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Valagussa G, Purpura G, Balatti V, Trentin L, Signori A, Grossi E. Quantitative assessment of tip-toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross-sectional study. Autism Res 2024; 17:311-323. [PMID: 38108559 DOI: 10.1002/aur.3072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
The term "toe walking" describes walking on the toes with a lack of heel strike upon initiation of the stance phase of gait. In individuals with autism spectrum disorder (ASD), this phenomenon, or "tip-toe behavior" (TTB), can be present in a substantial proportion of subjects even during standing. In this study, we investigated TTB in 50 persons with ASD (age range 4-26 years). We evaluated TTB through an observational/report-based assessment protocol. Subsequently, we employed a new structured video-based coding protocol based on standardized video recordings, focusing on static and dynamic conditions. Finally, the findings of the two protocols were compared. Twenty-four subjects with TTB were identified and classified according to three functional groups: TTB1, present only during running (6 subjects); TTB2, present during walking and running (11 subjects); and TTB3, present during standing, walking, and running (7 subjects). Moreover, we found that TTB3 subjects exhibited a significantly higher quantity of TTB compared with subjects in the TTB1 and TTB2 groups during both standing and walking tests. Additionally, a high quantity of TTB in the static test was found to be related to a high quantity of TTB in the dynamic test. Variables such as age, autism severity, intellectual disability, and gender were not significantly associated with the mean percent of TTB both in static and dynamic tests in multivariate analysis. This structured video-based coding approach appears feasible and useful for assessing TTB in individuals with ASD and it has the potential to provide insights into TTB trajectories and aid in designing possible interventions.
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Affiliation(s)
- Giulio Valagussa
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Valeria Balatti
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Luca Trentin
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio (CO), Italy
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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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Valagussa G, Purpura G, Nale A, Pirovano R, Mazzucchelli M, Grossi E, Perin C. Sensory Profile of Children and Adolescents with Autism Spectrum Disorder and Tip-Toe Behavior: Results of an Observational Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091336. [PMID: 36138645 PMCID: PMC9497722 DOI: 10.3390/children9091336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023]
Abstract
Atypical sensory processing is frequently reported in persons with autism spectrum disorders (ASD), and it is one of the described diagnostic criteria for ASD. There is also mounting literature supporting the presence of motor impairments in individuals with ASD. Among these motor signs, tip-toe behavior (TTB) is a possible clinical finding, but its etiology is not clearly understood. It is suggested that TTB in ASD could be a sign of a sensory modulation impairment, but evidence is lacking and controversial. The main aim of this pilot study is to explore sensory features in a sample (4 females; 28 males) of children and adolescents with ASD (age range: 7-18). All participants also presented Intellectual Disability. Participants were divided in two groups, matched for age and gender, on the basis of the presence or absence of TTB (16 ASD TTB group vs. 16 ASD NO-TTB group) and then evaluated by using the Short Sensory Profile. We found that both ASD groups tend to significantly present sensory-related behavioral symptoms, but ASD TTB individuals more frequently showed the specific pattern of "under responsive/seeks sensation" than ASD NO-TTB individuals. These preliminary findings support that sensory-motor features might be taken into consideration when rehabilitation for TTB in children and adolescents with ASD is necessary.
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Affiliation(s)
- Giulio Valagussa
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Alessandra Nale
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Rita Pirovano
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Miryam Mazzucchelli
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Cecilia Perin
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
- Correspondence:
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Valagussa G, Piscitelli D, Baruffini S, Panzeri V, Perin C, Mazzucchelli M, Cornaggia CM, Pellicciari L, Grossi E. Little Evidence for Conservative Toe Walking Interventions in Autism Spectrum Disorders: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00329-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AbstractThis systematic review summarizes the evidence about toe walking (TW) interventions in persons with autism. Following the PRISMA guidelines, a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane Library, Google Scholar, and Opengrey was performed. Nine articles (all case reports or case series) were included. Methodological quality was assessed using the Mayo Evidence-Based Practice Centre tool. The included studies considered 17 subjects (16 males; age range: 4–15 years). All studies reported a reduction of TW frequency, but the follow-up was lacking in seven studies. There is a lack of high-quality studies with a sufficiently large and well-characterized sample to assess the effectiveness of TW interventions in autistic persons. These findings strongly support the need for further research in this area.
