longer sessions do not necessarily lead to better results. In the specific displacement skills tested, the motor interventions significantly improved children\u0026apos;s ability to run fast, slide sideways, hop on one foot, and jump across the floor, but had limited effect on the front slide and standing long jump. The reason for this is that the front slide and standing long jump are more difficult than other displacement tests, especially the standing long jump, which requires a high level of strength and explosive power, and the front slide, which requires good coordination and balance, and it is difficult to improve the performance of the standing long jump and front slide quickly through a short training. The interventions included in the literature are not specific to the strength and coordination of the children and the results may be different if the corresponding interventions are used. It is also difficult for preschool children with autism to improve in the long jump, and even with interventions, the results are not significant in the short term.\u003c/p\u003e\n\u003cp\u003eAgain there was better overall facilitation of object control skills in children with autism through the motor intervention, which in this study was divided into throwing category skills as well as ball item skills. In the throwing category, the motor intervention improved the performance of children with autism on hand throwing more than on overhand throwing, and due to the small amount of literature included, the results for the throwing category should be treated with caution. For ball skills, the motor intervention was better at improving children with autism\u0026apos;s ability to kick and hit a stationary ball but did not have a significant effect on children with autism\u0026apos;s ability to shoot the ball in place. The reason for the lack of significant improvement in children\u0026apos;s ability to tap the ball may be that tapping the ball is more upper limb dominated and requires some ball support, so it is difficult to achieve a significant improvement without targeted ball practice.\u003c/p\u003e"},{"header":"5. Limitations of the study","content":"\u003cp\u003eThere are also limitations to this meta-analysis. These limitations include:\u003c/p\u003e\n\u003cp\u003e(1) The various strategies used in physical education classes do not include research on multiple physical education interventions.\u003c/p\u003e\n\u003cp\u003e(2) Heterogeneity in the number of physical education classes per week and their duration in the intervention and control groups.\u003c/p\u003e\n\u003cp\u003e(3) The role of potential confounding factors.\u003c/p\u003e\n\u003cp\u003e(4) Sports that are not fully integrated.\u003c/p\u003e\n\u003cp\u003e(5) Some children are younger and may have compliance problems.\u003c/p\u003e"},{"header":"6.\tConclusions and recommendations","content":"\u003cp\u003eThe motor intervention had a significant effect on the improvement of gross motor skills in children with autism, as evidenced by significant improvements in total TGMD scores, and displacement and object control skills scores. However, for individual items such as the standing long jump the improvement was not significant. In the specific interventions, the best results were obtained for children aged 7-12 years with a simultaneous intervention duration of 1800 min or more. Future studies should focus on the design of the experimental protocol, especially the reasonable control, and evaluation of the motor interventions to ensure the effective implementation of the motor interventions. The effects of different intervention components and the ratio of each component as well as the intensity of the intervention on the gross motor skills of children with autism are lacking in the current study. It is recommended that further exploration of motor intervention programs to promote the development of motor skills in children with autism should be conducted to identify the key features of effective interventions, including the periodicity, frequency, and duration of interventions, as well as the content of interventions to provide a basis and reference for physical education practices for special groups of children This will serve as a basis and reference for the development of gross motor skills in children with autism.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eCAO, as the first author, was responsible for compiling the main body of the paper and organizing the data for the paper. FAN was responsible for evaluating the paper in stages and giving advice on writing. MAO was responsible for assisting in organizing the data and formatting the paper. