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Bhat AN. Fewer children with autism spectrum disorder with motor challenges receive physical and recreational therapies compared to standard therapies: A SPARK data set analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1161-1174. [PMID: 37605823 PMCID: PMC10881894 DOI: 10.1177/13623613231193196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
LAY ABSTRACT There are clear disparities in motor services provided to children with autism spectrum disorder (physical and recreational therapies) compared to their standard therapies (speech-language and occupational therapies). Children with autism spectrum disorder need greater access to and funding for motor services (physical and recreational therapies) and physical activity programs. Movement experts including PTs, adapted physical educators, and community exercise/sports coaches/professionals need basic, specialized, and continuing education training to meet the needs of children and adults with autism spectrum disorder not only for providing early developmental and school-based services but also for ensuring appropriate built environments and providing general physical therapy/adapted physical education services as well as physical activity programs.
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Gu T, Jin C, Lin L, Wang X, Li X, Jing J, Cao M. The relationship between executive function and the association of motor coordination difficulties and social communication deficits in autistic children. Front Psychiatry 2024; 15:1363406. [PMID: 38596639 PMCID: PMC11002984 DOI: 10.3389/fpsyt.2024.1363406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/13/2024] [Indexed: 04/11/2024] Open
Abstract
Background Motor coordination difficulties could contribute to social communication deficits in autistic children. However, the exploration of the mechanism implicated in these claims has been limited by the lack of potential confounders such as executive function (EF). Methods We investigated the role that EF plays in the relationship between motor coordination and social communication in a school-aged autistic population via a structural model in a statistically robust manner. The results of questionnaires, including the Developmental Coordination Disorder questionnaire, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale, were collected to measure motor coordination, social communication deficits, and EF. Results A total of 182 autistic children (7.61±1.31 years, 87.9% boys) were included in the final analysis. In the model with EF as a mediator, the total effect (β=-0.599, P<0.001) and the direct effect (β=-0.331, P =0.003) of motor coordination function on social communication were both significant among autistic children without intellectual disability (ID), as were indirect effects through EF (β=-0.268, P<0.001). Conclusion EF partially mediates the motor coordination and social communication correlation among autistic children. We suggest that motor coordination should be included in the routine evaluation of autistic surveillance and rehabilitation procedures.
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Affiliation(s)
- Tingfeng Gu
- Maternal and Child Health Department, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengkai Jin
- Maternal and Child Health Department, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lizi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xin Wang
- Maternal and Child Health Department, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiuhong Li
- Maternal and Child Health Department, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Maternal and Child Health Department, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Muqing Cao
- School of Sport and Health, Guangzhou Sport University, Guangzhou, China
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Su WC, Cleffi C, Srinivasan S, Bhat A. A Pilot Study Comparing the Efficacy, Fidelity, Acceptability, and Feasibility of Telehealth and Face-to-Face Creative Movement Interventions in Children with Autism Spectrum Disorder. TELEMEDICINE REPORTS 2024; 5:67-77. [PMID: 38558955 PMCID: PMC10979681 DOI: 10.1089/tmr.2023.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 04/04/2024]
Abstract
Aims We compared the efficacy, fidelity, acceptability, and feasibility of a creative movement (CM) intervention for children with autism spectrum disorder (ASD), delivered face-to-face (F2F) or through telehealth (TH). Methods Fifteen children with ASD received the CM intervention F2F or through TH. Motor assessments were used to evaluate effects of F2F and TH interventions on children's motor skills, while video coding was used to assess affect, socially directed verbalization, interpersonal synchrony, and motor coordination during training. Stakeholder feedback and training fidelity data on the intervention were also collected. Results Children in both subgroups showed similar baseline performance and training-related improvements in motor skills, positive/interested affect, socially directed verbalization, interpersonal synchrony, and dual/multilimb coordination. Parents in the TH subgroup considered the intervention feasible and acceptable; however, they reported greater effort to supervise and redirect their child's attention compared to the F2F subgroup. Trainers for the TH subgroup reported more communication difficulties, technological issues, and longer session lengths, but found greater parental involvement compared to the F2F subgroup. Conclusions CM interventions are consistent, acceptable, feasible, and effective in improving social, behavioral-affective, and motor skills of children with ASD, regardless of the method of delivery. Clinicians should make efforts to reduce communication/technological issues and parental burden when delivering CM interventions through TH. ClinicalTrials.Gov Study ID-NCT04258254.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
