Slower pace in early walking onset is related to communication, motor skills, and adaptive function in autistic toddlers

The onset of walking is a major developmental milestone in early childhood and is critical to the development of language and social communication. Delays in walking have been described in individuals with ASD. Yet, less is known about the quality of early gait development in toddlers with ASD and the relationship to motor skills, social communication, and language. Quantitative measures of locomotion can improve our ability to evaluate subtle and specific motor differences in toddlers with ASD and their relationship to other developmental domains. We used quantitative gait analysis to evaluate locomotion in toddlers with ASD (n = 51) and compared these data to a reference chronological aged (CA) and mental aged (MA) matched typically developing (TD) cohort (n = 45). We also examined the relationship of quantitative gait metrics to developmental measures among toddlers with ASD. We found that although toddlers with ASD achieved a typical age range of walking onset, they exhibited a pattern of slower pace compared to the TD cohort when matched by CA and MA. We also found that slower measures of pace were associated with lower developmental scores of communication, motor skills, and adaptive function. Our findings improve characterization of locomotion in toddlers with ASD and the relationship of motor skills to other developmental domains. Locomotion is a critical motor milestone and can drive many areas of development such as language. Here, using quantitative gait analysis and developmental measures, we find that toddlers with ASD have atypical gait patterns that differentiate them from TD toddlers. We also found that atypical gait patterns were associated with lower scores on developmental measures of communication, motor skills, and adaptive function. Our findings improve motor characterization in early childhood and ASD.