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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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Fears NE, Templin TN, Sherrod GM, Bugnariu NL, Patterson RM, Miller HL. Autistic Children Use Less Efficient Goal-Directed Whole Body Movements Compared to Neurotypical Development. J Autism Dev Disord 2022:10.1007/s10803-022-05523-0. [PMID: 35441912 DOI: 10.1007/s10803-022-05523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/26/2022]
Abstract
Autistic children have differences in their movements which impact their functional performance. Virtual-reality enables researchers to study movement in safe, engaging environments. We used motion-capture to measure how 7-13-year-old autistic and neurotypical children make whole-body movements in a virtual-reality task. Although children in both groups were successful, we observed differences in their movements. Autistic children were less efficient moving to the target. Autistic children did not appear to use a movement strategy. While neurotypical children were more likely to overshoot near targets and undershoot far targets, autistic children did not modulate their strategy. Using kinematic data from tasks in virtual-reality, we can begin to understand the pattern of movement challenges experienced by autistic children.
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Affiliation(s)
- Nicholas E Fears
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- School of Kinesiology, University of Michigan, 830 N. University Ave., Ann Arbor, MI, 48170, USA
| | - Tylan N Templin
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Southwest Research Institute, 6220 Culebra Rd., San Antonio, TX, 78238, USA
| | - Gabriela M Sherrod
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of Alabama at Birmingham, 1720 University Blvd., Birmingham, AL, 35294, USA
| | - Nicoleta L Bugnariu
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- School of Health Sciences, University of the Pacific, 155 Fifth St., San Francisco, CA, 94103, USA
| | - Rita M Patterson
- University of North Texas Health Science Center, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
| | - Haylie L Miller
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA.
- School of Kinesiology, University of Michigan, 830 N. University Ave., Ann Arbor, MI, 48170, USA.
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Trudel SM, Winter EL, Fitzmaurice B, Norman G, Bray CR. Integration of physical health and sensory processing assessment for children with autism spectrum disorder in schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sierra M. Trudel
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Emily L. Winter
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Brenna Fitzmaurice
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Gina Norman
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Clark R. Bray
- Department of Mechanical Engineering University of Connecticut Storrs Connecticut USA
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Posar A, Visconti P. Early Motor Signs in Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020294. [PMID: 35205014 PMCID: PMC8870370 DOI: 10.3390/children9020294] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022]
Abstract
A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, we aimed at performing an update about the available data on the early motor function in children with autism spectrum disorder. Early motor impairment in these children can manifest itself both as a mere delay of motor development and as the presence of atypicalities of motor function, such as a higher rate and a larger inventory, of stereotyped movements both with and without objects. In the perspective of a timely diagnosis, the presence of early motor signs can be an important clue, especially in an individual considered at high risk for autism. Motor and communication (both verbal and non-verbal) skills are connected and a pathogenetic role of early motor dysfunctions in the development of autism can be hypothesized. From this, derives the importance of an early enabling intervention aimed at improving motor skills, which could also have favorable effects on other aspects of development.
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6225111
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
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Lopez-Espejo MA, Nuñez AC, Moscoso OC, Escobar RG. Clinical characteristics of children affected by autism spectrum disorder with and without generalized hypotonia. Eur J Pediatr 2021; 180:3243-3246. [PMID: 33855616 DOI: 10.1007/s00431-021-04038-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022]
Abstract
In this cross-sectional study, we aimed to evaluate the association between generalized hypotonia (GH) and demographic features and clinical characteristics in toddlers (2 to 5 years) with autism spectrum disorder (ASD). Among 93 children, 32 (34.4%) had GH. These patients had a later onset of independent walking (17 vs. 15 months, p < 0.01), a higher proportion of motor stereotypies (65.6 vs. 27.9%, p < 0.01), a lower mean total score in the parental-reported Generic Core Scale of Pediatric Quality of Life Inventory 4.0 (71 vs. 76 points, p 0.03), and a higher mean total score in the Calibrated Severity Score of Autism Diagnostic Observation Schedule version 2 at diagnosis (6 vs. 5 points, p 0.02) compared to the group without GH.Conclusion: Hypotonia is associated with other motor abnormalities and could be an early marker for higher autistic symptom severity and lower quality of life in young children with ASD. What is Known: • Motor function is closely related to autism spectrum disorder (ASD) • Muscle hypotonia is present in 15% to 67% of children with ASD What is New: • Muscle hypotonia is associated with higher autistic symptom severity and lower quality of life in children with ASD • Children with ASD and muscle hypotonia have more commonly motor stereotypies and a later onset of independent walking.
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Affiliation(s)
- Mauricio A Lopez-Espejo
- Unit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Neurodevelopmental Unit, UC CHRISTUS Clinical Hospital, Santiago, Chile
| | - Alicia C Nuñez
- Unit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Neurodevelopmental Unit, UC CHRISTUS Clinical Hospital, Santiago, Chile
| | - Odalie C Moscoso
- Unit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Neurodevelopmental Unit, UC CHRISTUS Clinical Hospital, Santiago, Chile
| | - Raul G Escobar
- Unit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Neurodevelopmental Unit, UC CHRISTUS Clinical Hospital, Santiago, Chile.