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Will EA, Hills KJ, Smith K, McQuillin S, Roberts JE. Developmental associations between motor and communication outcomes in Fragile X syndrome: Variation in the context of co-occurring autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225498. [PMID: 38456297 DOI: 10.1177/13623613231225498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
LAY ABSTRACT Fragile X syndrome (FXS), the leading heritable cause of intellectual disability, has a co-occurrence rate of autism spectrum disorder (ASD) estimated at ~60%. Children with FXS experience delayed achievement and slower development of key motor abilities, which happens to an even greater extent for children with both FXS and ASD. A multitude of studies have demonstrated that motor abilities are foundational skills related to later communication outcomes in neurotypical development, as well as in the context of ASD. However, these associations remain unexamined in FXS, or FXS + ASD. In this study, we aimed to determine the associations between early motor skills and their rate of development on communication outcomes in FXS. Furthermore, we investigated whether these associations varied in the context of co-occurring FXS + ASD. Results revealed within-FXS variation in the context of co-occurring ASD between some aspects of motor development and communication outcomes, yet within-FXS consistency between others. Findings provide evidence for variability in developmental processes and outcomes in FXS in the context of co-occurring ASD and offer implications for intervention.
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Skaletski EC, Barry K, Dennis E, Donnelly R, Huerta C, Jones A, Schmidt K, Kabakov S, Ausderau KK, Li JJ, Travers BG. Sensorimotor Features and Daily Living Skills in Autistic Children With and Without ADHD. J Autism Dev Disord 2024:10.1007/s10803-024-06256-y. [PMID: 38443659 DOI: 10.1007/s10803-024-06256-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 03/07/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) commonly co-occurs in autistic children. However, additional research is needed to explore the differences in motor skills and sensory features in autistic children with and without ADHD, as well as the impacts of these factors on daily living skills (DLS). This observational study sought to fill this gap with 67 autistic children (6.14-10.84 years-old), 43 of whom had ADHD. Autistic children with ADHD demonstrated higher sensory features and lower motor skills than autistic children without ADHD. In examining autism and ADHD features dimensionally, we found that overall sensory features, seeking, and hyporesponsiveness were driven by both autism and ADHD features, whereas motor skills, enhanced perception, and hyperresponsiveness were driven by only autism features. Additionally, in using these dimensional variables of autism and ADHD features, we found that differences in motor skills, sensory and autism features, but not ADHD features, impact DLS of autistic children, with autism features and motor skills being the strongest individual predictors of DLS. Together, these results demonstrate the uniqueness of motor skills and sensory features in autistic children with and without ADHD, as well as how autism features, sensory features, and motor skills contribute to DLS, emphasizing the importance of a comprehensive understanding of each individual and complexities of human development when supporting autistic children.
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Affiliation(s)
- Emily C Skaletski
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Avenue, Madison, WI, 53706, USA
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Kelly Barry
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Elizabeth Dennis
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Ryan Donnelly
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Celina Huerta
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Andrez Jones
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Kate Schmidt
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Sabrina Kabakov
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Karla K Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - James J Li
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Department of Psychology, University of Wisconsin-Madison, 1202 W Johnson St, Madison, WI, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA.
