Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population-Based Cohort.
One in three autistic preschoolers has clear motor delays—run the Vineland motor scale at intake so they don’t slip through the cracks.
01Research in Context
What this study did
The team looked at 2,084 autistic kids age six and under. They used the Vineland motor scale to see how many had real motor trouble. Then they compared that number to how many doctors had written "motor problems" in the child’s chart.
What they found
About one in three toddlers scored low on the Vineland motor part. That rate was almost the same as the rate of intellectual delays. Yet only one in seventy-five had motor issues noted by the doctor who gave the autism diagnosis.
How this fits with other research
Matson et al. (2011) already warned that motor issues hide inside autism. Payne et al. (2020) now shows the warning was spot-on: the problem is common but missed.
Thomas et al. (2021) asked older kids and found even higher risk for DCD. Together the two studies draw one line: motor trouble starts early and stays.
Lizon et al. (2024) adds a twist. They say autism motor deficits feel different from classic DCD drills. So the Vineland flag is only step one; the rehab plan needs an autism lens, not a one-size DCD packet.
Why it matters
If you screen intake with only the social and language modules, you will miss a third of kids who can’t climb stairs or hold a crayon. Add the Vineland motor domain to every autism assessment. When the score is low, write a PT/OT referral the same day. Early motor help can lift play skills, social play on playgrounds, and later handwriting.
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02At a glance
03Original abstract
Motor impairment is not currently included in the diagnostic criteria or evaluation of autism. This reflects the lack of large-scale studies demonstrating its prominence to advocate for change. We examined the prevalence of motor difficulties at the time of diagnosis in a large sample of children with autism utilizing standardized assessment, and the relationship between motor difficulties, core autism symptomology, and other prominent clinical features. Vineland Adaptive Behavior Scales were administered to children from the Western Australian Register for Autism Spectrum Disorders aged ≤6 years (N = 2,084; 81.2% males, 18.8% females). Prevalence of motor difficulties was quantified based on scores from the motor domain of the Vineland and then compared to other domains of functioning within the Vineland (communication, daily living, and socialization), the DSM criteria, intellectual level, age, and gender. Scores on the Vineland indicated that 35.4% of the sample met criteria for motor difficulties (standard score <70), a rate almost as common as intellectual impairment (37.7%). Motor difficulties were reported by diagnosing clinicians in only 1.34% of cases. Motor difficulties were common in those cases meeting diagnostic criteria for impairments in nonverbal behavior and the presence of restricted and repetitive behaviors. The prevalence of motor difficulties also increased with increasing age of diagnosis (P < 0.001). Findings from the present study highlight the need for further consideration of motor difficulties as a distinct specifier within the diagnostic criteria for ASD. Autism Res 2020, 13: 298-306. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this population-based cohort that included 2,084 children with autism aged ≤6 years, over one-third met the criteria for motor difficulties, a rate almost as common as intellectual disability. This study demonstrates that motor difficulties are a prominent feature of the autism phenotype requiring further consideration in both the diagnostic criteria and evaluation of autism.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2230