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Arkesteyn A, Cornelissen V, Steyaert J, Claes J, Michielsen M, Van Damme T. The concurrent validity and test-retest reliability of a submaximal exercise test in adolescents with autism. Disabil Rehabil 2024:1-11. [PMID: 38644598 DOI: 10.1080/09638288.2024.2340704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 04/04/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE There is a need for valid and reliable clinical assessment tools to assess cardiorespiratory fitness (CRF) levels in adolescents with autism. Therefore, this study aimed to examine the concurrent validity and test-retest reliability of the Astrand-Rhyming Test (ART) in this population. MATERIALS AND METHODS 45 adolescents with autism aged 12-18 years (n = 32 males, 14.47 ± 1.79 years) performed the ART twice (test-retest reliability) and completed a maximal cardiopulmonary exercise test (CPET) (concurrent validity). Reliability parameters included Pearson correlations, intraclass correlation coefficients (ICCs), standard error of measurements (SEM), minimal detectable changes (MDC), coefficients of variation, paired sample t-tests, linear regressions and Bland-Altman plots. The concurrent validity was evaluated with Pearson correlations, ICCs, paired sample t-tests, linear regressions and Bland-Altman plots. RESULTS Strong test-retest reliability (r = 0.84-0.85, ICC = 0.84-0.85) was found for the ART, but the wide limits of agreement intervals suggest the presence of substantial variability. The large SEM (4.73-5.08 mL/kg/min) and MDC (13.20-14.07 mL/kg/min) values suggest lower absolute reliability. Moderate to strong levels of association (r = 0.74-0.75) and agreement (ICC = 0.59-0.66) were found between estimated (ART1) and measured (CPET) VO2 max levels, but significant systematic differences (5.71-8.82 mL/kg/min) were observed. CONCLUSION The ART is an accessible and promising method to monitor submaximal CRF levels over time but is less appropriate to estimate maximal CRF levels in this population.
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Affiliation(s)
- Anke Arkesteyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Jean Steyaert
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven, Belgium
| | - Jomme Claes
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven, Belgium
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Ruan H, Eungpinichpong W, Wu H, Aonsri C. Effects of Parent-Delivered Traditional Thai Massage on Gait and Heart Rate Variability in Children with Autism: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:269-278. [PMID: 37713302 PMCID: PMC10954606 DOI: 10.1089/jicm.2023.0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Aim: To examine the effects of parent-delivered traditional Thai massage (TTM) intervention on heart rate variability (HRV) and gait in children with autism. Methods: This was a two-armed, randomized controlled trial conducted at the Haikou Special Education School in Haikou Province, China, between October 2021 and March 2022. A total of 48 children with autism, aged between 7 and 12 years, were selected from the school and randomly divided into either the parent-delivered TTM group or the control group (no intervention) in a 1:1 ratio. In addition to their regular daily school routines, the TTM group received 16 TTM interventions (twice a week), with each session lasting ∼50 min. HRV and gait parameters were measured at baseline, completion of the 8-week intervention, and 2 months follow-up. Results: The results of this study showed that the TTM intervention had a notable positive effect on HRV, with a significant reduction in low-frequency value (p = 0.001), and increased high-frequency value (p = 0.001), compared with the controls, and the advantages persisted during the follow-up period. However, only the stride length in the TTM group was significantly longer than that in the control group at the post-test (p = 0.039) and follow-up test (p = 0.043), while none of the other parameters of gait comparison showed statistical significance. Conclusions: Parent-delivered Thai massage increased HRV levels and stride length in comparison to the control group, and some effects of the intervention were maintained over the follow-up period. Clinical Trials Registry Identifier ChiCTR2100051355; September 21, 2021.
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Affiliation(s)
- Hui Ruan
- Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Physical Education, Hainan Normal University, Haikou, China
| | - Wichai Eungpinichpong
- BNOJHP Research Center, PT Division of Physical Therapy, Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Hua Wu
- Physical Education, Hainan Normal University, Haikou, China
- BNOJHP Research Center, PT Division of Physical Therapy, Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chanada Aonsri
- Department of Special Education, Khon Kaen University Demonstration School, Khon Kaen University, Khon Kaen, Thailand
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Mukherjee D, Bhavnani S, Lockwood Estrin G, Rao V, Dasgupta J, Irfan H, Chakrabarti B, Patel V, Belmonte MK. Digital tools for direct assessment of autism risk during early childhood: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:6-31. [PMID: 36336996 PMCID: PMC10771029 DOI: 10.1177/13623613221133176] [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: 11/09/2022]
Abstract
LAY ABSTRACT The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children's homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the 'proof-of-concept' stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children's behaviours or speech. Computerised analysis of children's interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.
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Affiliation(s)
- Debarati Mukherjee
- Indian Institute of Public Health - Bengaluru, Public Health Foundation of India, India
| | | | | | - Vaisnavi Rao
- Institute for Democracy and Economic Affairs (IDEAS), Malaysia
| | | | | | | | - Vikram Patel
- Child Development Group, Sangath, India
- Harvard Medical School, USA
- Harvard T.H. Chan School of Public Health, USA
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4
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Frank Y, Levy T, Lozano R, Friedman K, Underwood S, Kostic A, Walker H, Kolevzon A. Gait Abnormalities in Children with Phelan-McDermid Syndrome. J Child Neurol 2023; 38:665-671. [PMID: 37849292 DOI: 10.1177/08830738231204395] [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] [Indexed: 10/19/2023]
Abstract
Background: Phelan-McDermid syndrome is a genetic disorder caused by haploinsufficiency of the SHANK3 gene on chromosome 22q13.3 and is characterized by autism spectrum disorder, intellectual disability, speech and language abnormalities, hypotonia, and mild dysmorphic features. Early literature in Phelan-McDermid syndrome did not include gait abnormalities as part of the syndrome although recent prospective studies report that the prevalence of gait abnormalities ranges from 55% to 94%. We compared gait abnormalities in individuals with Phelan-McDermid syndrome, idiopathic autism spectrum disorder, and typically developing controls, and explored associations between gait abnormalities, autism spectrum disorder, and intellectual functioning. Method: The study cohort consists of 67 participants between the ages of 3 and 18 years, divided into 3 groups: Phelan-McDermid syndrome (n = 46), idiopathic autism spectrum disorder (n = 11), and typically developing controls (n = 10). Gait was recorded using a video camera and scored across 26 gait features using a "Gait Clinical Observations scale" designed specifically for this study. Results: Gait abnormalities were significantly higher in the Phelan-McDermid syndrome group as compared to idiopathic autism spectrum disorder or typically developing controls. The number of gait abnormalities across groups was also significantly correlated with Intellectual Quotient/Developmental Quotient (IQ/DQ). In analysis of covariance including IQ/DQ, the effect of group was not significant, but the effect of IQ/DQ was significant. Conclusions: Overall differences in gait abnormalities were determined by the degree of intellectual disability, which was significantly higher in Phelan-McDermid syndrome.
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Affiliation(s)
- Yitzchak Frank
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tess Levy
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reymundo Lozano
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kate Friedman
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Slayton Underwood
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ana Kostic
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hannah Walker
- Health and Behavior Sciences at Teachers College, Columbia University, New York, NY, USA
| | - Alexander Kolevzon
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Orozco IM, Hernandez K, Mata J, Todd T, Mache M, Jarvis DN. Evaluation of Skipping in College Students with and without Autism Spectrum Disorder. Percept Mot Skills 2023; 130:2015-2030. [PMID: 37548573 DOI: 10.1177/00315125231194342] [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] [Indexed: 08/08/2023]
Abstract
Children with Autism Spectrum Disorder (ASD) demonstrate motor skill deficits in comparison to their neurotypically developing peers. However, it is unknown whether these motor skill deficits persist into adulthood. We evaluated skipping kinematics and motor performance in college students with and without ASD. We collected kinematic data from 20 college students, 10 with ASD and 10 without ASD, using a 12-camera three-dimensional motion capture system while participants completed three skipping trials. We scored skipping performance using Everyone Can! and the Halverson Developmental Sequences for Skipping, and we processed data using Cortex, Visual 3D, and MATLAB. We extracted data for center of mass excursion, peak velocity of joint extension, and peak joint angles of the hip, knee, and ankle of the dominant leg. Independent t-tests and Mann-Whitney U tests were used to examine differences between groups with an alpha level of p ≤ 0.05. We found no statistically significant differences for peak sagittal plane joint angles, velocities, or vertical center of mass excursion. However, the ASD group demonstrated greater medio-lateral center of mass displacement (ASD M = .08, SD = .1 m; Control M = .03, S = .03 m; p = .026) and greater frontal plane knee excursion (ASD M = 11.49, SD = 6.23°; Control M = 5.29, SD = 2.44°; p = .01) than participants without ASD. Similarly, the ASD group performed less proficiently in skipping than the group without ASD, as assessed by the developmental scoring methods (Everyone Can! composite score medians [interquartile range]: ASD M = 10.5, SD = 8; Control M = 15.0, SD = 0, p = .008). Despite many similarities in skipping kinematics between groups, participants with ASD were less proficient in skip performance than participants without ASD. Interventions for individuals with ASD addressing skipping proficiency or the performance of other locomotor skills, such as running and jumping, may promote participation in activities that involve complex motor skills and help individuals with ASD lead more physically active lives.
