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Zreibe K, Kanner CH, Uher D, Beard G, Patterson M, Harris M, Doerger J, Calamia S, Chung WK, Montes J. Characterizing ambulatory function in children with PPP2R5D-related neurodevelopmental disorder. Gait Posture 2024; 110:77-83. [PMID: 38547676 PMCID: PMC11056288 DOI: 10.1016/j.gaitpost.2024.03.012] [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: 09/22/2023] [Revised: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Individuals with PPP2R5D-related neurodevelopmental disorder have an atypical gait pattern characterized by ataxia and incoordination. Structured, quantitative assessments are needed to further understand the impact of these impairments on function. RESEARCH QUESTION How do gait parameters and ambulatory function of individuals with PPP2R5D-related neurodevelopmental disorder compare to age and sex matched healthy norms? METHODS Twenty-six individuals with PPP2R5D pathogenic genetic variants participated in this observational, single visit study. Participants completed at least one of the following gait assessments: quantitative gait analysis at three different speeds (preferred pace walking (PPW), fast paced walking (FPW) and running, six-minute walk test (6MWT), 10-meter walk run (10MWR), and timed up and go (TUG). Descriptive statistics were used to summarize gait variables. Percent of predicted values were calculated using published norms. Paired t-tests and regression analyses were used to compare gait variables. RESULTS The median age of the participants was 8 years (range 4-27) and eighteen (69.2 %) were female. Individuals with PPP2R5D-related neurodevelopmental disorder walked slower and with a wider base of support than predicted for their age and sex. Stride velocity ranged from 48.9 % to 70.1 % and stride distance from 58.5 % to 81.9 % of predicted during PPW. Percent of predicted distance walked on the 6MWT ranged from 30.6 % to 71.1 % representing varied walking impairment. Increases in stride distance, not cadence, were associated with changes in stride velocity in FPW (R2 = 0.675, p =< 0.001) and running conditions (R2 = 0.918, p =< 0.001). SIGNIFICANCE We quantitatively assessed the abnormal gait in individuals with PPP2R5D-related neurodevelopmental disorder. These impairments may affect ability to adapt to environmental changes and participation in daily life. Rehabilitative interventions targeting gait speed and balance may improve function and safety for individuals with PPP2R5D-related neurodevelopmental disorder.
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Affiliation(s)
- Kyle Zreibe
- Department of Rehabilitation, UHealth-Jackson Holtz Children's Hospital, Miami, FL, USA; Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | - Cara H Kanner
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - David Uher
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Gabriella Beard
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Madison Patterson
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Matthew Harris
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Jerome Doerger
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Sean Calamia
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA USA
| | - Jacqueline Montes
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Jin X, Zhu H, Cao W, Zou X, Chen J. Identifying activity level related movement features of children with ASD based on ADOS videos. Sci Rep 2023; 13:3471. [PMID: 36859661 PMCID: PMC9975881 DOI: 10.1038/s41598-023-30628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects about 2% of children. Due to the shortage of clinicians, there is an urgent demand for a convenient and effective tool based on regular videos to assess the symptom. Computer-aided technologies have become widely used in clinical diagnosis, simplifying the diagnosis process while saving time and standardizing the procedure. In this study, we proposed a computer vision-based motion trajectory detection approach assisted with machine learning techniques, facilitating an objective and effective way to extract participants' movement features (MFs) to identify and evaluate children's activity levels that correspond to clinicians' professional ratings. The designed technique includes two key parts: (1) Extracting MFs of participants' different body key points in various activities segmented from autism diagnostic observation schedule (ADOS) videos, and (2) Identifying the most relevant MFs through established correlations with existing data sets of participants' activity level scores evaluated by clinicians. The research investigated two types of MFs, i.e., pixel distance (PD) and instantaneous pixel velocity (IPV), three participants' body key points, i.e., neck, right wrist, and middle hip, and five activities, including Table-play, Birthday-party, Joint-attention, Balloon-play, and Bubble-play segmented from ADOS videos. Among different combinations, the high correlations with the activity level scores evaluated by the clinicians (greater than 0.6 with p < 0.001) were found in Table-play activity for both the PD-based MFs of all three studied key points and the IPV-based MFs of the right wrist key point. These MFs were identified as the most relevant ones that could be utilized as an auxiliary means for automating the evaluation of activity levels in the ASD assessment.
