Fewer children with autism spectrum disorder with motor challenges receive physical and recreational therapies compared to standard therapies: A SPARK data set analysis

Abstract

Approximately 85% of children with autism spectrum disorder from the SPARK study receiving standard interventions such as speech-language and occupational therapies. In contrast, only 32%–13% of children with autism spectrum disorder received movement therapies such as physical and recreational therapies, respectively. Little is known about how service receipt changes as a function of children’s motor difficulties. Parents of children with autism spectrum disorder completed online surveys to provide a report of their child’s motor difficulties using the Developmental Coordination Disorder–Questionnaire as well as the various therapies their child received (speech-language therapy, occupational therapy, physical therapy, applied behavioral analysis, social skill interventions, recreational therapy) by location (at school, privately/in community, or both). While movement therapies (occupational therapy, physical therapy, recreational therapy) increased with increasing motor risk and severity, there continued to be large disparities in physical therapy (37%–55%) and recreational therapy (15%–19%) compared to occupational therapy (85%–92%) across various settings indicating clear unmet needs for specific motor services given that 88.3% of this sample of children with autism spectrum disorder is at risk for motor difficulties/Developmental Coordination Disorder. Developmental Coordination Disorder–Questionnaire fine- and gross-motor subscale scores were fairly comparably affected yet physical therapy/recreational therapy were less received versus occupational therapy. These findings explain the paucity of physical therapy/recreational therapy and physical activity programs for individuals with autism spectrum disorder and the need for movement experts to receive appropriate access and training to work with individuals with autism spectrum disorder. Lay Abstract There are clear disparities in motor services provided to children with autism spectrum disorder (physical and recreational therapies) compared to their standard therapies (speech-language and occupational therapies). Children with autism spectrum disorder need greater access to and funding for motor services (physical and recreational therapies) and physical activity programs. Movement experts including PTs, adapted physical educators, and community exercise/sports coaches/professionals need basic, specialized, and continuing education training to meet the needs of children and adults with autism spectrum disorder not only for providing early developmental and school-based services but also for ensuring appropriate built environments and providing general physical therapy/adapted physical education services as well as physical activity programs.

Developmental Differences in Reaching-and-Placing Movement and Its Potential in Classifying Children with and without Autism Spectrum Disorder: Deep Learning Approach

“…Despite the growing body of literature on motor di culties in children with ASD, the translation of these ndings to effective tools for early identi cation remains limited. Some researchers have advocated for the inclusion of motor di culties as diagnostic criteria or speci ers; however, the evaluation of motor di culties still heavily relies on parent reports and subjective behavioral assessments [5][6][7]. To our knowledge, this is the rst study to leverage continuous upper limb movement kinematics and deep learning methods for the classi cation of individuals with and without ASD.…”

“…Additionally, the core diagnostic features, such as social communication di culties, often do not become apparent until later stages of development, limiting their utility in early ASD identi cation [4]. While not constituting the primary diagnostic criteria, motor impairments are highly prevalent and signi cantly related to other social communication di culties of children with ASD [5][6][7]. More importantly, many motor signs, such as atypical reach-to-grasp movements, manifest early in life and hold promise as diagnostic biomarkers [4,8].…”

“…Motor di culties observed in children with ASD have a profound impact on their daily living skills and are linked to various developmental domains [5][6][7]. Motor skills are known to serve as the foundation for the emergence of other social and cognitive skills during development [23,24].…”

Theoretical–Methodological Foundations for the Global Integration Method (Método de Integração Global—MIG) in the Treatment of Autism Spectrum Disorder

“…Motor manifestations in autism are a relatively neglected aspect [3], and there are few interdisciplinary and intensive models of autism care, including motor physical therapy [57]. Virtually all levels of the motor system are compromised in autism [58][59][60].…”

“…Children and adolescents with ASD may present higher prevalence of intellectual disability, selfinjurious behavior, sensory/perceptual difficulties and emotional problems compared to those with typical development [2]. The current literature also highlights the presence of motor abnormalities in ASD, with approximately 80% of children presenting manifestations in different aspects of the motor system [3,4]. Generally, ASD manifests before the age of 3 and results in lifelong challenges for an individual.…”