The course and prognostic capability of motor difficulties in infants showing early signs of autism.
Fine motor lags at the first birthday predict later autism likelihood in high-risk babies.
01Research in Context
What this study did
Redquest et al. (2021) watched babies who had an older brother or sister with autism. They checked fine motor skills between 9 and 14 months. Then they scored each baby for autism signs at follow-up.
The team wanted to know if shaky fine motor skills early on could flag later autism risk.
What they found
Babies who showed fine motor delays at the first visit kept scoring higher on autism likelihood later. The ones whose fine motor skills stayed weak had the strongest link.
In short, poor pincer grasp, stacking, or bead sliding at one year whispered, “Watch me closer.”
How this fits with other research
Garrido et al. (2017) pooled earlier work and saw the same pattern: infant siblings lag in both language and fine motor. K et al. zoom in and say fine motor alone is a clear red flag.
Sosnowski et al. (2022) took the next step. They mapped fine and gross motor trajectories through age three. Their curves back up K et al.—kids on the low fine-motor track often meet ASD criteria later.
Kuang et al. (2025) asked whether the idea works for preterm babies. It does. BSID-III fine motor paths helped rule out ASD risk with 94 % certainty, showing the marker travels beyond sibling studies.
Hilton et al. (2012) looked at same-family pairs and found big motor gaps only in the children already diagnosed. K et al. flip the lens: they catch the gap before diagnosis, giving you a head start.
Why it matters
You can add a quick fine motor probe—can the baby scoop cereal with fingers, bang two blocks, or turn pages?—to any 9- to 14-month visit. A delay does not mean autism is certain, but it tells you to schedule closer watch, parent coaching, and maybe OT. Tracking the skill every few months shows whether the weakness sticks, sharpening your risk picture without extra cost or gear.
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02At a glance
03Original abstract
Delays within the motor domain are often overlooked as an early surveillance marker for autism. The present study evaluated motor difficulties and its potential as an early predictive marker for later autism likelihood in a cohort of infants (N = 96) showing early behavioral signs of autism aged 9-14 months. The motor domain was evaluated using the motor subscales of the Mullen Scales of Early Learning at baseline, and at a 6-month follow-up. The Autism Diagnostic Observation Schedule - Toddler Module (ADOS-T) was completed at follow-up as a measure of autism likelihood. Motor difficulties were common at baseline, with 63/96 (65.6%) infants scoring very low or below average in the gross motor domain and 29/96 (30.2%) in the fine motor domain. At follow-up, gross motor difficulties had resolved for many, with 23/63 (36.5%) infants maintaining these difficulties. Fine motor difficulties resolved in fewer infants, with 20/29 (69.0%) continuing to present with fine motor delays at follow-up. Adjusted linear regression models suggested that fine motor scores at baseline (β = -0.12, SE = 0.04) and follow-up (β = -0.17, SE = 0.05) were associated with higher ADOS-T scores; with difficulties across both timepoints (β = 5.60, SE = 1.35) the strongest (largest in magnitude) association with ADOS-T scores of the predictors examined. Motor difficulties are prominent in children displaying emerging signs of autism, with persistent fine motor difficulties predictive of the developing autism phenotype. The findings indicate the potential clinical value of including evaluation of motor skills within early autism surveillance measures. LAY SUMMARY: This prospective study evaluated motor development over a 6-month period in infants showing early behavioral signs of autism. Atypical motor development was a common feature of infants showing early signs of autism and persistent fine motor difficulties were predictive of the emerging autism phenotype.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2545