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Children express themselves with a limited vocabulary for emotions bound by maturation, thus, a Rate of Perceived Exertion (RPE) scale for quantifying physical activity (PA) intensity proves useful. However, these tools should be reassessed for their effectiveness among children with disabilities. This paper aims to assess the validity and reliability of modified scales, identify factors influencing RPE scores, and determine necessary modifications. It examines how age, maturity, and experience impact children's perceptions of exertion. Using a systematic review approach, the researchers analyzed 32 articles. Findings suggest that these scales are valid for assessing perceived exertion in younger children, but effectiveness depends on development, exercise modes, and environmental factors. The study may improve physical activity assessment tools for diverse child populations.