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Simarro Gonzalez M, Ni G, Lam V, Demopoulos C. Beyond words: an investigation of fine motor skills and the verbal communication spectrum in autism. Front Psychiatry 2024; 15:1379307. [PMID: 38835552 PMCID: PMC11148429 DOI: 10.3389/fpsyt.2024.1379307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction This study investigated the associations between fine motor skills and expressive verbal abilities in a group of 97 autistic participants (age 8-17, mean=12.41) and 46 typically developing youth (age 8-17, mean=12.48). Methods Participants completed assessments of motor and verbal communication skills, including finger tapping speed, grooved pegboard, grip strength, visual-motor integration tasks, and measures of speech and communication skills. ASD group performance on motor tests was compared to controls. Non-parametric tests were used to analyze group differences and correlations between motor and verbal communication skills. Based on prior research, we hypothesized that individuals on the autism spectrum would exhibit deficits in fine motor speed, dexterity, pencil motor control, but not manual motor strength. Additionally, we expected that impaired fine motor skills would be linked to poorer performance on standardized measures of verbal abilities. Results The results indicated that 80% of autistic participants demonstrated an impairment on at least one measure of motor skills, and as a group, they exhibited significantly poorer fine motor performance compared to the non-ASD group in dominant hand finger tapping speed, bilateral fine motor dexterity measured via the grooved pegboard task, and pencil motor coordination and visual-motor integration measured on the Beery-Buktenica Developmental Test of Visual-Motor Integration-Sixth Edition. Moreover, impaired fine motor skills were associated with poorer performance on standardized clinical measures of verbal abilities, including articulation errors, receptive and expressive language and vocabulary, rapid naming, oromotor sequencing, and parent reported functional communication skills and social communication symptoms. Discussion Overall,our findings suggest there is a high prevalence of fine motor impairments in ASD, and these impairments were associated with a range of verbal abilities. Further research is warranted to better understand the underlying mechanisms of these associations and develop targeted interventions to address both fine motor and verbal impairments in ASD.
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Affiliation(s)
- Marian Simarro Gonzalez
- Spoken Language Interest Group, Basque Centre on Cognition, Brain and Language, San Sebastian, Spain
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Gessica Ni
- Department of UCSF Epilepsy and Pediatric Brain Center, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
- Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Valerie Lam
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Carly Demopoulos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Kangarani-Farahani M, Malik MA, Zwicker JG. Motor Impairments in Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis. J Autism Dev Disord 2024; 54:1977-1997. [PMID: 36949273 DOI: 10.1007/s10803-023-05948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/24/2023]
Abstract
This article comprehensively reviews motor impairments in children with autism spectrum disorder (ASD) to: (1) determine the prevalence of motor problems in children with ASD; (2) understand the nature of motor difficulties in ASD and whether they are consistent with developmental coordination disorder (DCD); and (3) determine if the term DCD was used as a co-occurring diagnosis in children with ASD after publication of the DSM-5 in 2013. The following databases were systematically searched: MEDLINE, EMBASE, CINAHL, and PsycINFO from 2010 to December 2021. Articles were included if they: (1) were peer-reviewed and published in a scientific journal; (2) included children with ASD who were between 5 and 12 years; (3) used motor or function measures to assess motor abilities in children with ASD. Studies that included children with intellectual disabilities were excluded. Two independent reviewers reviewed titles, abstracts, and full-text articles for inclusion. Twenty-seven studies met the inclusion criteria and were assessed for quality by two independent reviewers using the Appraisal tool for Cross-Sectional Studies. The majority of articles (92.5%) indicated that 50-88% of children with ASD had significant motor impairments on standardized motor assessments and/or functional questionnaires. The nature of motor and function problems in ASD were consistent with DCD; however, only three out of 20 papers (15%) that were published from 2014 described the motor problems as DCD. One study reported that 15.1% of children with ASD with motor impairments had a co-occurring diagnosis of DCD, suggesting that DCD is under-recognized in this clinical population.
