Environmental and social determinants of leisure-time physical activity in children with autism spectrum disorder

Background: It is increasingly recognized that children's physical activity behaviors are shaped by neighborhood environment factors and their parent's support. However, these factors have been scarcely studied among children with autism spectrum disorder (ASD), a population at risk of inactivity. Objective: This cross-sectional survey study was designed to examine how neighborhood environmental factors and parental support are related to physical activity levels of children with ASD. Also, this study examined if the relationship between the environment and physical activity is modified by demographic factors and COVID-19 related concerns. Methods: An online survey was completed by parents of children with ASD aged 10–17 years. The questionnaire included items related to environmental factors (i.e., distance to school, distance to park, existence of sidewalks, walkability), parent support for physical activity (i.e., encouraging, watching, and providing transportation), child's physical activity, and demographic characteristics. The instrument also queried parental concerns about COVID-19 and their child's physical activity participation. Results: The results indicate that proximity to a local park and to school is positively associated with physical activity. Parent's encouraging behavior correlated with and predicted children's physical activity levels. Also, higher levels of COVID-19 related concerns among parents were related to decreased physical activity supporting behaviors. Conclusions: This study demonstrated that the neighborhood environment, in particular the distance between home and parks and schools, and parent support behavior are influential factors that may shape physical activity behaviors for children with ASD.