PURPOSE: To explore the effects of physical activity (PA) intervention on executive function (EF) and motor skills (MS) among children with attention deficit hyperactivity disorder and/or autism spectrum disorder (ASD). METHOD(S): Relevant studies were sourced from PubMed, Web of Science, Embase, Cochrane Library, CNKI and Wanfang Data. Only randomized controlled trials (RCT) were included based upon the following criteria: (1) participants were children and clinically diagnosed with ADHD/ASD, (2) intervention strategies were identified as chronic physical activity, and (3) EF (eg, cognitive flexibility) and/or MS (eg, gross motor skills) were measured at baseline and post-intervention and compared with an eligible control group. RESULT(S): Eleven studies involving 346 participants were finally identified. PA elicited significant improvements in EF and MS in children with ADHD/ASD. Regarding changes in the EF of participants, PA showed a great improvement in overall EF (standardized mean difference (SMD) 0.90, 95% confidence interval (CI) 0.49 to 1.30, p < 0.00001), inhibitory control (SMD 1.30, 95% CI 0.58 to 2.02, p = 0.0004) and cognitive flexibility (SMD 0.85, 95% CI 0.42 to 1.29, p = 0.0001), but no significant improvement in working memory (SMD 0.28, 95% CI -0.15 to 0.71, p = 0.20). Significant improvements were also found with respect to gross motor skills (SMD 0.80, 95% CI 0.30 to 1.30, p = 0.002), but no significant changes were found in fine motor skills (SMD 0.30, 95% CI -0.91 to 1.52, p = 0.62). CONCLUSION(S): Chronic PA interventions may promote EF and MS in children with ADHD/ASD, especially in inhibitory control, cognitive flexibility, and gross motor skills. However, PA interventions seemed to have insignificant effects on working memory and fine motor skills to children with ADHD/ASD. PROSPERO REGISTRATION NUMBER: CRD42019118622.

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