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Affiliation(s)
- Melika Kangarani-Farahani
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- BC Children's Hospital Research Institute, K3-180 4480 Oak Street, Vancouver, V6H 3V4, Canada
| | - Myrah Anum Malik
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- BC Children's Hospital Research Institute, K3-180 4480 Oak Street, Vancouver, V6H 3V4, Canada
| | - Jill G Zwicker
- BC Children's Hospital Research Institute, K3-180 4480 Oak Street, Vancouver, V6H 3V4, Canada.
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada.
- Department of Pediatrics, University of British Columbia, Vancouver, Canada.
- CanChild Centre for Childhood Disability Research, Hamilton, Canada.
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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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Wang JZ, Zhao S, Wu C, Adams RB, Newman MG, Shafir T, Tsachor R. Unlocking the Emotional World of Visual Media: An Overview of the Science, Research, and Impact of Understanding Emotion: Drawing Insights From Psychology, Engineering, and the Arts, This Article Provides a Comprehensive Overview of the Field of Emotion Analysis in Visual Media and Discusses the Latest Research, Systems, Challenges, Ethical Implications, and Potential Impact of Artificial Emotional Intelligence on Society. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2023; 111:1236-1286. [PMID: 37859667 PMCID: PMC10586271 DOI: 10.1109/jproc.2023.3273517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
The emergence of artificial emotional intelligence technology is revolutionizing the fields of computers and robotics, allowing for a new level of communication and understanding of human behavior that was once thought impossible. While recent advancements in deep learning have transformed the field of computer vision, automated understanding of evoked or expressed emotions in visual media remains in its infancy. This foundering stems from the absence of a universally accepted definition of "emotion," coupled with the inherently subjective nature of emotions and their intricate nuances. In this article, we provide a comprehensive, multidisciplinary overview of the field of emotion analysis in visual media, drawing on insights from psychology, engineering, and the arts. We begin by exploring the psychological foundations of emotion and the computational principles that underpin the understanding of emotions from images and videos. We then review the latest research and systems within the field, accentuating the most promising approaches. We also discuss the current technological challenges and limitations of emotion analysis, underscoring the necessity for continued investigation and innovation. We contend that this represents a "Holy Grail" research problem in computing and delineate pivotal directions for future inquiry. Finally, we examine the ethical ramifications of emotion-understanding technologies and contemplate their potential societal impacts. Overall, this article endeavors to equip readers with a deeper understanding of the domain of emotion analysis in visual media and to inspire further research and development in this captivating and rapidly evolving field.
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Affiliation(s)
- James Z Wang
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Sicheng Zhao
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Chenyan Wu
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Reginald B Adams
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Michelle G Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Tal Shafir
- Emily Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Rachelle Tsachor
- School of Theatre and Music, University of Illinois at Chicago, Chicago, IL 60607 USA
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Araujo MO, Tamplain P, Duarte NAC, Comodo ACM, Ferreira GOA, Queiróga A, Oliveira CS, Collange-Grecco LA. Transcranial direct current stimulation to facilitate neurofunctional rehabilitation in children with autism spectrum disorder: a protocol for a randomized, sham-controlled, double-blind clinical trial. Front Neurol 2023; 14:1196585. [PMID: 37396775 PMCID: PMC10310925 DOI: 10.3389/fneur.2023.1196585] [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: 03/30/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Background Anodal transcranial direct current stimulation (tDCS) over the primary motor cortex and cerebellum is gaining prominence in the literature due to its potential to favor learning and motor performance. If administered during motor training, tDCS is capable of increasing the effect of training. Considering the motor impairment presented by children with Autism Spectrum Disorders (ASD), atDCS applied during motor training may contribute to the rehabilitation of these children. However, it is necessary to examine and compare the effects of atDCS over the motor cortex and the cerebellum on the motor skills of children with ASD. This information may benefit future clinical indications of tDCS for rehabilitation of children with ASD. The aim of the proposed study is to determine whether anodal tDCS over the primary motor cortex and cerebellum can enhance the effects of gait training and postural control on motor skills, mobility, functional balance, cortical excitability, cognitive aspects and behavioral aspects in children with ASD. Our hypothesis is the active tDCS combined with motor training will enhance the performance of the participants in comparison to sham tDCS. Methods and design A randomized, sham-controlled, double-blind clinical trial will be conducted involving 30 children with ASD that will be recruited to receive ten sessions of sham or ten sessions of active anodal tDCS (1 mA, 20 min) over the primary motor cortex or cerebellun combined with motor training. The participants will be assessed before as well as one, four and eight weeks after the interventions. The primary outcome will be gross and fine motor skills. The secondary outcomes will be mobility, functional balance, motor cortical excitability, cognitive aspects and behavioral aspects. Discussion Although abnormalities in gait and balance are not primary characteristics of ASD, such abnormalities compromise independence and global functioning during the execution of routine activities of childhood. If demonstrated that anodal tDCS administered over areas of the brain involved in motor control, such as the primary motor cortex and cerebellum, can enhance the effects of gait and balance training in only ten sessions in two consecutive weeks, the clinical applicability of this stimulation modality will be expanded as well as more scientifically founded.Clinical trial registration February 16, 2023 (https://ensaiosclinicos.gov.br/rg/RBR-3bskhwf).
