Participation patterns and associated factors in children and adolescents with autism spectrum disorder: A nationwide population study.
Speech and caregiver support drive participation gaps in Taiwanese youth with ASD, not physical or sensory issues.
01Research in Context
What this study did
Lin et al. (2026) pulled every Taiwanese child with autism from the national disability registry.
They used the ICF checklist to see what helps or hurts real-world participation.
Kids were 6-17 years old. Data came from doctors, parents, and teachers.
What they found
Speech and mental delays were the biggest blocks to joining activities.
Physical or sensory problems mattered less.
Help from caregivers and friendly social attitudes boosted participation most.
How this fits with other research
Pan (2008) saw kids with ASD move less at recess. The new study says the gap is not from weak muscles but from poor talk skills.
Pickard et al. (2019) meta-analysis showed group sports give small social gains. The registry data explain why: speech limits must be fixed first or the child still sits out.
Miltenberger et al. (2013) found equal moderate-vigorous minutes between ASD and typical kids. Che-Yu et al. now show variety and duration, not heart-rate counts, are what families actually miss.
Why it matters
Stop blaming low activity on clumsiness or sensory issues. Target communication goals and teach peers to invite. Ask parents where they need help transporting or cueing their child. Add speech breaks into PE and recess so kids can ask to join. These quick moves raise participation more than extra gym time.
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02At a glance
03Original abstract
BACKGROUND: Participation is central to development and quality of life in autism spectrum disorder (ASD). Most evidence derives from Western populations, and little is known about how body function and environmental components of the International Classification of Functioning, Disability and Health (ICF) shape participation across developmental stages in East Asia. PURPOSE: To examine participation patterns and associated factors among Taiwanese children and adolescents with ASD using a national dataset. METHODS: Data were drawn from the Taiwan Databank of Persons with Disabilities, including 5190 children (aged 6-12) and 3603 adolescents (aged 13-17) with clinically confirmed ASD. Participation frequency and independence across six domains were assessed using the Functioning Scale of the Disability Evaluation System-Child version (FUNDES-Child). Body function and environmental factors were evaluated with standardized subscales. Analysis of covariance compared age groups, and multiple regression identified predictors. Robustness was tested using E-values. RESULTS: Children showed lower participation frequency, whereas adolescents had reduced independence in social domains. Mental and speech impairments were the strongest limiting factors, while physical and sensory impairments were less influential. Environmental supports, particularly caregiver assistance, social attitudes, and accessibility, were significant predictors. E-values indicated moderate robustness for daily living and mobility (3.11 - 3.47), very high robustness for environmental assistance and social attitude supports (27.7). CONCLUSION: Findings highlight the interplay of functional limitations and contextual supports. E-value analyses confirm the robustness of communication-related impairments and environmental supports, suggesting interventions in these domains are most reliable for enhancing participation in East Asian children and adolescents with ASD.
Research in developmental disabilities, 2026 · doi:10.1016/j.ridd.2026.105232