Motor delay - An early and more common "red flag" in girls rather than boys with autism spectrum disorder.
Girls with autism show motor delays more often than boys, so add a quick motor check to every girl you screen.
01Research in Context
What this study did
Doctors tracked preschool kids with autism. They noted who had motor delays and who did not.
They split the group by girls and boys. Then they counted how many in each group showed delays.
What they found
Girls with autism had more motor and global delays than boys. Being born early made the delays worse.
In plain words, if a preschool girl with autism walks, jumps, or holds a pencil late, she is not alone.
How this fits with other research
Eussen et al. (2016) asked parents about early worries. Parents of girls reported different, softer signs, like quiet play. Gabis et al. (2020) now adds motor delay as one of those soft but common signs in girls.
Matheis et al. (2019) matched girls and boys on IQ. Girls still scored lower on motor tests. This backs the new finding that the motor gap is real, not just because girls also have lower IQ.
Bhat (2024) checked two parent forms, DCD-Q and VABS. When both said motor delay, they were right 8 out of 10 times. You can trust parent reports when screening girls.
Block et al. (2026) followed kids into the teen years. Strength gaps widened, but basic motor gaps stayed the same. Watch motor skills early and keep checking them.
Why it matters
If you screen a preschool girl for autism and her words or play look borderline, add a quick motor test. Ask her to hop, stack blocks, or draw a circle. A delay here can be the red flag that gets her the right help faster. Use both DCD-Q and VABS motor questions in your intake. When parents say she is clumsy, believe them and add motor goals to her plan.
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02At a glance
03Original abstract
BACKGROUND: Autism and intellectual disability may coincide and be preceded by global developmental delay or by motor delay. HYPOTHESIS: Motor delay in the context of global developmental delay is an initial "red flag" for ASD, with added risk in girls. OBJECTIVE: To assess early developmental milestones in girls with ASD as compared to diagnosed boys, considering prematurity risk. METHOD: Developmental milestones in a cohort of 467 children with ASD - diagnosed at mean age of 3.4 years (SD = 2.2) - were analyzed according to gender and prematurity risk. RESULTS: 111 girls (24 %), 356 boys (76 %), presented with motor milestones acquisition grossly within the normal range. However, there was a shift towards acquisition of walking being at the later end of the norm range, with this shift being more prominent in girls. 60 % of girls and 47 % of boys with ASD had motor delay and 49 % of girls and 36 % of boys had global developmental delay. The extent of the delays was greater in the prematurity subgroup. CONCLUSION: Global delay of early milestones occurred in half of children with ASD and in 60 % of girls with ASD. Delayed acquisition of independent walking is relatively more common in girls subsequently diagnosed with ASD.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103702