Extended Abstract
Background and Purpose
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and restrictive, repetitive behaviors. Children with ASD often experience significant anxiety and stereotypical behaviors that compromise their quality of life, social integration, and educational progress. Anxiety manifests as heightened arousal, avoidance, and distress in response to overwhelming sensory stimuli. Stereotypical behaviors serve as self-regulatory mechanisms but hinder engagement in adaptive behaviors and learning.
Recent studies highlight movement-based interventions targeting sensory-motor and perceptual-motor integration as promising treatments for ASD symptoms. Sensory-motor exercises improve integration of sensory inputs and motor outputs, facilitating nervous system regulation and emotional control. Perceptual-motor activities emphasize cognitive-motor coordination through planning, sequencing, and goal-directed actions, enhancing executive function and behavioral flexibility. However, comparative evidence on the effects of sensory-motor versus perceptual-motor training on anxiety and stereotypical behaviors remains limited. This study assessed the comparative effectiveness of these interventions in children aged 8–12 years diagnosed with ASD, providing empirical guidance for targeted therapeutic programs.
 
Methods
This quasi-experimental randomized controlled study involved three groups: sensory-motor intervention, perceptual-motor intervention, and control. Twenty-four children meeting DSM-5 criteria for ASD and aged 8–12 years were purposively sampled, excluding those with severe intellectual disability or physical impairments preventing participation. Participants were randomly assigned equally (n=8 per group).
The sensory-motor group engaged in exercises enhancing sensory processing and motor coordination, including balance training, obstacle navigation, proprioceptive stimulation, and vestibular integration to improve body awareness and spatial movement. The perceptual-motor group performed tasks combining motor and cognitive elements, such as memory-based movement sequences, spatial orientation games, and rhythm-based exercises demanding executive control.
Interventions lasted 12 weeks, with three 60-minute sessions weekly, delivered in small groups by trained pediatric motor and cognitive therapists. The control group continued routine care without motor-based activities.
Outcomes measured pre- and post-intervention included anxiety via the Spence Children’s Anxiety Scale (SCAS) and stereotypical behaviors via the Repetitive Behavior Scale-Revised (RBS-R). Data were analyzed using MANCOVA controlling for baseline scores, with Tukey’s HSD for pairwise group comparisons.
 
Results
Post-test analyses revealed significant group effects on anxiety and stereotypy scores. Both intervention groups showed reduced anxiety and stereotypical behaviors versus controls, indicating motor-based training efficacy. Sensory-motor training yielded the largest improvements. Significant anxiety reductions were noted, particularly in subscales of uncertainty, fear, and arousal, suggesting sensory-motor integration plays a critical role in regulating emotional responses and physiological arousal in children with ASD.
Regarding stereotypical behaviors, sensory-motor training again demonstrated prominent reductions, likely due to proprioceptive and vestibular activities providing organizing input to the nervous system, thereby diminishing self-stimulatory behaviors. The perceptual-motor group also improved on these measures but to a lesser degree, indicating that while cognitive-motor activities enhance attentional engagement, direct sensory regulation through sensory-motor training more effectively reduces distress-driven behaviors. The control group showed no significant changes, reinforcing the attribution of improvements to the interventions.
 
Conclusion
This study supports structured physical interventions for managing core ASD symptoms. Both sensory-motor and perceptual-motor exercises reduce anxiety and stereotypical behaviors; however, sensory-motor approaches offer superior efficacy. Clinical application of sensory-motor exercises may be particularly beneficial for children with elevated anxiety and stereotypy. Limitations include small sample size and brief intervention duration. Nevertheless, findings advocate these low-cost, non-pharmacological interventions as viable. Future research should explore long-term outcomes, larger samples, and functional gains in daily and social activities.
 
Article Message
Sensory-motor and perceptual-motor training reduce anxiety and stereotypical behaviors in children with ASD, with sensory-motor training demonstrating greater overall efficacy likely due to direct sensory regulation. Motor-based interventions represent accessible, cost-effective strategies that promote emotional regulation and adaptive behaviors. Integration of these methods into therapeutic and educational settings is encouraged. Further studies should examine sustained effects, larger cohorts, and multimodal approaches.
 
 
Ethical Considerations
Ethical standards were rigorously maintained. Guardians provided informed consent, with rights to withdraw at any time. Confidentiality was preserved, and ethical approval was obtained from the Sports Sciences Research Institute of Iran (Code: SSRI.REC-2505-2948).
Authors’ Contributions
Conceptualization: Ali Torabi, Mahmoud Sheikh
Data Collection: Ali Torabi, Davood Homanian
Data Analysis: Ali Torabi, Mahmoud Sheikh
Manuscript Writing: Ali Torabi
Review and Editing: Mahmoud Sheikh, Davood Homanian
Funding Responsibility: Mahmoud Sheikh
Literature Review: Ali Torabi
Project Management: Mahmoud Sheikh
Additional Contributions: Technical assistance by research staff during intervention setup
Conflict of Interest
The authors declare no conflicts of interest.
 
Acknowledgments
The authors thank all participating children and their families for their cooperation and trust, and the staff of NarMak Children’s Center for logistical support. This study was supported by the Faculty of Physical Education, University of Tehran.