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Affiliation(s)
- Xuemei Jin
- South China Academy of Advanced Optoelectronics, South China Normal University (SCNU), Guangzhou, 510006, China
| | - Huilin Zhu
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
| | - Wei Cao
- South China Academy of Advanced Optoelectronics, South China Normal University (SCNU), Guangzhou, 510006, China
| | - Xiaobing Zou
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Jiajia Chen
- South China Academy of Advanced Optoelectronics, South China Normal University (SCNU), Guangzhou, 510006, China.
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Hawks ZW, Todorov A, Marrus N, Nishino T, Talovic M, Nebel MB, Girault JB, Davis S, Marek S, Seitzman BA, Eggebrecht AT, Elison J, Dager S, Mosconi MW, Tychsen L, Snyder AZ, Botteron K, Estes A, Evans A, Gerig G, Hazlett HC, McKinstry RC, Pandey J, Schultz RT, Styner M, Wolff JJ, Zwaigenbaum L, Markson L, Petersen SE, Constantino JN, White DA, Piven J, Pruett JR. A Prospective Evaluation of Infant Cerebellar-Cerebral Functional Connectivity in Relation to Behavioral Development in Autism Spectrum Disorder. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:149-161. [PMID: 36712571 PMCID: PMC9874081 DOI: 10.1016/j.bpsgos.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 02/01/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder diagnosed based on social impairment, restricted interests, and repetitive behaviors. Contemporary theories posit that cerebellar pathology contributes causally to ASD by disrupting error-based learning (EBL) during infancy. The present study represents the first test of this theory in a prospective infant sample, with potential implications for ASD detection. Methods Data from the Infant Brain Imaging Study (n = 94, 68 male) were used to examine 6-month cerebellar functional connectivity magnetic resonance imaging in relation to later (12/24-month) ASD-associated behaviors and outcomes. Hypothesis-driven univariate analyses and machine learning-based predictive tests examined cerebellar-frontoparietal network (FPN; subserves error signaling in support of EBL) and cerebellar-default mode network (DMN; broadly implicated in ASD) connections. Cerebellar-FPN functional connectivity was used as a proxy for EBL, and cerebellar-DMN functional connectivity provided a comparative foil. Data-driven functional connectivity magnetic resonance imaging enrichment examined brain-wide behavioral associations, with post hoc tests of cerebellar connections. Results Cerebellar-FPN and cerebellar-DMN connections did not demonstrate associations with ASD. Functional connectivity magnetic resonance imaging enrichment identified 6-month correlates of later ASD-associated behaviors in networks of a priori interest (FPN, DMN), as well as in cingulo-opercular (also implicated in error signaling) and medial visual networks. Post hoc tests did not suggest a role for cerebellar connections. Conclusions We failed to identify cerebellar functional connectivity-based contributions to ASD. However, we observed prospective correlates of ASD-associated behaviors in networks that support EBL. Future studies may replicate and extend network-level positive results, and tests of the cerebellum may investigate brain-behavior associations at different developmental stages and/or using different neuroimaging modalities.
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Affiliation(s)
- Zoë W. Hawks
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Muhamed Talovic
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Mary Beth Nebel
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jessica B. Girault
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Savannah Davis
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Scott Marek
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Benjamin A. Seitzman
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Stephen Dager
- Departments of Radiology, University of Washington, Seattle, Washington
| | - Matthew W. Mosconi
- Life Span Institute and Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
| | - Lawrence Tychsen
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Guido Gerig
- Department of Computer Science and Engineering, Tandon School of Engineering, New York University, New York, New York
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Lori Markson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Steven E. Petersen
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - John N. Constantino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Desirée A. White
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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Fine motor impairment in children with epilepsy: Relations with seizure severity and lateralizing value. Epilepsy Behav 2022; 127:108518. [PMID: 35016052 DOI: 10.1016/j.yebeh.2021.108518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/20/2022]
Abstract
Motor skill deficits are common in epilepsy. The Grooved Pegboard Test (GPT) is the most commonly used fine motor task and is included in the NIH Common Data Elements Battery for the assessment of epilepsy. However, there are limited data on its utility in children and adolescents. The present study investigated the effectiveness of this task in children and adolescents with epilepsy clinically referred for neuropsychological evaluation in a tertiary medical center. Two hundred and two children and adolescents (ages 6-16, 104 males, 98 females) completed the GPT. Base rates of impairment were calculated, correlational analyses determined relations with clinical variables, and ANOVAs and t-tests assessed for differences by seizure type, gender, and lateralized deficits in those with lateralized focal epilepsy. The GPT was sensitive to fine motor impairment in these children and adolescents, with over 60% having impaired performances. Further, performance was significantly correlated with IQ, age of epilepsy onset, number of medications, and seizure frequency. At the group level, those with lateralized focal epilepsy did not show significant differences between left and right hands, though the GPT correctly lateralized 63% of those with large between-hand performance disparities (i.e., one standard deviation or greater). In sum, the GPT is sensitive to fine motor deficits in pediatric epilepsy and is related to known epilepsy severity factors. However, the ability of the task to lateralize epilepsy onset is not robust.
