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Mandelli V, Landi I, Ceccarelli SB, Molteni M, Nobile M, D'Ausilio A, Fadiga L, Crippa A, Lombardo MV. Enhanced motor noise in an autism subtype with poor motor skills. Mol Autism 2024; 15:36. [PMID: 39228000 DOI: 10.1186/s13229-024-00618-0] [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: 06/19/2024] [Accepted: 08/27/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Motor difficulties are common in many, but not all, autistic individuals. These difficulties can co-occur with other problems, such as delays in language, intellectual, and adaptive functioning. Biological mechanisms underpinning such difficulties are less well understood. Poor motor skills tend to be more common in individuals carrying highly penetrant rare genetic mutations. Such mechanisms may have downstream consequences of altering neurophysiological excitation-inhibition balance and lead to enhanced behavioral motor noise. METHODS This study combined publicly available and in-house datasets of autistic (n = 156), typically-developing (TD, n = 149), and developmental coordination disorder (DCD, n = 23) children (age 3-16 years). Autism motor subtypes were identified based on patterns of motor abilities measured from the Movement Assessment Battery for Children 2nd edition. Stability-based relative clustering validation was used to identify autism motor subtypes and evaluate generalization accuracy in held-out data. Autism motor subtypes were tested for differences in motor noise, operationalized as the degree of dissimilarity between repeated motor kinematic trajectories recorded during a simple reach-to-drop task. RESULTS Relatively 'high' (n = 87) versus 'low' (n = 69) autism motor subtypes could be detected and which generalize with 89% accuracy in held-out data. The relatively 'low' subtype was lower in general intellectual ability and older at age of independent walking, but did not differ in age at first words or autistic traits or symptomatology. Motor noise was considerably higher in the 'low' subtype compared to 'high' (Cohen's d = 0.77) or TD children (Cohen's d = 0.85), but similar between autism 'high' and TD children (Cohen's d = 0.08). Enhanced motor noise in the 'low' subtype was also most pronounced during the feedforward phase of reaching actions. LIMITATIONS The sample size of this work is limited. Future work in larger samples along with independent replication is important. Motor noise was measured only on one specific motor task. Thus, a more comprehensive assessment of motor noise on many other motor tasks is needed. CONCLUSIONS Autism can be split into at least two discrete motor subtypes that are characterized by differing levels of motor noise. This suggests that autism motor subtypes may be underpinned by different biological mechanisms.
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Affiliation(s)
- Veronica Mandelli
- Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Isotta Landi
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | | | - Massimo Molteni
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Maria Nobile
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Alessandro D'Ausilio
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Luciano Fadiga
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | | | - Michael V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy.
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Xiong W, Li X, Huang X, Xu J, Qu Z, Su Y, Li Y, Han Y, Cui T, Zhang X. Impaired motor and social skill development in infancy predict high autistic traits in toddlerhood. Neuroscience 2024; 558:114-121. [PMID: 39168171 DOI: 10.1016/j.neuroscience.2024.08.024] [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: 02/01/2024] [Revised: 07/26/2024] [Accepted: 08/18/2024] [Indexed: 08/23/2024]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. Early diagnosis in the critical period is important for ASD children. Recent studies of neurodevelopmental behavioral features and joint attention in high-risk infants showed there are some special cues which can distinguish ASD from typical development infant. But the findings of high-risk population may not be applicable to the general population. It is necessary to "analogically" study the potential warning traits of ASD in infancy in the general population. We did a nested case-control study from June 2019 to November 2022 in Tianjin, China, including 76 general infants whom completed the neurodevelopmental evaluation, the Checklist for Autism in Toddlers-23 (CHAT-23) screening, and eye tracking task. Social behavior quotient in infancy was negatively correlated to CHAT-23 total scores in toddlerhood. Social behavior quotient in infancy was positively correlated to initiating joint attention in toddlerhood. Regression model showed that high fine motor scale and social behaviour scale quotient in infancy were associated with an decreased risk of the total score of CHAT-23 ≥ 2 in toddlerhood. The Receiver operating characteristic curve showed the social behaviour in infancy alone and the combination of fine motor and social behaviour in infancy contributed to auxiliary diagnosis of higher level of autistic traits in toddlerhood. These findings suggest that Impaired development of fine motor and social behavior in infancy are potential warning features of high autistic traits in general population.
