Clinically significant motor impairment affects 50-100% of those with Autism Spectrum Disorder (ASD). Although not included in the diagnostic criteria, research suggests that motor impairments appear during infancy, precipitate the onset and progression of classical autistic symptomology, and are associated with the severity of autist deficits. Presently, few studies directly address motor impairment in ASD. In those that do, physical education, exercise, and exergaming interventions have been found to enhance motor skill proficiency. Little is known about the effect of unstructured physical activity on motor skills in children with autism. Thus, this pilot study sought to examine the impact of unstructured, one-on-one, physically active play on motor skill proficiency as defined by the Test of Gross Motor Development-2 (TGMD-2) in autistic children between ages 3 and 10. Twenty, one-on-one, 60-minute play-based physical activity sessions were administered over a 10-week period (2x/week). The physical activity environment was arranged according to the North Carolina Treatment and Education of Autistic and Related Communications Handicapped Children (TEACCH) guidelines. Session structure precluded skill teaching and sought to elicit gross and fine motor activity within physical activity opportunity stations, but without regard to type or intensity of activity. A comparison of pre-and post-intervention TGMD-2 scores captured motor skill outcomes. Findings suggest that unstructured physically active play is not sufficient to improve global motor skill competency in young children with autism. However, active play fostered significant improvements in two in running skill scores. The TGMD-2 is designed to assess those skills that would foster participation in physical education and recreational settings. Improved running may advance play-abilities and support other forms of activity. Future research should consider using assessments more sensitive to acute changes in motor skill efficacy, measurement of time spent in physically active play, and qualitative analysis of parent-perceived outcome and improvement.

Both the brain and the individual’s environment contribute to the intertwined trajectory of developmental domains across the lifespan. The primary aim of this dissertation was to examine developmental cascades in autism through this combined perspective. First, we systematically investigated how neuroimaging techniques have been used to identify neuroanatomical and neurophysiological differences in infants with an elevated likelihood of developing autism. We found that, in addition to these distinct structural and functional differences, neuroimaging provides a novel opportunity to examine how these differences relate to developmental trajectories across a variety of domains. Second, we focused on assessing gross motor performance in autistic children within their home environment, and relating this performance to standardized measures of movement, adaptive behavior, and communication skills. We found notable levels of variability in gross motor performance, and significant relationships between these measures and measures of adaptive behavior. Finally, through an embodied cognition, developmental systems approach, we assessed the feasibility of using both neuroimaging and lab-based tasks to assess the relationship between cognitive and motor performance in autistic children. We designed and executed a novel study using functional near-infrared spectroscopy during a dual-task walking paradigm and found that, while the paradigm itself produces promising preliminary data, several aspects of the study design may need to be reconsidered in order to ensure feasibility across all participants. Combined, these findings suggest that we can best understand the relationships between developmental domains in autism through a multifaceted lens. This research provides foundational groundwork for comprehensive autism research methods and paves the way for identifying and supporting autistic children’s individual differences, both across the spectrum and within intersecting developmental domains. / 2026-08-19T00:00:00Z

MSc Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 2009. / As the medical world advances, there is an ever increasing survival rate of children that are born prematurely and of a low birth weight. For this reason more and more research is being done to investigate the consequences of being born pre-term and underweight. Research has shown that children who are born prematurely may show signs of developmental delay later on in life (Johnson, 2007). Motor development has been shown to be more affected by prematurity than any other causative factor of prematurity (Goyen and Lui, 2002). The main aim of the study was to establish the differences in global development between pre-term and full-term infants at eighteen months. The Bayley Scales of Infant Development II (BSID II) were used to determine performance in both the pre-term and the full-term group. These results were statistically analysed in greater detail in the mental and the motor section. The Mental and Psychomotor Developmental Indices (MDI and PDI) of the BSID II were used to determine the extent of the mental and motor delays in this sample. The Household Economic and Social Status Index (HESSI) was used in order to ascertain if the socioeconomic status of a family had any bearing on the development of the child in both the mental and the motor categories. This was statistically analysed. The socio-economic factors assessed in this study did not show any statistical significance but did confirm that these children come from similar backgrounds. The results of this study showed that there is a delay in the pre-term group when compared with the full-term group. The mean MDI for the full-term group was 105.25, this is compared with the pre-term group of 81.9, which is statistically significant (p<0.001). The PDI for the full-term group showed a mean score of 109.6. The mean score for the pre-term group was 86.8. This also showed a statistical significance (p<0.001). The pre-term infants in this study showed a significant delay both in the mental and the motor domains. The cognitive delays may be linked to an under-developed corpus callosum due to the premature birth. The motor delays may be caused due to a decreased motor control and developmental dyspraxia. Infants that are born prematurely are at a higher risk to suffer from developmental delays in the cognitive, language and the motor developmental domains. This study confirms what has been found in previous studies showing cognitive development to be the developmental domain most affected by prematurity. The results of this study are important as they support policy change to ensure that these children are followed-up to allow the at-risk children to reach their full potential.

