Adherence to 24-Hour Movement Guidelines Among Children and Adolescents with Intellectual Disabilities: A Systematic Review and Meta-Analysis

Background Meeting the 24-hour movement guidelines has been associated with a range of physical, mental, and social health in children and adolescents with intellectual disabilities. However, no systematic review or meta-analysis have identified the prevalence of meeting the guidelines (i.e., physical activity, screen time, and sleep duration). Therefore, this study aimed to examine the pooled prevalence of adherence to each individual behavior recommendation. Methods Five electronic databases, including Web of Science, Medline, PubMed, PsycINFO, and Scopus, were searched from their inception to September 2025. Meta-analysis with random-effects model was applied to pool the prevalence of multiple studies. Results Fifteen studies comprising 3261 participants (female = 36.5%) aged 7 to 18 years from ten countries/districts were identified. The meta-analysis demonstrated that 26% of children and adolescents with intellectual disabilities achieved the recommendations of the physical activity guidelines (95% CI: 0.21–0.32, p < 0.01); 54% of the target population adhered to the screen time guidelines (95% CI: 0.32–0.75, p < 0.01); and 47% of the sample met the sleep guidelines (95% CI: 0.19–0.77, p < 0.01). Conclusions Current evidence showing that prevalence of adherence to each individual behavior recommendation in children and adolescents with intellectual disabilities is low. In addition, due to most studies did not report combined behavior data at the individual level, preventing analysis of integrated guideline adherence patterns (e.g., the prevalence of meeting overall, any two, and any one movement guidelines).