Therapies are largely directed at social communication but not motor problems, which are seen in 87% of children in the SPARK sample, which is the largest ASD cohort in the U.S. The earliest delays in children with ASD are in their motor skills, and those deficiencies increase as time goes on. Bhat says that gap is not being addressed.

“Only 32% of children with ASD receive PT [physical therapy], and 13% receive recreational therapies to address their gross-motor problems,” she says. “In contrast, 80% receive speech or OT [occupational therapy] therapies for speech or fine-motor problems. Movement clinicians -- like OTs, PTs and adaptive physical educators -- have a role to play in improving motor skills of children with ASD. Access to these services should be made available to children who need them.”

Bhat’s project will study the associations between motor impairment, autism severity and comorbidities in children with ASD. She has found that motor problems are related to other ASD-related issues and specifically aims to “determine the risk for motor impairment in children with ASD and how that changes with increasing social communication impairment, repetitive behavior severity, comorbidities and levels of impairment using parent report measures.”

Two of her recent papers argue why motor problems should be added to the definition of autism:

• Is Motor Impairment in Autism Spectrum Disorder Distinct From Developmental Coordination Disorder? A Report From the SPARK Study
• Motor Impairment Increases in Children With Autism Spectrum Disorder as a Function of Social Communication, Cognitive and Functional Impairment, Repetitive Behavior Severity, and Comorbid Diagnoses: A SPARK Study Report

David Tulsky, director of the UD Center for Health Assessment Research and Translation (CHART), is the co-investigator, and Aaron Boulton, research assistant professor in CHART, is a collaborator on the grant.