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Lum JAG, Shandley K, Albein-Urios N, Kirkovski M, Papadopoulos N, Wilson RB, Enticott PG, Rinehart NJ. Meta-Analysis Reveals Gait Anomalies in Autism. Autism Res 2020; 14:733-747. [PMID: 33289353 DOI: 10.1002/aur.2443] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/05/2020] [Indexed: 01/05/2023]
Abstract
Gait abnormalities are frequently reported in autism. The empirical literature, however, is characterized by inconsistent findings concerning which aspects of gait are affected. We conducted a meta-analysis to summarize study findings that examined temporal and spatial (i.e., two-dimensional) gait parameters in pediatric and adult samples comprising individuals with autism and healthy controls. After searching electronic databases, a total of 18 studies were identified and included in this review. Results from the meta-analyses revealed autism is associated with a wider step width, slower walking speed, longer gait cycle, longer stance time and longer step time. Additionally, autism appears to be associated with greater intra-individual variability on measures of stride length, stride time and walking speed. Meta-regression analyses revealed cadence and gait cycle duration differences, between autism and control groups, become more pronounced with age. Overall, this review demonstrates that autism is associated with gait abnormalities. However, assessment of the methodological quality of the studies reveal, additional research is required to understand the extent that gait abnormalities are specifically linked to autism, or whether they may be secondary to other factors commonly found in this group, such as increased weight. LAY SUMMARY: It is often noted by clinicians that individuals with autism have an awkward or unusual walking style, which is also referred to as gait. In this report, we reviewed past studies that compared gait in individuals with and without autism. Our review indicates autism is associated with an abnormal gait. However, it is not yet clear whether gait abnormalities are caused by autism, or arise due to other factors such as heavier weight, which often co-occurs in this group.
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Affiliation(s)
- Jarrad A G Lum
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Kerrie Shandley
- Digital Mental Health and Wellbeing, Biopsychosocial and e-Health Research & Innovation Hub, Federation University, Victoria, Australia
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Melissa Kirkovski
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Nicole Papadopoulos
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Rujuta B Wilson
- UCLA Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, UCLA Division of Pediatric Neurology, California, Los Angeles, USA
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Nicole J Rinehart
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, Australia
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Eggleston JD, Harry JR, Cereceres PA, Olivas AN, Chavez EA, Boyle JB, Dufek JS. Lesser magnitudes of lower extremity variability during terminal swing characterizes walking patterns in children with autism. Clin Biomech (Bristol, Avon) 2020; 76:105031. [PMID: 32408186 PMCID: PMC7282997 DOI: 10.1016/j.clinbiomech.2020.105031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 03/14/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anecdotally, children with Autism Spectrum Disorder have highly variable lower extremity walking patterns, yet, this has not been sufficiently quantified. As such, the purpose of this study was to examine walking pattern variability by way of lower extremity coordination and spatio-temporal characteristics in children with autism compared with individuals with typical development during over-ground walking. METHODS Bilateral continuous relative phase variability was computed for the thigh-leg, leg-foot, and thigh-foot segment couples for 11 children with autism and 9 children with typical development at each gait sub-phase. Furthermore, left and right stride lengths and stride width were computed and compared. The Model Statistic was utilized to test for statistical differences in variability between each child with autism to an aggregate group with typical development. Effect sizes were computed to determine the meaningfulness between responses for children with autism and typical development. Coefficient of variation and effect sizes were computed for stride lengths and stride width. FINDINGS Analysis revealed that children with autism exhibited differences in variability in each gait sub-phase. Notably, all but two children with autism exhibited lesser variability in all segment couples during terminal swing. Differences in stride lengths were relatively minimal, however, greater coefficient of variation magnitudes in stride width were observed in children with autism. INTERPRETATION This finding reveals that children with autism may have limited or a preferred movement strategy when preparing the foot for ground contact. The findings from this study suggest variability may be an identifiable characteristic during movement in children with autism.