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Affiliation(s)
- Marcela O. Araujo
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Priscila Tamplain
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, United States
| | - Natália A. C. Duarte
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
| | - Andréa C. M. Comodo
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Giselle O. A. Ferreira
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Amanda Queiróga
- Department of Child Neurofunctional Physiotherapy, Center of Pediatric Neurostimulation, São Paulo, Brazil
| | - Claudia S. Oliveira
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
| | - Luanda A. Collange-Grecco
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
- Department of Child Neurofunctional Physiotherapy, Center of Pediatric Neurostimulation, São Paulo, Brazil
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Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
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Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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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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Cho AB, Otte K, Baskow I, Ehlen F, Maslahati T, Mansow-Model S, Schmitz-Hübsch T, Behnia B, Roepke S. 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] [Key Words] [MESH Headings] [Grants] [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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Affiliation(s)
- An Bin Cho
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Karen Otte
- Motognosis GmbH, Schönhauser Allee 177, 10119, Berlin, Germany
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lindenberger Weg 80, 13125, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine, Helmholtz Association (MDC), Robert-Rössle-Straße 10, 13125, Berlin, Germany
| | - Irina Baskow
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Felicitas Ehlen
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Jüdisches Krankenhaus Berlin, Heinz-Galinski-Str. 1, 13347, Berlin, Germany
| | - Tolou Maslahati
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | | | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lindenberger Weg 80, 13125, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine, Helmholtz Association (MDC), Robert-Rössle-Straße 10, 13125, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Behnoush Behnia
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Stefan Roepke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
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Lu SC, Rowe P, Tachtatzis C, Andonovic I, Anzulewicz A, Sobota K, Delafield-Butt J. Swipe kinematic differences in young children with autism spectrum disorders are task- and age-dependent: A smart tablet game approach. BRAIN DISORDERS 2022. [DOI: 10.1016/j.dscb.2022.100032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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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: 22] [Impact Index Per Article: 11.0] [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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Bennett HJ, Haegele JA. Running Biomechanics of Adolescents With Autism Spectrum Disorder. J Biomech Eng 2021; 143:111005. [PMID: 34076239 DOI: 10.1115/1.4051346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 11/08/2022]
Abstract
Research examining gait biomechanics of persons with autism spectrum disorder (ASD) has grown significantly in recent years and has demonstrated that persons with ASD walk at slower self-selected speeds and with shorter strides, wider step widths, and reduced lower extremity range of motion and moments compared to neurotypical controls. In contrast to walking, running has yet to be examined in persons with ASD. The purpose of this study was to examine lower extremity running biomechanics in adolescents (13-18-year-olds) with ASD and matched (age, sex, and body mass index (BMI)) neurotypical controls. Three-dimensional kinematics and ground reaction forces (GRFs) were recorded while participants ran at two matched speeds: self-selected speed of adolescents with ASD and at 3.0 m/s. Sagittal and frontal plane lower extremity biomechanics and vertical GRF waveforms were compared using two-way analyses of variances (ANOVAs) via statistical parametric mapping (SPM). Adolescents with ASD ran with reduced stride length at self-selected speed (0.29 m) and reduced vertical displacement (2.1 cm), loading-propulsion GRFs (by 14.5%), propulsion plantarflexion moments (18.5%), loading-propulsion hip abduction moments (44.4%), and loading knee abduction moments (69.4%) at both speeds. Running at 3.0 m/s increased sagittal plane hip and knee moments surrounding initial contact (both 10.4%) and frontal plane knee angles during midstance (2.9 deg) and propulsion (2.8 deg) compared to self-selected speeds. Reduced contributions from primarily the ankle plantarflexion but also knee abduction and hip abduction moments likely reduced the vertical GRF and displacement. As differences favored reduced loading, youth with ASD can safely be encouraged to engage in running as a physical activity.
