Autism notes: infants and toddlers

Lloyd, M., MacDonald, M., & Lord, C. (2013). Motor Skills of Toddlers with Autism Spectrum Disorders. Autism : The International Journal of Research and Practice, 17(2), 133–146.

With increased interest in the early diagnosis and treatment of children with autism spectrum disorders (ASD), more attention has been called to the motor skills of very young children with ASD. This study describes the gross and fine motor skills of a cross-sectional group of 162 children with ASD between the ages of 12 and 36 months, as well as a subset of 58 children followed longitudinally. Gross motor and fine motor age equivalent scores were obtained for all children. A 'motor difference' variable was calculated for each child's gross and fine motor skills by taking the absolute difference of the children's age equivalent motor score and their respective chronological age. In Study 1 (the cross-sectional analysis), ANCOVA (co-varied for nonverbal problem solving) revealed significant group differences in the gross motor and fine motor age difference variables. Post-hoc analysis revealed that gross motor and fine motor differences became significantly greater with each 6-month period of chronological age. In Study 2, 58 children were measured twice, an average of 12 months apart. Results indicate that the gross motor and fine motor difference scores significantly increased between the first and second measurements. The importance of addressing motor development in early intervention treatments is discussed.


Active play facilitates the development of motor skills, social skills, an understanding of the world, daily living skills, and adaptive behaviour; it also provides a unique opportunity for young children to be physically active and play games with peers (Pellegrini & Smith, 1998;Ridgers, Stratton, & Fairclough, 2006; Sutera et al., 2007).

Children with ASD, by definition, have difficulties in the social domain, thereby limiting their time engaged in play, with or without other children (Dewey, Lord, & Magill, 1988).

The children with ASD in this study achieved their motor milestones within typical ranges which is similar to the findings of other studies (Dawson, Osterling, Meltzoff, & Kuhl, 2000; Ozonoff, et al., 2008). However as the toddlers with ASD got older their fundamental motor skills fell significantly behind what would be expected for their chronological age.

Fundamental gross motor skills are complex and require coordination, motor planning and control. These skills are often learned through imitation in social contexts. We hypothesize that the slowing of gross motor development found in this study is partly due to the fact that gross motor skills are commonly explored and discovered during self-directed or self-regulated learning both with and without peers during play. This type of play and social engagement is a challenge for children with ASD. It is also possible that tactile sensitivities and/or aversions could contribute to the delays in fundamental motor skills. Therefore we propose that the limitations in motor proficiency demonstrated by the toddlers in this study may create a cycle where poor motor skills constrain social interactions, and poor social interactions constrain motor skill development.

The results of both the cross-sectional analysis and the longitudinal analysis also indicate that fine motor skills are also delayed in children with ASD and the children fall further behind as they get older. It is not clear why children with ASD have poor fine motor skills, but the impact on early learning opportunities and daily living skills is not trivial (Jasmin, et al., 2009).

It is possible that tactile sensitivities and an overall lack of social imitation contribute to these fine motor delays; however, the relative contributions of social and imitative deficits to fine motor skills is far from clear. This is an area that requires further study and emphasis in early interventions for children with ASD.

  • Jasmin E, Couture M, McKinley P, Reid G, Fombonne E, Gisel E. Sensori-motor and daily living skills of preschool children with autism spectrum disorders. Journal of Autism and Developmental Disorders.2009;39(2):231–241.
  • See original article for other references