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Affiliation(s)
- Isabel Munoz Orozco
- Department of Kinesiology, California State University, Northridge, CA, USA
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Kimberly Hernandez
- Department of Kinesiology, California State University, Northridge, CA, USA
| | - Joevanie Mata
- Department of Kinesiology, California State University, Northridge, CA, USA
| | - Teri Todd
- Department of Kinesiology, California State University, Northridge, CA, USA
| | - Melissa Mache
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Danielle N Jarvis
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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Ludyga S, Gerber M, Bruggisser F, Leuenberger R, Brotzmann M, Trescher S, Förster M, Zou L, Herbrecht E, Hanke M. A randomized cross-over trial investigating the neurocognitive effects of acute exercise on face recognition in children with autism spectrum disorder. Autism Res 2023; 16:1630-1639. [PMID: 37353966 DOI: 10.1002/aur.2977] [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: 03/31/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
Difficulties in face recognition contribute to social-cognitive problems in autistic children. Evidence on behavioral interventions targeting this cognitive domain is limited. In non-autistic individuals, a single exercise session is known to elicit temporary benefits for several cognitive functions. Our study investigates whether acute aerobic exercise influences face recognition in autistic children. In a randomized order, 29 participants completed a 20-min moderately-intense cycling bout on an ergometer and a control condition. Before and after each condition, participants categorized Mooney faces and instruments during a computerized cognitive task. Simultaneously, the N170 component of event-related potentials and pupil size were recorded using electroencephalography and eyetracking, respectively. As indicated by a greater increase of reaction time in the exercise compared to the control condition, the results revealed impaired face recognition following aerobic exercise. This effect was accompanied by a lower decrease of the positive N170 amplitude and a trend towards a greater constriction of the pupil size in the exercise compared to the control condition. Our findings highlight the interplay of the physiological state and face recognition in autistic children. Exercise-induced impairments in this social-cognitive ability may be due to an interference with the learning effect that is typically seen for the structural encoding of faces.
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Affiliation(s)
- Sebastian Ludyga
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Fabienne Bruggisser
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Rahel Leuenberger
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Mark Brotzmann
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | | | | | - Liye Zou
- School of Psychology, Body-Brain-Mind Laboratory, Shenzhen University, China
| | | | - Manuel Hanke
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
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7
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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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Xi K, Cai SQ, Yan HF, Tian Y, Cai J, Yang XM, Wang JM, Xing GG. CSMD3 Deficiency Leads to Motor Impairments and Autism-Like Behaviors via Dysfunction of Cerebellar Purkinje Cells in Mice. J Neurosci 2023; 43:3949-3969. [PMID: 37037606 PMCID: PMC10219040 DOI: 10.1523/jneurosci.1835-22.2023] [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: 09/27/2022] [Revised: 03/18/2023] [Accepted: 04/05/2023] [Indexed: 04/12/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with highly heritable heterogeneity. Mutations of CUB and sushi multiple domains 3 (CSMD3) gene have been reported in individuals with ASD. However, the underlying mechanisms of CSMD3 for the onset of ASD remain unexplored. Here, using male CSMD3 knock-out (CSMD3 -/-) mice, we found that genetic deletion of CSMD3 produced core autistic-like symptoms (social interaction deficits, restricted interests, and repetitive and stereotyped behaviors) and motor dysfunction in mice, indicating that the CSMD3 gene can be considered as a candidate for ASD. Moreover, we discovered that the ablation of CSMD3 in mice led to abnormal cerebellar Purkinje cell (PC) morphology in Crus I/II lobules, including aberrant developmental dendritogenesis and spinogenesis of PCs. Furthermore, combining in vivo fiber photometry calcium imaging and ex vivo electrophysiological recordings, we showed that the CSMD3 -/- mice exhibited an increased neuronal activity (calcium fluorescence signals) in PCs of Crus I/II lobules in response to movement activity, as well as an enhanced intrinsic excitability of PCs and an increase of excitatory rather than inhibitory synaptic input to the PCs, and an impaired long-term depression at the parallel fiber-PC synapse. These results suggest that CSMD3 plays an important role in the development of cerebellar PCs. Loss of CSMD3 causes abnormal PC morphology and dysfunction in the cerebellum, which may underlie the pathogenesis of motor deficits and core autistic-like symptoms in CSMD3 -/- mice. Our findings provide novel insight into the pathophysiological mechanisms by which CSMD3 mutations cause impairments in cerebellar function that may contribute to ASD.SIGNIFICANCE STATEMENT Autism spectrum disorder (ASD) is a neurodevelopmental disorder with highly heritable heterogeneity. Advances in genomic analysis have contributed to numerous candidate genes for the risk of ASD. Recently, a novel giant gene CSMD3 encoding a protein with CUB and sushi multiple domains (CSMDs) has been identified as a candidate gene for ASD. However, the underlying mechanisms of CSMD3 for the onset of ASD remain largely unknown. Here, we unravel that loss of CSMD3 results in abnormal morphology, increased intrinsic excitabilities, and impaired synaptic plasticity in cerebellar PCs, subsequently leading to motor deficits and ASD-like behaviors in mice. These results provide novel insight into the pathophysiological mechanisms by which CSMD3 mutations cause impairments in cerebellar function that may contribute to ASD.
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Affiliation(s)
- Ke Xi
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
- Health Science Center, Key Laboratory for Neuroscience, Ministry of Education of China and National Health Commission of China, Beijing 100191, People's Republic of China
| | - Si-Qing Cai
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
- Health Science Center, Key Laboratory for Neuroscience, Ministry of Education of China and National Health Commission of China, Beijing 100191, People's Republic of China
| | - Hui-Fang Yan
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Yue Tian
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
- Health Science Center, Key Laboratory for Neuroscience, Ministry of Education of China and National Health Commission of China, Beijing 100191, People's Republic of China
| | - Jie Cai
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
- Health Science Center, Key Laboratory for Neuroscience, Ministry of Education of China and National Health Commission of China, Beijing 100191, People's Republic of China
| | - Xiao-Mei Yang
- Department of Human Anatomy and Embryology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
| | - Jing-Min Wang
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Guo-Gang Xing
- Neuroscience Research Institute, Peking University, Beijing 100191, People's Republic of China
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
- Health Science Center, Key Laboratory for Neuroscience, Ministry of Education of China and National Health Commission of China, Beijing 100191, People's Republic of China
- Second Affiliated Hospital of Xinxiang Medical University, Henan 453002, People's Republic of China
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Luginsland LA, Haegele JA, Bennett HJ. Lower extremity joint stiffness of autistic adolescents during running at dual speeds. J Biomech 2023; 149:111478. [PMID: 36780731 DOI: 10.1016/j.jbiomech.2023.111478] [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: 06/24/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
Running is one of the most common forms of physical activity for autistic adolescents. However, research examining their lower extremity dynamics is sparse. In particular, no information exists regarding lower extremity joint stiffness in autistic adolescents. This study compared knee and ankle joint stiffness during the absorption phase of running between autistic adolescents and non-autistic controls. Motion capture and ground reaction forces were recorded for 22 autistic adolescents and 17 non-autistic age, sex, and BMI matched peers who ran at self-selected and standardized (3.0 m/s) speeds. Group × speed knee and ankle joint stiffness, change in moment, and range of motion were compared using mixed-model ANOVAs. There were no group × speed interactions for any variable. Autistic adolescents presented with significant (12 % and 19 %) reduced knee and ankle joint stiffness, respectively. In addition, autistic adolescents had significant reduced changes in knee and ankle joint moments by 11 % and 21 %, respectively, compared to their non-autistic peers. Only knee joint stiffness and knee joint moments were sensitive to running speed, each significantly increasing with speed by 6 %. Current literature suggests joint stiffness is an important mechanism for stability and usage of the stretch shortening cycle (or elastic recoil); as such, it is possible that the reduced ankle plantar flexor and knee extensor stiffness found in autistic adolescents in this study could be indicative of reduced efficiency during running. As group differences existed across both speeds, autistic adolescents may benefit from therapeutic and/or educational interventions targeting efficient running mechanics.
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Affiliation(s)
- Lauren A Luginsland
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
| | - Justin A Haegele
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
| | - Hunter J Bennett
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
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10
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Mavragani A, Eungpinichpong W, Wu H, Aonsri C. Physiological and Psychological Effects of Parent-Delivered Traditional Thai Massage in Children With Autism: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41839. [PMID: 36753320 PMCID: PMC9947755 DOI: 10.2196/41839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/09/2022] [Accepted: 12/29/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although many autistic children receive massage as a complementary therapy, it is not included in evidence-based practice for autism because evidence of its efficacy is lacking. Further, prior studies have failed to identify objective indicators of core symptoms or elucidate their mechanisms. OBJECTIVE We developed a parent-delivered traditional Thai massage (TTM) intervention for children with autism, aiming to experimentally determine whether children with autism truly experience positive effects from parent-delivered TTM and determine possible mechanisms of the observed effects. METHODS A 2-armed, parallel randomized controlled trial was conducted between February 2022 and June 2022. Forty-eight children with autism (aged 7-12 years) were recruited from the Hainan Special Education School and randomly assigned to either a parental TTM or control group at a ratio of 1:1 based on random numbers generated with Online Research Randomizer. The generated sequences were concealed in an opaque envelope. Individuals in the parental TTM group received 16 parent-delivered TTM sessions over 8 weeks at the school's health room after school, and the control group maintained a normal daily routine. Outcomes were assessed on admission, after 8 weeks, and at a 2-month follow-up and included the effect of massage treatment on autism symptoms, measured with the Autism Treatment Evaluation Checklist score (evaluated by parents and a blinded teacher), physiological parameters (ie, heart rate variability and gait), and the Parenting Stress Index, Fourth Edition-Short Form. RESULTS We finished all data collection on June 20, 2022. Data analysis will be started, and we expect to publish results in 2023. CONCLUSIONS This study will provide further evidence for massage treatment of autism and provide support for family-based care. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100051355; https://tinyurl.com/3dwjxsw5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41839.
