Using fine motor skills to predict language outcomes

Wait... using fine motor skills to predict language outcomes? People who don’t know child development might do a double take on that one. EI SLPs, on the other hand, know that all aspects of early development are connected and there might be some information we can use here!

The authors of this study measured fine motor growth and expressive language over the first three years of life using the Mullen Scales of Early Learning (MSEL), and confirmed or ruled out a diagnosis of autism for at-risk children (kids who had a sibling with a diagnosis of ASD). They wanted to see if there were differences in fine motor development among kids at high risk who ended up with an ASD diagnosis (HRA+), kids at high risk who did not end up with a diagnosis (HRA-), and low risk kids who did not have a sibling with ASD (LRC). They also wanted to know if early fine motor skills predicted expressive language at 3 years.


Well? There was no difference in status of fine motor skills at 6 months. But the HRA+ group showed slower fine motor development between 6 months and 2 years of age compared to the LRC group. The authors state, "Only beginning in the second year of life, did high-risk infants who were later diagnosed with ASD score significantly lower on the MSEL Fine Motor scale than high- and low-risk infants without eventual diagnosis." The authors suggest, “Our finding is consistent with those from prior research indicating that fine motor differences may be a characteristic of infants at high risk for ASD, rather than a core characteristic of the disorder.” One thing we should note is that, even though there were differences between groups in the statistical analysis, all of these fine motor scores fell within average range, so in individual assessments there might not be a flashing red light around that fine motor score.

What is really relevant to EI SLPs is that children who had better fine motor skills in early development had better expressive language scores at 3 years, and this association held for all three groups. The authors cite literature suggesting we might support language development by encouraging fine motor development in infancy (but this remains a hypothesis—they don’t yet have data to show that would work). For those of you who work under a Primary Service Provider model, this might be a good study to share with your teams!


Choi, B., Leech., K. A., Tager-Flusberg, H., & Nelson, C. A. (2018). Development of fine motor skills is associated with expressive language outcomes in infants at high and low risk for autism spectrum disorder. Journal of Neurodevelopmental Disorders, 10(14), 1–11.