Written by: Timothy Spadzinski, Occupational Therapy Student, University of Toronto

Edited by: Lizette Alexander, OT Reg. (Ont) with appreciation

 We often take day-to-day tasks for granted (i.e., walking, brushing our teeth, etc.). Take sitting for example – to sit up straight, our body must use core muscles to keep our spine straight, and not letting it bend one way or the other. In this example, core strength is just one of the many factors playing a role in sitting posture. These factors are called Gross Motor Skills. However, for some (i.e., Autism Spectrum Disorder (ASD) population), these skills may be more difficult to develop throughout childhood and even into adulthood. Today’s topic will discuss what Gross Motor Skills are, how challenges in this area impact children with ASD, and strategies to help develop these skills and reduce the impact of difficulties.

What are Gross Motor Skills?

Gross Motor Skills are movements that involve large muscle groups throughout the body (i.e., torso, upper/lower limbs), and create the foundation for everyday life – self-care (i.e., dressing, brushing hair, eating, etc.), productivity (chores, school-work, etc.), and leisure (i.e., sports, exercise, etc.) (Kid Sense, 2020; Veldman et al., 2019; Wilmot, n.d.). In last week’s blog, we discussed the importance of Fine Motor Skills and how they allow our hands to interact with our environment and have a big impact on cognitive development. In order to use those fine motor skills appropriately however, a child’s gross motor skills must provide the foundation for these movements (Kid Sense, 2020; Wilmot, n.d.). For example, to sustain posture when sitting in a classroom for 30 minutes, a child needs:

  • Core strength and endurance to sit upright on the chair. Pelvic muscles and abdominal muscles work together to maintain a straight back.
  • Muscle stability around the shoulders and neck to support their head
  • Body awareness to balance while sitting on the chair without falling off

These are just a few gross motor components that must be used throughout the activity to sustain fine motor skills when writing! (Kid Sense, 2020).

Key Factors in Developing Gross Motor Skills

·       Strength

·       Endurance

·       Motor Planning

·       Motor Learning

·       Body Awareness (Proprioception)

·       Balance

·       Coordination

·       Crossing the midline of the body

·       Muscle tone

(Kid Sense, 2020; Lee & Bo, 2015)

 Gross Motor Skills in Autism Spectrum Disorder

Among other criteria, ASD diagnoses are characterized by difficulties in social communication and restricted or repetitive behaviours (Autism Speaks, 2020). Some research suggests that social skill development (i.e., language & communication) in children with ASD may be greatly impacted by gross motor difficulties (Lee & Bo, 2015; Miller, 2012).

As mentioned in our discussion on Developmental Coordination Disorder, meaningful play is important for children with motor difficulties to explore the way they move but also has lots of social benefits as well. If a child has difficulty with gross motor skills, they may have limited ability to participate in group activities (i.e., play, sports, crafts, etc.), leading to fewer opportunities to practice social skills. For those not interested in sport, if a child diagnosed with autism has difficulties with gross motor skills in the classroom, they may need additional assistance from a teaching assistant. This may lead other students to limit their interactions with that child, resulting in fewer social opportunities (Miller, 2012). Motor difficulties may therefore compound difficulties for a child with an ASD diagnosis (Autism Speaks, 2020; Lee & Bo, 2015; Miller, 2012), and also result in lowered self-esteem and avoidance of future group activities (Kid Sense, 2020; Miller, 2012).

Difficulties in Gross Motor Skills should NOT be overlooked!

Working on gross motor skill development can provide benefits in day to day activities such as getting dressed, sitting at school, and learning to ride a bike. But one of the biggest benefits gross motor skills offer children, is the opportunity to participate in group activities, which provides natural opportunities to develop social skills with peers!


  • Create a physical exercise program with your child. Set goals with your child in what they want to learn (i.e., hopscotch, learning to ride a bike, jump rope, basketball, etc.) Having your child be a part of the process will make it fun for them! If this is frustrating for your child however, an Occupational Therapist can help.
  • Start small. Gradually increase the duration of each activity session and introduce new activities as your child develops stronger gross motor skills.
  • Build a routine. Routines provide stability for a child on the spectrum and have been shown to limit behavioural outbursts associated with difficulties in new situations. Using a visual schedule may help make this routine.
  • Be a role model. Children model behaviours that they see!

(Healy, 2018; Wilmot, n.d.)


How TCTC Can Help:

In summary, gross motor skills provide a foundation to support participation in day to day activities, play, fine motor skills, and even social skills. As children with ASD have been seen to have difficulties in developing these skills, it is important to address them as early as possible. Given the key factors and challenges above, Occupational Therapists (OTs) are able to assess which of these factors are having a role in a child’s gross motor difficulties. Whether it’s difficulties in strength, coordination, body awareness, sensory processing, or any other factor, OTs can determine what steps to take to help them develop these skills further.

If you believe your child could benefit from a focused approach to developing their gross motor skills, please contact us about how our OTs can help you and your child! If you would like more information, take a look at our available OT programs!


Autism Speaks. (2020). Autism diagnosis criteria: DSM-5. Retrieved from https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5

Healy, S. (2018). Autism and exercise: Are there special benefits? Autism Speaks. Retrieved from https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits

Kid Sense. (2020). Gross motor activities. Retrieved from https://childdevelopment.com.au/areas-of-concern/gross-motor-skills/gross-motor-activities/

Lee, C. & Bo, J. (2015). Motor functioning in children with autism spectrum disorder. Acta Psychopathologica, 1(13). doi: 10.4172/2469-6676.100013

Miller, B. (2012). Autism affects motor skills, study indicates. Washington University in St. Louis: theSource. Retrieved from https://source.wustl.edu/2012/02/autism-affects-motor-skills-study-indicates/

Veldman, S.L.C., Santos, R., Jones, R.A., Sousa-Sá, E., & Okely, A.D. (2019). Associations between gross motor skills and cognitive development in toddlers. Early Human Development, 132, 39–44. doi: https://doi.org/10.1016/j.earlhumdev.2019.04.005

Wilmot, K. (n.d.). Gross motor skills: What you need to know. Understood. Retrieved from https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/movement-coordination-issues/all-about-gross-motor-skills?utm_source=google&utm_medium=paid&utm_campaign=evrgrn-may20-fm&gclid=EAIaIQobChMI472e_Z7A6QIVicDACh3yhw6bEAAYASAAEgJx2vD_BwE