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Affiliation(s)
| | - Wichai Eungpinichpong
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Division of Physical Therapy, Khon Kaen University, Khon Kaen, Thailand
| | - Hua Wu
- School of Physical Education, Hainan Normal University, Haikou, China
| | - Chanada Aonsri
- Department of Special Education, Khon Kaen University Demonstration School, Khon Kaen University, Khon Kaen, Thailand
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Melnikov EY, Khodasevich LS, Polyakova AV, Legkaya EF. [Motor impairments in children with autism spectrum disorders: causes and possibilities for correction]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2023; 100:54-61. [PMID: 37735796 DOI: 10.17116/kurort202310004154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by triad of abnormalities in the form of developmental distortion with a lack of communicative abilities, behavioral and motor stereotypies. Etiology and pathogenesis of disease currently are unknown, but multifactorial causes of this pathology have been suggested. Although social disorders are considered a defining characteristic, motor disorders are a key feature of ASD. They are based on a postural control impairment, which is accompanied by delayed psychomotor development, reduced ability to motor synchronism in early childhood, modified arrangement of muscles, problems with balance and gait, postural instability, coordination deficiency, presence of motor dyspraxia and other abnormalities. OBJECTIVE To analyze current scientific data about motor disorders in ASD and their correction possibilities in children with this pathology. MATERIAL AND METHODS Analysis of publications, contained in PubMed and Google Scholar databases, which give consideration to motor disorders in children with ASD, was carried out. The search was done by keywords: motor disorders, children, autism spectrum disorder, causes, correction. RESULTS AND CONCLUSION Adaptive physical culture during individual training is one of the available and effective methods of physical rehabilitation in patients with ASD. Children with ASD need three levels of psychological support, each of which offers individual exercises, depending on the nature and severity of speech and cognitive impairment.
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Affiliation(s)
- E Yu Melnikov
- Research Center of Health Resort and Rehabilitation - branch of Federal Scientific and Clinical Center of Medical Rehabilitation and Health Resort of Federal Medical-Biological Agency in Sochi, Sochi, Russia
| | - L S Khodasevich
- Research Center of Health Resort and Rehabilitation - branch of Federal Scientific and Clinical Center of Medical Rehabilitation and Health Resort of Federal Medical-Biological Agency in Sochi, Sochi, Russia
- Kuban State Medical University, Krasnodar, Russia
| | | | - E F Legkaya
- Sochi Institute - branch of Peoples' Friendship University of Russia, Sochi, Russia
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12
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Olivas AN, Kendall MR, Parada A, Manning R, Eggleston JD. Children with autism display altered ankle strategies when changing speed during over-ground gait. Clin Biomech (Bristol, Avon) 2022; 100:105804. [PMID: 36327549 DOI: 10.1016/j.clinbiomech.2022.105804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Examining gait mechanics when altering speed has been used in various clinical populations to understand the pervasiveness of neurological impairments. Few studies have examined whether different gait mechanics exist when altering speed in children with Autism Spectrum Disorder, although autism may present as a movement disorder due to abnormalities in the central nervous system. Most autism gait-related research has used preferred walking speed, while different speeds may yield discernible patterns that can be used for future interventions. The purpose of this study was to examine kinematic strategies used by children with autism in preferred, fast, and slow walking speeds. METHODS Three-dimensional kinematic data were obtained on 14 children (aged 8-17 years) during preferred, fast, and slow walking. Hip, knee, and ankle angular joint positions were examined at loading response, pre-swing, and terminal swing sub-phases due to their importance on forward propulsion and weight transfer. Repeated measures analyses of variance (α = 0.05) were used to test for statistical differences and effect sizes were interpreted with Cohen's d. FINDINGS Although significant differences were observed for each joint and sub-phase, the left and right ankle joints during pre-swing displayed the most consistent differences among conditions (p < 0.001, and p < 0.001), respectively. Additionally, the left ankle displayed a moderate effect size (η2 = 0.71) and the right ankle displayed a large effect size (η2 = 0.80). INTERPRETATIONS These findings reveal that the ankle joint, during pre-swing, is the primary kinematic strategy used by children with autism when altering gait speed, whereas previous evidence suggests that the hip joint was the primary strategy.
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Affiliation(s)
- Alyssa N Olivas
- The Polytechnic School, Ira A. Fulton Schools of Engineering, Arizona State University, Mesa, AZ, USA; Department of Biomedical Engineering, The University of Texas at El Paso, El Paso, TX, USA
| | - Meagan R Kendall
- Department of Engineering Education and Leadership, The University of Texas at El Paso, El Paso, TX, USA
| | - Anita Parada
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Rhonda Manning
- Doctor of Physical Therapy Program, The University of Texas at El Paso, El Paso, TX, USA
| | - Jeffrey D Eggleston
- Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, USA; Interdisciplinary Health Sciences Doctoral Program, The University of Texas at El Paso, El Paso, TX, USA.
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13
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Classification of Autism and Control Gait in Children Using Multisegment Foot Kinematic Features. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9100552. [PMID: 36290520 PMCID: PMC9598184 DOI: 10.3390/bioengineering9100552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
Previous research has demonstrated that children with autism walk with atypical ankle kinematics and kinetics. Although these studies have utilized single-segment foot (SSF) data, multisegment foot (MSF) kinematics can provide further information on foot mechanics. Machine learning (ML) tools allow the combination of MSF kinematic features for classifying autism gait patterns. In this study, multiple ML models are investigated, and the most contributing features are determined. This study involved 19 children with autism and 21 age-matched controls performing walking trials. A 34-marker system and a 12-camera motion capture system were used to compute SSF and MSF angles during walking. Features extracted from these foot angles and their combinations were used to develop support vector machine (SVM) models. Additional techniques-S Hapley Additive exPlanations (SHAP) and the Shapley Additive Global importancE (SAGE) are used for local and global importance of the black-box ML models. The results suggest that models based on combinations of MSF kinematic features classify autism patterns with an accuracy of 96.3%, which is higher than using SSF kinematic features (83.8%). The relative angle between the metatarsal and midfoot segments had the highest contribution to the classification of autism gait patterns. The study demonstrated that kinematic features from MSF angles, supported by ML models, can provide an accurate and interpretable classification of autism and control patterns in children.
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14
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Mason AH, Pickett KA, Padilla AS, Travers BG. Combined Gait and Grasping in Autistic and Non-Autistic Youths. Dev Neurorehabil 2022; 25:452-461. [PMID: 35289701 PMCID: PMC9972923 DOI: 10.1080/17518423.2022.2052375] [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: 04/16/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 02/04/2023]
Abstract
This study was designed to extend research on motor skill development in autism spectrum disorder using a dual-task skill. Nine autistic and 18 non-autistic youths walked without grasping or while reaching to grasp a small or large object. Step extremity ratio, percent time in double support, and normalized speed were quantified. We hypothesized that gait would differ between autistic and non-autistic youth and that differences would be moderated by the phase (approach and grasp) and the complexity of the task (walking and grasping versus walking alone). Although gait parameters were similar during the walking-only trials, the combined task resulted in slower speed and shorter steps in autistic youth, particularly during the grasp phase. These findings, while in a small sample, offer preliminary evidence that autistic youth who show typical gait during simple assessments of motor ability may have difficulties in more complex tasks that require the coordination of movements.
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Affiliation(s)
- A H Mason
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - K A Pickett
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
- Program in Occupational Therapy, University of Wisconsin-Madison, Madison, WI, USA
| | - A S Padilla
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - B G Travers
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
- Program in Occupational Therapy, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
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15
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Daniel S, Wimpory D, Delafield-Butt JT, Malloch S, Holck U, Geretsegger M, Tortora S, Osborne N, Schögler B, Koch S, Elias-Masiques J, Howorth MC, Dunbar P, Swan K, Rochat MJ, Schlochtermeier R, Forster K, Amos P. Rhythmic Relating: Bidirectional Support for Social Timing in Autism Therapies. Front Psychol 2022; 13:793258. [PMID: 35693509 PMCID: PMC9186469 DOI: 10.3389/fpsyg.2022.793258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
We propose Rhythmic Relating for autism: a system of supports for friends, therapists, parents, and educators; a system which aims to augment bidirectional communication and complement existing therapeutic approaches. We begin by summarizing the developmental significance of social timing and the social-motor-synchrony challenges observed in early autism. Meta-analyses conclude the early primacy of such challenges, yet cite the lack of focused therapies. We identify core relational parameters in support of social-motor-synchrony and systematize these using the communicative musicality constructs: pulse; quality; and narrative. Rhythmic Relating aims to augment the clarity, contiguity, and pulse-beat of spontaneous behavior by recruiting rhythmic supports (cues, accents, turbulence) and relatable vitality; facilitating the predictive flow and just-ahead-in-time planning needed for good-enough social timing. From here, we describe possibilities for playful therapeutic interaction, small-step co-regulation, and layered sensorimotor integration. Lastly, we include several clinical case examples demonstrating the use of Rhythmic Relating within four different therapeutic approaches (Dance Movement Therapy, Improvisational Music Therapy, Play Therapy, and Musical Interaction Therapy). These clinical case examples are introduced here and several more are included in the Supplementary Material (Examples of Rhythmic Relating in Practice). A suite of pilot intervention studies is proposed to assess the efficacy of combining Rhythmic Relating with different therapeutic approaches in playful work with individuals with autism. Further experimental hypotheses are outlined, designed to clarify the significance of certain key features of the Rhythmic Relating approach.
