Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis.

Most children with autism (87-88%) have motor difficulties that don't improve much as they get older. Girls without intellectual disability tend to have better fine motor skills that improve with age. Children with autism and intellectual disability have more severe motor problems. Motor skills are connected to communication, repetitive behaviors, language, and daily living skills, even when accounting for intellectual ability.

This study analyzed motor performance in children with autism using SPARK dataset and the Developmental Coordination Disorder-Questionnaire (DCD-Q). Key findings include: 87-88% of children with ASD were at-risk for general motor impairment that persisted until age 15; motor difficulties across multiple domains remained largely stable with age except fine motor skills; females without intellectual disability showed better fine motor performance and age-related improvements; children with intellectual disability had greater motor difficulties across all domains; motor performance predicted social communication skills, repetitive behaviors, language delays, and functional delays even after controlling for age, sex, and cognitive ability. Different motor domains contributed differently to various outcomes, with gross motor skills being strongest predictors of social communication delays.

Motor difficulties should be routinely assessed and addressed in autism interventions. Different motor domains may require targeted approaches based on specific developmental goals. The persistence of motor difficulties suggests need for ongoing support throughout childhood and adolescence.

Sample size not reported. Study type unclear. Analysis relied on parent-report questionnaire (DCD-Q) rather than direct motor assessment. Causality cannot be established from this cross-sectional analysis despite predictive relationships identified.

When motor difficulties continue into adolescence/adulthood, they could negatively impact an individual with autism spectrum disorder (ASD)'s daily living skills, physical fitness, as well as physical and mental health/well-being. Few studies have examined motor difficulties in children with ASD as a function of sex or age; however, greater cognitive challenges are associated with worse general motor performance. Based on the Developmental Coordination Disorder-Questionnaire (DCD-Q) data from the SPARK study sample, 87%-88% children with ASD were at-risk for a general motor impairment that persisted until 15 years and was related to their core and co-occurring difficulties. Bhat et al. confirmed motor difficulties in children with ASD on multiple motor dimensions that predicted core and co-occurring conditions after accounting for age and sex.

However, presence of intellectual disability (ID) or cognitive delay was not controlled in the previous analysis. Additionally, the effects of age, sex, and cognitive ability on multidimensional motor difficulties of the SPARK sample have not been discussed before. Therefore, this analysis examines the effects of age, sex, and cognitive ability (presence of ID or level of cognitive delay) on the motor performance of children from the SPARK sample using the DCD-Q. Except fine motor skills, multiple motor domains did not change with age in children with ASD.

Females without ID improved their fine motor scores with age, and performed better compared to males without ID. Children with ASD and ID had greater motor difficulties across multiple motor domains than those without ID. Even after controlling for age, sex, and presence of ID/cognitive delay; motor performance was predictive of social communication skills, repetitive behavior severity, as well as language and functional delays. Gross motor skills contributed more than fine motor and general motor competence skills in predicting social communication delay.

However, fine motor and general motor competence skills contributed more than gross motor skills in predicting repetitive behavior severity and language delay. Both, fine and gross motor skills predicted functional delay. In light of consistent findings on motor difficulties in children with ASD, adding motor issues as a specifier within the ASD definition could provide a clear clinical route for movement clinicians to address motor difficulties of individuals with ASD.