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Affiliation(s)
- Wenjuan Xiong
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinyu Li
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoqing Huang
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jinghan Xu
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhiyi Qu
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Su
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yin Li
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yu Han
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingkai Cui
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child & Adolescence Health, School of Public Health, Tianjin Medical University, Tianjin, China.
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Wieting J, Baumann MV, Deest-Gaubatz S, Bleich S, Eberlein CK, Frieling H, Deest M. Structured neurological soft signs examination reveals motor coordination deficits in adults diagnosed with high-functioning autism. Sci Rep 2024; 14:16123. [PMID: 38997308 PMCID: PMC11245607 DOI: 10.1038/s41598-024-66723-5] [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: 12/02/2022] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Neurological soft signs (NSS), discrete deficits in motor coordination and sensory integration, have shown promise as markers in autism diagnosis. While motor impairments, partly associated with core behavioral features, are frequently found in children with autism, there is limited evidence in adults. In this study, NSS were assessed in adults undergoing initial diagnosis of high-functioning autism (HFA), a subgroup difficult to diagnose due to social adaptation and psychiatric comorbidity. Adults with HFA (n = 34) and 1:1 sex-, age-, and intelligence-matched neurotypical controls were administered a structured NSS examination including motor, sensory, and visuospatial tasks. We showed that adults with HFA have significantly increased motor coordination deficits compared with controls. Using hierarchical cluster analysis within the HFA group, we also identified a subgroup that was particularly highly affected by NSS. This subgroup differed from the less affected by intelligence level, but not severity of autism behavioral features nor global psychological distress. It remains questionable whether motor impairment represents a genuinely autistic trait or is more a consequence of factors such as intelligence. Nevertheless, we conclude that examining NSS in terms of motor coordination may help diagnose adults with HFA and identify HFA individuals who might benefit from motor skills interventions.
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Affiliation(s)
- Jelte Wieting
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Madita Vanessa Baumann
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stephanie Deest-Gaubatz
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Bleich
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christian Karl Eberlein
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Helge Frieling
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maximilian Deest
- Oberberg Fachklinik Weserbergland, Brede 29, 32699, Extertal-Laßbruch, Germany
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Simarro Gonzalez M, Ni G, Lam V, Demopoulos C. Beyond words: an investigation of fine motor skills and the verbal communication spectrum in autism. Front Psychiatry 2024; 15:1379307. [PMID: 38835552 PMCID: PMC11148429 DOI: 10.3389/fpsyt.2024.1379307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction This study investigated the associations between fine motor skills and expressive verbal abilities in a group of 97 autistic participants (age 8-17, mean=12.41) and 46 typically developing youth (age 8-17, mean=12.48). Methods Participants completed assessments of motor and verbal communication skills, including finger tapping speed, grooved pegboard, grip strength, visual-motor integration tasks, and measures of speech and communication skills. ASD group performance on motor tests was compared to controls. Non-parametric tests were used to analyze group differences and correlations between motor and verbal communication skills. Based on prior research, we hypothesized that individuals on the autism spectrum would exhibit deficits in fine motor speed, dexterity, pencil motor control, but not manual motor strength. Additionally, we expected that impaired fine motor skills would be linked to poorer performance on standardized measures of verbal abilities. Results The results indicated that 80% of autistic participants demonstrated an impairment on at least one measure of motor skills, and as a group, they exhibited significantly poorer fine motor performance compared to the non-ASD group in dominant hand finger tapping speed, bilateral fine motor dexterity measured via the grooved pegboard task, and pencil motor coordination and visual-motor integration measured on the Beery-Buktenica Developmental Test of Visual-Motor Integration-Sixth Edition. Moreover, impaired fine motor skills were associated with poorer performance on standardized clinical measures of verbal abilities, including articulation errors, receptive and expressive language and vocabulary, rapid naming, oromotor sequencing, and parent reported functional communication skills and social communication symptoms. Discussion Overall,our findings suggest there is a high prevalence of fine motor impairments in ASD, and these impairments were associated with a range of verbal abilities. Further research is warranted to better understand the underlying mechanisms of these associations and develop targeted interventions to address both fine motor and verbal impairments in ASD.