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Su WC, Mutersbaugh J, Huang WL, Bhat A, Gandjbakhche A. Developmental Differences in Reaching-and-Placing Movement and Its Potential in Classifying Children with and without Autism Spectrum Disorder: Deep Learning Approach. RESEARCH SQUARE 2024:rs.3.rs-3959596. [PMID: 38496641 PMCID: PMC10942561 DOI: 10.21203/rs.3.rs-3959596/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Autism Spectrum Disorder (ASD) is among the most prevalent neurodevelopmental disorders, yet the current diagnostic procedures rely on behavioral analyses and interviews and lack objective screening methods. This study seeks to address this gap by integrating upper limb kinematics and deep learning methods to identify potential biomarkers that could be validated in younger age groups in the future to enhance the identification of ASD. Forty-one school-age children, with and without an ASD diagnosis (Mean age ± SE = 10.3 ± 0.4; 12 Females), participated in the study. A single Inertial Measurement Unit (IMU) was affixed to the child's wrist as they engaged in a continuous reaching and placing task. Deep learning techniques were employed to classify children with and without ASD. Our findings suggest delays in motor planning and control in school-age children compared to healthy adults. Compared to TD children, children with ASD exhibited poor motor planning and control as seen by greater number of movement units, more movement overshooting, and prolonged time to peak velocity/acceleration. Compensatory movement strategies such as greater velocity and acceleration were also seen in the ASD group. More importantly, using Multilayer Perceptron (MLP) model, we demonstrated an accuracy of ~ 78.1% in classifying children with and without ASD. These findings underscore the potential use of studying upper limb movement kinematics during goal-directed arm movements and deep learning methods as valuable tools for classifying and, consequently, aiding in the diagnosis and early identification of ASD upon further validation in younger children.
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Abrams G, Jayashankar A, Kilroy E, Butera C, Harrison L, Ring P, Houssain A, Nalbach A, Cermak SA, Aziz-Zadeh L. Differences in Praxis Errors in Autism Spectrum Disorder Compared to Developmental Coordination Disorder. J Autism Dev Disord 2024; 54:1113-1129. [PMID: 36515853 DOI: 10.1007/s10803-022-05858-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.
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Affiliation(s)
- Gabriel Abrams
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Aditya Jayashankar
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Emily Kilroy
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Christiana Butera
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Laura Harrison
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Priscilla Ring
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Anusha Houssain
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Alexis Nalbach
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Sharon A Cermak
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Lisa Aziz-Zadeh
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA.
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA.
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Valagussa G, Purpura G, Balatti V, Trentin L, Signori A, Grossi E. Quantitative assessment of tip-toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross-sectional study. Autism Res 2024; 17:311-323. [PMID: 38108559 DOI: 10.1002/aur.3072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
The term "toe walking" describes walking on the toes with a lack of heel strike upon initiation of the stance phase of gait. In individuals with autism spectrum disorder (ASD), this phenomenon, or "tip-toe behavior" (TTB), can be present in a substantial proportion of subjects even during standing. In this study, we investigated TTB in 50 persons with ASD (age range 4-26 years). We evaluated TTB through an observational/report-based assessment protocol. Subsequently, we employed a new structured video-based coding protocol based on standardized video recordings, focusing on static and dynamic conditions. Finally, the findings of the two protocols were compared. Twenty-four subjects with TTB were identified and classified according to three functional groups: TTB1, present only during running (6 subjects); TTB2, present during walking and running (11 subjects); and TTB3, present during standing, walking, and running (7 subjects). Moreover, we found that TTB3 subjects exhibited a significantly higher quantity of TTB compared with subjects in the TTB1 and TTB2 groups during both standing and walking tests. Additionally, a high quantity of TTB in the static test was found to be related to a high quantity of TTB in the dynamic test. Variables such as age, autism severity, intellectual disability, and gender were not significantly associated with the mean percent of TTB both in static and dynamic tests in multivariate analysis. This structured video-based coding approach appears feasible and useful for assessing TTB in individuals with ASD and it has the potential to provide insights into TTB trajectories and aid in designing possible interventions.
