Autism & Developmental

Meeting the 24-hr movement guidelines: An update on US youth with autism spectrum disorder from the 2016 National Survey of Children's Health.

Healy et al. (2019) · Autism research : official journal of the International Society for Autism Research 2019
★ The Verdict

Autistic youth miss exercise, screen, and sleep guidelines together, so bundle all three in behavior plans.

✓ Read this if BCBAs working with school-age or teen clients in home, clinic, or school settings.
✗ Skip if Clinicians serving only preschoolers or adults with ASD.

01Research in Context

01

What this study did

Healy et al. (2019) looked at a big US survey of kids aged 3-18. They compared youth with autism to typical peers.

The team checked who met the 24-hour movement guidelines: one hour of exercise, under two hours of screens, and nine to eleven hours of sleep.

02

What they found

Kids with autism were far less likely to hit all three targets. Teens with severe autism had the worst sleep scores.

In plain words, autistic youth are missing the mark on exercise, screen-time, and sleep all at once.

03

How this fits with other research

Bergmann et al. (2019) seems to disagree. They found no activity gap in 4- to 7-year-olds. The key difference is age. The gap shows up after early childhood.

Whaling et al. (2025) updated the same survey and narrowed the age band to 3-11. They still saw lower screen and sleep adherence, backing the original picture.

Sirao et al. (2026) pooled dozens of sleep trials. Physical activity came out on top for improving sleep in autistic kids. The survey data explain why this matters so many are starting from behind.

04

Why it matters

If you write behavior plans, add movement and bedtime goals. A short walk after school or a visual bedtime routine can chip away at the shortfall shown in this survey. Track it like any other target behavior.

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Add a 20-minute post-lunch movement break to the daily schedule and graph compliance.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
35497
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

The purpose of this study was to examine how adherence to the physical activity (PA), screen-time (ST), and sleep duration guidelines differ between youth with autism spectrum disorder (ASD) and youth with typical development (TD). A secondary objective was to assess how PA, ST, and sleep duration varied among youth with ASD by age and ASD severity. Utilizing the 2016 National Survey of Children's Health data, parental reports of time spent by youth in PA, ST, and sleep were used to determine adherence to the 24-hr movement guidelines for 1008 youth with ASD and 34 489 youth with TD. Multivariate logistic regression analyses determined that children with ASD were less likely to meet the guidelines for PA, ST, and sleep duration, and adolescents with ASD were less likely to meet the guidelines for PA and ST than participants with TD. Furthermore, logistic regression analyses determined adolescents with severe ASD to be less likely to meet the sleep guideline compared to adolescents with mild ASD. Overall, youth with ASD were significantly less likely to adhere to all three guidelines. The findings highlight the breadth of health behaviors that require intervention to counteract the poorer health status among youth with ASD. Autism Res 2019, 12: 941-951. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: New health recommendations suggest children and adolescents should have at least 1 hr of physical activity, no more than 2 hr of screen-time (e.g., television), and 9-11 hr of sleep (or 8-10 hr for children aged 14 or older) every day. This article looked at how children and adolescents with autism meet these new guidelines. The two main results were that: (a) children with autism were less likely to meet all three guidelines compared to children without autism, and (b) adolescents with autism were less likely to meet the guidelines for physical activity and screen-time.

Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1016/J.ORCP.2016.05.005