ASD and gross motor skills

[MoMandaS]

My DS1 is 4.5. He has a preliminary diagnosis of HF ASD (from paediatrician) and his official assessment (by a team of various HCPs) is taking place in a few weeks. One of the first concerns that preschool raised at the beginning of all this, well over a year ago now, was that he seemed behind his peers physically, falling frequently and in the manner of a young toddler, walking with a puppet-like gait, often sliding off his chair by accident, that sort of thing. We were surprised to hear this as although he'd never been the most physically able of the babies/toddlers he grew up around, he seemed confident enough and certainly able to sit on chairs, etc.

However, it gradually dawned on me that he gets more 'clumsy', for want of a better word, when he's stressed, anxious, or generally emotionally insecure in a situation. For instance, he's been quite unsettled the last week or so with it being the Easter holidays, and we were in a shop the other day and he suddenly tripped over nothing and fell in a really strange, awkward way - like he didn't seem to try to stop or protect himself in any way. He was very upset afterwards, kept saying "I'm not good at walking". Something about it just made me start to worry that there could be something physically wrong. He can't usually walk for very long distances at all and wants to be carried, particularly if we're anywhere busy which is understandable, but occasionally astounds us by walking for at least 20 minutes.

I have wondered about dyspraxia but am wary of mentioning it to the assessment team in case they assume all his issues are down to that.

I don't know what I'm asking really. Does any of this sound familiar to anyone autistic or with an autistic child? Is there a correlation between ASD and being able to walk, run etc? Is it possible it's all down to sensory processing problems (vestibular/proprioceptive input or something)? Is there anything I can do to help him?

My son has ASD and has very weak fine and gross motor skills as part of his autism. He got Physio and is getting OT which has helped but in think he will always struggle somewhat with motor issues. He can function fine but just can't do sport or ride a bike etc. I would definitely mention it to the assessment team as you want to paint a full picture so they can work out exactly what issues he has and what help he needs. If he's being assessed by an OT or Physio these issues will be obvious to them anyway.

There's a strong correlation between ASD and being either hyper, or hypo - sensitive to one, two or several senses. There are now considered to be 7 senses, not just the 5 we grew up with, but also vestibular and proprioceptory which are to do with balance, and the 'sense of where you are in space'.

Have a bit of a google around those two terms and see what you think.
This could be a good place to start.

Your description of the falling /gait etc is exactly like my DS was at the same age. He has dyspraxia (severe) and is also diagnosed with ASD. He has low muscle tone, hypermobility and sensory processing disorder. He didn't really develop saving reflexes when he fell (so wouldn't put his arms out etc) until at least 6. His OT has explained he has extreme proprioceptive difficulties so he can't "feel" where he is in space iyswim. I would get a full OT assessment done if you can afford it. In my experience, the NHS services weren't very thorough and discharged him at 4. I used a private OT in order to get enough evidence to get weekly OT provision on his Statement.

Thanks, everyone! OT isn't mentioned on the list of people who will be present and nor is physio, but I'll mention it at the home visit (SALT and specialist HV) to flag it up, Imaginosity. After the MDT assessment there's supposed to be a discussion about next steps so I'll use that to request an OT assessment and if/when that's denied I'll look into getting one done privately, thank you, zen. We did mention the refusal to walk to the paediatrician and she's mentioned it in the report but says it's "probably behavioural".

I don't think seizures are a possibility, zzzzz, but I'll bear it in mind. I've never noticed him being particularly bendy but DH has apparently wondered about that, especially because his own joints are very mobile. He is certainly very floppy a lot of the time and I've always put it down to sensory processing, Back, but now I'm thinking there might be more to it, though I believe that's definitely a factor still.

Why would they not diagnose dyspraxia because of the ASD, I wonder, Polter? Because they think his dyspraxic symptoms are part of his autism rather than a comorbidity? I've had a look at the connective tissue disorders you mentioned and he does have some signs - but they could be explained away by other things! I think hypotonia is a definite possibility.

Really grateful for all your replies. I spend so much time thinking and worrying about him that sometimes I think I'm seeing things that aren't there, IYSWIM, and it's hard to see a way through to finding the answer! Also really worried about the assessment as the paediatrician said she thought it was unlikely they'd give an ASD diagnosis because of the way he presents, and then I just don't know where we'd go from there. Anyway, that's another topic so I'll stop rambling. Thanks all.

Some areas will diagnose both ASD and dyspraxia- my DD has a diagnosis of both.

Ds (nearly 7) has no diagnosis of anything, apart from a tentative 'severe expressive speech disorder' - he does have an EHCP, place in a complex needs unit, physio, OT, SALT and other random professionals. If your ds needs extra support then it should be based on his needs, not his diagnosis (although this can take quite a bit of determination and persistence!)

Oh ok, perhaps it's too do with area policy then, crafty. Thanks hazey, I know that's how it should be and to be fair we've been impressed that DS (or his preschool) has already had some good support even at this early stage. I just can't help thinking a concrete diagnosis will make things easier in the future, especially with him going up to school in September. But your example is reassuring!