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Affiliation(s)
- Hunter J Bennett
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529
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12
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Bennett HJ, Ringleb SI, Bobzien J, Haegele JA. Are Gait Biomechanics Related to Physical Activity Engagement? An Examination of Adolescents with ASD. Med Sci Sports Exerc 2021; 54:447-455. [PMID: 34628448 DOI: 10.1249/mss.0000000000002810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Adolescents with autism spectrum disorder (ASD) rarely meet physical activity (PA) guidelines, thus not reaping associated health benefits. Although many barriers exist, abnormal or inefficient gait biomechanics could negatively impact engagement in PA. This study has two purposes: first, to compare total body mechanical work between adolescents with ASD and neurotypical age, sex, and body mass index matched controls, and second to determine whether gait biomechanics are significantly related to engagement in PA. METHODS Twenty-five adolescents (age 13-18 years) with ASD and seventeen neurotypical controls (eight with ASD had no match) participated in the study. Three-dimensional motion capture and force platforms were used to record and analyze gait biomechanics at self-selected speeds and a standardized 1.3 m/s. Total body mechanical work (sum of joint works across lower extremity, low back, torso, and shoulders) was compared between groups (n = 17 for each) and speeds using a mixed model analysis of variance. Average daily light (LPA), moderate to vigorous (MVPA), and total PA was recorded for the entire dataset with ASD using triaxial accelerometers worn for one week. Regression analyses were performed between work, stride time variability, speed, and stride length with each PA variable. RESULTS Adolescents with ASD generated 9% more work compared to the controls (p=0.016). Speed and stride length were significant regressors of LPA, MVPA, and total PA, explaining greater than 0.20 variance (p<0.02 for all regressions). CONCLUSION Although adolescents with ASD walked with significantly greater work, the complex full-body variable is not significantly related to engagement in PA. In agreement with research spanning multiple populations and ages, speed and stride length are indicative of PA engagement in adolescents with ASD.
