# Exploring the Efficacy of the Occupational Therapy-Fundamental Motor Skills Training (OT-FMST) Protocol on Functional Performance in Children With Autism Spectrum Disorder

## TL;DR

This study shows that adding motor skills training to occupational therapy improves functional abilities and reduces caregiver help for children with autism.

## Contribution

The study introduces and evaluates a new protocol combining occupational therapy with fundamental motor skills training for children with ASD.

## Key findings

- The OT-FMST group showed greater functional performance improvements compared to the control group.
- Significant improvements were observed in self-care, social, and mobility skills in the experimental group.

## Abstract

Background

Autism spectrum disorder (ASD) is primarily characterized by deficits in social communication and restricted behaviors, but motor impairments are also highly prevalent and debilitating. Children with ASD often experience challenges in fundamental motor skills (FMS), particularly in coordination, postural control, and locomotor abilities. These impairments not only limit physical activity but also restrict social interaction, play, and communication, thereby compounding developmental challenges. Although sensory integration and FMS-based interventions have each shown positive outcomes, few studies have systematically combined them.

Methods

This study was conducted at the Santosh Occupational Therapy Department and included 60 children aged 3-7 years diagnosed with ASD (Indian Scale for Assessment of Autism (ISAA) scores 70-153). Participants were conveniently assigned to control and experimental groups. Both groups received occupational therapy (OT) focused on sensory integration, while the experimental group additionally underwent structured FMS training. Sessions were conducted four times per week for 12 weeks, lasting 45-50 minutes for the control group and 60-65 minutes for the experimental group. Primary outcome measures included the ISAA and the Pediatric Evaluation of Disability Inventory (PEDI), which assessed functional skills and caregiver assistance in self-care, mobility, and social domains.

Results

After the intervention, the functional performance of the OT-FMST group improved more than that of the control group. PEDI scores showed significant improvements in self-care skills across all levels (p < 0.05). Social functional skills also improved significantly across all score metrics (p < 0.01). Mobility skills improved significantly in raw and normative scores (p < 0.05), while scaled scores showed a positive but nonsignificant trend. Caregiver assistance needs were notably reduced in the experimental group, with significant improvements in self-care (raw and normative), mobility (scaled and normative), and all social assistance measures (p < 0.01). These findings suggest that the addition of FMS training promoted independence and functional gains beyond those achieved with sensory integration therapy alone.

Conclusions

The OT-FMST protocol was effective in enhancing functional skills and reducing caregiver dependence in children with ASD. Integrating structured FMS training with conventional OT provides a more comprehensive intervention approach, supporting improvements in self-care, mobility, and social participation. These results highlight the clinical value of incorporating FMS-based training into OT programs for children with ASD.