Motor organisation of social play in children with autism.

Play is a quintessential human behaviour, underpinned by motor organisation and fundamental for learning and development. However, the motor patterns underlying play have not been computationally characterised in children with autism, despite known play pattern differences, including reduced social and pretend play. Recent evidence of fundamental neuromotor disruption in autism suggests neuromotor organisation differences may underpin play differences. We employed a digital game to examine play patterns in 878 children aged 2.5-6 years old, including 372 diagnosed with autism spectrum disorders (ASD), 64 diagnosed with other neurodevelopmental disorders and 441 without known neurodevelopmental problems (WP). Computational characterisation of play patterns by network analysis revealed significant differences between groups in the motor organisation of its sequential steps. Children with ASD developed an indirect, two-step pattern during the social food-sharing aspect of the game, in contrast to a direct, single-step pattern by WP children. These findings provide new variables for the digital characterisation of ASD. They reveal differences in the sequential nature of goal-directed motor organisation made in play in autism that precede higher-order differences in social cognition and emotional regulation reported in the literature, giving important insight into the psychomotor nature of autism for its education, care and support.