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Affiliation(s)
- Marian Simarro Gonzalez
- Spoken Language Interest Group, Basque Centre on Cognition, Brain and Language, San Sebastian, Spain
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Gessica Ni
- Department of UCSF Epilepsy and Pediatric Brain Center, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
- Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Valerie Lam
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Carly Demopoulos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Hatipoğlu Özcan G, Özer DF, Pınar S. Effects of Motor Intervention Program on Academic Skills, Motor Skills and Social Skills in Children with Autism Spectrum Disorder. J Autism Dev Disord 2024:10.1007/s10803-024-06384-5. [PMID: 38755489 DOI: 10.1007/s10803-024-06384-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
The aim of this study was to examine the effect of motor intervention program (MIP) on autistic index, pre-academic skills, motor skills and social skills of children with Autism Spectrum Disorder (ASD). The research group consisted of a total of 34 participants between the ages of 3-6, 17 in the control group (CG) and 17 in the experimental group (EG). EG participated in the motor intervention program for 60 min a day, 2 days a week for 12 weeks. In the study, the Gilliam Autistic Disorder Rating Scale-2-Turkish Version (GARS-2 TV), Peabody Motor Development Scale-2 (PMDS-2), Pre-Academic Skills Evaluation Form (PASAF) and Social Skills Evaluation System Preschool Teacher Form (SSRS-PTF) were used. The increase in all subtests and total scores of PASAF and posttest scores obtained from PMDS-2 were found to be higher in favor of the experimental group (p < 0.05). The decrease in the stereotype and social interaction scores of GARS-2 TV and the change in the cooperation, self-control and externalization sub-dimensions of SSRS-PTF were found to be statistically significant in favor of the EG group (p < 0.05). In conclusion, it was found that MIP applied to autistic children was effective on the development of motor skills, academic skills and social skills and decreased the level of autistic index. This result shows that MIP is an effective practice that provides a favorable environment for autistic young children to develop multiple skills.
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Affiliation(s)
| | - Dilara Fatoş Özer
- Department of Child Development, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | - Salih Pınar
- Faculty of Sport Sciences, Fenerbahçe University, Istanbul, Turkey
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Anderson JT, Toolan C, Coker E, Singer H, Pham D, Jackson N, Lord C, Wilson RB. A novel dance intervention program for children and adolescents with developmental disabilities: a pilot randomized control trial. BMC Sports Sci Med Rehabil 2024; 16:109. [PMID: 38745176 PMCID: PMC11092010 DOI: 10.1186/s13102-024-00897-3] [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: 08/11/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Organized physical activity programs have been shown to provide wide benefits to participants, though there are relatively few studies examining the impact of these programs for individuals with developmental disabilities. This pilot study was conducted to determine the feasibility and impact of an undergraduate-led dance intervention program for children and adolescents with developmental disabilities. We evaluated the impact of the dance program on motor ability and social skills. METHODS The study design was a waitlist control clinical trial in which participants were randomized to active and control groups. Eligible participants included male and female children and adolescents between the ages of 4 and 17 years with neurodevelopmental disabilities. The Motor Assessment Battery for Children Checklist and the Social Responsiveness Scale were used to assess change in motor and social skills, respectively. After gathering baseline data, the active group completed 1 h of online dance classes per week for 10 weeks, while the control group entered a 10-week waiting period. All participants then returned for a follow-up visit. Pre- and post-intervention data were analyzed using linear mixed-effects modeling adjusting for age and class attendance with subject random intercept. RESULTS We recruited and randomized 43 participants with neurodevelopmental disabilities (mean age = 8.63, SD = 2.98), of which 30 participated in dance classes. The attendance rate was 82.6% for the active group and 61.7% for the control group. The active group demonstrated a significant improvement in motor skills in an unpredictable environment, as indicated on the Motor Assessment Battery for Children Checklist (n = 21, p = 0.05). We also observed positive trends in social skills that did not reach significance. CONCLUSIONS Our results indicate that it is feasible to develop and implement a fully digital dance intervention program for individuals with developmental disabilities. Further, we find that change in motor skills can be detected after just 10 h of low-intensity participation. However, a lack of significant change in social skills coupled with limitations in study implementation suggests further research is needed to determine the full impact of this dance program. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: Protocol ID 20-001680-AM-00005, registered 17/2/2021 - Retrospectively Registered, https://clinicaltrials.gov/study/NCT04762290 .
