Proof of Concept: “Tangiball” a Smart Toy to Map Neurodivergent Motor Function in Pre-School Children with Autism

Background: Autistic children may follow a qualitatively different trajectory of motor development, with differences in timing, speed and movement accuracy often leading to compensatory strategies later in childhood. Delays in identifying motor difficulties can affect intervention and long-term quality of life. Advances in sensor technology now offer opportunities for seamless collection of movement data during play. Method: “TangiBall”, developed iteratively with autistic children, families and patient groups, and engineered by a university medical device department, is an interactive toy designed to assess motor function. The device consists of a multi-coloured hub with sensor-equipped faceplates and animal-headed insertion jacks that light up and provide auditory rewards when correctly inserted. The system records movement accuracy and speed. This pilot study aimed to: (1) identify motor signatures in pre-school autistic children during play; (2) assess toy acceptability through parent and clinician interviews; and (3) obtain parent and clinician ratings. Results: Five autistic children (mean age 3 years 5 months) and five control children (mean age 4 years) participated. Mean age difference could explain some of the variance. More than 100,000 data points of real-time movement were collected across 5–10-minute sessions. Autistic children showed less controlled insertion and removal movements, greater variability in motor performance, and reduced engagement with the toy. Parents and clinicians rated TangiBall positively. Conclusion: Findings suggest differences in motor control between autistic and non-autistic children. This pilot study presents descriptive findings from a small sample (n = 5 per group). As such, results should be interpreted as exploratory and hypothesis-generating.