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eJocelyn J.Le Blanc,Michela Fagiolini.Autism：A\u0026ldquo;Critical Period\u0026rdquo; Disorder[J].Neural Plasticity,2011,10(11):17-18.\u003c/li\u003e\n \u003cli\u003eBhat A N，Landa Ｒ J，Galloway J C． Currentperspectives on motor functioning in infants，Children,and adults with autism spectrum disorders．Physical Therapy 2011，91:1116-1129\u003c/li\u003e\n \u003cli\u003eGregPayne. Introduction to human action development [M]. People\u0026apos;s Education Press,2008,09:121-124.\u003c/li\u003e\n \u003cli\u003eColombo-Dougovito A M，Ｒeeve Ｒ E． Exploring the interaction of motor and social skills with autism severity using the SFAＲI dataset．Perceptual＆ Motor Skills，2017，124: 413-424\u003c/li\u003e\n \u003cli\u003eMacdonald M，Lord C，Ulrich D A．The relationship of motor skills and social communicative skills in school- aged children with autism spectrum disorder.Adapted Physical Activity Quarterly，2013，30: 271-282\u003c/li\u003e\n \u003cli\u003eWu Zijing, Zeng Hui. A meta-analysis-based assessment of the value of forest ecosystem services in China[J]. Journal of Ecology,2021,41(14):5533-5545.\u003c/li\u003e\n \u003cli\u003eWei LJ, Dong HJ. Identification and treatment of heterogeneity in Meta-analysis [J]. Journal of the Second Military Medical University, 2006\u003c/li\u003e\n \u003cli\u003eYan Meilin. A study on the design of a gross motor development exercise program for children with moderate autism aged 4-5 years [D]. Hebei Normal University,2022.\u003c/li\u003e\n \u003cli\u003eSong Xiaojin. A study on the effect of 10 weeks of Ansai waist drum practice on the motor ability of children with autism[D]. Beijing Sports University,2020.\u003c/li\u003e\n \u003cli\u003eSu XG. Study on the effect of 10-week motor intervention on the motor development level of children with moderate autism and related mechanisms[D].Tianjin Institute of Physical Education,2021.\u003c/li\u003e\n \u003cli\u003eDong L.S., Bu J., Shen B., Pang Y.L., Song Y., Xing Y. Effects of 10-week motor intervention on basic motor skills and social interaction ability in children with autism [J]. Chinese Journal of Sports Medicine,2021,40(03):171-180.\u003c/li\u003e\n \u003cli\u003eSu Nan. The effect of dynamic balance training on the physical and mental conditions of children with autism[D]. Northeast Normal University, 2022.\u003c/li\u003e\n \u003cli\u003ePi Xiang. The effect of sensory integration training in the cognitive ability and motor development ability of children with autism[J].China Contemporary Medicine,2020,27(12):103-106.\u003c/li\u003e\n \u003cli\u003eLi Ling. Research on the effect of children\u0026apos;s fun athletics on the development of gross motor development of children with autism[D]. Xi\u0026apos;an Institute of Physical Education, 2022.\u003c/li\u003e\n \u003cli\u003eZheng YB. Research on the intervention of sports games in the rehabilitation training of children with autism spectrum disorders[D]. Liaoning Normal University, 2020.\u003c/li\u003e\n \u003cli\u003eHong Jia Yu. A study on the effect of dance therapy on the motor and social communication skills of children with autism[D]. Jiangxi Normal University, 2022.\u003c/li\u003e\n \u003cli\u003eZhang M-T. An intervention study of basic motor skills for children with autism spectrum disorders [D]. Huazhong Normal University,2019.\u003c/li\u003e\n \u003cli\u003eBremer, E., \u0026amp; Lloyd, M. (2016). School-Based Fundamental-Motor-Skill Intervention for Children With Autism-Like Characteristics: An Exploratory Study, Adapted Physical Activity Quarterly, 33(1), 66-88.\u003c/li\u003e\n \u003cli\u003eDong L, Shen B, Pang Y L, et al. FMS effects of a motor program for children with autism spectrum disorders[J]. Perceptual and Motor Skills, 2021, 128(4): 1421-1442.\u003c/li\u003e\n \u003cli\u003eFelzer-Kim I T, Hauck J L. How much instructional time is necessary? Mid-intervention results of fundamental movement skills training within ABA early intervention centers[J]. Frontiers in Integrative Neuroscience, 2020, 14: 24.\u003c/li\u003e\n \u003cli\u003eColumna L, Prieto L A, Beach P, et al. A randomized feasibility trial of a fundamental motor skill parent-mediated intervention for children with autism spectrum disorders[J]. International journal of environmental research and public health, 2021, 18(23): 12398.\u003c/li\u003e\n \u003cli\u003eMorales J, Pierantozzi E, Fukuda D H, et al. Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program[J]. Frontiers in Psychology, 2022, 13: 1067310.\u003c/li\u003e\n \u003cli\u003eLi B, Diao YC, Li J, Hong JT, Sun JG, Liu Y. Analysis and insight of the Test of Gross Motor Development (TGMD) in the United States[J]. Journal of Chengdu Institute of Physical Education,2021,47(02):58-64.