Reframing Body Representations in Autistic Individuals: A Systematic Review

Abstract

Body representations (BR) are multidimensional constructs that shape everyday functioning, autonomy, and quality of life. They include body schema (BS): the action-oriented representation of the body that supports movement and sensorimotor regulation, and body image (BI): the conscious perceptual, affective, and cognitive experience of the body. In autism, alterations in BR have been linked to sensory processing, motor coordination, social interaction, self-perception, and identity, yet the overall structure of these components remains unclear. This systematic review aimed to define a conceptual framework for BR in autism, identify the domains most consistently reported as different from non-autistic comparison groups, and synthesize current evidence on assessment approaches and clinical implications. Following PRISMA guidelines, we reviewed 54 studies published between 2000 and 2025, comprising 2982 participants. The findings showed a marked predominance of research on BS (81% of studies), particularly sensorimotor dimensions such as interoception (9 studies), proprioception (4 studies), and multisensory integration (3 studies). By contrast, BI was substantially less investigated, despite emerging evidence linking it to body dissatisfaction, body dysmorphic concerns, and identity-related difficulties. Across studies, BR differences were most often described in relation to bodily awareness, movement regulation, emotional processing, and self-referential perception. The review also highlighted major methodological limitations, including heterogeneity of constructs and an overreliance on self-report tools. Overall, BR emerges as a clinically relevant but still underdeveloped domain in autism research, underscoring the need for more comprehensive, developmentally sensitive, and multimodal assessment approaches.