In one sentence
In a small study, autistic adults were less accurate at skilled gestures — especially pretending to use a tool — than matched adults without autism, and that gap was not explained by finger dexterity or other motor scores.
What the researchers did
The team compared 19 autistic adults with 19 adults without autism, matched on age and gender. Everyone completed a video-scored test of upper-limb skilled movement: imitating gestures and producing them on command, including meaningless movements, everyday social gestures such as waving goodbye, and tool-use gestures such as hammering. A rater who did not know group membership scored the videos. Finger dexterity was measured with a coin-rotation task. In the autistic group the researchers also used standard motor scales, then checked whether those motor scores predicted gesture accuracy. Gesture here means planned, communicative or tool-related hand actions — not general clumsiness.
What they found
- Autistic adults scored significantly lower on gesture accuracy than the comparison group. Tool-based gestures were the most affected.
- Coin rotation (finger dexterity) was similar between groups, so fine motor skill did not look like the main explanation.
- The autistic group showed more motor signs on the broader scales, but those scores were not statistically linked to how well they performed gestures.
- The authors suggest gesture differences in this sample are not simply a by-product of motor impairment.
What this means for families and therapists
If an autistic adult struggles to show “how you brush your teeth” or to use a conventional social gesture, it may not be the same thing as poor handwriting or slow buttoning. Treating only strength or coordination may not automatically improve these actions. In therapy or daily living skills, it can help to teach the meaning and sequence of a gesture explicitly, pair it with a word or picture, and not assume the person “can’t move that way.” Speech and occupational therapists already work with gesture in children; this paper is a reminder that the same split — movement versus communicative plan — can still matter in adulthood. Families can ask whether an assessment is looking at communication and motor planning separately from dexterity. This is a small first look in adults with this particular test, not a new diagnostic tool.
Limitations and what we don't know yet
Nineteen people per group is a small sample, and the authors say the result should be read with caution. There was no comparison group of people with motor conditions but without autism, so a hidden motor link is not fully ruled out. The design is a single time point, so it cannot show cause. We do not know whether the same pattern holds in more diverse samples, or whether targeted gesture practice would change everyday communication. Larger studies are needed.
This is a plain-language summary of Aberrant gesture use in autism spectrum disorders is unrelated to motor abnormalities by Pavlidou A., Tolev A., Reinhold D. et al., European Archives of Psychiatry and Clinical Neuroscience (2025). Source license: CC-BY-4.0. It is not medical advice — talk to a qualified clinician before changing therapy.