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Affiliation(s)
- Jeffrey D Eggleston
- Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA.
| | - John R Harry
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | | | - Alyssa N Olivas
- Department of Biomedical Engineering, University of Texas at El Paso, El Paso, TX, USA
| | - Emily A Chavez
- Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - Jason B Boyle
- Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - Janet S Dufek
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
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Odeh CE, Gladfelter AL, Stoesser C, Roth S. Comprehensive motor skills assessment in children with autism spectrum disorder yields global deficits. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:290-300. [PMID: 35602998 PMCID: PMC9122380 DOI: 10.1080/20473869.2020.1764241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 05/31/2023]
Abstract
PURPOSE Although children with autism spectrum disorder (ASD) often display motor deficits, the nature of these motor deficits remains unspecified. The purpose of this study was to establish a robust motor profile in children with ASD across a wider range of motor skills by using two professionally administered standardized motor assessments alongside a parent report measure to capture a comprehensive view of motor performance compared to a group of neurotypical peers. METHODS Complex motor skills, balance and global motor performance were compared in twenty-four children, between the ages of 5-12 years, split into two groups: ASD and typically developing. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) and the Movement Assessment Battery for Children, Second Edition (MABC-2) were used to examine skill performance. Motor proficiency was also collected using the parent/caregiver form of the Vineland Adaptive Behavior Scales, 3rd edition (Vineland-3). RESULTS Children with ASD presented with significant differences in complex motor skills, balance skills, and global motor performance when compared to their neurotypical peers across all three measures. CONCLUSION This preliminary study indicated that the children with ASD had greater difficulty with global motor performance, including more difficulty performing complex motor tasks and balance tasks compared to their neurotypical peers. The parents of the children with ASD reported decreased proficiency of motor skills. Overall, the children with ASD demonstrated deficits performing tasks that targeted strength, speed, agility, coordination and both static and dynamic balance. While manifestations of motor skill deficits specific to the ASD population are variable, physical therapists should be included in the ongoing assessment and implementation of comprehensive therapeutic plans for children with ASD.
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Affiliation(s)
- Christina E. Odeh
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Allison L. Gladfelter
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Carolyn Stoesser
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Sarah Roth
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
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Goldman S, McCullough AK, Young SD, Mueller C, Stahl A, Zoeller A, Abbruzzese LD, Rao AK, Montes J. Quantitative gait assessment in children with 16p11.2 syndrome. J Neurodev Disord 2019; 11:26. [PMID: 31656164 PMCID: PMC6816222 DOI: 10.1186/s11689-019-9286-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/01/2019] [Indexed: 01/23/2023] Open
Abstract
Background Neurodevelopmental disorders such as 16p11.2 syndrome are frequently associated with motor impairments including locomotion. The lack of precise measures of gait, combined with the challenges inherent in studying children with neurodevelopmental disorders, hinders quantitative motor assessments. Gait and balance are quantifiable measures that may help to refine the motor phenotype in 16p11.2. The characterization of motor profile is useful to study the trajectories of locomotion performance of children with genetic variants and may provide insights into neural pathway dysfunction based on genotype/phenotype model. Methods Thirty-six children (21 probands with 16p11.2 deletion and duplication mutation and 15 unaffected siblings), with a mean age of 8.5 years (range 3.2–15.4) and 55% male, were enrolled. Of the probands, 23% (n = 6) had a confirmed diagnosis of autism spectrum disorder (ASD) and were all male. Gait assessments included 6-min walk test (6MWT), 10-m walk/run test (10MWR), timed-up-and-go test (TUG), and spatio-temporal measurements of preferred- and fast-paced walking. The Pediatric Evaluation of Disability Inventory-Computer Adaptive Tests (PEDI-CAT), a caregiver-reported functional assessment, was administered. Measures of balance were calculated using percent time in double support and base of support. Analyses of the six children with ASD were described separately. Results Thirty-six participants completed the protocol. Compared with sibling controls, probands had significantly lower scores on the 6MWT (p = 0.04), 10MWR (p = 0.01), and TUG (p = 0.005). Group differences were also identified in base of support (p = 0.003). Probands had significantly lower PEDI-CAT scores in all domains including the mobility scale (p < 0.001). Using age-matched subsamples, the ASD and non-ASD genetic variant groups had larger base of support compared to the controls. In the fast-paced condition, all participants increased their velocity, and there was a corresponding decrease in percent time in double support compared to the preferred-pace condition in all participants. Only the ASD group presented with upper limb arm/hand stereotypies. Conclusions Children with 16p11.2, with and without ASD, present with balance impairment during locomotion activities. Probands performed worse on functional assessments, and quantitative measures revealed differences in base of support. These results highlight the importance of using precise measures to differentiate motor dysfunction in children with neurodevelopmental disorders.