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Affiliation(s)
- Stuart Daniel
- British Association of Play Therapists, London, United Kingdom
| | - Dawn Wimpory
- BCU Health Board (NHS), Bangor, United Kingdom
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Jonathan T. Delafield-Butt
- Laboratory for Innovation in Autism, University of Strathclyde, Glasgow, United Kingdom
- School of Education, University of Strathclyde, Glasgow, United Kingdom
| | - Stephen Malloch
- Westmead Psychotherapy Program, School of Medicine, University of Sydney, Sydney, NSW, Australia
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW, Australia
| | - Ulla Holck
- Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Monika Geretsegger
- The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Suzi Tortora
- Dancing Dialogue, LCAT, New York, NY, United States
| | - Nigel Osborne
- Department of Music, University of Edinburgh, Edinburgh, United Kingdom
| | - Benjaman Schögler
- Perception Movement Action Research Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - Sabine Koch
- Research Institute for Creative Arts Therapies, Alanus University, Alfter, Germany
- School of Therapy Sciences, Creative Arts Therapies, SRH University Heidelberg, Heidelberg, Germany
| | - Judit Elias-Masiques
- BCU Health Board (NHS), Bangor, United Kingdom
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | | | | | - Karrie Swan
- Department of Counseling, Leadership, and Special Education, Missouri State University, Springfield, MO, United States
| | - Magali J. Rochat
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Katharine Forster
- BCU Health Board (NHS), Bangor, United Kingdom
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Pat Amos
- Independent Researcher, Ardmore, PA, United States
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16
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Motor signature of autism spectrum disorder in adults without intellectual impairment. Sci Rep 2022; 12:7670. [PMID: 35538115 PMCID: PMC9090847 DOI: 10.1038/s41598-022-10760-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/12/2022] [Indexed: 12/28/2022] Open
Abstract
Motor signs such as dyspraxia and abnormal gait are characteristic features of autism spectrum disorder (ASD). However, motor behavior in adults with ASD has scarcely been quantitatively characterized. In this pilot study, we aim to quantitatively examine motor signature of adults with ASD without intellectual impairment using marker-less visual-perceptive motion capture. 82 individuals (37 ASD and 45 healthy controls, HC) with an IQ > 85 and aged 18 to 65 years performed nine movement tasks and were filmed by a 3D-infrared camera. Anatomical models were quantified via custom-made software and resulting kinematic parameters were compared between individuals with ASD and HCs. Furthermore, the association between specific motor behaviour and severity of autistic symptoms (Autism Diagnostic Observation Schedule 2, Autism Spectrum Quotient) was explored. Adults with ASD showed a greater mediolateral deviation while walking, greater sway during normal, tandem and single leg stance, a reduced walking speed and cadence, a greater arrhythmicity during jumping jack tasks and an impaired manual dexterity during finger tapping tasks (p < 0.05 and |D|> 0.48) compared to HC. Furthermore, in the ASD group, some of these parameters correlated moderately to severity of ASD symptoms. Adults with ASD seem to display a specific motor signature in this disorder affecting movement timing and aspects of balance. The data appear to reinforce knowledge about motor signs reported in children and adolescents with ASD. Also, quantitative motor assessment via visual-perceptive computing may be a feasible instrument to detect subtle motor signs in ASD and perhaps suitable in the diagnosis of ASD in the future.
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17
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Effects of Square-Stepping Exercise on Motor and Cognitive Skills in Autism Spectrum Disorder Children and Adolescents: A Study Protocol. Healthcare (Basel) 2022; 10:healthcare10030450. [PMID: 35326928 PMCID: PMC8950471 DOI: 10.3390/healthcare10030450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/13/2022] [Accepted: 02/24/2022] [Indexed: 01/25/2023] Open
Abstract
Individuals with autism spectrum disorder (ASD) diagnoses present not only cognitive, emotional, communicative, and social challenges but also movement issues that affect their everyday activities, learning, and leisure. The use of the square-stepping exercise (SSE), a motor program initially created to strengthen the lower limbs of older adults, is spreading because of its advantages (e.g., balance and lower limb strength improvements). A study protocol to assess the SSE effects on motor, sensory, and cognitive skills in Spanish children and adolescents between 6 and 12 years old with ASD diagnoses is presented. A randomised clinical will be performed, recruiting 52 children and adolescents with ASD who will be distributed into two groups: an experimental (n = 26) and a control (n = 26) group. The SSE sessions will be held for 9 weeks (two times per week). The main variable will be balance, which will be measured with the Movement Assessment Battery for Children 2 (MABC2), and secondary outcomes will include sensory processing, attention, and executive functions. Assessments will be carried out before and at the end of the program implementation, including an additional follow up one month later. If this program obtains positive results, it should be implemented in different settings (schools, clinics, associations, etc.) to improve the quality of movement and development in children and adolescents with ASD, as it is an easy-to-use and structured tool.
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18
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Automatic Assessment of Motor Impairments in Autism Spectrum Disorders: A Systematic Review. Cognit Comput 2022. [DOI: 10.1007/s12559-021-09940-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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19
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Wang LAL, Petrulla V, Zampella CJ, Waller R, Schultz RT. Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychol Bull 2022; 148:273-300. [PMID: 35511567 PMCID: PMC9894569 DOI: 10.1037/bul0000358] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges' g = -1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Leah A. L. Wang
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania
| | | | - Casey J. Zampella
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | | | - Robert T. Schultz
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
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20
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Jafarnezhadgero AA, Dehghani M, Abdollahpourdarvishani M, Sheikhalizadeh H, Akrami M. Effect of textured foot orthoses on walking plantar pressure variables in children with autism spectrum disorders. J Biomech 2021; 129:110775. [PMID: 34600173 DOI: 10.1016/j.jbiomech.2021.110775] [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: 10/30/2020] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the effect of textured foot orthoses on plantar pressure variables in children with autism spectrum disorders (ASDs). Thirty boys were divided into two groups based on their health status, namely: autism spectrum disorder and healthy matched controls. Plantar pressure data were captured during stance phases of shod walking with and without textured foot orthoses. Remarkably larger peak force under the toe1 and metatarsal1 and peak pressure under the toe1 and toe2-5 regions were observed in the autism group comparing with the healthy group, while lower peak force under the toe1, metatarsal1 and metatarsal2 were seen during walking with textured foot orthoses comparing with the cases of walking without them. The results showed higher values of peak pressure under metatarsal3, metatarsal4 and metatarsal5 for the textured foot orthoses walking against the cases without them. Also, analysis depicted huge reductions from pre-to-posttest for the peak pressure under toe2-5 only cases within the autism group. The reason of observing higher peak values of forces and pressures within their forefoot can potentially be their tendency to walk on their toes comparing against the healthy control children. This causes lower pressure values within all toes and the first metatarsal regions during normal walking with textured foot orthoses than walking without them. The findings revealed that the use of textured foot orthoses reduced peak pressure under toe2-5 only in the autism group. This suggests that the use of such interventions can help boys with ASDs move more safely.
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Affiliation(s)
- Amir Ali Jafarnezhadgero
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Mahrokh Dehghani
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Mohammad Abdollahpourdarvishani
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Hamed Sheikhalizadeh
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Mohammad Akrami
- Department of Engineering, University of Exeter, Exeter EX4 4QF, UK
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21
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Vacher CM, Lacaille H, O'Reilly JJ, Salzbank J, Bakalar D, Sebaoui S, Liere P, Clarkson-Paredes C, Sasaki T, Sathyanesan A, Kratimenos P, Ellegood J, Lerch JP, Imamura Y, Popratiloff A, Hashimoto-Torii K, Gallo V, Schumacher M, Penn AA. Placental endocrine function shapes cerebellar development and social behavior. Nat Neurosci 2021; 24:1392-1401. [PMID: 34400844 PMCID: PMC8481124 DOI: 10.1038/s41593-021-00896-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
Compromised placental function or premature loss has been linked to diverse neurodevelopmental disorders. Here we show that placenta allopregnanolone (ALLO), a progesterone-derived GABA-A receptor (GABAAR) modulator, reduction alters neurodevelopment in a sex-linked manner. A new conditional mouse model, in which the gene encoding ALLO's synthetic enzyme (akr1c14) is specifically deleted in trophoblasts, directly demonstrated that placental ALLO insufficiency led to cerebellar white matter abnormalities that correlated with autistic-like behavior only in male offspring. A single injection of ALLO or muscimol, a GABAAR agonist, during late gestation abolished these alterations. Comparison of male and female human preterm infant cerebellum also showed sex-linked myelination marker alteration, suggesting similarities between mouse placental ALLO insufficiency and human preterm brain development. This study reveals a new role for a placental hormone in shaping brain regions and behaviors in a sex-linked manner. Placental hormone replacement might offer novel therapeutic opportunities to prevent later neurobehavioral disorders.
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Affiliation(s)
- Claire-Marie Vacher
- Department of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Helene Lacaille
- Department of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Jiaqi J O'Reilly
- Department of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Jacquelyn Salzbank
- Department of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Dana Bakalar
- National Institutes of Health, Bethesda, MD, USA
| | - Sonia Sebaoui
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
| | - Philippe Liere
- U1195 INSERM, Paris-Saclay University, Le Kremlin-Bicêtre Cedex, France
| | | | - Toru Sasaki
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
| | - Aaron Sathyanesan
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
| | - Panagiotis Kratimenos
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Pediatrics, Washington, DC, USA
| | - Jacob Ellegood
- Mouse Imaging Centre (MICe), Hospital for Sick Children, Toronto, ON, Canada
| | - Jason P Lerch
- Mouse Imaging Centre (MICe), Hospital for Sick Children, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Yuka Imamura
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Pittsburgh, PA, USA
| | - Anastas Popratiloff
- The George Washington University, Nanofabrication and Imaging Center, Washington, DC, USA
- The George Washington University, SMHS, Anatomy & Cell Biology, Washington, DC, USA
| | - Kazue Hashimoto-Torii
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Pediatrics, Washington, DC, USA
| | - Vittorio Gallo
- Center for Neuroscience Research, Children's National Health System, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Pediatrics, Washington, DC, USA
| | | | - Anna A Penn
- Department of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
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22
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Bennett HJ, Jones T, Valenzuela KA, Haegele JA. Coordination variability during running in adolescents with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1201-1215. [PMID: 34519564 DOI: 10.1177/13623613211044395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Walking and running are popular forms of physical activity that involve the whole body (pelvis/legs and arms/torso) and are coordinated by the neuromuscular system, generally without much conscious effort. However, autistic persons tend not to engage in sufficient amounts of these activities to enjoy their health benefits. Recent reports indicate that autistic individuals tend to experience altered coordination patterns and increased variability during walking tasks when compared to non-autistic controls. Greater stride-to-stride coordination variability, when the task has not changed (i.e. walking at same speed and on same surface), is likely indicative of motor control issues and is more metabolically wasteful. To date, although, research examining running is unavailable in any form for this population. This study aimed to determine if coordination variability during running differs between autistic adolescents and age, sex, and body mass index matched non-autistic controls. This study found that increased variability exists throughout the many different areas of the body (foot-leg, left/right thighs, and opposite arm-opposite thigh) for autistic adolescents compared to controls. Along with previous research, these findings indicate autistic persons exhibit motor control issues across both forms of locomotion (walking and running) and at multiple speeds. These findings highlight issues with motor control that can be addressed by therapeutic/rehabilitative programming. Reducing coordination variability, inherently lessening metabolic inefficiency, may be an important step toward encouraging autistic youth to engage in sufficient physical activity (i.e. running) to enjoy physiological and psychological benefits.
