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Not yet recruitingNCT07104708Updated Aug 14, 2025

Effects of Systematic Exercise Training on Core Symptoms, Executive Function and Brain Function in Children With ASD

An interventional study of The Child-Parent- Trainer exercise program and The regular physical training in Autism Spectrum Disorder, sponsored by Chen Li. Not yet recruiting at 1 site in China. Open to participants aged 3 Years to 9 Years. Per ClinicalTrials.gov, last updated 2025-08-14.

Sponsored by Chen Li · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
70
Allocation
Randomized
Ages
3 Years to 9 Years
Sex
All
01

Study summary

Studies have shown that children with ASD simultaneously have deficits in overall executive function and impairments in basic motor skills, which have a negative impact on cognitive and social all-round development. In recent years, intervention measures for the motor skills of children with ASD have gradually developed. However, based on the existing literature, there is still a lack of recommendations for sports training at present. The sustained effect of exercise intervention training on the core symptoms of ASD remains unclear. In terms of executive function, there are relatively few studies on the executive function of preschool children. The impact of motor training on working memory in school-aged children is still inconsistent. Furthermore, the connection characteristics of different brain regions in children with ASD after physical training remain unclear. This study will include 70 children with ASD aged 3 to 9 years for a multicenter randomized controlled trial (RCT). These children will be randomly assigned to the intervention group (Child-Parent-Trainer program) and the control group (regular physical education program) for 12 weeks, 5 days/week, 60 minutes/day training. Children's core symptoms, executive function, child/family quality of life, and functional near-infrared spectroscopy (fNIRS) were assessed at baseline (training weeks 0) and endpoints (training weeks 13 and 17), respectively. To verify the improvement effect of this exercise program on the autism severity, core symptoms and executive functions of children with ASD, as well as its impact on family quality of life. Furthermore, through fNIRS for monitoring changes in brain function, the potential neural physiological mechanisms will be explored.

Read the detailed description
  1. Procedures. The children in the group are randomly divided into a intervention group and a control group. The children will be trained for 12 weeks (5 days/week, 60 minutes/day) and the children will be evaluated for the severity of autism, core symptoms, executive function, child/family quality of life, and fNIRS at training weeks 0, 13, and 17, respectively.
  2. Demographic questionnaire and clinical data. The demographic questionnaire is completed by the child's primary caregiver, detailing child's name, gender, date of birth, height, weight, heart rate. Clinical data will be ascertained from the medical records, including information about DSM-5 diagnosis and comorbid conditions.
  3. Sample size. This study is a randomized controlled trial. The proposed sample size is based on using the sample size formula, which compares the two sample means, . Where, tα is the standard normal difference corresponding to the level, taking α=0.05 and tα=1.96; tβ is the u value corresponding to the probability β of type II error, taking β=0.10 and tβ=1.28; σ is the estimate of the population standard deviation; δ is the allowable error, the difference between two population means. According to literature review, taking the adjustment ability in executive function as the main observation index, it is calculated that δ/σ =0.84. The sample size of intervention group and control group was 30 children, respectively. Considering the sample loss rate of 15%, the two groups are finally determined to be 35 children respectively.
  4. Statistical analysis. SPSS 25.0 software (SPSS Inc) was used for statistical analysis for the scale data, including core symptoms and executive function, and the data were expressed as (M±SD). The scales scores and demographic variables of both groups of children will be compared using independent samples t-tests. Differences between baseline and 1 week and 1 month after exercise will be analysed using a repeated measures F-test. All statistical analyses were conducted with a statistical threshold P-value of \<0.05. The data collected through fNIRS will be performed via NirSpark analysis software. The general linear model (GLM) will be applied to integrate task effects and assess activation in relevant brain regions. To analyze the rsFC of brain in children with ASD before and after the exercise intervention, the FC_NIRS toolbox is used.
  5. Ethical matters and data protection. The patients participated in the study will sign the informed consent (obtained from the guardian). And this study was approved by the local ethics committee. Patient's name will be abbreviated and the research data will be assigned a code then to provide to the researcher. The authorization from parents on the patient's health information remains valid until the study is completed. After that, researchers will delete private information from the study record.
02

Conditions studied

  • Autism Spectrum Disorder

Keywords

  • executive function
  • brain function
  • exercise training
  • Autism spectrum disorder
03

In context

Autism Spectrum Disorder

1,727 studies on the registry are indexed under Autism Spectrum Disorder; 504 are open to participants now.

This study's planned enrollment of 70 is above the median of 52 across 1,371 interventional studies indexed under Autism Spectrum Disorder.