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Affiliation(s)
- Hunter J Bennett
- Department of Human Movement Sciences Department of Mechanical & Aerospace Engineering Department of Communication Disorders & Special Education, Old Dominion University, Norfolk, VA
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13
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Shafer RL, Wang Z, Bartolotti J, Mosconi MW. Visual and somatosensory feedback mechanisms of precision manual motor control in autism spectrum disorder. J Neurodev Disord 2021; 13:32. [PMID: 34496766 PMCID: PMC8427856 DOI: 10.1186/s11689-021-09381-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/11/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) show deficits processing sensory feedback to reactively adjust ongoing motor behaviors. Atypical reliance on visual and somatosensory feedback each have been reported during motor behaviors in ASD suggesting that impairments are not specific to one sensory domain but may instead reflect a deficit in multisensory processing, resulting in reliance on unimodal feedback. The present study tested this hypothesis by examining motor behavior across different visual and somatosensory feedback conditions during a visually guided precision grip force test. METHODS Participants with ASD (N = 43) and age-matched typically developing (TD) controls (N = 23), ages 10-20 years, completed a test of precision gripping. They pressed on force transducers with their index finger and thumb while receiving visual feedback on a computer screen in the form of a horizontal bar that moved upwards with increased force. They were instructed to press so that the bar reached the level of a static target bar and then to hold their grip force as steadily as possible. Visual feedback was manipulated by changing the gain of the force bar. Somatosensory feedback was manipulated by applying 80 Hz tendon vibration at the wrist to disrupt the somatosensory percept. Force variability (standard deviation) and irregularity (sample entropy) were examined using multilevel linear models. RESULTS While TD controls showed increased force variability with the tendon vibration on compared to off, individuals with ASD showed similar levels of force variability across tendon vibration conditions. Individuals with ASD showed stronger age-associated reductions in force variability relative to controls across conditions. The ASD group also showed greater age-associated increases in force irregularity relative to controls, especially at higher gain levels and when the tendon vibrator was turned on. CONCLUSIONS Our findings that disrupting somatosensory feedback did not contribute to changes in force variability or regularity among individuals with ASD suggests a reduced ability to integrate somatosensory feedback information to guide ongoing precision manual motor behavior. We also document stronger age-associated gains in force control in ASD relative to TD suggesting delayed development of multisensory feedback control of motor behavior.
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Affiliation(s)
- Robin L Shafer
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Zheng Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - James Bartolotti
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Matthew W Mosconi
- Life Span Institute, University of Kansas, Lawrence, KS, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
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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: 32] [Impact Index Per Article: 10.7] [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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Santos L, Geminiani A, Schydlo P, Olivieri I, Santos-Victor J, Pedrocchi A. Design of a Robotic Coach for Motor, Social and Cognitive Skills Training Toward Applications With ASD Children. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1223-1232. [PMID: 34152988 DOI: 10.1109/tnsre.2021.3091320] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Socially assistive robots may help the treatment of autism spectrum disorder(ASD), through games using dyadic interactions to train social skills. Existing systems are mainly based on simplified protocols which qualitatively evaluate subject performance. We propose a robotic coaching platform for training social, motor and cognitive capabilities, with two main contributions: (i) using triadic interactions(adult, robot and child), with robotic mirroring, and (ii) providing quantitative performance indicators. The key system features were accurately designed, including type of protocols, feedback systems and evaluation metrics, contemplating the requirements for applications with ASD children. We implemented two protocols, Robot-Master and Adult-Master, where children performed different gestures guided by the robot or the adult respectively, eventually receiving feedback about movement execution. In both, the robot mirrors the subject during the movement. To assess system functionalities, with a homogeneous group of subjects, tests were carried out with 28 healthy subjects; one preliminary acquisition was done with an ASD child. Data analysis was customized to design protocol-specific parameters for movement characterization. Our tests show that robotic mirroring execution depends on the complexity and standardization of movements, as well as on the robot technical features. The feedback system evaluated movement phases and successfully estimated the completion of the exercises. Future work includes improving platform flexibility and adaptability, and clinical trials with ASD children to test the impact of the robotic coach on reducing symptoms. We trust that the proposed quantitative performance indicators extend the current state-of-the-art towards clinical usage of robotic-based coaching systems.
