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Background: Autism is one of five diagnoses classified within autism spectrum disorder. The diagnosis is characterized by communication and sensory impairments, repetitive behaviors, and gross motor delays. While physical therapy is not a primary treatment for these children, physical therapy intervention addressing motor dysfunction may facilitate improved social interaction with peers. Purpose: The purpose of this case study is to address the use of Bal-A-Vis-X exercises that incorporate a multisystem approach in conjunction with pediatric physical therapy treatments for a child with a gross motor delay and previous diagnoses of autism and attention-deficit hyperactivity disorder (ADHD). Case Description: A 6 year-old boy, diagnosed with autism and ADHD, participated in physical therapy at a pediatric outpatient clinic to address his gross motor delay, balance deficits, gait abnormality and coordination impairments over several years. Intervention: Over a course of three years, several different multisystem exercises from the Bal-A-Vis-X program were incorporated into this child’s plan of care as an adjunct to primary interventions. Outcome Measures: The Bruininks-Oseretsky Test of Motor Development and Proficiency, Second Edition (BOT-2), which assessed coordination, balance and strength, was assessed every six months. The most recent six-month interval did not show notable improvements within two subscales: body coordination and strength and agility motor area composites. However, the Canadian Occupational Performance Measure (COPM) may be used to identify patient or parent reported changes in performing challenging activities. Discussion: Although improvements were not seen with BOT-2 testing, parent and self-report measures, such as the COPM, may best measure therapeutic benefits of Bal-A-Vis-X exercises. Further research addressing physical therapy management and assessment of children with autism is needed to improve functional outcomes.