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March 29, 2026

Motor and Cognitive Profiles in Children Who Are Three to Six Years Old and Have Autism Spectrum Disorder and Other Developmental Disabilities

Key Points

This study aims to identify the motor and cognitive profiles of children with autism spectrum disorder (ASD) and those with comorbid developmental disabilities.
Conducted a secondary analysis of a retrospective cohort from a multidisciplinary outpatient clinic.
Included 1127 children aged 36 to 77 months across various diagnostic groups (ASD, ID, ADHD, etc.).
Utilized the Wechsler Preschool and Primary Scale of Intelligence–Fourth Edition and Movement Assessment Battery for Children–Second Edition to assess profiles.
Children with ASD and comorbidities outperformed those with intellectual disabilities in cognitive tests.
The ASD + ID group showed the most motor deficits, with 89.6% struggling with motor skills.
Cognitive abilities, especially visual-spatial skills and working memory, significantly predicted motor performance across groups.

Abstract

Abstract 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). Intervention(s) or Exposure(s) 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.

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