Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses.

Abstract

Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges' g = −1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship. Public Significance StatementThese meta-analyses reveal that individuals on the autism spectrum exhibit a large deficit in gross motor skills compared to neurotypical individuals, regardless of the individual's age, sex, or cognitive ability. Further, gross motor impairment is modestly associated with social impairment for autistic individuals.

Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis

“…Children in the present study showed small age-related improvements in fine motor and visuomotor/ball skills as well as a small age-related decline in multilimb coordination/planning skills. Multiple other studies have reported a stable pattern of motor difficulties in children with ASD throughout childhood and adolescence with some developmental trends (Bhat, 2020;Biscaldi et al, 2014;Van Waelvelde et al, 2010;Wang et al, 2022). A recent meta-analysis of 114 motor outcome studies (N = 6423) did not find any moderating effects of age on gross motor performance (Wang et al, 2022).…”

“…They also present with functional difficulties during walking (e.g., toe walking or wide base of support) and other locomotor patterns such as difficulty performing complex skills requiring certain movement forms (e.g., long jump, single-leg hop, etc.) as well as difficulties with daily living skills of dressing, carrying objects, and planning complex motor sequences (e.g., when playing a sport) (Ament et al, 2014;Bhat et al, 2011;Fournier et al, 2010;Green et al, 2009;Jansiewicz et al, 2006;Kaur et al, 2018;Licari et al, 2020;Miller et al, 2021;Wang et al, 2022). Furthermore, they have significant fine motor difficulties during hand dexterity tasks, drawing, cutting and copying of shapes, writing legibly, as well as functional tasks of tying shoelaces, buttoning and zipping, and so forth (Bhat et al, 2018;Fears, Palmer, & Miller, 2021;Fleury et al, 2013;Kaur et al, 2018;Kushki et al, 2011;Shield et al, 2017).…”

Emerging signs of autism spectrum disorder in infancy: Putative neural substrate

“…Children, young people, and adults with ASD often show impaired motor skills. 50 , 51 , 52 Their motor behaviour is especially characterized by impaired planning of movements, in particular complex movements. 53 The impairments frequently qualify for the diagnosis of developmental coordination disorder but often this diagnosis is not provided due to a lack of attention to motor problems.…”

Motor abilities as a possible specifier of autism: A response to Bhat (2021)

“…A very recent meta-analysis (Wang et al, 2022) concluded that autism is significantly associated with extensive alterations in motor performances, which has a noteworthy effect size of 1.04. The authors demonstrated that the modality of the assessments moderates the magnitude of the observed effect itself significantly, with standardized clinical assessment having larger effects than kinetic/kinematic measures and parent reports.…”