Browse Autism Spectrum Disorder studies →

Lead sponsor

Chen Li is the lead sponsor of 11 studies on the registry; 8 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
3 Years to 9 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age: 3-9 years old.
  • Meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for ASD, And hold a certificate of ASD diagnosis issued by a Tertiary A hospital.
  • Borderline/normal intelligence or mild intellectual disability.
  • No serious behavior or emotional problems.
  • Able to simply ask and answer questions.
  • Be able to proactively express the need to use the toilet.
  • There are no physical impairments that affected participation in physical activities, and participants are able to cooperate to complete the intervention.
  • Informed parental consent.

Exclusion criteria

Exclusion Criteria:

  • Vision/ hearing disorders, schizophrenia, emotional disorders, mental retardation, Rett syndrome and other developmental disorders.
  • Medical conditions that limit the ability to be physically active, such as asthma, epilepsy, heart disease, and the acute phase after a fracture.
  • History of head trauma, physical disability, major organ disease, or severe musculoskeletal injury in the past two years.
  • Those who have participated in physical exercise regularly within the last 6 months.
  • Participants who changed treatment intervention midway after inclusion.
  • Unable to cooperate with persistent completion of intervention.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
70 participants (estimated)

Study arms

  • Experimental
    Intervention group

    The intervention group received systematic exercise training (the Child-Parent- Trainer exercise program) for 12 weeks (5 days/week, 60 minutes/day).

    Procedure: The Child-Parent- Trainer exercise program

  • Active comparator
    Control group

    The control group received regular physical training courses for 12 weeks (5 days/week, 60 minutes/day).

    Procedure: The regular physical training

Interventions

  • ProcedureThe Child-Parent- Trainer exercise program

    The Child-Parent-Trainer exercise program is a 12-week exercise training program, which is based on the sensory and cognitive needs of children with ASD, multiple game forms are integrated to form a multi-sensory intervention model. The exercise program is developed according to the types of exercise recommended in the Exercise Guidelines for Preschool Children of China, including the development of basic motor skills, such as physical movement, posture control, object control; development of important physical qualities, such as agility, balance, coordination. The training program for different age group consists of physical movement items, object control items and limb coordination items. The exercise intensity is moderate.

  • ProcedureThe regular physical training

    The regular physical training courses will last for 12 weeks. It is training in motor skills and fine motor skills. The items include passing the ball, lifting small dumbbells, running, handicrafts, etc. There is no requirement for the intensity of the exercise.

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What researchers measure

Primary outcomes

  1. The changes in degree of ASD disorder by Autism Diagnostic Observation Schedule-2

    The changes in degree of ASD disorder by Autism Diagnostic Observation Schedule-2 Description: The Autism Diagnostic Observation Schedule-2 (ADOS-2) is adopted to assess the changes in the degree of ASD disorder. The Autism Diagnostic Observation Schedule-2 (ADOS-2) is a standardized observational assessment. The assessment includes abilities in four areas: social interaction, stereotypical behavior, verbal communication, emotion, and abnormal behavior. Children in the our study were administered a module 1 for children with little or no phrase speech or Module 2, for children who use phrase speech but are not yet fluent. Standardized ADOS scores in the domains of social affect (SA) and restricted repetitive behaviors (RRB) were calculated as indicators of ASD severity.

    Time frame: Training weeks 0, 13, and 17.

  2. The changes in degree of ASD disorder by Childhood Autism Rating Scale (CARS)

    The Childhood Autism Rating Scale (CARS) are adopted to assess the changes in the degree of ASD disorder. The Childhood Autism Rating Scale (CARS) serves as an assessment indicator for the improvement of ASD symptoms. The scale consists of 15 items including relationship with people, imitation, emotional response, etc. The evaluation criteria for therapeutic effect are as follows: a CARS score reduction of less than or equal to 10 is considered effective, a CARS score reduction of 5 to 9 is considered effective, and a score reduction of less than 5 is considered ineffective.

    Time frame: Training weeks 0, 13, and 17.

  3. The changes of executive functions

    The preschool BRIEF is consisted of 63 entries and divided into 5 factors and 3 dimensions. The 5 factors are inhibition, conversion, affective control, working memory, and organizational planning. The 3 dimensions are the inhibitory self-regulation index (including inhibition and affective control), cognitive flexibility index (including conversion and affective control) and metacognitive index (including working memory and organizational planning). School-age children BRIEF, consisting of 86 entries, is divided into 2 dimensions: behavior management index (including 3 factors of inhibition, conversion and emotional control) and metacognitive function index (including 5 factors of task initiation, working memory, planning, organization and monitoring). The higher the score, the more impaired the executive function. We examine the score of BRIEF to reflect changes in executive function before and after training.

    Time frame: Training weeks 0, 13, and 17.