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Affiliation(s)
- Sylvie Goldman
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, PH18-331, New York, NY, 10032, USA. .,G.H. Sergievsky Center, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA.
| | - Aston K McCullough
- G.H. Sergievsky Center, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA.,Department ot Biobehaviroal Science, Columbia University, Teacher College, 525 West 120th Street, New York, NY, 10027, USA
| | - Sally Dunaway Young
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, PH18-331, New York, NY, 10032, USA.,Department of Neurology, Division of Neuromuscular Medicine, Stanford University, 2652 East Bayshore Road, Palo Alto, CA, 94303, USA
| | - Carly Mueller
- Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
| | - Adrianna Stahl
- Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
| | - Audrey Zoeller
- Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
| | - Laurel Daniels Abbruzzese
- Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
| | - Ashwini K Rao
- G.H. Sergievsky Center, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA.,Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
| | - Jacqueline Montes
- Department of Neurology, Division of Child Neurology, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, PH18-331, New York, NY, 10032, USA.,Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia University Irving Medical Center, Presbyterian Hospital, 622 W 168th Street, New York, NY, 10032, USA
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9
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MacDonald M, McIntyre LL. The relationship of age, early motor skills and observable child behaviors in young children with developmental delays. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 93:103445. [PMID: 31376505 PMCID: PMC6739246 DOI: 10.1016/j.ridd.2019.103445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/20/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Children with disabilities often experience delays in one or more domains of development including motor skill delays. Delays in motor skill development may put children further behind their peers without disabilities in respect to aspects of early learning. AIMS The purpose of this study was to examine how gross motor skills mediated the relationship of age and the observable child behaviors of compliance and adaptive behavior in a group of young children (2-4 years) with developmental disabilities around one time point. METHODS Children with developmental disabilities (N = 113) were assessed on direct measures of motor skills and the child behaviors of compliance and adaptive behavior. Two independent simple mediation analyses were conducted using PROCESS, an ordinary least squares path analysis appropriate for small sample sizes. RESULTS Age had a positive relationship with gross motor skills (a = .66, p < .001) when the outcome variable was adaptive behavior and age had a positive relationship with gross motor skills (a = .66, p < .001) when the outcome variable was compliance. CONCLUSIONS Motor skill development may promote or hinder development in other childhood behaviors such as compliance and adaptive behavior.
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Affiliation(s)
- Megan MacDonald
- College of Public Health & Human Sciences, Oregon State University, United States.
| | - Laura Lee McIntyre
- Department of Special Education and Clinical Sciences, University of Oregon, United States
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10
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Eggleston JD, Harry JR, Dufek JS. Lower extremity joint stiffness during walking distinguishes children with and without autism. Hum Mov Sci 2018; 62:25-33. [PMID: 30218847 PMCID: PMC6251740 DOI: 10.1016/j.humov.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 01/14/2023]
Abstract
How children with Autism Spectrum Disorder (ASD) and peers with typical development (TD) modulate lower extremity stiffness during walking could identify a mechanism for gait differences between groups. We quantified differences in lower extremity joint stiffness and linear impulses, along the vertical and anterior/posterior axes during over-ground walking in children with ASD compared to age- and gender-matched children with TD. Nine age- and gender-matched pairs of children, aged 5-12 years, completed the current study. Joint stiffness and linear impulses were computed in four sub-phases of stance: loading response, mid-stance, terminal stance, and pre-swing. The Model Statistic technique (α = 0.05) was used to test for statistical significance between the matched-pairs for each variable and sub-phase. Furthermore, dependent t-tests (α = 0.05) were utilized, at the group level, to determine whether significant differences existed between sub-phases. Results indicate that children with ASD may exhibit greater stiffness in pre-swing, and thus, produce inefficient propulsive forces during walking. We attribute these differences to sensory processing dysfunction previously observed in children with ASD.
