All ETDs from UAB

Advisory Committee Chair

Kristi Guest

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Autism spectrum disorder (ASD) is neurodevelopmental disorder that affects 1 in 36 children. Fine motor skill delays and deficits are a common occurrence among autistic individuals. Fine motor delays tend to present in toddlerhood and deficits tend to persist into adulthood. However, fine motor skill delays and deficits are not a component of the diagnostic criteria for an ASD diagnosis. While fine motor differences between autistic and typically developing individuals are well established, it remains unclear if these differences exist between autistic individuals and those with other neurodevelopmental disorders and whether they provide additional insight into diagnosing ASD more accurately. Additionally, having a hand preference may have a protective effect on fine motor skills uniquely for autistic individuals. The current study examined how well the Peabody Motor Development Scales, Second Edition (PDMS-2) and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) scores predict Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) comparison scores and ASD diagnosis in a clinical sample of individuals referred for an ASD evaluation. It also examined if having a hand preference had a uniquely protective effect on PDMS-2 and BOT-2 scores within the ASD group but not the non-ASD group. Results revealed that poorer PDMS-2 scores significantly predicted ASD diagnosis but not ADOS-2 comparison scores. BOT-2 scores were not significant predictors of ADOS-2 comparison scores or ASD diagnosis. Additionally, poorer language composite scores and higher maternal education predicted higher ADOS-2 comparison scores and an ASD diagnosis within the PDMS-2 subsample. Next, having a hand preference did not significantly interact with ASD group. Results of the current study suggest that fine motor skills may be an important component in differentiating between ASD and other neurodevelopmental disabilities. Also, while poorer language skills are a common trend among autistic individuals, it appears that families of lower socioeconomic status may need additional resources to recognize ASD symptoms and to differentiate these from symptoms of other neurodevelopmental disabilities. Overall, the results indicate that multi-/interdisciplinary approaches should be prioritized when evaluating for ASD, particularly for complex cases.



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