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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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17
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Clark CCT, Bisi MC, Duncan MJ, Stagni R. Technology-based methods for the assessment of fine and gross motor skill in children: A systematic overview of available solutions and future steps for effective in-field use. J Sports Sci 2021; 39:1236-1276. [PMID: 33588689 DOI: 10.1080/02640414.2020.1864984] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The present review aims at providing researchers and practitioners with a holistic overview of technology-based methods for the assessment of fine and gross motor skill in children. We conducted a search of electronic databases using Web of Science, PubMed and Google Scholar, including studies published up to March 2020, that assessed fine and/or gross motor skills, and utilized technological assessment of varying study design. A total of 739 papers were initially retrieved, and after title/abstract screening, removal of duplicates, and full-text screening, 47 were included. Results suggest that motor skills can be quantitatively estimated using objective methods based on a wearable- and/or laboratory-based technology, for typically developing (TD) and non-TD children. Fine motor skill assessment solutions were; force transducers, instrumented tablets and pens, surface electromyography, and optoelectronic systems. Gross motor skill assessment solutions were; inertial measurements units, optoelectronic systems, baropodometric mats, and force platforms. This review provides a guide in identifying and evaluating the plethora of available technological solutions to motor skill assessment. Although promising, there is still a need for large-scale studies to validate these approaches in terms of accuracy, repeatability, and usability, where interdisciplinary collaborations between researchers and practitioners and transparent reporting practices should be advocated.
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Affiliation(s)
- Cain C T Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK.,Warwickshire InStitute for Diabetes, Endocrinology & Metabolism (WISDEM), University Hospitals Coventry & Warwickshire (UHCW) NHS Trust, Coventry, UK
| | - Maria Cristina Bisi
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
| | - Michael J Duncan
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Rita Stagni
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
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18
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Surgent OJ, Walczak M, Zarzycki O, Ausderau K, Travers BG. IQ and Sensory Symptom Severity Best Predict Motor Ability in Children With and Without Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:243-254. [PMID: 32410096 PMCID: PMC7665981 DOI: 10.1007/s10803-020-04536-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Motor challenges are commonly reported in autism spectrum disorder (ASD). Yet, there is substantial heterogeneity in motor ability within ASD, and it is unknown what behavioral characteristics best explain individual differences in motor ability in ASD and related conditions. This observational study examined motor ability as a function of sensory features, attention deficit/hyperactivity symptoms, ASD symptoms, and IQ in 110 children with ASD, typical development, or an intermediate behavioral profile. While motor challenges were more prevalent in the ASD group compared to other groups, sensory symptom severity and IQ across all individuals best predicted motor performance above-and-beyond group status. Therefore, motor challenges may be best characterized by individual variation in sensory features and cognitive abilities rather than diagnostic group.
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Affiliation(s)
- Olivia J Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Matthew Walczak
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA
| | - Oskar Zarzycki
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Karla Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA.
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Room 435, Madison, WI, 53705, USA.
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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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Busti Ceccarelli S, Ferrante C, Gazzola E, Marzocchi GM, Nobile M, Molteni M, Crippa A. Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E250. [PMID: 33238562 PMCID: PMC7700578 DOI: 10.3390/children7110250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023]
Abstract
In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children.
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Affiliation(s)
- Silvia Busti Ceccarelli
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy; (S.B.C.); (M.N.); (M.M.)
| | - Camilla Ferrante
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (C.F.); (E.G.); (G.M.M.)
| | - Erica Gazzola
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (C.F.); (E.G.); (G.M.M.)
| | - Gian Marco Marzocchi
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (C.F.); (E.G.); (G.M.M.)
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy; (S.B.C.); (M.N.); (M.M.)
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy; (S.B.C.); (M.N.); (M.M.)
| | - Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy; (S.B.C.); (M.N.); (M.M.)