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Affiliation(s)
- Giulio Valagussa
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Valeria Balatti
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Luca Trentin
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
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Chen Y, Siles B, Tager-Flusberg H. Receptive language and receptive-expressive discrepancy in minimally verbal autistic children and adolescents. Autism Res 2024; 17:381-394. [PMID: 38149732 PMCID: PMC10922817 DOI: 10.1002/aur.3079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/08/2023] [Indexed: 12/28/2023]
Abstract
Among the approximately one-third of autistic individuals who experience considerable challenges in acquiring spoken language and are minimally verbal (MV), relatively little is known about the range of their receptive language abilities. This study included 1579 MV autistic children and adolescents between 5 and 18 years of age drawn from the National Database for Autism Research and the SFARI Base data repository. MV autistic children and adolescents demonstrated significantly lower receptive language compared to the norms on standardized language assessment and parent report measures. Moreover, their receptive language gap widened with age. Overall, our sample demonstrated significantly better receptive than expressive language. However, at the individual level, only about 25% of MV autistic children and adolescents demonstrated significantly better receptive language relative to their minimal expressive levels. Social skills explained a significant proportion of the variance in parent-reported receptive language skills, while motor skills were the most significant predictor of greater receptive-expressive discrepancy. Findings from this study revealed the heterogeneous language profiles in MV autistic children and adolescents, underscoring the importance of individualizing interventions to match their different communication strengths and needs and integrating multiple interconnected areas to optimize their overall development of language comprehension, socialization, and general motor skills.
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Affiliation(s)
- Yanru Chen
- Department of Psychological & Brain Sciences, Boston University, 100 Cummington Mall, Boston, MA 02155
| | - Brynn Siles
- Department of Psychological & Brain Sciences, Boston University, 100 Cummington Mall, Boston, MA 02155
| | - Helen Tager-Flusberg
- Department of Psychological & Brain Sciences, Boston University, 100 Cummington Mall, Boston, MA 02155
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Helsel BC, Foster RNS, Sherman J, Ptomey LT, Montgomery RN, Washburn RA, Donnelly JE. A Remotely Delivered Yoga Intervention for Adolescents with Autism Spectrum Disorder: Feasibility and Effectiveness for Improving Skills Related to Physical Activity. J Autism Dev Disord 2023; 53:3958-3967. [PMID: 35939186 PMCID: PMC10124171 DOI: 10.1007/s10803-022-05702-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
This study evaluated the feasibility of remotely delivered yoga for improving four physical activity-related skills: motor skills, strength, balance, and flexibility in adolescents with autism spectrum disorder (ASD). Nineteen of 20 participants enrolled (age 13.2 ± 2.2 years; 60% male) completed the 12-week intervention and attended 83% of the scheduled yoga sessions. Overall, physical activity-related skills improved pre to post intervention (Φ = 0.90, p = 0.005, 95% CI 0.72-1.0). Specifically, significant increases in leg strength (12.5%, p = 0.039), flexibility (40.3%, p = 0.008), and dynamic balance on the right (11.1%, p = 0.001) and left legs (8.1%, p = 0.003) were observed across 12 weeks. These results demonstrate the feasibility and potential effectiveness of yoga to improve physical activity-related skills in adolescents with ASD.
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Affiliation(s)
- Brian C Helsel
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
| | - Rachel N S Foster
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
- Department of Applied Behavioral Science, University of Kansas, Kansas City, USA
| | - Joseph Sherman
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Lauren T Ptomey
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Robert N Montgomery
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
- Department of Biostatistics & Data Science, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Richard A Washburn
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Joseph E Donnelly
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
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Su WC, Culotta M, Mueller J, Tsuzuki D, Bhat AN. Autism-Related Differences in Cortical Activation When Observing, Producing, and Imitating Communicative Gestures: An fNIRS Study. Brain Sci 2023; 13:1284. [PMID: 37759885 PMCID: PMC10527424 DOI: 10.3390/brainsci13091284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Children with autism spectrum disorder (ASD) have difficulties in gestural communication during social interactions. However, the neural mechanisms involved in naturalistic gestural communication remain poorly understood. In this study, cortical activation patterns associated with gestural communication were examined in thirty-two children with and without ASD (mean age: 11.0 years, SE: 0.6 years). Functional near-infrared spectroscopy (fNIRS) was used to record cortical activation while children produced, observed, or imitated communicative gestures. Children with ASD demonstrated more spatial and temporal errors when performing and imitating communicative gestures. Although both typically developing (TD) children and children with ASD showed left-lateralized cortical activation during gesture production, children with ASD showed hyperactivation in the middle/inferior frontal gyrus (MIFG) during observation and imitation, and hypoactivation in the middle/superior temporal gyrus (MSTG) during gesture production compared to their TD peers. More importantly, children with ASD exhibited greater MSTG activation during imitation than during gesture production, suggesting that imitation could be an effective intervention strategy to engage cortical regions crucial for processing and producing gestures. Our study provides valuable insights into the neural mechanisms underlying gestural communication difficulties in ASD, while also identifying potential neurobiomarkers that could serve as objective measures for evaluating intervention effectiveness in children with ASD.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA; (W.-C.S.); (M.C.)
