Methodological considerations in the use of standardized motor assessment tools for children with autism spectrum disorder: A scoping review

Background: This scoping review identified methodological parameters affecting evaluation when administering standardized motor assessment tools among children with autism spectrum disorder (ASD). Method: PubMed, CINAHL, PsycINFO, Scopus, ERIC and Web of Science were searched for English-language articles published 1/1990–8/2022. Studies of children with ASD, 3–18-years old, using performance-based standardized motor assessment tools, were included. ASD sample characteristics, enrollment criteria, accommodations and missing motor outcome data were synthesized. Results: Among 5,432 references, 180 studies using 11 assessments were included. The most frequently used tools were the Movement Assessment Battery for Children, Bruininks-Oseretsky Test of Motor Proficiency and the Test of Gross Motor Development. Large-scale studies were lacking, and girls underrepresented. Low cognitive level was an exclusion criterion explicitly or as a related criterion in 87 (48%) studies. Behavioral issues were noted anecdotally. Methodological detail varied, particularly regarding missing data, administrators’ professions, training and inter-rater reliability. Seventy-four studies reported a total of 197 accommodations, related mainly to modifications of the tasks, accommodations to the testing procedure and changes in the physical setting in which the test was conducted. Conclusions: The findings, building on previous reports, indicate that children and adolescents with ASD cannot be approached uniformly over the entire spectrum of intelligence (IQ) and behavioral profiles in motor assessments. Administration challenges may stem from ASD characteristics beyond cognitive ability. Inconsistency relating to the IQ variable and incomplete methodological reports continue to be obstacles to comparative conclusions. ASD-specific versions of the tools with a supplementary report, describing cooperation, off-task behaviors and engagement, and combining several tools are recommended. This review could inform development of guidelines regarding motor assessments for children with ASD.