Promoting inclusion in physical activity: HPE & autism

Physical activity is important for everybody. Even for children with disabilities. Yet Health and Physical Education (HPE) classes are one of the most anxiety-inducing classes at school. Traditionally, HPE hasn’t promoted inclusion in physical activity with its focus on competitive team sports. It’s time we all got physical.

How much physical activity should kids do each day?

The Australian Government Physical Activity and Exercise Guidelines recommend that children do at least an hour each day of moderate physical activity. It also recommends that children spend no more than 2 hours in sedentary screen time. Exercise could be done in shorter sessions throughout the day. It should include a mix of activities that make the heart beat faster, and strengthen muscles and bones. One piece of research found that half of children around the world spend less than an hour outside each day. This is less than what prisoners in jails are guaranteed, and shows that children don’t get their required physical activity each day.

What are the benefits of physical activity?

Benefits of regular physical activity include having healthy muscles, bones, hearts and lungs. It improves coordination and flexibility, helps maintain healthy body weight, and improve concentration. Over time, exercise also reduces the chance of disease such as type 2 diabetes and heart disease.

What about physical activity for children with autism?

Children with autism have even more reason to be physically active.

A study in 2019 found that autistic children have higher rates of obesity compared to the general population. This has been linked to low levels of physical activity and restrictive diets.

graph showing increased prevalence of obesity in children with autism
Data from

Numerous studies such as Healy et al have found that children with autism are more likely to have decreased physical activity. McCoy et al recommend that there are targeted programs for autistic children to increase physical activity. In fact, most studies find that autistic adults do not reach the recommended physical activity levels. This indicates that healthy physical activity habits are not successfully developed during youth. Both self-reported and measured studies found that activity levels were well below the recommendation.

graph showing decreased physical activity across multiple studies of autistic adults
Data from

There are an estimated 107,700 school aged students with autism in Australia. According to data from the ABS, around 15% of school aged children with autism report difficulties with sports participation at school. In addition, 63% report difficulties fitting in socially. So we need to do better at inclusion in physical activity classes.

The struggles of inclusion in HPE class

Traditional Health and Physical Education classes rely on learning team sports. This is challenging for children with autism for several reasons.

1. Complex social rules

Team sports require understanding of complex social rules. There are many different rules and roles to learn for each game. Furthermore, many of these are implied and not explicit. If an autistic child was told to go field in a game of cricket, what on earth does that mean? Do you just stand in the field? Are you meant to be looking at something? And where exactly do you stand? Additionally, how do you navigate the complex facial expressions and emotions of team mates (probably expressing frustration at you)? Say the opposition is engaging in some banter – do you take that name calling literal and how do you respond? And what about when you’re the last one picked to be on a team and feel excluded because you are different? It’s very anxiety inducing.

2. Sensory overload

Team sports are loud and fast paced. “Kick it to me”, “Pass here”, “Over here”. If you’re on a court or field, then it’s likely a noisy place to be with lots of shouting. Not to mention the loud whistles and sirens, or the loud echo from indoor games. Children with autism experience sensory overload from the noise, lights and rapid movement. Games also move quickly and you have to think quickly and respond fast. Children with autism can’t always respond that quickly when they have to process everything first.

In addition, sports classes often require a change of clothes into PE gear. There may be sensory issues with the specialist clothing or protective gear for some sports. Is the material itchy? Has it been worn by other people? Is it hot and sweaty? These sensory discomforts may be a barrier to sports participation for autistic children. Perhaps the school requires students to change into PE clothing during the day. For children with autism who have low levels of personal care skills, this can be a huge barrier to participation.

3. Coordination and Balance

Team sports require coordination and balance. Children with autism often have low muscle tone, delays in gross motor skills and balance. Also, autistic children’s hand-eye coordination is often not developed as quickly as their peers. ‘Flat foot’ and abnormal walking patterns that are common in autistic children also leads to increased fatigue, uncoordinated gait and extra joint stress.

4. Emotional regulation

Sports can induce anxiety. Worries about being picked for a team, understanding the rules, or being teased for low skill levels.

Sports can be frustrating. It’s frustrating when your body doesn’t do what you want it to do. My son still can’t jump rope and Jump Rope Challenge Day was a nightmare at school for him. It’s also frustrating when your team loses or you come last in a race. Competition is hard and autistic children don’t always have the same emotional maturity or graciousness around winning and losing as their age-peers. They experience big emotions and this can lead to meltdowns or dysregulation.