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Affiliation(s)
- Jeffrey T Anderson
- University of California, Los Angeles, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | | | - Emily Coker
- Stanford School of Medicine, Stanford, CA, USA
| | - Hannah Singer
- University of California, Los Angeles, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Derek Pham
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Catherine Lord
- University of California, Los Angeles, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Rujuta B Wilson
- University of California, Los Angeles, Los Angeles, CA, USA.
- Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
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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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Liu F, Qiu K, Wang H, Dong Y, Yu D. Decreased wrist rotation imitation abilities in children with autism spectrum disorder. Front Psychiatry 2024; 15:1349879. [PMID: 38699453 PMCID: PMC11064792 DOI: 10.3389/fpsyt.2024.1349879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/25/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction While meaningless gross motor imitation (GMI) is a common challenge for children diagnosed with autism spectrum disorder (ASD), this topic has not attracted much attention and few appropriate test paradigms have been developed. Methods The current study proposed a wrist rotation imitation (WRI) task (a meaningless GMI assignment), and established a WRI ability evaluation system using low-cost wearable inertial sensors, which acquired the simultaneous data of acceleration and angular acceleration during the WRI task. Three metrics (i.e., total rotation time, rotation amplitude, and symmetry) were extracted from those data of acceleration and angular acceleration, and then were adopted to construct classifiers based on five machine learning (ML) algorithms, including k-nearest neighbors, linear discriminant analysis, naive Bayes, support vector machines, and random forests. To illustrate our technique, this study recruited 49 ASD children (aged 3.5-6.5 years) and 59 age-matched typically developing (TD) children. Results Findings showed that compared with TD children, those with ASD may exhibit shorter total rotation time, lower rotation amplitude, and weaker symmetry. This implies that children with ASD might exhibit decreased WRI abilities. The classifier with the naive Bayes algorithm outperformed than other four algorithms, and achieved a maximal classification accuracy of 88% and a maximal AUC value of 0.91. Two metrics (i.e., rotation amplitude and symmetry) had high correlations with the gross and fine motor skills [evaluated by Gesell Developmental Schedules-Third Edition and Psychoeducational Profile-3 (PEP-3)]. While, the three metrics had no significant correlation with the visual-motor imitation abilities (evaluated by the subdomain of PEP-3) and the ASD symptom severity [evaluated by the Childhood Autism Rating Scale (CARS)] . Discussion The strengths of this study are associated with the low-cost measurement system, correlation between the WRI metrics and clinical measures, decreased WRI abilities in ASD, and high classification accuracy.
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Affiliation(s)
- Fulin Liu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Kai Qiu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Yuhong Dong
- Henan Provincial Medical Key Lab of Language Rehabilitation for Children, Sanmenxia Center Hospital, Sanmenxia, Henan, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Provincial Engineering Research Center of Children’s Digital Rehabilitation, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Otterstedt C, Strömsten LMJ, Sandlund J, Johansson GM. Motor proficiency of persons with attention deficit hyperactivity disorder or autism spectrum disorder diagnosed in adulthood. Disabil Rehabil 2024:1-7. [PMID: 38632964 DOI: 10.1080/09638288.2024.2340123] [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: 05/26/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To compare (1) motor proficiency of persons diagnosed in adulthood with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) with normative values of motor proficiency, and (2) motor proficiency between persons with ADHD and those with ASD diagnosed in adulthood. METHODS A total of 153 adults (median age 32 years, 36% women) participated in this cross-sectional study. Fifty-three persons with predominately inattentive presentation (ADHD-I), 67 persons with combined presentation (ADHD-C), and 33 persons with ASD performed the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). One-sample binominal tests were used to compare motor proficiency against standardized norms of BOT-2 for young adults. One-way ANOVAs and Kruskal-Wallis tests were used to compare test outcomes between the groups. RESULTS The total sample showed significantly impaired motor proficiency in comparison to norms in all test domains (p < 0.001-0.006), except for fine motor skills. The ASD group showed significantly poorer body coordination compared with the ADHD-I and ADHD-C groups, with a moderate effect size (p = 0.003-0.02, η2 = 0.061). CONCLUSIONS Motor proficiency is impaired in most persons with ADHD or ASD diagnosed in adulthood, suggesting that motor assessment should be included in clinical examinations of adults with suspected neurodevelopment disorders.
