August 2018

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Editor Message


Autism and motor skills

It’s becoming more evident that children with autism spectrum disorder (ASD), who are often observed to be “clumsy” or “uncoordinated,” have higher rates of motor impairments than typically developing children. The so-called “odd gait” of children with autism, as well as other motor difficulties common in this population, emerge early, often before ASD is diagnosed.

As infants, these children may have trouble turning over and sitting up and be late in learning to crawl. Later on, they may lag behind peers in learning to walk or have trouble coordinating their movements. Some experts, like Nicole Rinehart, PhD, who is featured in this issue (See “Understanding the ‘odd gait’ of autism,” page 15), think motor skill deficits should get more attention in ASD, both in terms of being added to the current diagnostic criteria and as a pathway to improved understanding of the neurobiological underpinnings of the disorder.

Motor impairments may also play a role in the deficits in social and communication skills that are the traditional hallmarks of ASD, according to emerging research by Rinehart and others.

As children develop motor skills, they gain new opportunities for interacting with other children and with their environment. The hypothesis is that when these developments lag behind, so may the acquisition of certain nonmotor skills. Others disagree, suggesting there’s little evidence thus far of a causal relationship, and that it is more likely that the motor and social skill deficits arising from the same source—faulty connections in the brain.

Whatever answer science eventually discovers, lower extremity practitioners have a role to pay in the treatment of these children. Improving motor skills not only helps children with ASD be more physically active, it also may improve their ability to communicate and connect socially, according to recent small studies.

In kids with ASD, motor skills may be one of the last thing parents focus on, but improving them through devices, physical therapy, adaptive sports, and other interventions could be a pathway to a richer, healthier life. Email me at

By Emily Delzell, Senior Editor


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  • Understanding the ‘odd gait’ of autism

    Children with autism spectrum disorder (ASD) are often described as “uncoordinated” or “clumsy” and many have clear motor control impairments. Early intervention to address motor deficits may improve physical skills and the difficulties with social functioning that are the hallmark of the disorder.

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