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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Increasing evidence suggests that early motor impairments are a common feature of autism. Thus, scalable, quantitative methods for measuring motor behavior in young autistic children are needed. This work presents an engaging and scalable assessment of visual-motor abilities based on a bubble-popping game administered on a tablet. Participants are 233 children ranging from 1.5 to 10 years of age (147 neurotypical children and 86 children diagnosed with autism spectrum disorder [autistic], of which 32 are also diagnosed with co-occurring attention-deficit\/hyperactivity disorder [autistic+ADHD]). Computer vision analyses are used to extract several game-based touch features, which are compared across autistic, autistic+ADHD, and neurotypical participants. Results show that younger (1.5-3 years) autistic children pop the bubbles at a lower rate, and their ability to touch the bubble\u2019s center is less accurate compared to neurotypical children. When they pop a bubble, their finger lingers for a longer period, and they show more variability in their performance. In older children (3-10-years), consistent with previous research, the presence of co-occurring ADHD is associated with greater motor impairment, reflected in lower accuracy and more variable performance. Several motor features are correlated with standardized assessments of fine motor and cognitive abilities, as evaluated by an independent clinical assessment. 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G.D., and G.S. developed technology related to the app that has been licensed, and both they and Duke University have benefited financially. G.D. G.D. is on the Scientific Advisory Boards of Akili Interactive, Inc, Zynerba, Nonverbal Learning Disability Project, and Tris Pharma, is a consultant to Apple, Gerson Lehrman Group, and Guidepoint Global, Inc., and receives book royalties from Guilford Press and Springer Nature. G.D. has stock interests in Neuvana, Inc., and has invention disclosures and patent applications registered at the Duke Office of Licensing and Ventures. G.S. was a consultant for Apple, Volvo, Restore3D, SIS, when this work started. He is a scientific advisor to Tanku and has invention disclosures and patent applications registered at the Duke Office of Licensing and Ventures. He received speaking fees from Janssen when this work started. 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