Adolescents with an autism spectrum disorder (ASD) are less physically active compared to typically developing peers. The reasons for not being physically active are complex and depend on several factors, which have not been comprehensively described from the adolescent's perspective. Therefore, the aim was to describe how adolescents with an ASD perceive, experience and reflect on their participation in physical activity. Interviews with 24 adolescents diagnosed with high-functioning ASD, aged 12-16 years, were analysed with qualitative content analysis with an inductive approach. They expressed a variety of reasons determining their willingness to participate, which were conceptualized as: Conditional participation in physical activities. The present study presents an alternative perspective on participation in physical activity, with impact on intervention design.

Introduction: Physical inactivity is one of the biggest current public health problems. Few adolescents with autism spectrum disorder (ASD) achieve the recommendation of daily physical activity (PA). The reasons for not being physically active depend on several complex factors, yet not comprehensively described from the adolescents’point of view. The absence of their perspective means that intervention strategies for health enhancing physical activity may not encompass the experiences of the adolescents themselves. Therefore the purpose of this study was to develop an understanding of the perceptions, experiences and reflections of adolescents with ASDs’participation in PA.

Participants and methods: Twenty-four adolescents, diagnosed with ASD without a co-occurring intellectual disability, aged 12-16 years, participated in the study.Data was collected using qualitative interviews and inductively analyzed using qualitative content analysis.

Results: Adolescents with ASD were a heterogeneous group in regard to their current PA habits and preferences. Their willingness to participate in PA was conditioned regarding; what, where, when and with whom. They described challenges in the activity and the social context during PA, especially during the mandatory physical education. Perceived demands, freedom of choice, physical ability and sense of control affected their PA participation.

Conclusion: Findings indicate that the adolescents’willingness to participate was associated with interacting and individual-related conditions, which can be misinterpreted as unwillingness to participate in PA. Thus aspects of autonomy and knowledge about individual conditions and needs have to be recognized when intervention strategies for health enhancing physical activities are planned for this population.