Physicians aren’t adequately screening for or addressing a widespread symptom of autism, according to new research.
As many as 87% of autistic children experience movement impairments such as delays in crawling or walking, poor coordination, balance difficulties, abnormal walking patterns, and challenges with fine motor skills like grasping objects or drawing, researchers noted.
Yet few child neurologists correctly recognize these motor deficits as a feature of autism, and more than half underestimate how prevalent these problems are, researchers reported in the journal Pediatric Neurology.
Senior researcher Dr. Rujuta Wilson, a pediatric neurologist with UCLA Health, stated in a news release: “Motor concerns are just as common, if not more common, than verbal language difficulties in children with autism, yet they’re being significantly under-recognized and under-treated.”
Study Findings
Researchers surveyed 100 child neurologists and neurodevelopmental specialists across the United States about their knowledge of motor problems in children with autism.
Movement impairments often appear during infancy and can continue without intervention, triggering a cascade of developmental delays, researchers explained.
For instance, when toddlers don’t smoothly transition to walking, they miss developmental opportunities that come from greater access to objects and more sophisticated interactions with caregivers, researchers noted.
When motor problems remain untreated, they can hinder a child’s ability to explore their surroundings, develop language skills, and engage socially with others, researchers said.
Previous research has demonstrated that these problems frequently go undetected and unmanaged. One Australian study found that while 80% of autistic children showed motor deficits on standardized tests, clinicians only identified these problems in slightly over 1% of cases, researchers noted.
Knowledge Gaps Among U.S. Neurologists
The new survey revealed similar blind spots among U.S. child neurologists:
- Only 36% correctly identified motor deficits as a potential autism feature, despite their inclusion in diagnostic criteria since 2013
- More than half underestimated motor problem prevalence, with 57% estimating they affect just 15% to 50% of children
- Approximately 58% said they perform detailed motor evaluations on patients, while others cited behavioral barriers, time constraints, or inadequate training as obstacles to conducting assessments
Recommendations for Improvement
Wilson emphasized: “We need to ensure that training on the assessment of unique motor difficulties in autistic individuals is well developed during medical school and residency training. There are important considerations when working with this population, including sensory sensitivities, language differences and behavioral challenges, and there are strategies and support that can be used to ensure autistic individuals receive the most comprehensive care.”
Wilson suggested that doctors keep easily accessible toys and objects available to evaluate children’s fine motor control, strength, and coordination.
He added: “It’s also crucial that we develop more practical screening tools that can be used efficiently in clinical settings.” These tools should accommodate individuals with intellectual disability and those who are minimally verbal, Wilson said. Additionally, they should include caregiver report measures that don’t require extensive training or time to implement.
This research highlights a significant gap in autism care, where a highly prevalent symptom affecting the vast majority of autistic children often goes unrecognized and untreated, potentially impacting their broader development and quality of life.