Simone Gill is part of a big, bicoastal research study exploring ways to recognize and treat autism in young children.

Caregivers of young autistic children who are nonverbal often face an excruciating wait to find out if or when the little ones will learn to speak. Some autistic children start with significant delays but develop language during early school years; others remain only minimally verbal much later. Simone Gill, an associate professor of occupational therapy, is trying to understand why this is so. She believes a child’s motor skills could help predict later language development. In an interdisciplinary research project, Gill and Helen Tager-Flusberg, a professor of psychological and brain sciences at the College of Arts & Sciences and principal investigator of the five-year National Institutes of Health (NIH)–funded study, are working with speech therapists from Massachusetts General Hospital to explore whether oral motor function may be related to gross motor function, or the way a child moves their whole body.

“Researchers are finding that there are these differences in movement that might be keeping [children] from being able to engage in social interaction,” says Gill. “If that is the case, then that would suggest we could create interventions that perhaps could improve both [speech and motor skills]. And if they’re not related, then perhaps we need targeted interventions to work on one area versus another.”

Researchers launched their data collection remotely in 2020 during the COVID-19 pandemic, having children aged three and a half to seven, with and without autism, complete a battery of physical tests over Zoom conference calls. Using a technology developed at New York University, researchers analyzed the video frame by frame to count how many steps a child took and calculated their velocity, balance, and other motor skills. Since mid-2022, families have been participating in the study in person at BU’s Center for Autism Research Excellence. Autistic children are asked to walk on a special mat embedded with sensors, which calculates their speed and how far apart their steps are compared to children without autism. Kids balance on one foot (with researchers observing if and when they reach out to steady themselves), and then researchers have them complete a series of movement tests that include putting items in a box, throwing a ball against a wall, and jumping.

Hope remains that we can create interventions that will be more impactful for [autistic] children and their families.

—Simone Gill

Gill says her team collected data from 105 children remotely during the pandemic and aim to assess an additional 60 children in person—30 who are typically developing and 30 with autism—before the NIH grant ends in June 2024. The preliminary results suggest autistic kids’ gross motor skills and the ability to speak may be more closely related than previously thought, she says. Many of the minimally verbal autistic children she’s observed display other movement challenges or inconsistencies, be they ever so slight. Developmental psychologists at Boston Children’s Hospital are conducting brain imaging to better understand any differences in the groups of autistic children being observed. Finally, researchers are analyzing the effectiveness of two play-based interventions for movement and language deficits, administered at the Kasari Lab at the University of California–Los Angeles. Gill says she’s optimistic that the findings will open a new window into the inner workings of neurodivergent children and give their families and support teams peace of mind.

“Hope remains that we can create interventions that will be more impactful for [autistic] children and their families,” Gill says. “The hope is maybe they won’t have to go to five different specialists to receive help. Maybe they could just go to a few because we are able to put our resources together and find out how to help them in the most efficient way.”

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