Autism is often thought of through the lens of social communication and behavior, yet many autistic children also experience motor difficulties — from delayed walking and coordination issues to challenges with fine motor skills. A new study from UCLA reveals a troubling disconnect: many child neurologists are not fully prepared to detect or address these motor impairments, despite their prevalence and impact.

The Study & Key Findings

• UCLA led a survey of 100 child neurologists and neurodevelopmental specialists across the U.S. to assess their understanding and clinical practices regarding motor difficulties in autistic patients.

• Only 36% of respondents correctly identified motor deficits as an associated feature of autism — despite the fact that such impairments have been in diagnostic criteria since 2013.

• Many clinicians underestimated how widespread motor challenges are. Over half believed they affect 15–50% of autistic children, whereas research suggests the rate could be as high as 87%.

• Barriers were significant. Neurologists cited behavioral challenges, time constraints, and lack of training or familiarity with standardized motor assessment tools as major obstacles to detection.

Why Motor Issues Matter (Not Just an “Extra”)

Motor impairments in autism aren’t merely a side note — they can affect multiple domains of development:

• Delayed Milestones: Delays in crawling, walking, or coordinating movement can limit a child’s ability to explore, which in turn affects cognitive and social development.

• Fine Motor Skills: Difficulties with grasping, drawing, or manipulating small objects can impact writing, self-care, and learning tasks.

• Cascading Impact: When motor ability is compromised, engagement with the environment, peer play, and caregiver interaction may all suffer.

Because neurologists have specialized training in brain and nervous system function, they are well-positioned to detect subtle motor signs that otherwise might be overlooked. But unless they are trained to do so, this critical opportunity is missed.

Barriers to Better Recognition

The UCLA study highlights several systemic challenges:

1. Training Gaps
   Many neurologists reported that their medical schooling or residency didn’t sufficiently teach motor assessment in autism, especially tailored strategies for children with sensory, communication, or behavioral differences.

2. Time Constraints & Clinical Workflow
   Standard neurological visits are already packed; incorporating detailed motor assessments may be impractical in time-limited appointments.

3. Assessment Tool Challenges
   Motor assessments often require specialized equipment, training, or protocols, which may discourage routine use — especially in settings with fewer resources.

4. Comorbidities & Complexity
   Many autistic patients also present with other neurologic issues (e.g. seizures), cognitive impairments, or behavioral challenges, making motor evaluation more complex. UCLA Health

Recommendations & Promising Approaches

To close the gap between what research shows and what practice delivers, the UCLA team (led by Dr. Rujuta Wilson) recommends several strategies:

• Strengthen training in medical school and residency so that future pediatric neurologists are equipped to recognize and assess motor impairments in autism.

• Develop practical, efficient screening tools tailored for busy clinical settings — tools that don’t require extensive training or long administration times.

• Use caregiver reports and observation-based methods (e.g. monitoring how a child interacts with toys/objects) as adjuncts to structured testing.

• Adapt assessments for all communication levels, including children who are minimally verbal or have intellectual disability.

• Promote interdisciplinary collaboration between neurologists, physical therapists, occupational therapists, and developmental pediatricians to offer more holistic care.

Conclusion

The UCLA study serves as an important alarm bell: despite strong evidence that motor dysfunction is a common and impactful component of autism, many child neurologists currently lack the awareness, training, or tools to reliably detect it. Recognizing and addressing these gaps is not an optional add-on — it’s essential to delivering holistic, high-quality care to autistic children.

By investing in better education, streamlined assessment tools, and cross-disciplinary approaches, we can better support children’s development, maximize their opportunities, and reduce the long-term impact of undetected motor challenges.