Sports can be embarrassing. When you don’t have the same skill level, speed, balance, or coordination as your peers and are constantly being compared it can feel really rough.

How to increase inclusion in physical activity

person running shows inclusion in physical activity
Photo by on

1. Consider the choice of physical activity

Participation in organised team sports decreases after age 17, which correlates strongly with the end of school. In fact, in adults, the most common physical activities are walking (46.5%); Fitness/gym (37.5%); Athletics/jogging/running (20.7%); Swimming (17.5%); Cycling (15%); and Bush walking (9.8%). Team sports like tennis, football, basketball and netball have participation rates of less that 5%. of the adult population.

So, most adults that continue life long healthy physical activity engage in mostly independent, self-paced, non-competitive sports. Yet the activities that are promoted in school are team based, group-paced and competitive sports.

Perhaps we need to consider the choice of physical activity in HPE. Sports that might suit autistic children include walking, Pokemon Go, yoga, dance, gymnastics, hiking, cycling, playground play, martial arts or swimming. These activities are rarely offered in HPE class, yet would be more inclusive and reflective of lifelong physical activities.

2. Consider the social aspect of physical activity

Maybe HPE doesn’t always need to be about competitive sports with complex rules. There are minimal references to team sports within the Australian Curriculum for Health and Physical Education. The achievement standard refers to “movement skills and movement concepts” and “personal health fitness”. This could be achieved without an over-emphasis on complex social games and competitive sports.

3. Remove the special class and be inclusive not exclusive

Schools may offer a ‘special class’ of HPE for children with disabilities. They may also offer an non-competitive, non-team sports option that gets offered to the “non-sporty” kids or the students that aren’t being developed for competitive zone sports teams. But this segregation and streaming isn’t inclusive and reinforces the stereotypes of ‘sporty’ vs ‘non-sporty’. This is completely against what we should be focusing on – lifelong healthy physical activity for all people. Furthermore, the Disability Inclusion Act 2018 ,which led to the creation of state based Disability Inclusion Plans has the action for education to

  • support inclusive education culture and practices.
  • provide curriculum and learning opportunities that are personalised and tailored to the individual, and prepare students for life beyond school.

4. Consider the comparison and assessment

The risk in HPE is to have comparative assessment. The best sports player who kicks the ball furthest is awarded an A. The person who didn’t participate much gets a D. Rather than peer-comparisons, try assessing using personal goals. A child with autism might improve in their physical skills and performance and for them it is a personal best. It shows growth in their physical skills, so should be acknowledged. They may never reach the level of one of their peers. They may develop at a slower rate compared to their peers. But for them they have made improvements in their physical activity. If you always receive a failing grade for HPE, it’s hardly going to encourage you to continue in physical activity. Also consider the actual achievement standards of the Australian Curriculum. This achievement standard is from Year 7-8 HPE in version 9.0 of the Australian Curriculum.

Students apply and transfer movement skills and movement concepts across a range of situations. They implement and evaluate the effectiveness of movement strategies on movement outcomes. Students propose and evaluate strategies designed to achieve personal health, fitness and wellbeing outcomes. They select, use and refine strategies to support inclusion, fair play and collaboration across a range of movement contexts.

So, physical activity and lifelong healthy exercise should be accessible for all students, autism or not.

Conclusion: inclusion in physical activity

In conclusion, complex social rules, sensory overload, emotional regulation and more slowly developed balance and coordination can be functional barriers for children with autism to access physical activity. But it doesn’t have to be that way. We can have inclusion in physical activity with just a little thought.

Also see: 20 sports for children with autism to try


Healy, S., Haegele, J.A., Grenier, M. et al. Physical Activity, Screen-Time Behavior, and Obesity Among 13-Year Olds in Ireland with and without Autism Spectrum Disorder. J Autism Dev Disord 47, 49–57 (2017).

McCoy, S.M., Jakicic, J.M. & Gibbs, B.B. Comparison of Obesity, Physical Activity, and Sedentary Behaviors Between Adolescents With Autism Spectrum Disorders and Without. J Autism Dev Disord 46, 2317–2326 (2016).

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