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23
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Zampella CJ, Wang LAL, Haley M, Hutchinson AG, de Marchena A. Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review. Curr Psychiatry Rep 2021; 23:64. [PMID: 34387753 DOI: 10.1007/s11920-021-01280-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD). RECENT FINDINGS Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.
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Affiliation(s)
- Casey J Zampella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Leah A L Wang
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret Haley
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anne G Hutchinson
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley de Marchena
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA
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24
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Rahman S, Ahmed SF, Shahid O, Arrafi MA, Ahad MAR. Automated Detection Approaches to Autism Spectrum Disorder Based on Human Activity Analysis: A Review. Cognit Comput 2021. [DOI: 10.1007/s12559-021-09895-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Holloway JM, Long TM, Biasini FJ. The intersection of gross motor abilities and participation in children with autism spectrum disorder. INFANTS AND YOUNG CHILDREN 2021; 34:178-189. [PMID: 34211254 PMCID: PMC8240862 DOI: 10.1097/iyc.0000000000000192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many children with autism spectrum disorder (ASD) demonstrate movement difficulties in addition to problems with social communication and interactions, and repetitive or restrictive behaviors. The goal of early intervention for children with disabilities is to promote participation in routines and activities, but little is known about the role gross motor abilities contribute to participation for young children with ASD. The purpose of this study was to examine relationships between gross motor abilities and participation in preschool-aged children with ASD. Twenty-two children with ASD participated in the study. Gross motor skills were measured using the Peabody Developmental Motor Scales, Second Edition. Participation was measured using the Preschool Activity Card Sort. Children who had greater gross motor skills also demonstrated greater participation in self-care, high demand leisure, and social interaction activities. Results also identified activities that may be difficult for preschoolers with ASD. Findings suggest that early childhood intervention providers consider the impact of gross motor deficits within the context of participation in daily routines and activities.
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Affiliation(s)
- Jamie M Holloway
- School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Toby M Long
- Department of Pediatrics, Georgetown University, Washington DC, United States
| | - Fred J Biasini
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
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26
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Lee CM, Bo J. Visuomotor adaptation and its relationship with motor ability in children with and without autism spectrum disorder. Hum Mov Sci 2021; 78:102826. [PMID: 34139390 DOI: 10.1016/j.humov.2021.102826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 11/24/2022]
Abstract
The high prevalence rates of motor impairments among individuals with autism spectrum disorder (ASD) lead to increased attention to motor learning. The current study examined the visuomotor adaptability in children with and without ASD using a computerized visuomotor adaptation task in which the real-time visual feedback of hand movement was rotated. The relationships between visuomotor adaptability and clinical symptomology were also investigated. Results revealed that the children with ASD showed a slower rate of improvement and smaller after-effects than their peers on the measures of motor planning. Additionally, autistic characteristics significantly moderated the association between individuals' adaptability and fine motor skills. The findings contribute to the growing evidence of compromised visuomotor adaptability, which suggested the importance of addressing these clinical features of ASD.
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Affiliation(s)
- Chimei M Lee
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, United States of America.
| | - Jin Bo
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, 48197, United States of America
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27
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Simmons DH, Titley HK, Hansel C, Mason P. Behavioral Tests for Mouse Models of Autism: An Argument for the Inclusion of Cerebellum-Controlled Motor Behaviors. Neuroscience 2021; 462:303-319. [PMID: 32417339 DOI: 10.1016/j.neuroscience.2020.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022]
Abstract
Mouse models of Autism Spectrum Disorder (ASD) have been interrogated using a variety of behavioral tests in order to understand the symptoms of ASD. However, the hallmark behaviors that are classically affected in ASD - deficits in social interaction and communication as well as the occurrence of repetitive behaviors - do not have direct murine equivalents. Thus, it is critical to identify the caveats that come with modeling a human disorder in mice. The most commonly used behavioral tests represent complex cognitive processes based on largely unknown brain circuitry. Motor impairments provide an alternative, scientifically rigorous approach to understanding ASD symptoms. Difficulties with motor coordination and learning - seen in both patients and mice - point to an involvement of the cerebellum in ASD pathology. This brain area supports types of motor learning that are conserved throughout vertebrate evolution, allowing for direct comparisons of functional abnormalities between humans with autism and ASD mouse models. Studying simple motor behaviors provides researchers with clearly interpretable results. We describe and evaluate methods used on mouse behavioral assays designed to test for social, communicative, perseverative, anxious, nociceptive, and motor learning abnormalities. We comment on the effectiveness and validity of each test based on how much information its results give, as well as its relevance to ASD, and will argue for an inclusion of cerebellum-supported motor behaviors in the phenotypic description of ASD mouse models. LAY SUMMARY: Mouse models of Autism Spectrum Disorder help us gain insight about ASD symptoms in human patients. However, there are many differences between mice and humans, which makes interpreting behaviors challenging. Here, we discuss a battery of behavioral tests for specific mouse behaviors to explore whether each test does indeed evaluate the intended measure, and whether these tests are useful in learning about ASD.
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Affiliation(s)
- Dana H Simmons
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Heather K Titley
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Christian Hansel
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA.
| | - Peggy Mason
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA.
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28
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Jequier Gygax M, Maillard AM, Favre J. Could Gait Biomechanics Become a Marker of Atypical Neuronal Circuitry in Human Development?-The Example of Autism Spectrum Disorder. Front Bioeng Biotechnol 2021; 9:624522. [PMID: 33796508 PMCID: PMC8009281 DOI: 10.3389/fbioe.2021.624522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/19/2021] [Indexed: 12/28/2022] Open
Abstract
This perspective paper presents converging recent knowledge in neurosciences (motor neurophysiology, neuroimaging and neuro cognition) and biomechanics to outline the relationships between maturing neuronal network, behavior, and gait in human development. Autism Spectrum Disorder (ASD) represents a particularly relevant neurodevelopmental disorder (NDD) to study these convergences, as an early life condition presenting with sensorimotor and social behavioral alterations. ASD diagnosis relies solely on behavioral criteria. The absence of biological marker in ASD is a main challenge, and hampers correlations between behavioral development and standardized data such as brain structure alterations, brain connectivity, or genetic profile. Gait, as a way to study motor system development, represents a well-studied, early life ability that can be characterized through standardized biomechanical analysis. Therefore, developmental gait biomechanics might appear as a possible motor phenotype and biomarker, solid enough to be correlated to neuronal network maturation, in normal and atypical developmental trajectories—like in ASD.
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Affiliation(s)
- Marine Jequier Gygax
- Service des Troubles du Spectre de l'Autisme, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne M Maillard
- Service des Troubles du Spectre de l'Autisme, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
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29
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Rahn RM, Weichselbaum CT, Gutmann DH, Dougherty JD, Maloney SE. Shared developmental gait disruptions across two mouse models of neurodevelopmental disorders. J Neurodev Disord 2021; 13:10. [PMID: 33743598 PMCID: PMC7980331 DOI: 10.1186/s11689-021-09359-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Motor deficits such as abnormal gait are an underappreciated yet characteristic phenotype of many neurodevelopmental disorders (NDDs), including Williams Syndrome (WS) and Neurofibromatosis Type 1 (NF1). Compared to cognitive phenotypes, gait phenotypes are readily and comparably assessed in both humans and model organisms and are controlled by well-defined CNS circuits. Discovery of a common gait phenotype between NDDs might suggest shared cellular and molecular deficits and highlight simple outcome variables to potentially quantify longitudinal treatment efficacy in NDDs. METHODS We characterized gait using the DigiGait assay in two different murine NDD models: the complete deletion (CD) mouse, which models hemizygous loss of the complete WS locus, and the Nf1+/R681X mouse, which models a NF1 patient-derived heterozygous germline NF1 mutation. Longitudinal data were collected across four developmental time points (postnatal days 21-30) and one early adulthood time point. RESULTS Compared to wildtype littermate controls, both models displayed markedly similar spatial, temporal, and postural gait abnormalities during development. Developing CD mice also displayed significant decreases in variability metrics. Multiple gait abnormalities observed across development in the Nf1+/R681X mice persisted into early adulthood, including increased stride length and decreased stride frequency, while developmental abnormalities in the CD model largely resolved by adulthood. CONCLUSIONS These findings suggest that the subcomponents of gait affected in NDDs show overlap between disorders as well as some disorder-specific features, which may change over the course of development. Our incorporation of spatial, temporal, and postural gait measures also provides a template for gait characterization in other NDD models and a platform to examining circuits or longitudinal therapeutics.
