Looking Beyond Social Deficits in Autism
How are social and motor development related in Autism Spectrum Disorders?
In Canada, 1 in 66 children are diagnosed with autism spectrum disorder (ASD, Autism Ontario, 2018). ASD is a spectrum disorder meaning that people with autism can have very different characteristics. A famous quote by Dr. Stephen Shore emphasizes this quite nicely: “If you've met one person with autism, you've met one person with autism.” For instance, one autistic person may have strong communication skills, while another may have poor communication skills. Such characteristics contribute to an individual’s level of functioning. Typically, an individual considered high functioning would need very little support whereas someone considered low functioning would need substantial support.
ASD is often characterized by social and communication deficits as well as repetitive and restricted interests. Although these characteristics are very common among autistic people, they also experience a myriad of other challenges, such as mental health concerns (e.g., depression, anxiety), sleep issues, and motor deficits, which is the focus of this post.
What is motor functioning? Motor functioning is defined as the ability to perform movements through the use of motor neurons (Nugent, 2013). Our motor skills help us perform activities, like writing, running, showering, and cooking,. Research suggests people on the spectrum exhibit motor deficits (Bhat, Landa, & Galloway, 2011; Ming et al., 2007; Provost, Lopez, & Heimerl, 2006), such as balance and coordination issues, as well as difficulties with throwing, catching, and running (Bhat et al., 2011; Ming et al., 2007; Provost, Lopez, & Heimerl, 2006).
Motor = Social. Adequate motor skill abilities allow us to independently perform activities of daily living, such as cooking, showering, and going to the bathroom. Perhaps not as obvious, our motor skills can actually have a direct impact on our social skills. Thinking back to childhood, I am sure most of us can recall doing some of the following activities with our friends: going to the park, skipping, playing tag, and throwing a ball — activities that all require some sort of motor skill. It is often through these activities that we enhance our social skills, as they offer us an opportunity to meet other children and build friendships, thus promoting social development. If we had motor deficits, we might have been less likely to join in with our peers. We may have been fearful that our peers would tease us because of our inability to participate in these activities. Or, because we were not able to partake in these activities with a high degree of skill, we may have avoided the activity all together. In this case, poor motor skills can act a barrier to social development, which is especially problematic for autistic people, as social skills are already compromised.
Social = Motor. There is evidence-based research showing that social deficits can act as a barrier to motor development. In one of my PhD studies, a father of an autistic child* told me a story illustrating this fact (*minor context changes to protect the individual’s identity). His daughter was a very skilled soccer player and had relatively strong motor skills, but her social skills were “awkward”; she had difficulty with back and forth conversation and was perceived as “weird” by her peers. It was these social deficits that acted as a barrier to her motor development. She joined a soccer team, and although she did not struggle with the soccer skills, she struggled with social interactions. Her reduced social and communication skills made it difficult for her teammates to accept her. As a result, she was often left out and excluded from team activities, which eventually caused her to quit the soccer team. The problem? Once she was no longer on the team, she was playing soccer less and therefore had fewer opportunities to practice physical and motor skills.
Take home message. There is a reciprocal relationship between social and motor deficits; social deficits can prevent motor skill development and motor deficits can prevent social skill development. What can we do? First, we need to highlight that motor deficits may be a characteristic associated with autism. The more we are aware of these deficits, the more likely that they will be addressed. It is crucial for motor development to receive the same attention as social and communication development. One step in the right direction might be to include motor deficits in the criteria used to diagnose autism spectrum disorder. The further we emphasize the social and motor relationship among autistic people, the more clinicians, caregivers, and therapists may address motor deficits in day to day life. Further, any therapies that address social skills should address motor skills. Likewise, any therapies addressing motor skills should address social skills. Unless we do this, we are limiting maximum development in either of these domains. By considering these recommendations, we can develop and implement necessary therapies needed to address motor deficits in autistic people, which can then lead to improved quality of life.
American Psychiatric Association. (2016). Autism. Retrieved from: http://www.apa.org/topics/autism/
Bhat, A. N., Landa, R. J., & Galloway, J.C., (2009). Current perspectives on motor functioning in infants, children, and adults with autism spectrum disorder. Physical Therapy, 91(7), 1116-1129.
Ming, X., Brimacombe, M., & Wagner, G. C. (2007). Prevalence of motor impairment in autism spectrum disorders. Brain & Development, 29(9), 565-570.
Nugent, P. (2013) Motor Function. Retrieved from: https://psychologydictionary.org/motor-function/
Provost, B., Lopez, B. R., & Heimeral, S. (2007). A comparison of motor delays in young children: Autism spectrum disorder, developmental delay, and developmental concerns. Journal of Autism and Developmental Disorder, 37(2), 321-328.