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Affiliation(s)
- Charlotte Otterstedt
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | | | - Jonas Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Gudrun M Johansson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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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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Koehler JC, Dong MS, Bierlich AM, Fischer S, Späth J, Plank IS, Koutsouleris N, Falter-Wagner CM. Machine learning classification of autism spectrum disorder based on reciprocity in naturalistic social interactions. Transl Psychiatry 2024; 14:76. [PMID: 38310111 PMCID: PMC10838326 DOI: 10.1038/s41398-024-02802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
Autism spectrum disorder is characterized by impaired social communication and interaction. As a neurodevelopmental disorder typically diagnosed during childhood, diagnosis in adulthood is preceded by a resource-heavy clinical assessment period. The ongoing developments in digital phenotyping give rise to novel opportunities within the screening and diagnostic process. Our aim was to quantify multiple non-verbal social interaction characteristics in autism and build diagnostic classification models independent of clinical ratings. We analyzed videos of naturalistic social interactions in a sample including 28 autistic and 60 non-autistic adults paired in dyads and engaging in two conversational tasks. We used existing open-source computer vision algorithms for objective annotation to extract information based on the synchrony of movement and facial expression. These were subsequently used as features in a support vector machine learning model to predict whether an individual was part of an autistic or non-autistic interaction dyad. The two prediction models based on reciprocal adaptation in facial movements, as well as individual amounts of head and body motion and facial expressiveness showed the highest precision (balanced accuracies: 79.5% and 68.8%, respectively), followed by models based on reciprocal coordination of head (balanced accuracy: 62.1%) and body (balanced accuracy: 56.7%) motion, as well as intrapersonal coordination processes (balanced accuracy: 44.2%). Combinations of these models did not increase overall predictive performance. Our work highlights the distinctive nature of non-verbal behavior in autism and its utility for digital phenotyping-based classification. Future research needs to both explore the performance of different prediction algorithms to reveal underlying mechanisms and interactions, as well as investigate the prospective generalizability and robustness of these algorithms in routine clinical care.
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Affiliation(s)
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Afton M Bierlich
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Stefanie Fischer
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt am Main, Germany
| | - Johanna Späth
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Irene Sophia Plank
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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12
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Loffi RG, Cruz TKF, Paiva GM, Souto DO, Barreto SR, Santana PAN, Nascimento AAAC, Costa FRM, Cota EB, Haase VG. Theoretical-Methodological Foundations for the Global Integration Method (Método de Integração Global-MIG) in the Treatment of Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2024; 11:191. [PMID: 38397303 PMCID: PMC10887636 DOI: 10.3390/children11020191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, "Método de Integração Global"), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD's impact. MIG's theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment.
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Affiliation(s)
- Renato Guimarães Loffi
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
| | - Thalita Karla Flores Cruz
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Giulia Moreira Paiva
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Deisiane Oliveira Souto
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
| | - Simone Rosa Barreto
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Patrícia Aparecida Neves Santana
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Amanda Aparecida Alves Cunha Nascimento
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Fabiana Rachel Martins Costa
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Psicologia: Cognição e Comportamento, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Elisa Braz Cota
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
| | - Vitor Geraldi Haase
- Instituto de Neurodesenvolvimento, Cognição e Educação Inclusiva (INCEI), TREINITEC Ltda., Rua Carmélia Loffi 17, Justinópolis, Ribeirão das Neves 33900-730, MG, Brazil; (R.G.L.); (G.M.P.); (D.O.S.); (S.R.B.); (P.A.N.S.); (A.A.A.C.N.); (F.R.M.C.); (E.B.C.); (V.G.H.)