\u003c/li\u003e\n \u003cli\u003eYang Qingxuan. Experimental interventions on large muscle movement development of preschool children in the perspective of movement development [J]. Journal of Xi\u0026apos;an Sports College,2017,34(3):341.\u003c/li\u003e\n \u003cli\u003eAMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and statistical manual of mental disorders［M］. 5th ed. Arlington: American Psychiatric Publishing, 2013:936-937.\u003c/li\u003e\n \u003cli\u003eVAN CAPELLE A, BRODERICK C R, VAN DOORN N,et al. Interventions to improve fundamental motor skills in pre-school aged children: A systematic review and metaanalysis [J ]. Journal of Science and Medicine in Sport,2017, 20(7):658-666.\u003c/li\u003e\n \u003cli\u003eWICK K, LEEGER-ASCHMANN C S, MONN N D,et al.Interventions to promote fundamental movement skills in childcare and kindergarten : A systematic review andmeta-analysis[J]. Sports Medicine, 2017,47:2045-2068.\u003c/li\u003e\n \u003cli\u003eDONATH L, FAU DE O, HAGMANN S, et al., Fundamental movement skills in preschoolers: A randomized controlled trial targeting object control proficiency[J]. Child:Care, Health and Development, 2015. 41(6):1179-1187.\u003c/li\u003e\n \u003cli\u003eLOGAN S W, ROBINSON L E, WILSON A E, et al.Getting the fundamentals of movement: A meta-analysis of the effectiveness of motor skill interventions in children [J]. Child: Care, Health and Development, 2012,38(3):305-315.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"autism, children, gross motor skills, Meta analysis","lastPublishedDoi":"10.21203/rs.3.rs-3802549/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3802549/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eOBJECTIVE\u003c/h2\u003e \u003cp\u003eTo systematically and quantitatively evaluate the effects of different forms of interventions on the development of gross motor skills in children with autism and to provide a reference for further enhancing the development of gross skills in children with autism.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eRandomised controlled trials (RCTs) on gross motor skill interventions for children with autism were collected according to the criteria developed by searching in China Knowledge Network (CNKI), Wanfang Digital Resources, Wipu database, and web of science database. The Chinese and English search terms included: (autism OR autism spectrum disorder) AND (motor skill OR fundamental motor skill OR fundamental movement skill) AND (pupil OR child). The retrieved literature was screened, data extracted, and the quality of the included literature was evaluated using Cochrane. Meta-analysis and sensitivity analysis, regression analysis, and publication bias were performed using Review Manager 5.4 and Stata 15.1 software.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eMeta-analysis results showed that targeted motor interventions significantly improved the development of gross motor skills in children with autism and were effective in improving the total TGMD scores of children with autism (SMD\u0026thinsp;=\u0026thinsp;13.61, 95% CI [8.77,18.46]). There was a significant increase in displacement skills (SMD\u0026thinsp;=\u0026thinsp;7.07, 95% CI [5.20,8.94]) and object control skills (SMD\u0026thinsp;=\u0026thinsp;6.55, 95% CI [4.98,8.12]). In terms of displacement skills, a certain duration of motor intervention had a good effect on children with autism for fast running, side sliding, single-leg jumping, and straddle jumping, but not for front sliding and standing long jump. In terms of object control skills: the motor intervention significantly improved children with autism's ability to throw the ball underhand, kick the ball, and hit the stationary ball, but not overhand throwing and slapping the ball in place.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eTargeted motor interventions have an important role in promoting gross skills in children with autism spectrum disorders. Further research should be conducted to validate this with larger sample sizes and high-quality RCTs.\u003c/p\u003e","manuscriptTitle":"The effect of motor interventions on gross motor skills in children with autism: a systematic review and META analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-02 20:10:28","doi":"10.21203/rs.3.rs-3802549/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"eba86d0a-cc7c-49d1-bc92-025941683a0c","owner":[],"postedDate":"January 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-01-10T20:45:05+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-02 20:10:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3802549","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3802549","identity":"rs-3802549","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}