Can Gross Motor Skills Be Trained Through Telehealth-Based Training? Insights From a Randomized Controlled Trial of Creative Movement and Play-Based Interventions in Children With Autism Spectrum Disorder
Authors: Myers Catherine , Srinivasan Sudha , Patel Bansri , Amonkar Nidhi , Su Wan-Chun , Cleffi Corina , Bhat Anjana , Williams Sarah 
Published: July 2022

Background
The motor trajectories of children with autism spectrum disorder (ASD) are often compromised, leading to difficulties in gross motor performance and locomotor skills by late childhood. Our past work has suggested that whole-body movement interventions using rhythmic contexts can facilitate gross motor skills in children with ASD.

Objective
This study compares the effects of whole-body movement interventions delivered face-to-face (F2F) versus via telehealth (TH) and compares these effects to those of a standard-of-care, seated play (SP) intervention on the gross motor performance of children with ASD.

Methods
A total of 45 children with ASD aged between 5 and 14 years were seen for 10 weeks, with pretests and posttests conducted during the first and 10th weeks. Children were matched based on age, gender, and level of functioning and then randomly assigned to the general movement (GM), creative movement (CM), or SP groups. An equal number of children in each group received the training via F2F and TH modes. Training was provided in 2 sessions per week for 8 weeks, with sessions lasting from 1 to 1.15 hours. The CM and GM groups received whole-body movement training, whereas the SP group engaged in tabletop activities. The gross and fine motor subtests (fine motor precision, fine motor integration, balance, bilateral coordination, running speed and agility, and strength) of the Bruininks-Oseretsky Test of Motor Proficiency were administered at pre- and posttest. We reported standard scores on body coordination, strength and agility, and fine manual control composites.

Results
The CM and GM groups showed significant improvements on the body coordination composite (CM group’s scores—pretest: mean 35.3, SE 2.1; posttest: mean 40.5, SE 2.7; P<.005; GM group’s scores—pretest: mean 38.1, SE 3.2; posttest: mean 44.7, SE 3.3; P<.005). The GM group’s scores (pretest: mean 36.1, SE 2.6; posttest: mean 40.9, SE 3.1; P<.001) also improved on the strength and agility composite, and a trend for similar improvements was observed in the CM group’s scores (pretest: mean 32.5, SE 2.4; posttest: mean 34.5, SE 2.7; P=.09). The SP group did not show any improvements on the gross motor composites. The SP group’s scores instead showed significant improvements on the fine manual control composite (pretest: mean 36.4, SE 2.3; posttest: mean 41.6, SE 2.5; P<.005). Fine motor skills remained unchanged in the CM and GM groups. In each of the 3 groups, there were no significant differences in the amount of improvements (posttest − pretest) observed for children seen F2F versus via TH for the body coordination (CM group—F2F: mean 4.1, SE 2.6; TH: mean 5.4, SE 1.6; P=.70; GM group—F2F: mean 6.5, SE 2.7; TH: mean 5.6, SE 2.5; P=.80), strength and agility (CM group—F2F: mean 1.3, SE 1.4; TH: mean 2, SE 1.1; P=.70; GM group—F2F: mean 3.7, SE 1.3; TH: mean 5.6, SE 1.5; P=.40), and fine manual control composite standard scores (SP group—F2F: mean 2.2, SE 2.8; TH: mean 1.9, SE 1.2; P=.80).

Conclusions
The findings of our pilot study emphasize the importance of training gross and fine motor skills in children with ASD and suggest that virtual modes of intervention delivery can be used by movement clinicians to train these skills.

Conflicts of Interest
None declared.