Motor and cognitive profiles in children who are 3 to 6 years old and have autism spectrum disorder and other developmental disabilities

IMPORTANCE: The debate on whether different motor and cognitive profiles of children with autism spectrum disorder (ASD) reflect distinct patterns of comorbidities with significant implications continues in autism research. OBJECTIVE: The aim of this study was to determine the motor and cognitive profiles of children with ASD alone as well as those with ASD and comorbid developmental disabilities. Additionally, it was assessed whether the cognitive abilities were linked to the motor performance of children with ASD. DESIGN: This study was a secondary analysis of a retrospective cohort. SETTING: The setting was a multidisciplinary outpatient clinic in Taiwan. PARTICIPANTS: Diagnostic groups included ASD (n = 263), intellectual disability (ID; n = 95), attention deficit hyperactivity disorder (ADHD; n = 222), ASD plus ID (ASD + ID; n = 77), ASD plus ADHD (ASD + ADHD; n = 74), and speech/language delay (SLD; n = 396). MAIN OUTCOMES AND MEASURES: The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition and Movement Assessment Battery for Children-Second Edition were used to examine motor and cognitive profiles and their relationship in 1127 young children who were 36 to 77 months old. RESULTS: Children with ASD, ASD + ADHD, and SLD performed significantly better than those with ID and ASD + ID on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition test for cognitive abilities. The ASD + ID group exhibited the most pronounced motor deficits, with 89.6% of children experiencing difficulties. Significant associations were found between cognitive abilities and motor skills within the ASD, ASD + ID, and ASD + ADHD groups. Multiple regression revealed that visual-spatial ability predicted motor performance across all groups, while verbal comprehension was a significant predictor of motor performance in the ASD + ID, ID, and SLD groups. Working memory was an important predictor of motor performance in the ASD, ASD + ADHD, and SLD groups. CONCLUSIONS: These findings highlight that children with ASD and comorbid developmental disabilities present unique motor and cognitive profiles. RELEVANCE: The relationship between specific cognitive domains and motor skills suggests that individual cognitive profiles may help identify distinct etiological subtypes of ASD and associated comorbidities and provide a cognitively informed basis for physical therapy decision-making in early childhood.