Choosing an Appropriate Physical Exercise to Reduce Stereotypic Behavior in Children with Autism Spectrum Disorders: A Non-randomized Crossover Study.
Choose exercises that move the same body part as the child’s stereotypy—ball tapping cut hand-flapping but left body-rocking alone.
01Research in Context
What this study did
Tse et al. (2018) tested a ball-tapping game with kids who have autism.
The kids tapped a small ball back and forth with their hands.
The team watched if hand-flapping and body-rocking changed after play.
What they found
Hand-flapping dropped after ball tapping.
Body-rocking stayed the same.
The authors say the game only helps when it uses the same muscles as the stereotypy.
How this fits with other research
Arsham et al. (2025) also used exercise—bike riding—and saw all stereotypies fall.
Their program worked on every form, not just hand movements.
The difference: bike riding is whole-body, while ball tapping is hand-only.
Slaton et al. (2025) went further. They paired differential reinforcement with new skills and cut stereotypy to near zero.
Their package outperforms the mixed results from pure exercise.
Staats et al. (2000) warned us years ago: match the treatment to the cause.
Andy et al. echo that idea, but match exercise to the body part instead of to the reinforcer.
Why it matters
Pick the right exercise for the right movement. If a child flaps hands, a hand game like ball tapping can help. If the child rocks the whole trunk, pick a full-body activity like bike riding or add reinforcement-based tactics. Always test; one size will not fit all.
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Join Free →Watch which muscles the child uses during stereotypy, then pick a 5-minute game that moves those exact muscles and measure before and after.
02At a glance
03Original abstract
Considerable evidence has shown that physical exercise could be an effective treatment in reducing stereotypical autism spectrum disorder (ASD) behaviors in children. The present study seeks to examine the underlying mechanism by considering the theoretical operant nature of stereotypy. Children with ASD (n = 30) who exhibited hand-flapping and body-rocking stereotypies were asked to participate in both control (story-time) and experimental (ball-tapping-exercise intervention) conditions. The experimental condition comprised 15 min of ball tapping during which the children were asked to tap a plastic ball as many times as they could. Results indicated that hand-flapping stereotypy was significantly reduced but body-rocking stereotypy following the ball-tapping-exercise intervention was not. These results not only confirm the positive impact of exercise intervention on stereotypic behavior as shown in many previous studies, but further suggest that physical exercise should be matched with the biomechanics of stereotypy to produce a desirable behavioral benefit.
Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-017-3419-3