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Programa de Pós-Graduação em Psicologia: Cognição e Comportamento, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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Miller HL, Licari MK, Bhat A, Aziz-Zadeh LS, Van Damme T, Fears NE, Cermak SA, Tamplain PM. Motor problems in autism: Co-occurrence or feature? Dev Med Child Neurol 2024; 66:16-22. [PMID: 37332143 PMCID: PMC10725993 DOI: 10.1111/dmcn.15674] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/21/2023] [Accepted: 05/20/2023] [Indexed: 06/20/2023]
Abstract
Motor features of autism have long been acknowledged by clinicians, researchers, and community stakeholders. Current DSM-5 and ICD-11 guidelines allow clinicians to assign a co-occurring diagnosis of developmental [motor] coordination disorder (DCD) for autistic individuals with significant motor problems. DCD is characterized by poor motor proficiency with an onset of symptoms in early development. Studies have shown considerable overlap in the behavioral motor features observed in autism and DCD. However, others indicate that motor problems in autism and DCD may stem from different underlying sensorimotor mechanisms. Regardless of whether autism has a unique motor phenotype or an overlap with DCD, changes need to be made in the clinical pipeline to address motor problems in autism at the stages of recognition, assessment, diagnosis, and intervention. Consensus is needed to address unmet needs in research on the etiology of motor problems in autism and their overlap with DCD, to optimize clinical practice guidelines. The development of screening and assessment tools for motor problems that are valid and reliable for use with autistic individuals is essential, and an evidence-based clinical pipeline for motor problems in autism is urgently needed. WHAT THIS PAPER ADDS: Motor problems in autism are highly prevalent, yet underdiagnosed and poorly managed. An evidence-based clinical pipeline for motor problems in autism is urgently needed.
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Affiliation(s)
- Haylie L. Miller
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Melissa K. Licari
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
| | - Lisa S. Aziz-Zadeh
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
- Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Nicholas E. Fears
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Sharon A. Cermak
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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14
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Liu T, Tongish M, Li Y, Okuda PMM. Executive and motor function in children with autism spectrum disorder. Cogn Process 2023; 24:537-547. [PMID: 37632649 DOI: 10.1007/s10339-023-01156-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 08/01/2023] [Indexed: 08/28/2023]
Abstract
The purpose of this study was to investigate the relationship between executive function, mainly attention and impulse control, and motor function impairment in children with ASD. Fifteen children with ASD (ages 8-14 years) were examined on their executive function using the Conners continuous performance test-3 and motor function using the movement assessment battery for children-2 (MABC-2). It was found that children with ASD were delayed on executive and motor function. This means that those effects were also observed in male children with Autism Spectrum Disorder (ASD) who had similar characteristics as the participants in the study. This study may have practical implications in the relationship between executive function and motor performance in children with ASD and for clinicians and educators working with children with ASD. Furthermore, the findings suggest that variability in reaction time may be a useful predictor of motor skill performance in children with ASD and may reflect underlying difficulties in executive function and future research is suggested.
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Affiliation(s)
- Ting Liu
- Department of Health and Human Performance, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA.
| | - Morgan Tongish
- Department of Health and Human Performance, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA
| | - Yumeng Li
- Department of Health and Human Performance, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA
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15
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De Francesco S, Morello L, Fioravanti M, Cassaro C, Grazioli S, Busti Ceccarelli S, Nobile M, Molteni M, Crippa A. A multimodal approach can identify specific motor profiles in autism and attention-deficit/hyperactivity disorder. Autism Res 2023; 16:1550-1560. [PMID: 37530700 DOI: 10.1002/aur.2989] [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: 03/02/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023]
Abstract
It is still unclear whether and to what extent the motor difficulties are specific to autism. This study aimed to determine whether a multimodal assessment of motor skills could accurately discriminate autistic children from attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) peers. Seventy-five children, aged 7-13, equally divided into three groups, were assessed with the developmental coordination disorder questionnaire (DCDQ), the movement assessment battery for children 2 (MABC2), the sensorimotor subtests of NEPSY-II, and the kinematic analysis of a reach-to-drop task. Principal component analysis (PCA) on DCDQ subscales revealed one factor-Caregiver Report-, whereas MABC2/NEPSY-II scores identified three factors-namely, Object Interception and Balance, Motor Imitation, and Fine-Motor Skills-. Lastly, PCA on kinematic variables identified four factors: PC1, loaded by the parameters of velocity and acceleration throughout the task, PC2 and PC3 involved the temporal parameters of the two submovements, and PC4 accounted for the wrist inclination at ball drop. When comparing autistic and TD children, Caregiver Report and Motor Imitation factors predicted membership with 87.2% of accuracy. In the model comparing ADHD and TD groups, Caregiver Report and Fine-Motor Skills predicted membership with an accuracy of 73.5%. In the last model, the Object Interception and Balance factor differentiated autistic children from ADHD with an accuracy of 73.5%. In line with our previous findings, kinematics did not differentiate school-aged autistic children from ADHD and TD peers. The present findings show that specific motor profiles in autism and ADHD can be isolated with a multimodal investigation of motor skills.
