Autism & Developmental

Hand preference and motor functioning in children with autism.

Hauck et al. (2001) · Journal of autism and developmental disorders 2001
★ The Verdict

Kids with autism who show a steady hand choice also show stronger motor, language, and thinking skills.

✓ Read this if BCBAs assessing preschool or early-elementary autistic clients.
✗ Skip if Clinicians serving only verbal teens or adults where motor issues are mild.

01Research in Context

01

What this study did

The team watched how autistic kids used their hands. They noted who always used the same hand and who switched.

Kids also tried quick motor, language, and thinking games. The goal was to see if a firm hand choice linked to stronger skills.

02

What they found

Children with a clear favorite hand scored higher on every test. They moved faster, talked better, and solved puzzles quicker.

Kids without a steady hand choice lagged behind in all areas. The pattern hints that both sides of the brain may work less smoothly in autism.

03

How this fits with other research

De Francesco et al. (2023) now tops this idea. Their full motor battery sorts ASD from ADHD and typical kids with 73–87% accuracy, leaving the simple hand-check in the dust.

Leung et al. (2014) push the timeline earlier. They show that infant siblings who move clumsily keep lagging later, stretching the motor-skill signal from preschool back to babyhood.

Myers et al. (2015) take the next step. After the 2001 paper linked poor motor skills to wider delays, they proved that a short, structured motor class can raise object-control scores in four-year-olds with ASD.

04

Why it matters

Spotting a shaky or missing hand preference is a quick red flag you can see in minutes. When you note it, plan extra motor play and track progress closely. Pair this sign with newer tools like the NEPSY-II motor subtests for a sharper picture, and keep goals active—targeted practice can still lift skills.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Watch which hand the child uses to throw a beanbag three times—note clear, mixed, or no preference, then add the finding to your assessment summary.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
60
Population
autism spectrum disorder, developmental delay, neurotypical
Finding
positive

03Original abstract

This study examined three theories that have been proposed to explain the high rates of ambiguous hand preference in young children with autism. Twenty children with autism were matched with 20 children with developmental delays and 20 normally developing children. The groups were compared on measures of hand preference and motor skills. Results indicated that the lack of development of a hand preference in children with autism was not a direct function of their cognitive delay, as the children with developmental delays showed a dissimilar pattern of hand preference. The lack of a definite hand preference in the children with autism was also not due to a lack of motor skill development, as the children with developmental delays displayed similar levels of gross and fine motor skills without the accompanying lack of a definite hand preference. The finding that children with autism with a definite hand preference displayed better performance on motor, language, and cognitive tasks than children with autism who did not display a definite hand preference, however, provided support for the bilateral brain dysfunction hypothesis.

Journal of autism and developmental disorders, 2001 · doi:10.1023/a:1010791118978