- Biomechanics and Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
| | - McKenzie Culotta
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA; (W.-C.S.); (M.C.)
- Biomechanics and Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
| | - Jessica Mueller
- Department of Behavioral Health, Swank Autism Center, Nemours Children’s Hospital, Wilmington, DE 19803, USA;
| | - Daisuke Tsuzuki
- Department of Information Sciences, Kochi University, Kochi 780-8520, Japan;
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA; (W.-C.S.); (M.C.)
- Biomechanics and Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
- Interdisciplinary Neuroscience Graduate Program, Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19713, USA
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Su WC, Culotta M, Mueller J, Tsuzuki D, Bhat A. fNIRS-Based Differences in Cortical Activation during Tool Use, Pantomimed Actions, and Meaningless Actions between Children with and without Autism Spectrum Disorder (ASD). Brain Sci 2023; 13:876. [PMID: 37371356 DOI: 10.3390/brainsci13060876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Children with autism spectrum disorder (ASD) have difficulties with tool use and pantomime actions. The current study utilized functional near-infrared spectroscopy (fNIRS) to examine the neural mechanisms underlying these gestural difficulties. Thirty-one children with and without ASD (age (mean ± SE) = 11.0 ± 0.6) completed a naturalistic peg-hammering task using an actual hammer (hammer condition), pantomiming hammering actions (pantomime condition), and performing meaningless actions with similar joint motions (meaningless condition). Children with ASD exhibited poor praxis performance (praxis error: TD = 17.9 ± 1.7; ASD = 27.0 ± 2.6, p < 0.01), which was significantly correlated with their cortical activation (R = 0.257 to 0.543). Both groups showed left-lateralized activation, but children with ASD demonstrated more bilateral activation during all gestural conditions. Compared to typically developing children, children with ASD showed hyperactivation of the inferior parietal lobe and hypoactivation of the middle/inferior frontal and middle/superior temporal regions. Our findings indicate intact technical reasoning (typical left-IPL activation) but atypical visuospatial and proprioceptive processing (hyperactivation of the right IPL) during tool use in children with ASD. These results have important implications for clinicians and researchers, who should focus on facilitating/reducing the burden of visuospatial and proprioceptive processing in children with ASD. Additionally, fNIRS-related biomarkers could be used for early identification through early object play/tool use and to examine neural effects following gesture-based interventions.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA
- Biomechanics & Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
| | - McKenzie Culotta
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA
- Biomechanics & Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
| | - Jessica Mueller
- Department of Behavioral Health, Swank Autism Center, A. I. du Pont Nemours Children's Hospital, Wilmington, DE 19803, USA
| | - Daisuke Tsuzuki
- Department of Information Science, Faculty of Science and Technology, Kochi University, Kochi 780-8520, Japan
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA
- Biomechanics & Movement Science Program, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
- Interdisciplinary Neuroscience Graduate (ING) Program, Department of Psychological & Brain Sciences, University of Delaware, Newark, DE 19716, USA
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13
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Butler LK, Tager-Flusberg H. Fine motor skill and expressive language in minimally verbal and verbal school-aged autistic children. Autism Res 2023; 16:630-641. [PMID: 36578205 PMCID: PMC10320849 DOI: 10.1002/aur.2883] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022]
Abstract
Fine motor skill is associated with expressive language outcomes in infants who have an autistic sibling and in young autistic children. Fewer studies have focused on school-aged children even though around 80% have motor impairments and 30% remain minimally verbal (MV) into their school years. Moreover, expressive language is not a unitary construct, but it is made up of components such as speech production, structural language, and social-pragmatic language use. We used natural language sampling to investigate the relationship between fine motor and speech intelligibility, mean length of utterance and conversational turns in MV and verbal autistic children between the ages of 4 and 7 while controlling for age and adaptive behavior. Fine motor skill predicted speech production, measured by percent intelligible utterances. Fine motor skill and adaptive behavior predicted structural language, measured by mean length of utterance in morphemes. Adaptive behavior, but not fine motor skill, predicted social-pragmatic language use measured by number of conversational turns. Simple linear regressions by group corrected for multiple comparisons showed that fine motor skill predicted intelligibility for MV but not verbal children. Fine motor skill and adaptive behavior predicted mean length of utterance for both MV and verbal children. These findings suggest that future studies should explore whether MV children may benefit from interventions targeting fine motor along with speech and language into their school years.