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21
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Amaefule CO, Lüdtke S, Kirste T, Teipel SJ. Effect of Spatial Disorientation in a Virtual Environment on Gait and Vital Features in Patients with Dementia: Pilot Single-Blind Randomized Control Trial. JMIR Serious Games 2020; 8:e18455. [PMID: 33030436 PMCID: PMC7582144 DOI: 10.2196/18455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 12/03/2022] Open
Abstract
Background Orientation deficits are among the most devastating consequences of early dementia. Digital navigation devices could overcome these deficits if adaptable to the user’s needs (ie, provide situation-aware, proactive navigation assistance). To fulfill this task, systems need to automatically detect spatial disorientation from sensors in real time. Ideally, this would require field studies consisting of real-world navigation. However, such field studies can be challenging and are not guaranteed to cover sufficient instances of disorientation due to the large variability of real-world settings and a lack of control over the environment. Objective Extending a foregoing field study, we aim to evaluate the feasibility of using a sophisticated virtual reality (VR) setup, which allows a more controlled observation of disorientation states and accompanying behavioral and physiological parameters in cognitively healthy older people and people with dementia. Methods In this feasibility study, we described the experimental design and pilot outcomes of an ongoing study aimed at investigating the effect of disorientation on gait and selected physiological features in a virtual laboratory. We transferred a real-world navigation task to a treadmill-based virtual system for gait analysis. Disorientation was induced by deliberately manipulating landmarks in the VR projection. Associated responses in motion behavior and physiological parameters were recorded by sensors. Primary outcomes were variations in motion and physiological parameters, frequency of disorientation, and questionnaire-derived usability estimates (immersion and perceived control of the gait system) for our population of interest. At this time, the included participants were 9 cognitively healthy older participants [5/9 women, 4/9 men; mean age 70 years, SD 4.40; Mini–Mental State Examination (MMSE) mean 29, SD 0.70) and 4 participants with dementia (2/4 women, 2/4 men; mean age 78 years, SD 2.30 years; MMSE mean 20.50, SD 7.54). Recruitment is ongoing, with the aim of including 30 cognitively healthy older participants and 20 participants with dementia. Results All 13 participants completed the experiment. Patients’ route was adapted by shortening it relative to the original route. Average instances of disorientation were 21.40, 36.50, and 37.50 for the cognitively healthy older control, cognitively healthy older experimental participants, and participants with dementia, respectively. Questionnaire outcomes indicated that participants experienced adequate usability and immersion; 4.30 for presence, 3.73 for involvement, and 3.85 for realism of 7 possible points, indicating a good overall ability to cope with the experiment. Variations were also observed in motion and physiological parameters during instances of disorientation. Conclusions This study presents the first feasibility outcomes of a study investigating the viability of using a sophisticated VR setup, based on an earlier real-world navigation study, to study spatial disorientation among cognitively healthy older people and people with dementia. Preliminary outcomes give confidence to the notion that our setup can be used to assess motion and physiological markers of disorientation, even in people with cognitive decline. Trial Registration ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT04134806
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Affiliation(s)
| | - Stefan Lüdtke
- Institute of Visual & Analytic Computing, University of Rostock, Rostock, Germany
| | - Thomas Kirste
- Institute of Visual & Analytic Computing, University of Rostock, Rostock, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic and Psychotherapeutic Medicine, University Medicine Rostock, Rostock, Germany
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22
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Motor Improvement in Adolescents Affected by Ataxia Secondary to Acquired Brain Injury: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8967138. [PMID: 31886263 PMCID: PMC6899307 DOI: 10.1155/2019/8967138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/01/2019] [Accepted: 08/10/2019] [Indexed: 11/23/2022]
Abstract
Aim To assess changes in locomotion and balance in adolescents affected by ataxia secondary to acquired brain injury after a rehabilitation treatment with physiotherapy and the Gait Real-time Analysis Interactive Lab (GRAIL), an immersive virtual reality platform. Methods 11 ataxic adolescents (16(5) years old, 4.7(6.7) years from injury) underwent 20 45-minute sessions with GRAIL plus 20 45-minute sessions of physiotherapy in one month. Patients were assessed before and after rehabilitation with functional scales and three-dimensional multiple-step gait analysis. Results Results showed significant improvements in ataxia score assessed by the Scale for the Assessment and Rating of Ataxia, in dimension D and E of Gross Motor Function Measure, in walking endurance and in balance abilities. Moreover, the training fostered significant changes at hip, knee, and ankle joints, and the decrease of gait variability, toward healthy references. Interpretation In spite of the pilot nature of the study, data suggest that training with immersive virtual reality and physiotherapy is a promising approach for ataxic gait rehabilitation, even in chronic conditions.
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