Patterns of objectively measured motor activity among infants developing ASD and concerns for ADHD

Rachel Reetzke, Ana Maria Iosif, Burt Hatch, Leiana de la Paz, Annie Chuang, Sally Ozonoff, Meghan Miller

Research output: Contribution to journalArticlepeer-review


Background: Heightened motor activity is a hallmark of attention-deficit/hyperactivity disorder (ADHD), yet high activity levels are also often reported in young children with autism spectrum disorder (ASD). It is currently unclear whether increased motor activity represents a distinct versus shared early predictor of ASD and ADHD; no prior studies have directly examined this prospectively. We investigated differences in longitudinal patterns of objectively measured motor activity during early development. Methods: Participants included 113 infants at high and low risk for ASD or ADHD. Continuous motion-based activity was recorded using tri-axial accelerometers at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into one of three outcome groups: ASD (n = 19), ADHD Concerns (n = 17), and Typically Developing (TD; n = 77). Group differences in trajectories of motor activity were examined in structured and semistructured contexts. Associations with behaviors relevant to ASD, ADHD, and general development were also examined. Results: In both structured and semistructured contexts, both the ASD and ADHD Concerns groups exhibited heightened activity relative to the TD group by 18 months; the ASD group exhibited higher activity than the ADHD Concerns group at 24–36 months in the structured context only. Attention/behavior regulation, nonverbal, and verbal development—but not social engagement—were differentially associated with objectively measured activity by outcome group across contexts. Conclusions: Overactivity may be a shared, rather than distinct, precursor of atypical development in infants/toddlers developing ASD and concerns for ADHD, emerging as early as 18 months. Group differences in overactivity may be context-specific and associated with different underlying mechanisms.

Original languageEnglish (US)
Pages (from-to)663-673
Number of pages11
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Issue number6
StatePublished - Jun 2022


  • Activity level
  • attention-deficit/hyperactivity disorder
  • autism spectrum disorder
  • infancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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