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Affiliation(s)
- Lindsay K. Butler
- Boston University Psychological & Brain Sciences 64 Cummington Mall Boston MA 02215 USA
| | - Helen Tager-Flusberg
- Boston University Psychological & Brain Sciences 64 Cummington Mall Boston MA 02215 USA
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14
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Bhat A, Tulsky DS, Boulton AJ. Cross-replicating findings on unique motor impairments of children with ASD using confirmatory factor analysis and a novel SPARK study sample. Autism Res 2023; 16:967-980. [PMID: 36840933 DOI: 10.1002/aur.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/09/2023] [Indexed: 02/26/2023]
Abstract
A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder-Questionnaire (DCD-Q) is a widely used motor screening tool, yet scant evidence exists regarding its psychometric properties in children with ASD. In a recent Exploratory Factor Analysis (EFA) of the 15-item DCD-Q in a large sample of children with ASD (SPARK study), we found a 5-factor latent structure that identified unique motor impairments in a large sample of children with ASD (Bhat et al., 2022). In the current study, we extend this work by cross-replicating the EFA findings of unique ASD-related motor issues using Confirmatory Factor Analysis (CFA) in a new, more recent wave of children with ASD from the SPARK study (N = 9721). The fits and interpretability of 11 hypothesis-driven CFA models, including 8 correlated-factors, 1 second-order, and 2 bifactor models were compared. Our findings supported the previous 5-factor model with 2 gross motor subdomains, 1 fine motor domain (similar to the original DCD-Q) and 2 general coordination subdomains. This model demonstrated acceptable fit in the new sample as well as superior fit compared to several other parsimonious correlated-factors models. However, the second-order and bifactor models fit slightly better and supported the presence of a general motor skills factor, although 38% of the common variance in the DCD-Q items remained attributable to the 5 subdomains. Using one of the bifactor models, measurement invariance was also supported for DCD-Q across sex, race, and co-occurring conditions of language disorder and intellectual disability. Only partial invariance was supported when testing DCD-Q scores across different age groups. These findings reveal a more complex dimensional picture of the DCD-Q in children with ASD. Results suggest that the DCD-Q can be used in two ways, total scores adequately assess general motor skills for brief screening and subdomain scores offer unique information on the multidimensional motor problems of children with ASD. If subdomain data are of interest, our findings call into question the practice of relying on 3 original subscales of the DCD-Q when screening for ASD-related motor difficulties, whereas 4 out of 5 subscale scores may better highlight domain-specific motor problems. Future studies should continue to further validate DCD-Q's ability to screen for multidimensional motor problems.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - David S Tulsky
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
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15
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Zappullo I, Conson M, Baiano C, Cecere R, Raimo G, Kirby A. The Relationships between Self-Reported Motor Functioning and Autistic Traits: The Italian Version of the Adult Developmental Coordination Disorders/Dyspraxia Checklist (ADC). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1101. [PMID: 36673857 PMCID: PMC9859597 DOI: 10.3390/ijerph20021101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND We developed the Italian version of the adult developmental co-ordination disorders/dyspraxia checklist (ADC), providing reliability and concurrent validity data for the scale (Aim 1). In addition, we investigated the relationships between motor coordination difficulties and different autistic traits (Aim 2). METHODS 498 participants (341 females; age range = 18-34) underwent the Italian version of the ADC, as well as a handwriting speed test, the autism spectrum quotient, the empathy quotient, and the systemizing quotient. RESULTS The distinction between three main factors (A, B, and C) identified in the original version of the ADC was confirmed here. Internal consistency of the ADC subscales was adequate, as well as the correlation with the handwriting speed test used to assess concurrent validity. No substantial sex differences on the ADC scores were found. Furthermore, data revealed that poor autistic-related communication skills and lower levels of systemizing tendencies were, among all the investigated autistic traits, those more strongly associated with higher motor coordination difficulties. CONCLUSIONS The Italian ADC seems a valuable tool for assessing motor coordination difficulties in adults and can reveal the nuanced impact exerted by different autistic traits on self-reported motor functioning.