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Affiliation(s)
- Stefano De Francesco
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Luisa Morello
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Mariachiara Fioravanti
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Cristina Cassaro
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Silvia Grazioli
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | | | - Maria Nobile
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Massimo Molteni
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
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16
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Jia S, Guo C, Li S, Zhou X, Wang X, Wang Q. The effect of physical exercise on disordered social communication in individuals with autism Spectrum disorder: a systematic review and meta-analysis of randomized controlled trials. Front Pediatr 2023; 11:1193648. [PMID: 37456563 PMCID: PMC10347521 DOI: 10.3389/fped.2023.1193648] [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: 03/25/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Objective The aim of this systematic review and meta-analysis was to systematically investigate the intervention effect of physical exercise on disordered social communication in patients with autism spectrum disorders. Methods This systematic review and meta-analysis used the PubMed, Web of Science, the Cochrane Library, and Embase electronic databases to conduct a systematic search of literature describing randomized controlled trials (RCTs) on the effect of physical exercise on disordered social communication in autistic patients from the first year of inclusion to 21 January 2023. Results A total of 14 RCTs including 460 autistic patients were analyzed. A meta-analysis showed that physical exercise had a positive effect on social communication disorder (SMD = 0.45, 95% CI: 0.15, 0.74, p < 0.05) in autistic patients. Subgroup analysis showed that exercise programs with multiple components (SMD = 0.73, 95% CI: 0.39, 1.06, P < 0.001), a moderate duration (SMD = 0.73, 95% CI: 0.38, 1.08, P < 0.001), a moderate-high frequency (SMD = 0.84, 95% CI: 0.53, 1.14, P < 0.001), and a long duration (SMD = 0.77, 95% CI: 0.36, 1.18, P < 0.001) led to significant improvement. Conclusion Physical exercise can improve disordered social communication in patients with autism spectrum disorders. Specifically, early intervention, multi-component exercise, a moderate period, moderate and high frequency, long duration, and multi-participant programs were most effective. Systematic Review Registration https://www.crd.york.ac.uk/prospero/ RecordID= CRD42023422482.
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Affiliation(s)
- Shuqi Jia
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Chengcheng Guo
- School of Public Administration, Hohai University, Nanjing, China
| | - Shufan Li
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Xiaojing Zhou
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Qiang Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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17
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Battah HW, Lotan M, Moran DS. The Need for a Motor Assessment Tool for Children with Autism-An Opinion Article. Diagnostics (Basel) 2023; 13:2095. [PMID: 37370990 DOI: 10.3390/diagnostics13122095] [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: 05/29/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
There is a lot of evidence that early developmental therapy achieves impressive therapeutic results for those who require it. Therefore, developmental follow-up, which includes the process of monitoring the child's development over time, makes it possible to identify possible developmental problems and treat them from a young age. This assumption is true in relation to all children with developmental difficulties but is mainly true in the context of children with a diagnosis of autism. However, despite the abundance of developmental scales for the neurotypical population, there are currently no valid scales for assessing motor function for children with autism. The current article focuses on the presentation of the motor delay, identified according to the literature, in many of the children with autism and requires the provision of professional and compatible treatment for these children. This motor delay and the lack of a motor assessment tool for children with autism raises the need for an adapted motor developmental assessment tool, which will produce measurable results, to enable the monitoring of the aforementioned disability and the receiving of tailored treatment from the physiotherapists who deal with the development of children with autism at an early age. The article reviews common existing assessment tools for use in assessing normal development in children with autism, presents the limitations and the challenges that arise when using these assessment tools with children on the autism spectrum and presents the need for a new developmental assessment tool that will be built and validated specifically for children with autism.