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Affiliation(s)
- Rachel M Rahn
- Department of Genetics, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Department of Radiology, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA
| | - Claire T Weichselbaum
- Department of Genetics, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA
| | - David H Gutmann
- Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA
| | - Joseph D Dougherty
- Department of Genetics, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.,Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA
| | - Susan E Maloney
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA. .,Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1093, USA.
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30
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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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31
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May T, Mcginley J, Murphy A, Hinkley T, Papadopoulos N, Williams KJ, Mcgillivray J, Enticott PG, Leventer RJ, Rinehart NJ. A Multidisciplinary Perspective on Motor Impairment as an Early Behavioural Marker in Children with Autism Spectrum Disorder. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12225] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Tamara May
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University,
- Department of Paediatrics, University of Melbourne,
- Murdoch Childrens Research Institute,
| | - Jennifer Mcginley
- Department of Physiotherapy, School of Health Sciences, University of Melbourne,
| | - Anna Murphy
- Clinical Research Centre for Movement Disorders and Gait, Monash Health,
| | - Trina Hinkley
- Institute for Physical Activity and Nutrition, Deakin University,
| | - Nicole Papadopoulos
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University,
| | - Katrina J Williams
- Department of Paediatrics, University of Melbourne,
- Murdoch Childrens Research Institute,
- Developmental Medicine, Royal Children's Hospital,
| | - Jane Mcgillivray
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University,
| | - Peter G Enticott
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University,
| | - Richard J Leventer
- Department of Paediatrics, University of Melbourne,
- Murdoch Childrens Research Institute,
- Department of Neurology, Royal Children's Hospital,
| | - Nicole J Rinehart
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University,
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Perin C, Valagussa G, Mazzucchelli M, Gariboldi V, Cerri CG, Meroni R, Grossi E, Cornaggia CM, Menant J, Piscitelli D. Physiological Profile Assessment of Posture in Children and Adolescents with Autism Spectrum Disorder and Typically Developing Peers. Brain Sci 2020; 10:brainsci10100681. [PMID: 32992546 PMCID: PMC7601261 DOI: 10.3390/brainsci10100681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 02/05/2023] Open
Abstract
A sound postural system requires sensorimotor integration. Evidence suggests that individuals with Autism Spectrum Disorder (ASD) present sensorimotor integration impairments. The Physiological Profile Assessment (PPA) can be used to evaluate postural capacity assessing five physiological subsets (i.e., vision, reaction time, peripheral sensation, lower limb strength, balance); however, no studies applied the PPA in young individuals. Therefore, this study aimed to investigate the PPA in children and adolescents with ASD compared with age-matched typically developing (TD) individuals and examine the relationship between the PPA subset within the ASD and TD participants according to different age groups. Percentiles from the PPA were obtained from the TD children and adolescents (n = 135) for each test. Performances of the individuals with ASD (n = 18) were examined relative to the TD percentiles. ASD participants' scores were above the 90th percentile (i.e., poor performance) in most sensory, motor and balance parameters. Performance in most of the PPA tests significantly improved with older age in the TD group but not in the ASD group. The study findings support the use of the PPA in TD children and adolescents while further research should investigate postural capacity in a larger ASD sample to enhance the understanding of sensorimotor systems contributing to compromised postural control.
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Affiliation(s)
- Cecilia Perin
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- Correspondence: ; Tel.: +39-0362-986-446; Fax: +39-0362-986-439
| | - Giulio Valagussa
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Como, Italy;
| | - Miryam Mazzucchelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Valentina Gariboldi
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- ASST Rhodense, Ospedale “G. Salvini”, 20024 Milan, Italy
| | - Cesare Giuseppe Cerri
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Roberto Meroni
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, 4671 Luxembourg, Luxembourg;
| | - Enzo Grossi
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Como, Italy;
| | - Cesare Maria Cornaggia
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Jasmine Menant
- Neuroscience Research Australia and School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
- School of Physical Therapy and Athletic Training, Pacific University, Hillsboro, OR 97123, USA
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33
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Fertan E, Wong AA, Purdon MK, Weaver ICG, Brown RE. The effect of background strain on the behavioral phenotypes of the MDGA2 +/- mouse model of autism spectrum disorder. GENES BRAIN AND BEHAVIOR 2020; 20:e12696. [PMID: 32808443 DOI: 10.1111/gbb.12696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/27/2020] [Accepted: 08/14/2020] [Indexed: 12/26/2022]
Abstract
The membrane-associated mucin (MAM) domain containing glycosylphosphatidylinositol anchor 2 protein single knock-out mice (MDGA2+/- ) are models of ASD. We examined the behavioral phenotypes of male and female MDGA2+/- and wildtype mice on C57BL6/NJ and C57BL6/N backgrounds at 2 months of age and measured MDGA2, neuroligin 1 and neuroligin 2 levels at 7 months. Mice on the C57BL6/NJ background performed better than those on the C57BL6/N background in visual ability and in learning and memory performance in the Morris water maze and differed in measures of motor behavior and anxiety. Mice with the MDGA2+/- genotype differed from WT mice in motor, social and repetitive behavior and anxiety, but most of these effects involved interactions between MDGA2+/- genotype and background strain. The background strain also influenced MDGA2 levels and NLGN2 association in MDGA2+/- mice. Our findings emphasize the importance of the background strain used in studies of genetically modified mice.
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Affiliation(s)
- Emre Fertan
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Aimée A Wong
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michaela K Purdon
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ian C G Weaver
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Brain Repair Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Brain Repair Centre, Dalhousie University, Halifax, Nova Scotia, Canada
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Akula SK, McCullough KB, Weichselbaum C, Dougherty JD, Maloney SE. The trajectory of gait development in mice. Brain Behav 2020; 10:e01636. [PMID: 32333523 PMCID: PMC7303394 DOI: 10.1002/brb3.1636] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/13/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Gait irregularities are prevalent in neurodevelopmental disorders (NDDs). However, there is a paucity of information on gait phenotypes in NDD experimental models. This is in part due to the lack of understanding of the normal developmental trajectory of gait maturation in the mouse. MATERIALS AND METHODS Using the DigiGait system, we have developed a quantitative, standardized, and reproducible assay of developmental gait metrics in commonly used mouse strains that can be added to the battery of mouse model phenotyping. With this assay, we characterized the trajectory of gait in the developing C57BL/6J and FVB/AntJ mouse lines. RESULTS In both lines, a mature stride consisted of 40% swing and 60% stance in the forelimbs, which mirrors the mature human stride. In C57BL/6J mice, developmental trajectories were observed for stance width, paw overlap distance, braking and propulsion time, rate of stance loading, peak paw area, and metrics of intraindividual variability. In FVB/AntJ mice, developmental trajectories were observed for percent shared stance, paw overlap distance, rate of stance loading, and peak paw area, although in different directions than C57 mice. By accounting for the impact of body length on stride measurements, we demonstrate the importance of considering body length when interpreting gait metrics. CONCLUSION Overall, our results show that aspects of mouse gait development parallel a timeline of normal human gait development, such as the percent of stride that is stance phase and swing phase. This study may be used as a standard reference for developmental gait phenotyping of murine models, such as models of neurodevelopmental disease.
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Affiliation(s)
- Shyam K Akula
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA.,Harvard-MIT MD/PhD Program, Harvard Medical School, Boston, MA, USA
| | - Katherine B McCullough
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Claire Weichselbaum
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Joseph D Dougherty
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA.,Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan E Maloney
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
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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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Wilson RB, Elashoff D, Gouelle A, Smith BA, Wilson AM, Dickinson A, Safari T, Hyde C, Jeste SS. Quantitative Gait Analysis in Duplication 15q Syndrome and Nonsyndromic ASD. Autism Res 2020; 13:1102-1110. [PMID: 32282133 DOI: 10.1002/aur.2298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/23/2020] [Accepted: 03/14/2020] [Indexed: 01/12/2023]
Abstract
Motor impairments occur frequently in genetic syndromes highly penetrant for autism spectrum disorder (syndromic ASD) and in individuals with ASD without a genetic diagnosis (nonsyndromic ASD). In particular, abnormalities in gait in ASD have been linked to language delay, ASD severity, and likelihood of having a genetic disorder. Quantitative measures of motor function can improve our ability to evaluate motor differences in individuals with syndromic and nonsyndromic ASD with varying levels of intellectual disability and adaptive skills. To evaluate this methodology, we chose to use quantitative gait analysis to study duplication 15q syndrome (dup15q syndrome), a genetic disorder highly penetrant for motor delays, intellectual disability, and ASD. We evaluated quantitative gait variables in individuals with dup15q syndrome (n = 39) and nonsyndromic ASD (n = 21) and compared these data to a reference typically developing cohort. We found a gait pattern of slow pace, poor postural control, and large gait variability in dup15q syndrome. Our findings improve characterization of motor function in dup15q syndrome and nonsyndromic ASD. Quantitative gait analysis can be used as a translational method and can improve our identification of clinical endpoints to be used in treatment trials for these syndromes. Autism Res 2020, 13: 1102-1110. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Motor impairments, particularly abnormalities in walking, occur frequently in genetic syndromes highly penetrant for autism spectrum disorder (syndromic ASD). Here, using quantitative gait analysis, we find that individuals with duplication 15q syndrome have an atypical gait pattern that differentiates them from typically developing and nonsyndromic ASD individuals. Our findings improve motor characterization in dup15q syndrome and nonsyndromic ASD.