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Affiliation(s)
- Isa Zappullo
- Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Massimiliano Conson
- Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | | | - Roberta Cecere
- Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Gennaro Raimo
- Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
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16
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Miller HL, Templin TN, Fears NE, Sherrod GM, Patterson RM, Bugnariu NL. Movement smoothness during dynamic postural control to a static target differs between autistic and neurotypical children. Gait Posture 2023; 99:76-82. [PMID: 36335658 PMCID: PMC10644903 DOI: 10.1016/j.gaitpost.2022.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/11/2022] [Accepted: 10/23/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Autistic children and adults have known differences in motor performance, including postural instability and atypical gross motor control. Few studies have specifically tested dynamic postural control. This is the first study to quantify movement smoothness and its relationship to task performance during lateral dynamic postural control tasks in autism. RESEARCH QUESTION We sought to test the hypothesis that autistic children would have less smooth movements to lateral static targets compared to neurotypical children, and that this difference would relate to specific movement strategies. METHODS We used camera-based motion-capture to measure spatiotemporal characteristics of lateral movement of a marker placed on the C7 vertebrae, and of markers comprising trunk and pelvis segments during a dynamic postural movements to near and far targets administered in an immersive virtual environment. We tested a sample of 15 autistic children and 11 age-matched neurotypical children. We quantified movement smoothness using log dimensionless jerk. RESULTS Autistic children exhibited more medial-lateral pelvic position range of motion compared to neurotypical children, and used a stepping strategy more often compared to neurotypical children. Autistic children also had higher log dimensionless jerk than neurotypical children for motion of the C7 marker. All participants had higher log dimensionless jerk for far targets than for near targets. Autistic children had longer trial durations than neurotypical children, and younger children had longer trial durations than older children across diagnostic groups. SIGNIFICANCE The stepping strategy observed more often in the autistic group likely contributed to log dimensionless jerk and reduced movement smoothness. This strategy is indicative of either an attempt to prevent an impending loss of balance, or an attempt to compensate for and recover from a loss of balance once it is detected.
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Affiliation(s)
- Haylie L Miller
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA; University of Michigan, 830 N. University Ave., Ann Arbor, MI 48170, USA.
