Motor Planning Difficulties & Autism

Instructor: Lisa Millraney

Lisa has 27 years of experience treating speech, language, memory and swallowing disorders. She has a master's degree in speech pathology from Vanderbilt University.

In this lesson, we will explore motor planning difficulties experienced by children with autism. We will learn how motor planning works, what can go wrong, and how parents and therapists can help children to improve their performance in daily life.

Imagine, Sequence, and Execute

A child's life is full of learning! Every day, they are exposed to situations they have never experienced before, and given opportunities to master new skills. Learning to perform a new task requires praxis, the ability of the human brain to conceive, plan, and carry out a sequence of events.

The simplest tasks require much more planning than most of us realize, because we learned them when we were very young. The first time, or the first few times, little Carol performs a novel task like getting juice out of the refrigerator, putting her shirt on, or printing her name, it takes a lot of conscious thought to get all the steps in the right order to reach the goal.

Her mother Eliza might relate this to her memories of learning to drive. She had to think about which way to turn the steering wheel, which pedal to push when, and so forth. With time and repetition, those steps became automatic. In the same way, Carol repeats again and again, and quickly gains the motor planning skills needed to get dressed, write, or prepare a snack.

Differences on the Spectrum

The principles of praxis don't fall into place as readily for children with autism spectrum disorders. Where Carol rapidly learned how to make a tower of blocks or eat hot oatmeal with a spoon, her younger brother Noah who has autism had trouble just learning to crawl. The positive feedback Carol gets from her parents and her very environment every time she is successful is lacking when Noah fumbles around trying to sit down in his car seat, or seems confused about how to carry his toys to the toy box to put them away.

Children with autism have some of the following difficulties with motor planning:

  • trying to do a task exactly the same way every time, and not adapting to variable situations
  • not being able to complete tasks with several steps
  • if they attempt the multi-step task, they get the steps out of order or leave some out
  • they have a hard time imitating a task when shown, but can do it spontaneously. This is one of the hallmarks of motor planning problems, or dyspraxia.

An Early Warning Sign

Noah's motor planning challenges concerned his mom. She shared her concerns with her pediatrician, who referred them to Mary, an occupational therapist. Mary explained there are several reasons children with autism have impaired motor planning. ''Their brains seem to be wired differently,'' she said. ''Their sensory integration skills are challenged. That means their ability to take in information from their body, and interpret and use it to tell them how they should be moving.

''Besides that, they have issues with their vestibular system. It's located in the inner ear, and tells you where your body is. Kids on the spectrum can't process the vestibular information accurately—they often get either too much information and get overstimulated, or too little and need more input. Put all of these factors together, and you can see why motor planning problems are sometimes the first sign of autism. Children may be slow in learning tasks, or seem clumsy, scared, or hyperactive, before they are even diagnosed with a spectrum disorder.''

''What can we do to help him?'' Eliza asked.

''Lots!'' Mary assured her. ''We'll start right away.''

Tackling the Problem

Mary began working one-on-one with Noah, breaking everyday activities down into small steps, then helping him master each step. She used movement activities like swinging and rocking to focus on his vestibular system and give it just the right amount of input. She also used rhythm to help him learn to manage his movements.

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