The central nervous system (CNS) develops in a temporally and spatially organised manner. Any adverse events happening during the critical periods of early brain formation may lead to arrest in the process or injury to specific developed structures. Infants born at less than 30 weeks of gestation and those with intra-partum asphyxia are at risk of motor delay. The cause of this delay may be related to injuries in the brain such as the motor cortex, basal ganglia and cerebellum, all of which are essential in controlling movements. According to the dynamical systems theory of motor development, other than the CNS, body systems within the infant such as the musculoskeletal system, and external to the infant such as environmental enrichment and supportive child-rearing practice also have a decisive role in motor development in infants. / Paediatric physiotherapists have been involved in the management of these infants since birth. A number of well-established assessment tools are used to assess these infants’ motor functions. Most of these tools typically do not describe the movement patterns of infants but emphasise the achievement of age-specific motor milestones. The Alberta Infant Motor Scale (AIMS) is one of the few tools that acknowledge the importance of movement quality. / The overall aim of the present research was to examine the impact of adverse events in early infancy, including birth prior to 30 weeks of gestation and intra-partum asphyxia, on motor development of infants during the first two years of (corrected) age. One hundred and twenty infants were recruited, including 58 preterm infants, 10 infants with post-asphyxia neonatal encephalopathy (NE) and 52 term born infants as the control group. All the infants were assessed using the AIMS at 4, 8, 12 and 18 months of (corrected) age. / The preterm group scored significantly lower on various sub-scores of the AIMS at all age levels than the control group. Uneven progression in the sit subscale from 4 to 8 months corrected age (CA) was found in the preterm infants, possibly due to a dominant extensor strength, inadequate tonus and postural control in the trunk. At 12 and 18 months CA, limited variations in movements were evident in some preterm infants in the crawling, sitting and standing positions. The ten infants with post-asphyxia NE showed scattered motor development, related mostly to the severity of their NE. The moderate NE group had the most varied motor outcomes ranging from normal to suspected mild cerebral palsy. / The AIMS was shown to be a valid assessment tool in the preterm population although limitations in its use were found at 4 months CA and when the infants walked or were close to independent ambulation. The present results show that motor performance of typically and non-typically developing infants should be investigated longitudinally as variations are the characteristic of early development. The dynamical systems theory provides a more satisfactory explanation of the motoric differences in infants in this study. All these findings have great implications for the clinical management of these at risk infants.

Previous studies found that providing infants with repeated opportunities for reaching improved the emergence and quality of the behavior, presumably via exploratory and selective processes (Bojczyk & Corbetta, 2004; Lobo et al., 2008). Here we further examined the effects of opportunities for reaching by exposing infants to multimodal objects that were activated either continuously by a hidden motor or contingently by hand-toy contact. We asked if such objects would motivate infants to try to reach for them even more than still and silent objects. Forty-four pre-reaching infants were recruited within the week prior to turning three months of age and were seen for 16 consecutive days. Three groups received daily exposure to objects that either moved and made noise continuously (continuous), moved and made noise only on hand-object contact (contingent), or did not move or make noise when touched (repeated task exposure). A control group received no daily experience. On day 1, all infants were assessed in the laboratory to ensure they were not reaching. From days 2-15, an experimenter tested the repeated groups in the home. On day 16, all infants’ reaching was reassessed in our laboratory. Arm kinematics were recorded during laboratory visits. All testing was the same: infants were seated in an infant chair behind a table and an experimenter placed 1 toy on the table at midline for one minute. Infants received ten trials per day. We measured amount of intentional reaches, hand-toy distance, and peak movement speed. Intentional reaching significantly increased for all repeated groups. Examination of infants that improved showed that the contingent group displayed a significantly higher gain in reaching over time relative to the repeated task exposure and continuous groups. Kinematic measures indicated that these young infants modulated the speed of their reaching movements to match task demands. Specifically, infants in the continuous group displayed increased peak speeds of their movements in order to contact a moving object. Results suggest that repeated opportunities to reach for objects underlies the emergence of reaching; however this process may be aided by providing a salient, multimodal link that highlights the effects of successful action.

This study described the effect of a non-augmented (Spoken Communication, SC) and two augmented language interventions (Augmented Communication-Input, AC-I or Augmented Communication-Output, AC-O) on the upper-body, gross and fine motor skills of toddlers at the onset and conclusion of the intervention. The data presented are from a longitudinal study by Romski, Sevcik, Adamson, Cheslock, Smith, Barker, & Bakeman (2010). Three standardized assessments and five observational measures examined the participants' motor skills used to activate the speech generating device (SGD), language abilities and outcomes. The AC-O intervention decreased physical prompting, increased error-free symbol activations, and increased developmentally appropriate gross and fine motor use. An augmented intervention that utilizes a SGD may facilitate both language and motor development through the combination of the communicative goals and increased motor learning opportunities when accessing the SGD device.