| | - Tylan N Templin
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA; Southwest Research Institute, 6220 Culebra Rd., San Antonio, TX 78238, USA
| | - Nicholas E Fears
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA; University of Michigan, 830 N. University Ave., Ann Arbor, MI 48170, USA; Louisiana State University, School of Kinesiology, 1246 Pleasant Hall, Baton Rouge, LA 70803, USA
| | - Gabriela M Sherrod
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA; University of Alabama at Birmingham, 1720 University Blvd., Birmingham, AL 35294, USA
| | - Rita M Patterson
- University of North Texas Health Science Center, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA
| | - Nicoleta L Bugnariu
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX 76109, USA; University of the Pacific, School of Health Sciences, 3200 Fifth Ave., Sacramento, CA 95817, USA
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17
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Bhat A. Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis. Autism Res 2023; 16:208-229. [PMID: 36533674 PMCID: PMC9939031 DOI: 10.1002/aur.2870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
When motor difficulties continue into adolescence/adulthood, they could negatively impact an individual with autism spectrum disorder (ASD)'s daily living skills, physical fitness, as well as physical and mental health/well-being. Few studies have examined motor difficulties in children with ASD as a function of sex or age; however, greater cognitive challenges are associated with worse general motor performance. Based on the Developmental Coordination Disorder-Questionnaire (DCD-Q) data from the SPARK study sample, 87%-88% children with ASD were at-risk for a general motor impairment that persisted until 15 years and was related to their core and co-occurring difficulties. Bhat et al. confirmed motor difficulties in children with ASD on multiple motor dimensions that predicted core and co-occurring conditions after accounting for age and sex. However, presence of intellectual disability (ID) or cognitive delay was not controlled in the previous analysis. Additionally, the effects of age, sex, and cognitive ability on multidimensional motor difficulties of the SPARK sample have not been discussed before. Therefore, this analysis examines the effects of age, sex, and cognitive ability (presence of ID or level of cognitive delay) on the motor performance of children from the SPARK sample using the DCD-Q. Except fine motor skills, multiple motor domains did not change with age in children with ASD. Females without ID improved their fine motor scores with age, and performed better compared to males without ID. Children with ASD and ID had greater motor difficulties across multiple motor domains than those without ID. Even after controlling for age, sex, and presence of ID/cognitive delay; motor performance was predictive of social communication skills, repetitive behavior severity, as well as language and functional delays. Gross motor skills contributed more than fine motor and general motor competence skills in predicting social communication delay. However, fine motor and general motor competence skills contributed more than gross motor skills in predicting repetitive behavior severity and language delay. Both, fine and gross motor skills predicted functional delay. In light of consistent findings on motor difficulties in children with ASD, adding motor issues as a specifier within the ASD definition could provide a clear clinical route for movement clinicians to address motor difficulties of individuals with ASD.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
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18
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Ketcheson LR, Pitchford EA, Staples KL, MacDonald M, Ulrich DA. Supporting the need for the motor domain to be included in the definition of autism spectrum disorder: A response to Bishop et al.'s critique of Bhat (2021). Autism Res 2022; 15:1796-1798. [PMID: 36052511 DOI: 10.1002/aur.2811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Leah R Ketcheson
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | | | - Kerri L Staples
- School of Health Promotion and Kinesiology, Texas Woman's University, Denton, Texas, USA
| | - Megan MacDonald
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Dale A Ulrich
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
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19
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Belmonte MK. Motor symptoms in the ASD diagnostic criteria: A conservative perspective. Autism Res 2022; 15:1582-1584. [PMID: 35968612 DOI: 10.1002/aur.2793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Matthew K Belmonte
- The Com DEALL Trust, Bangalore, India.,Division of Psychology, Nottingham Trent University, Nottingham, UK
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20
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Bishop SL, Wickstrom J, Thurm A. Insufficient evidence for inclusion of motor deficits in the ASD diagnostic criteria: A response to Bhat (2021). Autism Res 2022; 15:1374-1375. [PMID: 35779237 DOI: 10.1002/aur.2775] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/19/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Somer L Bishop
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | | | - Audrey Thurm
- National Institutes of Mental Health, NIH, Bethesda, Maryland, USA
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21
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Bhat A. Why add motor to the definition of ASD: A response to Bishop et al.'s critique of Bhat (2021). Autism Res 2022; 15:1376-1379. [PMID: 35779238 PMCID: PMC9936216 DOI: 10.1002/aur.2776] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Anjana Bhat
- Physical Therapy Department, University of Delaware, Newark, Delaware, USA
- Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
- Behavioral Neuroscience Division, Psychological & Brain Sciences Department, University of Delaware, Newark, Delaware, USA
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