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Affiliation(s)
- Rujuta B Wilson
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - David Elashoff
- Department of Medicine Statistics Core, David Geffen School of Medicine, Los Angeles, California, USA
| | - Arnaud Gouelle
- Gait and Balance Academy, Protokinetics, Havertown, Pennsylvania, USA.,Laboratory Performance, Sante, Metrologie, Societe (PSMS), UFR STAPS, Reims, France
| | - Beth A Smith
- Division of Biokinesiology and Physical Therapy and Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Andrew M Wilson
- Greater Los Angeles VA HealthCare System, Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | - Abigail Dickinson
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Tabitha Safari
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Carly Hyde
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Shafali S Jeste
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Bloch C, Vogeley K, Georgescu AL, Falter-Wagner CM. INTRApersonal Synchrony as Constituent of INTERpersonal Synchrony and Its Relevance for Autism Spectrum Disorder. Front Robot AI 2019; 6:73. [PMID: 33501088 PMCID: PMC7805712 DOI: 10.3389/frobt.2019.00073] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/30/2019] [Indexed: 11/13/2022] Open
Abstract
INTERpersonal synchrony leads to increased empathy, rapport and understanding, enabling successful human-human interactions and reciprocal bonding. Research shows that individuals with Autism Spectrum Disorder (ASD) exhibit difficulties to INTERpersonally synchronize but underlying causes are yet unknown. In order to successfully synchronize with others, INTRApersonal synchronization of communicative signals appears to be a necessary prerequisite. We understand INTRApersonal synchrony as an implicit factor of INTERpersonal synchrony and therefore hypothesize that atypicalities of INTRApersonal synchrony may add to INTERpersonal synchrony problems in ASD and their interaction partners. In this perspective article, we first review evidence for INTERpersonal dissynchrony in ASD, with respect to different approaches and assessment methods. Second, we draft a theoretical conceptualization of INTRApersonal dissynchrony in ASD based on a temporal model of human interaction. We will outline literature indicating INTRApersonal dissynchrony in ASD, therefore highlighting findings of atypical timing functions and findings from clinical and behavioral studies that indicate peculiar motion patterns and communicative signal production in ASD. Third, we hypothesize that findings from these domains suggest an assessment and investigation of temporal parameters of social behavior in individuals with ASD. We will further propose specific goals of empirical approaches on INTRApersonal dissynchrony. Finally we present implications of research on INTRApersonal timing in ASD for diagnostic and therapeutic purposes, what in our opinion warrants the increase of research efforts in this domain.
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Affiliation(s)
- Carola Bloch
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, Ludwig-Maximilians-University, Munich, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM3), Research Center Jülich, Jülich, Germany
| | - Alexandra L. Georgescu
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Christine M. Falter-Wagner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Ludwig-Maximilians-University, Munich, Germany
- Department of Psychology, Faculty of Human Science, University of Cologne, Cologne, Germany
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Leyden J, Fung L, Frick S. Autism and toe-walking: are they related? Trends and treatment patterns between 2005 and 2016. J Child Orthop 2019; 13:340-345. [PMID: 31489038 PMCID: PMC6701446 DOI: 10.1302/1863-2548.13.180160] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study quantified toe-walking trends and treatment decisions in patients with autism spectrum disorder (ASD) in the United States between 2005 and 2016 using a large national private-payer database. METHODS A retrospective database review was performed on paediatric patients with ASD, and for International Classification of Diseases-9/10 diagnosis codes for toe-walking. Patients were filtered based on treatment type by Current Procedural Terminology (CPT) code. Continued toe-walking rates were assessed for each patient population and treatment group. A Pearson's chi-squared test was used to evaluate differences in group characteristics. RESULTS Of 2 221 009 paediatric patients in the database, 5739 patients had a diagnosis of ASD, and 8.4% of patients with ASD also had a diagnosis of toe-walking (n = 484). For typically developing children in the database, 0.47% of patients had a diagnosis of persistent toe-walking. In all, 59.3% of ASD patients underwent physical therapy, 7.4% serial casting and 3.3% surgical correction, compared with 38.1%, 3.6% and 1.2% of normally developing children, respectively (chi-square 6.4031; p < 0.040699). Without intervention, 63.6% of patients with ASD continued to toe-walk within ten years of their diagnosis, with 19.3% of patients without ASD (chi-square 82.9762; p < 0.0001). CONCLUSION This study supports the association between a greater prevalence of toe-walking in children with ASD. We showed that patients with ASD and toe-walking receive surgical correction at nearly triple the rate of children without ASD who toe-walk. The continued rate of toe-walking is comparable between treatment groups as well as between ASD and typically developing children. Typically developing children have higher rates of toe-walking resolution without intervention than children with ASD. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- J. Leyden
- Stanford University School of Medicine, Stanford, California, USA,Correspondence should be sent to: Jacinta Leyden, Stanford University School of Medicine, 2225 Alma Street, Palo Alto, CA 94301, USA. or
| | - L. Fung
- Stanford Department of Psychiatry and Behavioral Sciences, Stanford, California, USA
| | - S. Frick
- Stanford Department of Pediatric Orthopaedics, Stanford, California, USA
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Millar L, McConnachie A, Minnis H, Wilson P, Thompson L, Anzulewicz A, Sobota K, Rowe P, Gillberg C, Delafield-Butt J. Phase 3 diagnostic evaluation of a smart tablet serious game to identify autism in 760 children 3-5 years old in Sweden and the United Kingdom. BMJ Open 2019; 9:e026226. [PMID: 31315858 PMCID: PMC6661582 DOI: 10.1136/bmjopen-2018-026226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Recent evidence suggests an underlying movement disruption may be a core component of autism spectrum disorder (ASD) and a new, accessible early biomarker. Mobile smart technologies such as iPads contain inertial movement and touch screen sensors capable of recording subsecond movement patterns during gameplay. A previous pilot study employed machine learning analysis of motor patterns recorded from children 3-5 years old. It identified those with ASD from age-matched and gender-matched controls with 93% accuracy, presenting an attractive assessment method suitable for use in the home, clinic or classroom. METHODS AND ANALYSIS This is a phase III prospective, diagnostic classification study designed according to the Standards for Reporting Diagnostic Accuracy Studies guidelines. Three cohorts are investigated: children typically developing (TD); children with a clinical diagnosis of ASD and children with a diagnosis of another neurodevelopmental disorder (OND) that is not ASD. The study will be completed in Glasgow, UK and Gothenburg, Sweden. The recruitment target is 760 children (280 TD, 280 ASD and 200 OND). Children play two games on the iPad then a third party data acquisition and analysis algorithm (Play.Care, Harimata) will classify the data as positively or negatively associated with ASD. The results are blind until data collection is complete, when the algorithm's classification will be compared against medical diagnosis. Furthermore, parents of participants in the ASD and OND groups will complete three questionnaires: Strengths and Difficulties Questionnaire; Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations Questionnaire and the Adaptive Behavioural Assessment System-3 or Vineland Adaptive Behavior Scales-II. The primary outcome measure is sensitivity and specificity of Play.Care to differentiate ASD children from TD children. Secondary outcomes measures include the accuracy of Play.Care to differentiate ASD children from OND children. ETHICS AND DISSEMINATION This study was approved by the West of Scotland Research Ethics Service Committee 3 and the University of Strathclyde Ethics Committee. Results will be disseminated in peer-reviewed publications and at international scientific conferences. TRIAL REGISTRATION NUMBER NCT03438994; Pre-results.
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Affiliation(s)
- Lindsay Millar
- Laboratory for Innovation in Autism, University of Strathclyde, Glasgow, UK
- Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Helen Minnis
- Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Philip Wilson
- Centre for Rural Health, University of Aberdeen, Aberdeen, UK
| | - Lucy Thompson
- Centre for Rural Health, University of Aberdeen, Aberdeen, UK
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Philip Rowe
- Laboratory for Innovation in Autism, University of Strathclyde, Glasgow, UK
- Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Christopher Gillberg
- Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ichikawa T, Shigeta M, Urakawa T, Sawatome A, Tanaka M, Kurita Y, Araki O, Ichikawa H, Takemura H. Correlation Between Gait Perception and Autistic Traits in the General Population: A Study on Event-Related Evoked Potentials. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:3135-3138. [PMID: 31946552 DOI: 10.1109/embc.2019.8857577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Previous studies have shown that people with autistic traits have difficulties in motion perception, such as human gait as depicted on a point-light display. A recent study reported that adults with autism spectrum disorders showed atypical visual event-related evoked potentials (ERPs) in response to radial optic flow. To determine the correlation between gait perception and autistic traits in the general population, the present study recorded ERPs time-locked to the onset of approaching and receding point-light walkers. ERPs were measured using an 8-channel system in 19 adults and the correlation between the ERP components and the Subthreshold Autism Trait Questionnaire (SATQ) score were assessed to quantitatively measure autistic traits in the general population. The results showed that the higher SATQ score was, the longer the latency of the ERP component for an approaching walker was. In conclusion, people with autistic traits have trouble perceiving the approach of other people.
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41
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Affiliation(s)
- Keith Fluegge
- Keith Fluegge is with the Institute of Health and Environmental Research, Cleveland, OH
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42
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Jesus TS, Landry MD, Hoenig H. Global Need for Physical Rehabilitation: Systematic Analysis from the Global Burden of Disease Study 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060980. [PMID: 30893793 PMCID: PMC6466363 DOI: 10.3390/ijerph16060980] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/19/2019] [Accepted: 03/15/2019] [Indexed: 12/29/2022]
Abstract
Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions likely benefiting from physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts germane to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99% CI: 4.8–5.4; r2 = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts likely benefiting from physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs likley benefiting from physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries did Age-standardized YLD Rates significantly decrease (p < 0.01; r2 = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs. This growth was found globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced, thereby highlighting important unmet needs.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, Rua da Junqueira 100, 1349-008 Lisbon, Portugal.
| | - Michel D Landry
- Physical Therapy Division, Department of Orthopeadic Surgery, School of Medicine, Duke University, Durham, NC 27705, USA.
- Duke Global Health Institute (DGHI), Duke University, Durham, NC 27710, USA.