A contemporary view of early childhood motor development considers environmental influences as critical factors in optimal growth and behavior, with the home being the primary agent. However, minimal research exists examining the relationship between motor development and the home. The present dissertation addresses this gap with the goal of creating an innovative parental self-report instrument for assessing the quality and quantity of factors (affordances and events) in the home that are conducive to enhancing motor development in children ages 18-to-42 months. In Study 1, following initial face validity determination, expert opinion feedback and selective pilot-testing, construct validity was examined using 381 Portuguese families. Factor analysis techniques were used to (1) compare competing factorial models according to previous theoretical assumptions, and to (2) analyze the fit of the preferred model. Of the five plausible models tested, the 5-factor solution provided the best fit to the data. Reliability was established through the scale reliability coefficient with a value of .85. Study 2 tests for the content validity of the instrument, examining the relationship between the inventory and level of motor development. Fifty-one (51) participants from the original sample were assessed for motor development using the Peabody Developmental Motor Scales II (PDMS2). Comparisons were made between the PDMS2 classifications of the AHEMD-SR quartile groups. Results supported the primary hypothesis, that is, less favorable motor development was associated with less availability of home affordances. Furthermore, the interaction of (factors) Inside Space and Variety of Stimulation was significantly related to both Gross and Total Motor Development scores. The findings of these two studies suggest that the AHEMD-SR is a valid and reliable instrument for assessing how well home environments afford movement and potentially promote motor development.

The central nervous system (CNS) develops in a temporally and spatially organised manner. Any adverse events happening during the critical periods of early brain formation may lead to arrest in the process or injury to specific developed structures. Infants born at less than 30 weeks of gestation and those with intra-partum asphyxia are at risk of motor delay. The cause of this delay may be related to injuries in the brain such as the motor cortex, basal ganglia and cerebellum, all of which are essential in controlling movements. According to the dynamical systems theory of motor development, other than the CNS, body systems within the infant such as the musculoskeletal system, and external to the infant such as environmental enrichment and supportive child-rearing practice also have a decisive role in motor development in infants. / Paediatric physiotherapists have been involved in the management of these infants since birth. A number of well-established assessment tools are used to assess these infants’ motor functions. Most of these tools typically do not describe the movement patterns of infants but emphasise the achievement of age-specific motor milestones. The Alberta Infant Motor Scale (AIMS) is one of the few tools that acknowledge the importance of movement quality. / The overall aim of the present research was to examine the impact of adverse events in early infancy, including birth prior to 30 weeks of gestation and intra-partum asphyxia, on motor development of infants during the first two years of (corrected) age. One hundred and twenty infants were recruited, including 58 preterm infants, 10 infants with post-asphyxia neonatal encephalopathy (NE) and 52 term born infants as the control group. All the infants were assessed using the AIMS at 4, 8, 12 and 18 months of (corrected) age. / The preterm group scored significantly lower on various sub-scores of the AIMS at all age levels than the control group. Uneven progression in the sit subscale from 4 to 8 months corrected age (CA) was found in the preterm infants, possibly due to a dominant extensor strength, inadequate tonus and postural control in the trunk. At 12 and 18 months CA, limited variations in movements were evident in some preterm infants in the crawling, sitting and standing positions. The ten infants with post-asphyxia NE showed scattered motor development, related mostly to the severity of their NE. The moderate NE group had the most varied motor outcomes ranging from normal to suspected mild cerebral palsy. / The AIMS was shown to be a valid assessment tool in the preterm population although limitations in its use were found at 4 months CA and when the infants walked or were close to independent ambulation. The present results show that motor performance of typically and non-typically developing infants should be investigated longitudinally as variations are the characteristic of early development. The dynamical systems theory provides a more satisfactory explanation of the motoric differences in infants in this study. All these findings have great implications for the clinical management of these at risk infants.

Thesis (Ed.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University by Beatriz Fernandez. Sargent College of Allied Health Professions. Dept. of Occupational Therapy. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The principle of proximo-distal direction of motor development is investigated in this study. Treatment of motor dysfunction has often been based upon the assumption that development occurs first in proximal muscle groups and then in distal groups. A longitudinal study was done on ten infants at five, seven, and nine months of age. Proximal and distal skills were measured and the relationship between them was studied. Two scales were used to assess the infant's reaching abilities (proximal skills), and prehension abilities (distal skills). The scales were developed by Loria (1978) and represented a combination of fmdings from studies done by Halverson (1931, 1932), Gesell and Amatruda (1947) and Kopp (1974). In Loria's scales (1980) unequal weight was given to the criteria used. In the present study however, the scales were modified so that each item was weighted equally. Both scales were used in this research, Loria's Original Scales and the new Adapted Scales. High positive correlations were found between proximal and distal scales of infant motor development at 5, 7, and 9 months of age. An exception was observed at the 9 months of age when using Loria's Original Scales, where results showed significantly lower correlations. However, when using the modified version of the scales, the correlations found suggest that both skills develop simultaneously or co-occur in infants at these ages. / 2031-01-01