Fewer children with autism spectrum disorder with motor challenges receive physical and recreational therapies compared to standard therapies: A SPARK data set analysis.
Anjana N Bhat
PMID 37605823WHAT IT FOUND
Most children with autism in this large US sample were at risk for motor impairment, but few received physical or recreational therapy compared to speech and occupational therapy.
Even children with the most severe motor difficulties had far lower access to gross motor services than fine motor or sedentary therapies.
Key findings
0188.3% of children were at risk for motor impairment based on parent-reported DCD-Q scores.
02Only 34.8% of the sample received Physical Therapy and 14.7% received Recreational Therapy, compared to 83.2% receiving Occupational Therapy and 85.8% receiving Speech-Language Therapy.
03Children with extremely high motor impairment severity received more PT and RT than those with very low severity, but the disparity with OT remained large (PT 54.7% vs OT 92.4%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relies entirely on parent-reported data for both motor impairment (DCD-Q) and service receipt, which may be subject to recall bias or misinterpretation. Adapted Physical Education (APE) in schools was not tracked, potentially underestimating the total amount of gross motor activity children received. The study is cross-sectional, so it cannot determine causality or whether services led to improved outcomes, only that access is unequal. The sample is predominantly White (78.3%) and male (80.4%), which may limit generalizability to other demographic groups.
Declared interests
The author received access to the SPARK database via an agreement with the Simons Foundation. The study was supported by NIH and non-US government grants. No commercial conflicts of interest were declared.
The easy way to misread this
Do not assume that OT services fully address gross motor and physical activity needs for children with ASD. This study shows that while OT is widely available, PT and RT are significantly under-utilized even in children with severe motor impairments, suggesting a gap in functional movement and physical health support that OT alone may not cover.