Remarks y Structured physical exercise included planned or purposeful sports games, aerobic exercise, cycling and yoga. This could be completed individually or in pairs or groups. y The WHO guidelines on physical activity and sedentary behaviour advises that children and adolescents should do at least an average of 60 minutes per day of moderate- to vigorous-intensity, mostly aerobic, physical activity across the week (68). Vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone, should be incorporated at least three days a week. y These approaches should be implemented in the context of broader strategies focused on promoting inclusive and enabling environments for all, including children and adolescents with autism.

Implementation considerations y Structured physical exercise programmes will be available in a variety of settings including educational, rehabilitation, recreation and other community settings. y Adjustments to structured physical exercise programmes in order to meet the needs of children and adolescents with autism may be needed. These may include greater use of written and visual information, more concrete and structured approaches, providing for short breaks and involvement of a carer in treatment sessions. y Make reasonable adjustments or adaptations and provide visual supports if useful. y Ensure that all children and adolescents with autism have full access to health- and social-care services, including mental health services. y Promote access to information about treatment options suitable for the child or adolescent’s needs and developmental level, and promote supported decision-making. y Make arrangements to support children and adolescents and their family and carers during times of increased need and transitions, such as puberty and starting or changing schools.