Physical activity and physical function are essential components of health and well-being for every individual. For autistic adults, there are often unique difficulties that hinder access to physiotherapy and assessment. Motor difficulties, such as impairments in coordination, balance, and gait, exist in some autistic adults and can affect their level of physical activity and risk of falls.

These difficulties, along with barriers to accessing healthcare services, contribute to an increased risk of chronic health conditions and a reduced quality of life. In this situation, advanced technologies such as telehealth and wearable devices may offer promising solutions for improving access to remote assessment and monitoring.

Study Objective and Innovative Approach

This pilot study, whose protocol was published in JMIR Res Protoc, 2026 Aug 31, presents an innovative approach to assessing physical function and physical activity. Its main objective is to examine the feasibility, construct validity, and reliability of remotely administered physical function and balance assessments for autistic adults. In addition, the study seeks to investigate inter-racial and ethnic disparities, as well as the relationships between physical function, physical activity, fall risk, and quality of life.

The study is designed as a two-stage, cross-sectional study and does not include therapeutic intervention. Data collection is conducted entirely remotely, and participants aged 18-59, who are autistic adults with legal independence, were recruited through a dedicated database.

How will the study be conducted?

  • Participants complete self-report questionnaires.
  • Their steps are monitored for two weeks using a wearable device (Fitbit Inspire 3).
  • A random subgroup of 25 participants undergoes a single telehealth-based physical function assessment session, which includes measures such as sit-to-stand repetitions, standing balance with eyes open and closed, and single-leg stance.

The construct validity of the physical function measures will be examined by comparing them to other relevant measures such as daily step count, functional outcome surveys, and fall risk surveys. The reliability of the remote performance scoring will be assessed by six examiners who will analyze recorded videos of the assessments.

Partners and Expected Results

As of May 2025, 155 autistic adults have been recruited for the study, of whom 65.2% are women and 77% identified as Black or Hispanic. It is important to note that, as of this writing, data analysis is expected to be completed only in July 2026, and the submission of the manuscript of the main results is expected in August 2026. Therefore, the study has not yet published its final findings and full conclusions.

Potential Implications and Limitations

If the results support this approach, they may provide initial evidence for more accessible telehealth-based assessment methods, and serve as a basis for broader studies on physical function, physical activity, and quality of life in autistic people. A major limitation is that this is a protocol study, and the results are not yet available. Also, remote physical function assessments are performed on only a relatively small subgroup of participants, which will require confirmation in larger samples in the future.