Children on the autism spectrum often struggle with the long-term goal of acquiring gross motor skills due to sensory and coordination challenges. Gross motor skills relate to large muscle movements. When your child learns to sit on their own, crawl, walk, and run, they are developing their gross motor skills. Delays in gross motor development can have significant long-term consequences in a variety of ways. For example, if your child struggles with moving in different ways early on (sitting up on their own, walking, or running) they may be reluctant to engage in everyday activities in the future, as well as physical activities such as sports or even informal playground play. This can limit your child’s opportunities to interact with their peers and / or caregivers and can potentially affect their social development and independence.

Helping your child to progress towards the long-term goal of developing their gross motor skills can help them coordinate and control their body movements. In many cases, improvements in gross motor skill development can also support fine motor skill development. 

The following strategies may help your child make progress towards the long-term goal of gross motor skill development:

• Floor time. Providing your child with lots of opportunities to explore different ways of positioning their body on the floor in supported and unsupported ways can encourage muscle strength development. Let them roll around, reach for items, pivot, and practice sitting (perhaps with your support). You can also encourage your child’s floor time by offering them a favorite toy to engage with, or joining them on the floor. 
• Go barefoot. Although we often think of gross motor skill development to primarily be related to the development of “larger” muscles, one set of muscles that are important to strengthen as a part of this process are those in your child’s feet. Giving them lots of opportunities to be barefoot can help your child to develop the muscles in their feet by bearing weight on them. When we are barefoot, our feet have an easier time “grasping” the ground, providing traction for movements like walking. Be aware of any sensory issues your child might have, as the feel of certain surfaces on their feet may be unpleasant.  
• Support your child as they try new movements. As your child begins to move from sitting to standing to cruising to walking, you can do a variety of things to provide physical support for them. For example, you can place a favorite toy on a couch and place your child on the floor in front of the couch. The couch will provide physical support for your child to pull themselves up and reach for the toy. You can also provide physical support as your child moves from standing to cruising to walking. You can hold their hands as they practice walking or even provide assistance by using a walking harness. You can also turn physically supporting your child as they learn to stand or walk into a game or fun activity with furniture or other items in your home. 
• Decrease support as your child gains confidence and skills. With practice and consistency, your child will improve their gross motor skills as well as their confidence. While it’s important to provide your child with physical support as they learn to stand and walk independently, it is equally important to decrease the physical support and assistance you provide as they gain confidence and skill. Instead, you can provide emotional support by celebrating small increases in standing duration or walking distance as your child develops their skills. 
• Take breaks. Developing gross motor skills is a process and, like developing any other skills, can take time. If you are working on standing or walking with your child and your child sits down while you are working on extending standing or walking duration, allow them to have a short break before retrying.
• Make it fun. There are lots of fun activities you can set up for your child - and many you can participate in, too - that will help your child develop their coordination and balance skills. “Coordination” is your child’s ability to use different parts of their body together in different ways to sustain more complex body movements and activities. “Balance” is your child’s ability to stay upright, and their ability to maintain control of their body while upright. Fun games like “freeze dance,” rolling a ball back and forth on the floor with a parent, caregiver, or peer, or putting some masking tape on the floor and trying to walk on top of it can all help your child develop the coordination and balance, while working towards mastering the the long-term goal of gross motor skills. 
• Additional resources:

•  For parents:‍
• --> 14 ways to help your toddler with balance and coordination‍
• --> Teach your Child with Autism to Imitate Gross Motor Movements at the Table‍
• --> Teaching Children to Stand ‍
• --> 27 Gross Motor Skills Activities for Little Kid

In order to help your child master the long-term goal of gross motor skills, you can work on the short-term goals of standing, and walking.

Standing

For the short-term goal of standing, you can choose a target such as increasing standing duration by 1 minute, increasing standing duration by 2 minutes, increasing standing duration by 5 minutes, etc.

• Step 1: Decide how long you would like your child to practice standing. For example, you can choose the target of increasing standing duration by 2 minutes while working on the short-term goal of standing. The task analysis for increasing standing duration by 2 minutes could be as follows:

1. Place / have two of your favorite toys at eye-level, which is a level that can be reached while standing (a table, or somewhere else of appropriate height).
2. Stand close enough to the toys such that you are able to reach them, and have a timer set for 2 minutes.
3. While standing, reach for the toys and engage with them with both hands while standing independently rather than holding onto the couch, table, etc.
4. When the timer goes off, take a break (sit down).

• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as an image of a person standing, or a verbal SD (“Time to practice standing!” or “Let’s play with some toys while standing!”).
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt their part independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently (i.e., their part). For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, if your child is able to complete their entire part of the task analysis independently, record how long it takes your child to complete it independently (e.g., 2 min, or even 5 min if they decide and are able to stand longer than the timer setting, etc.).
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of increasing standing duration by 2 minutes), provide the SD from Step 2 and allow your child to attempt their part independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to stand next to the couch, table, or other item, then reach for the toys, followed by standing independently while playing with the toys until the timer goes off after 2 minutes).
• Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, you can track progress by recording how long it takes your child to complete their part in all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at increasing standing duration by 2 minutes during a session. 
• Step 6: Track how your child makes progress to meet the target of increasing standing duration by 2 minutes by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at increasing standing duration by 2 minutes over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete their part in all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Walking

For the short-term goal of walking, you can choose a target such as increasing walking practice by 1 minute, increasing walking practice by 2 minutes, increasing walking practice by 5 minutes, etc.

• Step 1: Decide how long you would like your child to practice walking. For example, you can choose the target of increasing walking practice by 1 minute while working on the short-term goal of walking. The task analysis for increasing walking practice by 2 minutes could be as follows:

1. Place a favorite toy at your child’s eye-level (on a couch, table, or somewhere else), and show it to your child so they know where the toy is.
2. Move to another room so that your child will need to walk towards the toy to reach it, and set a timer for 1 minute.
3. Walk towards the toy in order to access the toy.
4. Pick up the toy. If the timer has not gone off, continue walking until the timer goes off, and find a place to sit with your toy.
5. When the timer goes off, sit down. 

• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as an image of a person walking, or a verbal SD (“Time to practice walking!” or “Let’s go get that toy!”).
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt their part independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently (i.e., their part). For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, if your child is able to complete their entire part of the task analysis independently, record how long it takes your child to complete it independently (e.g., 1 min, or even 2 min if they decide and are able to walk longer than the timer setting, etc.).
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of increasing walking practice by 1 minute), provide the SD from Step 2 and allow your child to attempt their part independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to stand next to the couch, table, or other item, then walk towards the toy, followed by playing with the toy).
• Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, you can track progress by recording how long it takes your child to complete their part in all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at increasing walking practice by 1 minute during a session. 
• Step 6: Track how your child makes progress to meet the target of increasing walking practice by 1 minute by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at increasing walking practice by 1 minute over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete their part in all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

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