Why motor skills matter more than behavior in autism therapy
If you’re raising a child on the autism spectrum, chances are you’ve already encountered a list of therapies: speech therapy, occupational therapy, ABA (Applied Behavioral Analysis), and maybe even physical therapy.
Each of these has its role, but there’s one essential piece of the puzzle that rarely makes it into the early intervention toolkit: whole-body apraxia.
Many autistic children face profound difficulties with coordinated movement, motor planning, and sensory-motor integration—yet these aren’t typically treated as priorities. Instead, traditional therapies often focus only on visible behavior, making assumptions that can be deeply misleading.
In this article, we’ll explore how conventional therapy models may be missing critical neuromotor issues—and what parents can do to ensure their child receives the right kind of support.
A Closer Look at What Therapy Plans Typically Include
After an autism diagnosis, families are usually offered a predictable mix of services:
- ABA (Applied Behavioral Analysis)
- Speech Therapy
- Occupational Therapy (OT)
- Physical Therapy (PT)—if mentioned at all
Among these, ABA often takes center stage, particularly when treatment is funded through public systems or insurance.
OT and speech services are more widely recommended, while PT—which is essential for addressing broader motor coordination—is frequently overlooked, despite high rates of motor impairment in children with autism.
Behavioral Approaches: Where They Fall Short
ABA is built on behaviorist principles, aiming to increase “desirable” behaviors while reducing those labeled as “maladaptive,” such as stimming, aggression, or wandering. Variations like Pivotal Response Training (PRT) attempt to embed behavior management strategies into everyday life and communication.
However, these approaches typically lack insight into the child’s underlying neurodevelopmental, motor, and sensory processing challenges. They often rely on the faulty logic that a child’s inability to respond must mean they don’t understand.
When behavior is used as the only measure of cognitive ability, children with motor impairments are easily misunderstood.
In truth, many of these children understand far more than they can express—and the problem lies not in cognition, but in motor output.
The Overlooked Reality: Motor Impairments in Autism
Motor difficulties are not rare in autism—they’re the norm.
A major study by the SPARK Consortium (Bhat, 2020) found that nearly 87% of children with autism show motor impairments. Despite that:
- Only 79.8% receive OT
- Just 31.6% get PT
- A mere 13% access recreational therapies like horseback riding or aquatic therapy
This means many children are missing out on therapies designed to help them move, regulate, and participate more fully in life.
What Therapy Should Address—But Often Doesn’t
OTs commonly focus on fine motor tasks like cutting, writing, or buttoning, along with sensory integration. PTs handle gross motor skills such as posture, gait, and strength. Some speech therapists may touch on motor elements like oral coordination or breath control.
But even in these professions, training specific to autism-related motor challenges is often lacking.
Many therapists are not equipped to treat:
- Difficulties initiating movement
- Motor planning breakdowns
- Whole-body apraxia
- Dysregulation linked to motor dysfunction
These aren’t subtle delays. They are central to how a child experiences the world, interacts with their environment, and communicates.
Why Motor Issues Get Missed or Misdiagnosed
Children who are nonspeaking, highly sensitive, or engage in self-injurious behavior are often pushed into compliance-based therapies like ABA. Unfortunately, their true challenges—especially motor-related ones—are often misinterpreted as defiance or cognitive delay.
Here’s how it often plays out:
- A child struggles to carry out a verbal or motor task
- Professionals assume the child doesn’t understand
- The focus shifts to compliance and performance
- The child becomes increasingly frustrated or dysregulated
This cycle doesn’t support the child—it shames and limits them.
Motor impairments aren’t always visible. But ignoring them can cause lasting emotional and developmental harm.
Why “Presume Competence” Must Be the Baseline
To “presume competence” means believing that your child can understand, think, and learn—even if they can’t demonstrate it through conventional means.
It’s not wishful thinking—it’s a necessary mindset for recognizing:
- Sensory overload as a real barrier
- Movement delays as misunderstood communication
- Behavior as a signal, not a verdict
Instead of correcting behavior, we should be asking:
“What is this child trying to tell us through their actions?”
Presuming competence helps uncover the real reason behind “noncompliance,” often pointing to:
- Overstimulation
- Frustrated expression
- Anxiety or fear
- Internal dysregulation from health or motor challenges
What a Better Therapy Model Could Look Like
What if therapy didn’t start with behavior modification, but with understanding the body?
A truly supportive model would include:
- Full sensory-motor assessments
- Motor coaching tailored to whole-body apraxia
- Functional vision screenings to support motor tasks
- OT and PT delivered with a neurodevelopmental focus
- Parent training to understand motor delays
- Motor-accessible communication tools like Spellers Method or AAC
- Health evaluations to rule out physiological factors affecting motor control
This model isn’t just comprehensive—it’s humanizing. It acknowledges that motor function is foundational to independence, expression, and confidence.
Why This Matters for Your Family
If your child…
- Isn’t progressing in therapy
- Can’t communicate clearly
- Seems constantly overwhelmed or frustrated
…it might not be about effort, attention, or ability. It might be about motor challenges that haven’t been addressed.
Ignoring the body leads to assumptions that children are unintelligent or incapable. But when we support their regulation, movement, and vision, we create a foundation for true growth.
Motor issues don’t mean a child isn’t smart.
They mean the child needs different access to express their intelligence.
What You Can Start Doing Right Now
Here are five immediate, actionable steps:
- ✅ Ask for evaluations that include motor planning—not just fine or gross motor screening.
- ✅ Educate yourself on whole-body apraxia and sensory-motor integration.
- ✅ Advocate for therapy approaches that consider motor complexity, not just compliance.
- ✅ Question assumptions—especially about nonspeaking or “behavioral” kids.
- ✅ Always, always presume competence and push for supports that honor your child’s potential.
Final Thoughts
Your child isn’t broken.
They aren’t “just behavioral.”
They are navigating a world with a body and brain that may not sync easily—and they need therapies that understand that complexity.
Behavior-focused methods may miss what truly matters.
Motor impairment is not peripheral—it’s central.
When you address movement, vision, and regulation, you unlock your child’s ability to connect, communicate, and thrive.
If something about your child’s current therapy plan doesn’t sit right with you…
You might be seeing what others have missed.
Want More Help?
Explore more resources on motor-based communication, whole-body apraxia, and sensory-motor strategies for autism by visiting Spellers Center Atlanta website, our blog, homepage or reaching out to our team.
Let’s start building therapy plans that truly reflect your child’s strengths, challenges, and potential.
Be sure to check out the Spellers Documentary to see how Spellers Method has impacted people lives.