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Affiliation(s)
- Jeffrey D Eggleston
- Department of Kinesiology, University of Texas at El Paso, 500 University Avenue, El Paso, TX 79968, USA.
| | - John R Harry
- Department of Kinesiology and Sport Management, Texas Tech University, 2500 Broadway, Box 43011, Lubbock, TX 79409, USA
| | - Janet S Dufek
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, 4505 South Maryland Parkway, Las Vegas, NV 89154, USA
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Fitzpatrick P, Frazier JA, Cochran D, Mitchell T, Coleman C, Schmidt RC. Relationship Between Theory of Mind, Emotion Recognition, and Social Synchrony in Adolescents With and Without Autism. Front Psychol 2018; 9:1337. [PMID: 30108541 PMCID: PMC6079204 DOI: 10.3389/fpsyg.2018.01337] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022] Open
Abstract
Difficulty in social communication and interaction is a primary diagnostic feature of ASD. Research has found that adolescents with ASD display various impairments in social behavior such as theory of mind (ToM), emotion recognition, and social synchrony. However, not much is known about the relationships among these dimensions of social behavior. Adolescents with and without ASD participated in the study. ToM ability was measured by viewing social animations of geometric shapes, recognition of facial emotions was measured by viewing pictures of faces, and synchrony ability was measured with a spontaneously arising interpersonal movement task completed with a caregiver and an intentional interpersonal task. Attention and social responsiveness were measured using parent reports. We then examined the relationship between ToM, emotion recognition, clinical measures of attention and social responsiveness, and social synchronization that arises either spontaneously or intentionally. Results indicate that spontaneous synchrony was related to ToM and intentional synchrony was related to clinical measures of attention and social responsiveness. Facial emotion recognition was not related to either ToM or social synchrony. Our findings highlight the importance of biological motion perception and production and attention for more fully understanding the social behavior characteristic of ASD. The findings suggest that the processes underlying difficulties in spontaneous synchrony in ASD are different than the processes underlying difficulties in intentional synchronization.
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Affiliation(s)
- Paula Fitzpatrick
- Department of Psychology, Assumption College, Worcester, MA, United States
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - David Cochran
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Teresa Mitchell
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Psychology, Brandeis University, Boston, MA, United States
| | - Caitlin Coleman
- Department of Psychology, Assumption College, Worcester, MA, United States
| | - R. C. Schmidt
- Department of Psychology, College of the Holy Cross, Worcester, MA, United States
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12
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Fulceri F, Grossi E, Contaldo A, Narzisi A, Apicella F, Parrini I, Tancredi R, Calderoni S, Muratori F. Motor Skills as Moderators of Core Symptoms in Autism Spectrum Disorders: Preliminary Data From an Exploratory Analysis With Artificial Neural Networks. Front Psychol 2018; 9:2683. [PMID: 30687159 PMCID: PMC6333655 DOI: 10.3389/fpsyg.2018.02683] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/13/2018] [Indexed: 02/05/2023] Open
Abstract
Motor disturbances have been widely observed in children with autism spectrum disorder (ASD), and motor problems are currently reported as associated features supporting the diagnosis of ASD in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Studies on this issue reported disturbances in different motor domains, including both gross and fine motor areas as well as coordination, postural control, and standing balance. However, they failed to clearly state whether motor impairments are related to demographical and developmental features of ASD. Both the different methodological approaches assessing motor skills and the heterogeneity in clinical features of participants analyzed have been implicated as contributors to variance in findings. However, the non-linearity of the relationships between variables may account for the inability of the traditional analysis to grasp the core problem suggesting that the "single symptom approach analysis" should be overcome. Artificial neural networks (ANNs) are computational adaptive systems inspired by the functioning processes of the human brain particularly adapted to solving non-linear problems. This study aimed to apply the ANNs to reveal the entire spectrum of the relationship between motor skills and clinical variables. Thirty-two male children with ASD [mean age: 48.5 months (SD: 8.8); age range: 30-60 months] were recruited in a tertiary care university hospital. A multidisciplinary comprehensive diagnostic evaluation was associated with a standardized assessment battery for motor skills, the Peabody Developmental Motor Scale-Second Edition. Exploratory analyses were performed through the ANNs. The findings revealed that poor motor skills were a common clinical feature of preschoolers with ASD, relating both to the high level of repetitive behaviors and to the low level of expressive language. Moreover, unobvious trends among motor, cognitive and social skills have been detected. In conclusion, motor abnormalities in preschoolers with ASD were widespread, and the degree of impairment may inform clinicians about the severity of ASD core symptoms. Understanding motor disturbances in children with ASD may be relevant to clarify neurobiological basis and ultimately to guide the development of tailored treatments.
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Affiliation(s)
- Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Institute, Tavernerio, Italy
| | | | | | | | | | | | - Sara Calderoni
- IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Sara Calderoni, ;
| | - Filippo Muratori
- IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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