  4. The changes of brain function detection indicators

    We monitor cerebral hemodynamic changes through the fNIRS device. The Go/No-Go paradigm task was performed on children over 4 years old. This paradigm consists of two main parts, GO and GO /No-Go. During the GO task, participants are shown pictures of two animals (a giraffe and a lion) and instructed to quickly press the space bar when they see an animal picture. During the GO /No-Go task, pictures of two animals (a tiger and an elephant) are shown at random, and children are asked to quickly press the space bar when they see an elephant. To record correct rate and response time for analysis. All the subjects will undergo resting-state functional connectivity tests. We will compare the differences in fNIRS features before and after training.

    Time frame: Training weeks 0, 13, and 17.

Secondary outcomes

  1. The changes of children's life quality by Child Eating Behavior Questionnaire (CEBQ)

    The dietary Behavior status of children was evaluated through the Child Eating Behavior Questionnaire (CEBQ). It includes 8 subscales such as food response, emotional overeating, and food preferences, covering 35 items. The answer score ranges from 1 to 5. If at least 80% of the items have been completed, the average value of each sub-scale will be calculated.

    Time frame: Training weeks 0, 13, and 17.

  2. The changes of children's life quality by Children's Sleep Habits Questionnaire (CSHQ)

    The children's sleep habits questionnaire includes eight behaviors such as pre-sleep resistance, delayed sleep initiation, and sleep duration. A total score greater than 41 points indicates the presence of sleep disorders.

    Time frame: Training weeks 0, 13, and 17.

  3. The changes of parents' life quality by Parenting Stress Index (PSI)

    The Parenting Stress Index was used to assess the mental stress that parents experience during the process of raising children. This scale consists of 36 items and covers 3 dimensions, including parenting distress, dysfunctional parent-child interaction, and children in difficulty. It is scored on a 5-point scale, with a higher score indicating greater parenting pressure. People with a total score of ≥P90 are considered to be under high pressure.

    Time frame: Training weeks 0, 13, and 17.

  4. The changes in heart rate

    Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). When the children are doing aerobic exercise, we monitor the changes of heart rate and analysis.

    Time frame: At exercise training.

07

Study locations

1 site
  • Growth, Development and Mental health of Children and Adolescence Center
    Chongqing, Chongqing Municipality 400014, China
08

