Motor Assessments for Children with Autism Spectrum Disorder

Overview

Children with autism spectrum disorder (ASD) experience a range of health disparities, including high rates of obesity and inactivity. While participation in physical activity (PA) plays an integral role in the prevention of obesity and maintenance of a healthy weight, children must first have the requisite levels of motor skill competence to maximize their opportunities for participation.

Preschool-aged children with ASD perform fine and gross motor skills with significantly less competence than neurotypical children of the same age, with scores being similar to younger children of comparable mental age. Whereas school-aged children with ASD demonstrate significantly lower levels of motor skill competence compared to neurotypical children matched on chronological or mental age. By 9 to 12 years of age, children with ASD are performing fundamental motor skills with similar levels of competence as neurotypical children approximately half their age.

Although the primary focus of early intervention efforts for children with ASD has remained almost exclusively on improving social communication skills, motor skills have also been recognized as 1 of 8 areas that should be targeted. Furthermore, the motor domain may be among the earliest and most measurable signs of ASD.

Given the relationships that exist among social, communication, and motor behavior early in life, it can be assumed that improving motor skills during early development will have cascading effects on other areas of development. As more is learned about ASD, the most widely understood message continues to be the earlier the intervention, the better the outcome.

Physiotherapists play a critical role in evaluating current levels of motor skill competence and leading the development of treatment plans to address these motor deficits.

This online pediatric physiotherapy course will include a review of research across these areas and outline strategies for using assessments as a baseline to guide the development of treatment plans and determine the effectiveness of that treatment.

Relevance to physiotherapy practice

With the prevalence of autism having increased nearly 150% since 2000, physiotherapists are working with more children with autism than ever before. Children with autism experience a variety of health disparities, including higher rates of obesity and lower levels of physical activity (PA). In order for a child to participate meaningfully in PA, they must first have the requisite motor skills to do so. To develop treatment plans that will promote positive trajectories of PA and health for children with autism, physiotherapists must first determine their current levels of motor skill competence.

The Test of Gross Motor Development (TGMD) uses a developmental framework to examine changes in gross motor competency, making it one of the most commonly used measures in children.  Pediatric physiotherapists use the TGMD as a measure of motor skill competence for children with and without disabilities to detect possible motor delays, determine a child’s eligibility to receive required services, develop treatment goals, and evaluate a child’s progress towards meeting their goals. To do this effectively, they need to feel confident that the measure they are using is reliable, precise, and capable of detecting improvements. This presentation will review research that establishes the validity and reliability of the recent revisions to the TGMD, published in 2019.

Learning objectives

In this online course, we will:

• Translate the current research into advocacy for the importance of early motor skill intervention for children with autism spectrum disorder and other developmental disabilities.
• Use the Test of Gross Motor Development as a measure of motor skill competency to individualize and evaluate the effectiveness of treatment plans for all children.

• Develop treatment plans that can positively impact the health disparities experienced by many children with autism spectrum disorder.

The Presenter: Kerri Staples 

Kerri Staples is a Postdoctoral Research Fellow in the School of Kinesiology at the University of Michigan. Previously she was an Assistant Professor in the Faculty of Kinesiology & Health Studies at the University of Regina.

Dr. Staples’ research focuses on the acquisition of fundamental motor skills and the relationships among motor competence, physical activity, health-related fitness, and weight status to inform the development of intervention and evidence-based practices for children with autism spectrum disorder (ASD) and other intellectual or developmental disabilities. Her current research is funded by the Organization for Autism Research to examine these components of health longitudinally among children with and without ASD, between the ages of 3 and 9 years.

Through the lens of physical literacy, the outcomes of her research aim to provide children of all abilities with the skills needed to achieve successful participation in physical activity and maintain an active lifestyle to promote overall health and well-being throughout their lifespan. Dr. Staples has used the Test of Gross Motor Development for 17 years and was among the first researchers to adapt the assessment for use with children with ASD.