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Motor Assessments

Motor impairment is common among individuals with autism spectrum disorder (ASD) (Aspy & Grossman, 2011; Nayate, Bradshaw, & Rinehart, 2005; Ozonoff et al., 2008; Siaperas et al., 2012). Therefore, a motor assessment is important to understanding the complex needs of an individual on the spectrum.

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Overview

Motor impairment is common among individuals with autism spectrum disorder (ASD) (Aspy & Grossman, 2011; Nayate, Bradshaw, & Rinehart, 2005; Ozonoff et al., 2008; Siaperas et al., 2012). Therefore, a motor assessment is important to understanding the complex needs of an individual on the spectrum. Liu and Breslin (2013b) underscored the need for fine and gross motor performance to be included in ASD screening since motor development precedes language development, asserting that this practice may enhance the potential for earlier diagnosis. Though motor assessments have not been developed specifically for use with students with autism spectrum disorder (ASD), a variety of instruments are available that may be useful when assessing the motor performance of these students. However, multifaceted assessment and ongoing instrumentation research is important

Included within this section of the TARGET is summary information about the following assessments for motor assessment:

  • Beery-Buktenica Developmental Test of Visual-Motor Integration – Sixth Edition (Beery VMI)
  • Bruininks-Oseretsky Test of Motor Proficiency – Second Edition (BOT-2)
  • Clinical Observation of Motor and Postural Skills – Second Edition (COMPS-2)
  • Evaluation Tool of Children’s Handwriting (ETCH)
  • Minnesota Handwriting Assessment (MHA)
  • Movement Assessment Battery for Children – Second Edition (Movement ABC-2/MABC-2)
  • Peabody Developmental Motor Scales – Second Edition (PDMS-2)
  • Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT)
  • Quick Neurological Screening Test- Third Edition, Revised (QNST-3R)
  • School Function Assessment (SFA)
  • Test of Handwriting Skills – Revised (THS-R)
  • Wide Range Assessment of Visual Motor Abilities (WRAVMA)

The summary of motor assessments included in this section is not intended to be all-inclusive. Rather, the assessments were selected based on their prevalence within clinical and academic settings as well as their relevance to children with ASD.

Assessment of motor functioning may be affected by other aspects of individual functioning. For example, Green and colleagues (2016) found that FSIQ contributes considerably to Beery VMI performance. Similar conclusions about the effect of cognitive ability on motor assessment performance were drawn from a study using the BOT-2, as well (Jeoung, 2018). Language and communication may also affect motor assessment. For example, use of a picture activity schedule (rather than with verbal instructions) when administering the MABC-2 was found to elicit better motor skill performance among children with ASD (Liu & Breslin, 2013a). PEDI-CAT results have been found to be associated with management of life tasks, which are essential for independence, among children and adolescents with ASD (Kao, Kramer, Liljenquist, & Coster, 2014).

Research regarding ASD symptom severity relationship to motor functioning is sparse. However, visuomotor functioning was not associated with overall level of ASD severity in a study conducted by Green et al. (2016). However, McDonald et al. (2014) warned against comparing results of different motor assessments, even when they purport to measure the same constructs. Rather, assessment using multiple instruments and approaches is most likely to yield results useful for serving student needs. This also can include data about motor functioning from parents. Kramer and colleagues (2016) found the PEDI-CAT to be a parent-friendly and reliable instrument for this purpose.

Also limited is research regarding ways motor assessment may inform intervention for persons with ASD. However, the SFA was found to be a tool useful for helping with school-based planning, specifically (Davies, Soon, Young, & Clausen-Yamaki, 2004). However, the available research does underscore the need to consider multiple aspects of individuals’ functioning during assessment of motor functioning, as well as to gather data from multiple sources and approaches.

Misconceptions

Myth:

Occupational therapists are not necessary/essential members of autism evaluation teams.

Reality:

According to the DSM-5, sensory differences are now included as a core characteristic of ASD (American Psychiatric Association, 2013). Sensory differences have long been included in the IDEA and state definitions of Autism or Other or Pervasive Developmental Disorders. Motor skills deficits are an associated feature of autism spectrum disorder. Both motor and sensory differences impact functioning at a very basic level. Occupational therapists have unique training necessary for evaluation of and treatment planning for motor and sensory issues (cf. Aspy & Grossman, 2011; Baranek, 2002; Baranek, Parham, & Bodfish, 2005; Nayate, Bradshaw, & Rinehart, 2005; Ozonoff, et al., 2008; Schaaf & Miller, 2005).

Myth:

Only children with handwriting challenges require assessment and intervention from an occupational therapist.

Reality:

Occupational therapists are trained to evaluate and treat a range of areas, including activities of daily living, education, leisure, play, social participation, and work. For children with autism spectrum disorder, any of these may be impacted and, therefore, warrant assessment by an occupational therapist (American Occupational Therapy Association, 2002).

Myth:

Because they cannot follow directions and sustain attention for long, children with autism cannot be tested using standardized motor assessments. Therapists can only use observation and interviews to assess motor skill performance.

Reality:

Children with autism spectrum disorder are unique individuals and have a wide range of abilities to follow directions and sustain attention; therefore, judgments about the use of standardized motor instruments should be made on an individual basis.

Myth:

Motor skills are a relative strength for children with autism compared to other areas; therefore, motor skills do not need to be assessed.

Reality:

Because it appears that motor problems are inherent in autism (Aspy & Grossman, 2011; Nayate, Bradshaw, & Rinehart, 2005; Ozonoff et al., 2008), a motor assessment is important to understanding the complex needs of an individual on the spectrum.