Digital motor markers for early autism detection: promise, pitfalls, and a path to clinics

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that is commonly characterized by repetitive behaviors, limited interests, and difficulties in communication and social interaction (1). Motor system abnormalities, which are frequently overlooked or underestimated, are becoming increasingly recognized as potential biomarkers, even though basic socio-communicative features remain the standard diagnostic criteria (2). Among the numerous motor challenges that are commonly observed and have a cascading impact on cognitive and socio-emotional development are postural control, bilateral coordination, fine motor skills, and motor imitation (3). Recent evidence indicates that infants later diagnosed with ASD exhibit distinct early motor trajectories when compared to typically developing infants (4). Relevant differences in movement activity and altered motor profiles can be detected between 6 and 12 months of age (5–7), before the onset of clear socio-communicative symptoms, making them powerful, non-verbal indicators of atypical neurodevelopmental trajectories.