Relationship between early motor milestones and severity of restricted and repetitive behaviors in children and adolescents with autism spectrum disorder.
Later sitting, later walking, and current toe-walking each flag higher repetitive-behavior scores in autistic clients.
01Research in Context
What this study did
The team looked at the kids and teens with autism. They asked parents when the child first sat and first walked. They scored how often the child toe-walks today. They also gave a standard checklist that counts repetitive behaviors like hand-flapping or lining up toys.
Then they ran two simple tests. Did later sitting or walking predict higher RRB scores? Does current toe-walking add anything after you know the milestone dates?
What they found
Kids who sat or walked later had slightly higher RRB scores. The link was small but real even after age and IQ were held still.
Children who still toe-walked scored even higher on body-type mannerisms. Milestone timing and toe-walking each added unique pieces, so both matter.
How this fits with other research
Sasson et al. (2022) watched autistic teens run and saw messy, wasteful strides. Uljarević et al. (2017) now show that early motor delays foretell more RRBs. Together the papers draw a line: early clumsy motor skills → later odd movement habits.
Iversen et al. (2021) pooled data from almost the kids and found that weak executive function also tracks with more RRBs. Motor timing and executive control are different roads that both lead to the same repetitive-behavior town.
Uljarević et al. (2017) also studied fear and RRBs in the same year. Fear and late milestones are separate risk signals; you can have one without the other, yet each bumps RRBs up a little.
Why it matters
At intake, ask two quick history questions: “When did your child first sit without help? First walk?” Note if the child still walks on toes. If either milestone was late or toe-walking is present, plan extra RRB probes and consider motor-based play goals. The data say these kids are the same ones who later score highest on repetitive-mannerism checklists.
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02At a glance
03Original abstract
This study explored the relationships between the later age of achievement of early motor milestones, current motor atypicalities (toe walking), and the severity of restricted and repetitive behaviors (RRBs) in individuals with autism spectrum disorder (ASD). Parents of 147 children and adolescents with ASD (Mage = 8.09 years, SD = 4.28; 119 males) completed an early developmental milestones questionnaire and the Social Responsiveness Scale as a measure of Insistence on Sameness (IS) and Repetitive Mannerisms (RM). Two hierarchical regression analyses were conducted to test whether RM and IS behaviors were predicted by early motor milestones, or current toe walking. The final model predicting RM accounted for 15% of the variance (F = 3.02, p = .009), with toe walking as a unique and independent predictor of RM scores (t = 3.568, p = .001). The final model predicting IS accounted for 19.1% of variance in IS scores (F = 4.045, p = .001), with chronological age (CA) (t = 2.92, p = .004), age when first standing (t = 2.09, p = .038), and toe walking (t = 2.53, p = .013) as unique independent predictors. Toe walking (t = 2.4, p = .018) and age when first sitting (t = 2.08, p = .04) predicted the severity of RRBs on the Autism Diagnostic Observation Schedule (F = 2.334, p = .036). Our study replicates previous findings on the relationship between concurrent motor impairments and RRBs, and provides the first evidence for the association between RRBs and age of attainment of early motor milestones. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1163-1168. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1763