Standing balance on unsteady surfaces in children on the autism spectrum: The effects of IQ
Open accessAbstract
Background Postural stability difficulties are commonly reported in people on the autism spectrum. However, it is unclear whether unsteady surfaces may exacerbate postural stability difficulties in children and adolescents with autism spectrum disorder (ASD). Understanding balance on unsteady surfaces is important because uneven surfaces are commonly encountered in daily life.Methods Twenty-one youth on the autism spectrum and 16 youth with typical development (ages 6-16 years, IQ ≥ 79) stood on both a fixed and unsteady (tiltable) platform, and center of pressure was measured.Results The group with ASD exhibited differentially more postural sway on the unsteady surface compared to the group with typical development. However, there was substantial variability within the ASD group. Follow-up analyses suggested that much of the variability in postural sway in the ASD group was accounted for by IQ.Conclusions Clinically, these findings suggest that not all individuals with ASD struggle more with postural stability on unsteady surfaces. Instead children and adolescents with ASD and below-average IQ may have particular difficulty on unsteady surfaces and may require accommodations. Further, these findings lay the groundwork for future research to investigate the underlying mechanisms of poorer balance across the autism spectrum.
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Children with ASD generally exhibit an incorrect arrangement of body segments relative to each other.
“Children with ASD generally exhibit an incorrect arrangement of body segments relative to each other [12,13,14].”
From Postural Differences in Speaking Versus Non-Speaking Children with Autism Spectrum Disorder (2025) · cites this paper as [13]
The Abstract Results report greater postural sway in the ASD group on an unsteady surface, which supports a narrower claim about balance difficulties. The Methods measure center-of-pressure sway, not the arrangement of body segments relative to each other. The Abstract Conclusions also caution that not all children with ASD have greater difficulty. (LLM, conf=0.82)
Experimental — accuracy not yet measuredChildren with ASD demonstrate slower development of postural control mechanisms compared to their peers.
“Children with ASD demonstrate slower development of postural control mechanisms compared to their peers.”
From Postural Differences in Speaking Versus Non-Speaking Children with Autism Spectrum Disorder (2025) · cites this paper as [13]
The Introduction (page unavailable) reports prior evidence of atypical postural-control development in ASD, and the Results (page unavailable) find greater sway in children with ASD on an unsteady surface. But the Discussion & Implications (page unavailable) says this study did not assess developmental changes or underlying mechanisms; it does not establish that those mechanisms develop more slowly than in peers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn numerous studies involving children with autism spectrum, displacements of the center of gravity have been observed on stabilimeter platforms.
“In numerous studies involving children with the autism spectrum, displacements of the center of gravity have been observed on stabilimeter platforms [1,5,6,7,9,10,13,15].”
From Postural Differences in Speaking Versus Non-Speaking Children with Autism Spectrum Disorder (2025) · cites this paper as [13]
The Methods and Results describe children and adolescents on the autism spectrum standing on fixed and tiltable platforms, with greater postural sway on the unsteady surface. But the measured quantity was center of pressure, not center of gravity. The Introduction also says that only one earlier autism study used a tiltable surface, and that study involved young adults; it does not support the claim of numerous such studies in children. (LLM, conf=0.86)
Experimental — accuracy not yet measuredNintendo Wii Balance Board studies reported greater postural instability and movement variability in youth with ASD versus TD peers.
“Nintendo Wii Balance Board studies [11, 28, 33, 43, 49, 51] reported greater postural instability and movement variability in youth with ASD versus TD peers.”
From Static and dynamic balance in children and adolescents with autism spectrum disorder compared with typically developing peers: a systematic review and meta-analysis (2026) · cites this paper as [11]
The Methods (Procedures; page unavailable) confirm use of a Nintendo Wii Balance Board, and the Discussion & Implications (page unavailable) reports poorer balance in children and adolescents with ASD on the unsteady surface. The Results describe wide variability in sway area across participants with ASD, not greater movement variability within individuals versus TD peers; that part of the claim is not established. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCenter-of-mass area showed large effect sizes in eyes open-stable, eyes closed-stable, and eyes closed-unstable conditions.
“COM area showed large effect sizes in eyes open–stable, eyes closed–stable, and eyes closed–unstable conditions [11, 23, 32, 35, 38, 43]”
From Static and dynamic balance in children and adolescents with autism spectrum disorder compared with typically developing peers: a systematic review and meta-analysis (2026) · cites this paper as [11]
The Methods (Center of Pressure Data Reduction and Analyses; page unavailable) say the study measured center-of-pressure (COP) area, not center-of-mass area. The Methods (Procedures) describe fixed and tiltable surfaces, and the Results report effect sizes for the group, surface, and their interaction—not large effect sizes for the three specified eyes-open or eyes-closed conditions. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Travers et al. linked lower IQ to greater impairments, highlighting cognitive influences on postural control.
“Travers et al. [11] linked lower IQ to greater impairments, highlighting cognitive influences on postural control.”
An increase in the angle of lumbar lordosis affects the movement of the center of gravity during activities such as walking in the frontal plane, and in a standing position, deflections to the left and forward occur.
“It has been demonstrated that an increase in the angle of lumbar lordosis affects the movement of the center of gravity during activities such as walking in the frontal plane. At the same time, in a standing position, deflections to the left and forward occur [1,6,13,15].”
From Postural Differences in Speaking Versus Non-Speaking Children with Autism Spectrum Disorder (2025) · cites this paper as [13]
The Methods describe measuring center-of-pressure sway during standing, and the Results compare sway on fixed and unsteady surfaces in children on the autism spectrum. Our copy does not address lumbar lordosis, its effect during walking, or leftward and forward deflections while standing (searched those terms and their directional paraphrases). No page numbers were available for these passages. (LLM, conf=0.75)
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Postural control processes during standing and step initiation in autism spectrum disorder
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“It explains their greater “clumsiness” and frequent falls [4,6,9,10,13–15].”
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“Travers et al. [11] linked lower IQ to greater impairments, highlighting cognitive influences on postural control.”
Influential
- Authors
- Travers, B. G., Mason, A. H., Gruben, K. G., Dean, D. C., & McLaughlin, K.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Travers, Brittany G.
- Venue
- Research in Autism Spectrum Disorders
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 51
- Pages
- 9-17
- ISSN
- 1878-0237 (ISSN-L)
- 1750-9467
- PMC
- PMC6186444
- OpenAlex
- W2795095193
- Cited by
- 33
- References
- 48
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 9 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research in Autism (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Hartwell Foundation
- Waisman Center
- National Institutes of Health
- National Institute of Mental Health (K99MH110596)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD090256, P30HD003352)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Keywords
- autism spectrum disorder, postural stability, standing balance, postural sway, center of pressure, intelligence quotient, children and adolescents, interindividual variability
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