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Meaningful participation is related to satisfaction of the psychological needs of competence, autonomy, and relatedness within Self-determination theory. The purpose of this study is to explore whether need satisfaction in physical education (PE), organized sport, and self-organized physical activity (PA) among adolescents with disability differs in relation to their peers without disabilities over a three-year period. Participants were students of secondary or upper secondary school (T1:  N  = 2979), reporting either having a disability ( n  = 328) or not ( n  = 2651). The psychological needs were measured in the three PA contexts over three time-points. Differences between groups were assessed with  t -tests and Cohen’s  d . Adolescents with disability reported: in PE, lower need satisfaction across all three time-points; in organized sport, lower levels on all needs at T1, and lower levels of autonomy and relatedness at T2; in self-organized PA, no differences between the groups across all three time points, except for lower autonomy at T2. The findings indicate that adolescents with disabilities are particularly vulnerable to reduced participation in PE and partly in organized sport. Rehabilitation institutions should collaborate closely with stakeholders in PA (e.g., PE teachers and coaches) in adolescents’ municipalities to transfer knowledge about nurturing psychological needs in PA.Implications for rehabilitationMeaningful participation in physical activity (PA) for the individual can be related to their own perceptions of satisfaction of the three basic psychological needs of competence, autonomy, and relatedness.Findings from the current study indicate that adolescents with disabilities are particularly vulnerable to experiencing reduced participation in physical education (PE) and partly in organized sport.Health care practitioners working in rehabilitation should support adolescents’ three psychological needs in PA while they are attending rehabilitation to give them valuable experiences with meaningful participation in PA, which could be transferred and useful for PA participation after rehabilitation.Health care practitioners at rehabilitation institutions should collaborate closely with stakeholders in the PA context of adolescents’ local areas (e.g., PE teachers and coaches) to transfer knowledge about how to nurture psychological need fulfillment in PA. Meaningful participation in physical activity (PA) for the individual can be related to their own perceptions of satisfaction of the three basic psychological needs of competence, autonomy, and relatedness. Findings from the current study indicate that adolescents with disabilities are particularly vulnerable to experiencing reduced participation in physical education (PE) and partly in organized sport. Health care practitioners working in rehabilitation should support adolescents’ three psychological needs in PA while they are attending rehabilitation to give them valuable experiences with meaningful participation in PA, which could be transferred and useful for PA participation after rehabilitation. Health care practitioners at rehabilitation institutions should collaborate closely with stakeholders in the PA context of adolescents’ local areas (e.g., PE teachers and coaches) to transfer knowledge about how to nurture psychological need fulfillment in PA.

disability and rehabilitation

Differences in participation across physical activity contexts between adolescents with and without disability over three years: a self-determination theory perspective