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC 27705, USA.
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Biffi E, Costantini C, Ceccarelli SB, Cesareo A, Marzocchi GM, Nobile M, Molteni M, Crippa A. Gait Pattern and Motor Performance During Discrete Gait Perturbation in Children With Autism Spectrum Disorders. Front Psychol 2018; 9:2530. [PMID: 30618953 PMCID: PMC6297554 DOI: 10.3389/fpsyg.2018.02530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/27/2018] [Indexed: 12/27/2022] Open
Abstract
Quantitative evaluation of gait has been considered a useful tool with which to identify subtle signs of motor system peculiarities in autism spectrum disorder (ASD). However, there is a paucity of studies reporting gait data in ASD as well as investigating learning processes of locomotor activity. Novel advanced technologies that couple treadmills with virtual reality environments and motion capture systems allows the evaluation of gait patterns on multiple steps and the effects of induced gait perturbations, as well as the ability to manipulate visual and proprioceptive feedbacks. This study aims at describing the gait pattern and motor performance during discrete gait perturbation of drug-naïve, school-aged children with ASD compared to typically developing (TD) peers matched by gender and age. Gait analysis was carried out in an immersive virtual environment using a 3-D motion analysis system with a dual-belt, instrumented treadmill. After 6 min of walking, 20 steps were recorded as baseline. Then, each participant was exposed to 20 trials with a discrete gait perturbation applying a split-belt acceleration to the dominant side at toe-off. Single steps around perturbations were inspected. Finally, 20 steps were recorded during a post-perturbation session. At baseline, children with ASD had reduced ankle flexion moment, greater hip flexion at the initial contact, and greater pelvic anteversion. After the discrete gait perturbation, variations of peak of knee extension significantly differed between groups and correlated with the severity of autistic core symptoms. Throughout perturbation trials, more than 60% of parameters showed reliable adaptation with a decay rate comparable between groups. Overall, these findings depicted gait peculiarities in children with ASD, including both kinetic and kinematic features; a motor adaptation comparable to their TD peers, even though with an atypical pattern; and a motor adaptation rate comparable to TD children but involving different aspects of locomotion. The platform showed its usability with children with ASD and its reliability in the definition of paradigms for the study of motor learning while doing complex tasks, such as gait. The additional possibility to accurately manipulate visual and proprioceptive feedback will allow researchers to systematically investigate motor system features in people with ASD.
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Affiliation(s)
- Emilia Biffi
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | | | | | - Ambra Cesareo
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | - Maria Nobile
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
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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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Non-diagnostic symptoms in a mouse model of autism in relation to neuroanatomy: the BTBR strain reinvestigated. Transl Psychiatry 2018; 8:234. [PMID: 30367028 PMCID: PMC6203744 DOI: 10.1038/s41398-018-0280-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/02/2018] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
Several mouse models of autism spectrum disorder (ASD), including the BTBR T + tf/J (BTBR) inbred strain, display a diverse array of behavioral deficits with particular face validity. Here we propose that phenotyping these preclinical models of ASD should avoid excessive reliance on appearance validity of the behavioral observations. BTBR mice were examined in three non-diagnostic symptoms modalities, beside an anatomical investigation for construct validity. The BTBR strain displayed poor sensorimotor integration as reflected by shorter stride length and greater latency on the balance beam task (BBT) when compared with C57BL/6 (B6) controls. Also, locomotor indices in the open-field task (OFT) revealed that BTBR mice traveled longer distances with a remarkably faster exploration than the B6 group in favor of hyperactivity and impulsiveness. Furthermore, analysis of spatial performance including search strategies in the Morris water task (MWT) indicated spatial impairment in the BTBR strain due to failure to employ spatial strategies during navigation. Quantitative cytoarchitectonics and volumetric examinations also indicated abnormal cortical and subcortical morphology in the BTBR mice. The results are discussed in relation to the neuroanatomical correlates of motor and cognitive impairments in the BTBR strain. We conclude that non-diagnostic autistic-like symptoms in the BTBR mouse strain can be impacted by autism risk factors in a similar way than the traditional diagnostic signs.
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Eggleston JD, Landers MR, Bates BT, Nagelhout E, Dufek JS. Weighted Walking Influences Lower Extremity Coordination in Children on the Autism Spectrum. Percept Mot Skills 2018; 125:1103-1122. [PMID: 30319016 DOI: 10.1177/0031512518803178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is sparse quantitative research regarding gait coordination patterns of children on the autism spectrum, though previous studies, relying only upon observational data, have alluded to characteristically poor movement coordination. This study compared walking with a weighted vest, a backpack carriage, and an unloaded walking condition on lower extremity coordination among 10 male children (aged 8-17 years) on the autism spectrum. All participants completed 15 gait trials in the following three conditions: (a) unloaded, (b) wearing a backpack weighted with 15% body mass, and (c) wearing a vest weighted with 15% body mass. We used continuous relative phase analysis to quantify lower extremity coordination and analyzed data through both group and single-subject comparisons. We used the Model Statistic to test for statistical significance at each of the normalized data points for each segment couple (thigh-leg, leg-foot, and thigh-foot). The first 10 and last 10 stride blocks were tested for possible accommodation strategies. Group comparisons revealed no coordination changes among the three conditions (likely due to insufficient statistical power), while single-subject comparisons exposed significant decreased variability in gait coordination patterns ( p < .05) in both loaded conditions, relative to the unloaded condition. These participants exhibited variable coordination patterns during the unloaded gait. When walking with loads, coordination pattern variability of the lower extremities was decreased. This finding suggests that walking while carrying or wearing heavy objects may reduce the number of potential motor pattern choices and thus decrease the overall variability of lower extremity movement patterns. Additional research with a larger and more diverse participant sample is required to confirm this conclusion.
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Affiliation(s)
| | - Merrill R Landers
- 2 Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA
| | - Barry T Bates
- 3 Department of Human Physiology, University of Oregon, Eugene, OR, USA.,4 Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
| | - Ed Nagelhout
- 5 Department of English, University of Nevada, Las Vegas, NV, USA
| | - Janet S Dufek
- 4 Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
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47
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Valagussa G, Trentin L, Signori A, Grossi E. Toe Walking Assessment in Autism Spectrum Disorder Subjects: A Systematic Review. Autism Res 2018; 11:1404-1415. [PMID: 30199607 DOI: 10.1002/aur.2009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/16/2018] [Indexed: 02/05/2023]
Abstract
There is increasing evidence that autism spectrum disorder (ASD) subjects have also motor impairments. Toe walking (TW) is a phenomenon that can be found in ASD subjects during gait, even if this condition was found not to be necessarily related only to walking, since these children often also stand and run on their tiptoes. Since persistent TW in ASD subjects may contribute to secondary shortening of the Achilles's tendon, it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The aim of this systematic review is to critically evaluate and describe the methods employed to assess toe walking in ASD subjects. The systematic review protocol was previously registered on PROSPERO. We conducted an extensive literature search in PubMed, CINAHL, PsycINFO, The Cochrane Library, and Scopus databases. There were no restrictions on the types of study design eligible for inclusion. Ten studies were included in the systematic review. Risk of bias of the included studies was conducted using the following instruments depending on the study types: STROBE Statement, Cochrane risk of bias tool, and CARE checklist. Almost all the included studies (8/10) proposed a tip-toe behavior (TTB) assessment only during walking. Nine out of ten of the included studies assessed TTB using a qualitative methodology. The results evidenced the heterogeneity of qualitative methods and a lack of a structured quantitative test to assess toe walking in ASD subjects. Autism Res 2018, 11: 1404-1415. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY ABSTRACT: Toe walking (TW) is a phenomenon that can be found during ASD subject's gait. The persistence of this behavior may contribute to secondary Achilles's tendon shortening. In this perspective it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The current systematic review aimed to describe the methods employed to assess TW. The results evidenced the lack and the need of a structured quantitative test to assess TW in ASD subjects.
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Affiliation(s)
- Giulio Valagussa
- Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, CO, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luca Trentin
- Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, CO, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, CO, Italy
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Moon AL, Haan N, Wilkinson LS, Thomas KL, Hall J. CACNA1C: Association With Psychiatric Disorders, Behavior, and Neurogenesis. Schizophr Bull 2018; 44:958-965. [PMID: 29982775 PMCID: PMC6101623 DOI: 10.1093/schbul/sby096] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Large-scale genome-wide association studies have consistently shown that genetic variation in CACNA1C, a gene that encodes calcium voltage-gated channel subunit alpha1C, increases risk for psychiatric disorders. CACNA1C encodes the Cav1.2 subunit of voltage-gated calcium channels, which themselves have been functionally implicated in a broad spectrum of neuropsychiatric syndromes. Research has concentrated on uncovering the underlying biological mechanisms that could be responsible for this increased risk. This review presents an overview of recent findings regarding Cacna1c variation in animal models, particularly focusing on behavioral phenotypes associated with neurodevelopmental disorders such as cognition, anxiety and depressive phenotypes, and fear conditioning. The impact of reduced gene dosage of Cacna1c on adult hippocampal neurogenesis is also assessed, including new data from a novel Cacna1c+/- rat model.
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Affiliation(s)
- Anna L Moon
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Niels Haan
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Lawrence S Wilkinson
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- School of Psychology, Cardiff University, Cardiff, UK
| | - Kerrie L Thomas
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
- School of Biosciences, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Neuromotor and cognitive responses of adults with autism spectrum disorder compared to neurotypical adults. Exp Brain Res 2018; 236:2321-2332. [DOI: 10.1007/s00221-018-5300-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/24/2018] [Indexed: 10/14/2022]
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‘We’re Doing AFL Auskick as Well’: Experiences of an Adapted Football Program for Children With Autism. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2018. [DOI: 10.1123/jmld.2016-0055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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