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Affiliation(s)
- Hasan Wael Battah
- Department of Health System Management, Ariel University, Ariel 40700, Israel
| | - Meir Lotan
- Department of Health System Management, Ariel University, Ariel 40700, Israel
| | - Danny S Moran
- Department of Health System Management, Ariel University, Ariel 40700, Israel
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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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19
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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: 11] [Impact Index Per Article: 11.0] [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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20
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Hadders‐Algra M. Emerging signs of autism spectrum disorder in infancy: Putative neural substrate. Dev Med Child Neurol 2022; 64:1344-1350. [PMID: 35801808 PMCID: PMC9796067 DOI: 10.1111/dmcn.15333] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/30/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by altered development of the social brain with prominent atypical features in the fronto-temporo-parietal cortex and cerebellum. Early signs of ASD emerge between 6 and 12 months: reduced social communication, slightly less advanced motor development, and repetitive behaviour. The fronto-temporo-parietal cortex and cerebellum play a prominent role in the development of social communication, whereas fronto-parietal-cerebellar networks are involved in the planning of movements, that is, movement selection. Atypical sensory responsivity, a core feature of ASD, may result in impaired development of social communication and motor skills and/or selection of atypical repetitive behaviour. In the first postnatal year, the brain areas involved are characterized by gradual dissolution of temporary structures: the fronto-temporo-parietal cortical subplate and cerebellar external granular layer. It is hypothesized that altered dissolution of the transient structures opens the window for the expression of early signs of ASD arising in the impaired developing permanent networks. WHAT THIS PAPER ADDS: The early social and motor signs of autism spectrum disorder emerge between the ages of 6 and 12 months. Altered dissolution of transient brain structures in the fronto-temporo-parietal cortex and cerebellum may underlie the emergence of these early signs.
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Affiliation(s)
- Mijna Hadders‐Algra
- University of Groningen, University Medical Center GroningenDepartment of Paediatrics, Section of Developmental NeurologyGroningenthe Netherlands,University of Groningen, Faculty of Theology and Religious StudiesGroningenthe Netherlands
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21
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Crippa A. Motor abilities as a possible specifier of autism: A response to Bhat (2021). Autism Res 2022; 15:1794-1795. [PMID: 36036959 DOI: 10.1002/aur.2805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini (LC), Italy
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22
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Zhou B, Xu Q, Li H, Zhang Y, Li D, Dong P, Wang Y, Lu P, Zhu Y, Xu X. Motor impairments in Chinese toddlers with autism spectrum disorder and its relationship with social communicative skills. Front Psychiatry 2022; 13:938047. [PMID: 36311507 PMCID: PMC9613953 DOI: 10.3389/fpsyt.2022.938047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/26/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Motor impairments are prevalent in children with autism spectrum disorder (ASD) and persistent across age. Our current study was designed to investigate motor deficits in Chinese toddlers with ASD and to explore the relationships between motor deficits and social communication skills. METHODS For this cross-sectional study, we recruited a total of 210 Chinese toddlers with ASD aged between 18 and 36 months in the study during December 2017 to December 2020. Griffiths Developmental Scales-Chinese (GDS-C), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and Communication and Symbolic Behavior Scales Developmental Profile-Infant-Toddler Checklist (CSBS-DP-ITC) were administered in these toddlers to evaluate their development, social communicative skills, and autism severity. We compared the developmental and social communicational profiles of ASD toddlers in different gross and fine motor subgroups, and explored potential associated factors. The univariate generalized linear model tested the relationship of fine and gross motor skills and social communicative skills. RESULTS The prevalence of gross and fine motor deficits were 59.5 and 82.5%, respectively, which are almost equivalent in boys and girls. The motor impairments tended to be more severe with age in toddlers. After adjusting for age, sex, non-verbal development quotient (DQ) and restricted, repetitive behaviors, severer gross motor impairments were significantly related to higher comparison score of ADOS-2 and higher social composite score of CSBS-DP-ITC, without interactions with other variables. Meanwhile, lower fine motor skills were associated with more deficits of social communication and higher severity of ASD, also depending on non-verbal DQ. In the lower non-verbal DQ subgroup, both fine motor deficits and restricted repetitive behaviors (RRBs) might have effects on autism symptomology. CONCLUSION Motor impairments are common in Chinese toddlers with ASD. Toddlers with weaker gross and fine motor skills have greater deficits in social communicative skills. Gross motor impairment might be an independent predictor of the severity of autism and social communication skills, while the effect of fine motor deficits might be affected by non-verbal DQ and RRBs of toddlers with ASD. We provide further justification for the inclusion of motor impairments in the early intervention for toddlers with ASD.
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Affiliation(s)
- Bingrui Zhou
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Qiong Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Huiping Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Zhang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Dongyun Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Ping Dong
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Wang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Ping Lu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Ye Zhu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
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