Peer-reviewed article

Recommendations for the Inclusion of Autistic Children in Community-Based Physical Activity Programmes: A Delphi Study.

Ryan E, McDonnell D, Healy S, Lloyd RS, Kinsella S · 31 May 2026

Abstract

A range of barriers to Physical Activity (PA) participation contribute to autistic children being less physically active than their non-autistic peers. While these barriers have been well documented, further research is needed into methods of overcoming these barriers. This study aimed to create a series of best practice recommendations for the inclusion of autistic children in community-based PA programmes. This was achieved using the Delphi Method involving the opinions of international experts in the area of inclusion of autistic children in PA. Three rounds of questionnaires were distributed to the panel of 22 experts, aiming to reach consensus on a series of topics related to the inclusion of autistic children in community-based PA programmes (consensus ⩾67% agreement). Topics included coaches and volunteers, programme characteristics, and bridging sessions. Sixteen consensus statements were established which were then used to create the 'STARTS' recommendations, which centre around: (1) Skill development, (2) Training for coaches/volunteers, (3) Aims for sessions, (4) Resources to improve children's experiences, (5) Transitioning from bridging programmes to mainstream programmes, and (6) Supports to improve inclusion. The STARTS recommendations will assist clubs/organisations when setting up or modifying community-based PA programmes which include autistic children.Lay abstractAutistic children can often find participation in physical activity programmes difficult and as a result are often less physical active than to non-autistic children. Many studies have explained why these difficulties exist, such as lack of suitable programmes, uneducated coaches, lack of coach, or physicality difficulties, but there is less information available about practical ways to make programmes more inclusive. This study aimed to create clear, practical recommendations to help community sports clubs and physical activity programmes to better include autistic children. To do this, the Delphi Method was used. This involved a group of 'experts' with experience in autism and physical activity to share their views over several rounds of online questionnaires. Twenty-two international experts took part in this study, and over three rounds, they were asked to share suggestions and opinions, answer multiple-choice questions, and rate different ideas. By the end of the process, the experts agreed on 16 key recommendations, which were then used to create the 'STARTS' recommendations. This splits the recommendations into six topics: (1) Skill development, (2) Training for coaches/volunteers, (3) Aims for sessions, (4) Resources to improve children's experiences, (5) Transitioning from autism-specific programmes to mainstream programmes, and (6) Supports to improve inclusion. These recommendations offer practical guidance for clubs and organisations that want to create or adapt community-based physical activity programmes to promote inclusion and help autistic children feel welcomed and supported.