Effects of interactive exercise intervention on core symptoms, executive functions, and brain function in children with autism spectrum disorder: a study protocol for a randomized controlled trial

Abstract Background The global prevalence of autism spectrum disorder (ASD) has risen substantially over the past decade. Notably, Children with ASD generally exhibit abnormalities in executive functions, which in turn undermine their social adaptive development. Although exercise interventions alleviate core ASD symptoms, most existing programs adopt a single- component design and fail to align with the physical and mental developmental characteristics of children with ASD, resulting in limited popularization and clinical translation. Furthermore, systematic research exploring the synergistic effects of comprehensive exercise training on ASD core symptoms, executive functions, and brain functional network connectivity remains insufficient. Based on the developmental characteristics of children with ASD, we developed a differentiated, age-stratified, three-dimensional dynamic Interactive Exercise Intervention Program (child-led, coach-guided, and parent-assisted). This multicenter randomized controlled trial (RCT) aims to verify whether this tailored interactive exercise training can alleviates core symptoms, improve executive function, brain function, and enhance family quality of life in children with ASD, so as to provide high-quality evidence for its rehabilitation clinical application. Methods A total of 70 children aged 3–9 years with ASD and with normal, borderline, or mild intellectual disability will be randomly allocated to either an intervention group (interactive exercise intervention) or a control group (sensory integration-based sports courses). All participants will receive a 12-week intervention (5 days/week, 60 min/day). Outcome measures, including core symptoms, executive functions, brain function, and family quality of life, will be assessed at baseline (T0), post-intervention (T1) and 1-month follow-up (T2). Longitudinal intra-group and cross-sectional inter-group comparative analyses will be performed to evaluate the intervention efficacy. Discussion Currently, comprehensive exercise intervention models targeting both core symptoms and executive functions in children with ASD are still lacking in clinical practice. If the present study verifies the efficacy of our self-developed Interactive Exercise Training Program in improving these two key domains, it may provide a novel, feasible strategy for home-based rehabilitation of children with ASD and establish a reliable evidence for its widespread clinical application. Trial registration Clinical Trial Registration Number: NCT07104708. Registered 29 July 2025.