The relationship between executive function and the association of motor coordination difficulties and social communication deficits in autistic children

Background: Motor coordination difficulties could contribute to social communication deficits in autistic children. However, the exploration of the mechanism implicated in these claims has been limited by the lack of potential confounders such as executive function (EF). Methods: We investigated the role that EF plays in the relationship between motor coordination and social communication in a school-aged autistic population via a structural model in a statistically robust manner. The results of questionnaires, including the Developmental Coordination Disorder questionnaire, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale, were collected to measure motor coordination, social communication deficits, and EF. Results: A total of 182 autistic children (7.61 +/- 1.31 years, 87.9% boys) were included in the final analysis. In the model with EF as a mediator, the total effect (beta=-0.599, P<0.001) and the direct effect (beta=-0.331, P =0.003) of motor coordination function on social communication were both significant among autistic children without intellectual disability (ID), as were indirect effects through EF (beta=-0.268, P<0.001). Conclusion: EF partially mediates the motor coordination and social communication correlation among autistic children. We suggest that motor coordination should be included in the routine evaluation of autistic surveillance and rehabilitation procedures.