References and documents

Publications

  • Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018 Aug 11;392(10146):508-520. doi: 10.1016/S0140-6736(18)31129-2. Epub 2018 Aug 2. PubMed 30078460 ↗
  • Xu G, Strathearn L, Liu B, O'Brien M, Kopelman TG, Zhu J, Snetselaar LG, Bao W. Prevalence and Treatment Patterns of Autism Spectrum Disorder in the United States, 2016. JAMA Pediatr. 2019 Feb 1;173(2):153-159. doi: 10.1001/jamapediatrics.2018.4208. PubMed 30508021 ↗
  • Demetriou EA, Lampit A, Quintana DS, Naismith SL, Song YJC, Pye JE, Hickie I, Guastella AJ. Autism spectrum disorders: a meta-analysis of executive function. Mol Psychiatry. 2018 May;23(5):1198-1204. doi: 10.1038/mp.2017.75. Epub 2017 Apr 25. PubMed 28439105 ↗
  • Lippi G, Mattiuzzi C, Sanchis-Gomar F. Updated overview on interplay between physical exercise, neurotrophins, and cognitive function in humans. J Sport Health Sci. 2020 Jan;9(1):74-81. doi: 10.1016/j.jshs.2019.07.012. Epub 2019 Sep 6. PubMed 31921482 ↗
  • Zampella CJ, Wang LAL, Haley M, Hutchinson AG, de Marchena A. Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review. Curr Psychiatry Rep. 2021 Aug 13;23(10):64. doi: 10.1007/s11920-021-01280-6. PubMed 34387753 ↗
  • Chan JS, Deng K, Yan JH. The effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents: A meta-analysis of controlled trials. Autism. 2021 May;25(4):874-886. doi: 10.1177/1362361320977645. Epub 2020 Dec 11. PubMed 33307759 ↗
  • Sandbank M, Bottema-Beutel K, Woynaroski T. Intervention Recommendations for Children With Autism in Light of a Changing Evidence Base. JAMA Pediatr. 2021 Apr 1;175(4):341-342. doi: 10.1001/jamapediatrics.2020.4730. No abstract available. PubMed 33165523 ↗
  • Jia M, Zhang J, Pan J, Hu F, Zhu Z. Benefits of exercise for children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Front Psychiatry. 2024 Oct 7;15:1462601. doi: 10.3389/fpsyt.2024.1462601. eCollection 2024. PubMed 39435130 ↗
  • Tao R, Yang Y, Wilson M, Chang JR, Liu C, Sit CHP. Comparative effectiveness of physical activity interventions on cognitive functions in children and adolescents with Neurodevelopmental Disorders: a systematic review and network meta-analysis of randomized controlled trials. Int J Behav Nutr Phys Act. 2025 Jan 13;22(1):6. doi: 10.1186/s12966-024-01702-7. PubMed 39806448 ↗
  • Chan AS, Sze SL, Siu NY, Lau EM, Cheung MC. A chinese mind-body exercise improves self-control of children with autism: a randomized controlled trial. PLoS One. 2013 Jul 10;8(7):e68184. doi: 10.1371/journal.pone.0068184. Print 2013. PubMed 23874533 ↗
  • Toscano CVA, Ferreira JP, Quinaud RT, Silva KMN, Carvalho HM, Gaspar JM. Exercise improves the social and behavioral skills of children and adolescent with autism spectrum disorders. Front Psychiatry. 2022 Dec 22;13:1027799. doi: 10.3389/fpsyt.2022.1027799. eCollection 2022. PubMed 36620673 ↗
  • Grospretre S, Ruffino C, Derguy C, Gueugneau N. Sport and Autism: What Do We Know so Far? A Review. Sports Med Open. 2024 Oct 3;10(1):107. doi: 10.1186/s40798-024-00765-x. PubMed 39361117 ↗
  • Zhang F, Roeyers H. Exploring brain functions in autism spectrum disorder: A systematic review on functional near-infrared spectroscopy (fNIRS) studies. Int J Psychophysiol. 2019 Mar;137:41-53. doi: 10.1016/j.ijpsycho.2019.01.003. Epub 2019 Jan 19. PubMed 30664885 ↗
  • Mazzoni A, Grove R, Eapen V, Lenroot RK, Bruggemann J. The promise of functional near-infrared spectroscopy in autism research: What do we know and where do we go? Soc Neurosci. 2019 Oct;14(5):505-518. doi: 10.1080/17470919.2018.1497701. Epub 2018 Jul 21. PubMed 29985114 ↗
  • Deng J, Lei T, Du X. Effects of sensory integration training on balance function and executive function in children with autism spectrum disorder: evidence from Footscan and fNIRS. Front Psychol. 2023 Oct 25;14:1269462. doi: 10.3389/fpsyg.2023.1269462. eCollection 2023. PubMed 37946875 ↗
  • Chen H, Liang Q, Wang B, Liu H, Dong G, Li K. Sports game intervention aids executive function enhancement in children with autism - An fNIRS study. Neurosci Lett. 2024 Feb 6;822:137647. doi: 10.1016/j.neulet.2024.137647. Epub 2024 Jan 17. PubMed 38242348 ↗
  • Yeung MK. An optical window into brain function in children and adolescents: A systematic review of functional near-infrared spectroscopy studies. Neuroimage. 2021 Feb 15;227:117672. doi: 10.1016/j.neuroimage.2020.117672. Epub 2020 Dec 24. PubMed 33359349 ↗
  • Xu L, Hua Q, Yu J, Li J. Classification of autism spectrum disorder based on sample entropy of spontaneous functional near infra-red spectroscopy signal. Clin Neurophysiol. 2020 Jun;131(6):1365-1374. doi: 10.1016/j.clinph.2019.12.400. Epub 2020 Jan 13. PubMed 32311592 ↗
  • Eng CM, Pocsai M, Fulton VE, Moron SP, Thiessen ED, Fisher AV. Longitudinal investigation of executive function development employing task-based, teacher reports, and fNIRS multimethodology in 4- to 5-year-old children. Dev Sci. 2022 Nov;25(6):e13328. doi: 10.1111/desc.13328. Epub 2022 Oct 21. PubMed 36221252 ↗

Individual participant data

Plan to share: No — Data is confidential during the study.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 14, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07104708
Lead sponsor
Chen Li
Collaborators
Gansu Provincial Maternal and Child Health Care Hospital
Responsible party
Chen Li (Professor, Director, Children's Hospital of Chongqing Medical University) — Sponsor-investigator
First posted
Aug 5, 2025
Start date
Aug 2025 (estimated)
Primary completion
Jul 2027 (estimated)
Completion
Jun 2028 (estimated)
Last update
Aug 14, 2025

Study contacts

Li Chen, doctor
Contact
chenli2012@126.com
136 7762 0103 ext. +86
Li Chen, doctor
study director · Children's Hospital of Chongqing Medical University
yu T Li, Doctor
study chair · Children's Hospital of Chongqing Medical University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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