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Latrèche K, Kojovic N, Franchini M, Schaer M. Attention to Face as a Predictor of Developmental Change and Treatment Outcome in Young Children with Autism Spectrum Disorder. Biomedicines 2021; 9:942. [PMID: 34440147 PMCID: PMC8392329 DOI: 10.3390/biomedicines9080942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
The beneficial effect of early intervention is well described for children with autism spectrum disorder (ASD). Response to early intervention is, however, highly heterogeneous in affected children, and there is currently only scarce information about predictors of response to intervention. Based on the hypothesis that impaired social orienting hinders the subsequent development of social communication and interactions in children with ASD, we sought to examine whether the level of social orienting modulates treatment outcome in young children with ASD. We used eye-tracking technology to measure social orienting in a group of 111 preschoolers, comprising 95 young children with ASD and 16 children with typical development, as they watched a 29 s video of a woman engaging in child-directed speech. In line with previous studies, we report that attention to face is robustly correlated with autistic symptoms and cognitive and adaptive skills at baseline. We further leverage longitudinal data in a subgroup of 81 children with ASD and show that the level of social orienting at baseline is a significant predictor of developmental gains and treatment outcome. These results pave the way for identifying subgroups of children who show a better response to early and intensive intervention, a first step toward precision medicine for children with autism.
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Affiliation(s)
- Kenza Latrèche
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland; (N.K.); (M.S.)
| | - Nada Kojovic
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland; (N.K.); (M.S.)
| | | | - Marie Schaer
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland; (N.K.); (M.S.)
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Grossi E, Caminada E, Goffredo M, Vescovo B, Castrignano T, Piscitelli D, Valagussa G, Franceschini M, Vanzulli F. Patterns of Restricted and Repetitive Behaviors in Autism Spectrum Disorders: A Cross-Sectional Video Recording Study. Preliminary Report. Brain Sci 2021; 11:678. [PMID: 34064245 PMCID: PMC8224357 DOI: 10.3390/brainsci11060678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Several instruments have been proposed to investigate restricted, repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD). Systematic video observations may overcome questionnaire and interview limitations to investigate RRBs. This study aimed to analyze stereotypic patterns through video recordings and to determine the correlation between the number and appearance of RRBs to ASD severity. METHODS Twenty health professionals wearing a body cam recorded 780 specific RRBs during everyday activities of 67 individuals with ASD (mean age: 14.2 ± 3.72 years) for three months. Each stereotypy was classified according to its complexity pattern (i.e., simple or complex) based on body parts and sensory channels involved. RESULTS The RRBs spectrum for each subject ranged from one to 33 different patterns (mean: 11.6 ± 6.82). Individuals with a lower number of stereotypies shown a lower ASD severity compared to subjects with a higher number of stereotypies (p = 0.044). No significant differences were observed between individuals exhibiting simple (n = 40) and complex patterns (n = 27) of stereotypies on ASD severity, age, sex, and the number of stereotypes. CONCLUSIONS This study represents the first attempt to systematically document expression patterns of RRBs with a data-driven approach. This may provide a better understanding of the pathophysiology and management of RRBs.
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Affiliation(s)
- Enzo Grossi
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
| | - Elisa Caminada
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
| | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCSS San Raffaele Pisana, 00163 Rome, Italy;
| | - Beatrice Vescovo
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
| | - Tristana Castrignano
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy;
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Giulio Valagussa
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy;
| | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCSS San Raffaele Pisana, 00163 Rome, Italy;
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00163 Rome, Italy
| | - Franco Vanzulli
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Tavernerio, Italy; (E.G.); (E.C.); (B.V.); (T.C.); (G.V.); (F.V.)
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Ramos-Sánchez CP, Kortekaas D, Van Biesen D, Vancampfort D, Van Damme T. The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1189-1199. [DOI: 10.1007/s10803-021-05022-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 01/23/2023]
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13
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One-Year Follow-Up Diagnostic Stability of Autism Spectrum Disorder Diagnosis in a Clinical Sample of Children and Toddlers. Brain Sci 2021; 11:brainsci11010037. [PMID: 33401390 PMCID: PMC7823497 DOI: 10.3390/brainsci11010037] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 12/05/2022] Open
Abstract
Some studies show that the diagnosis of Autism Spectrum Disorder could be considered reliable and stable in children aged 18 to 24 months. Nevertheless, the diagnostic stability of early ASD diagnosis has not yet been fully demonstrated. This observational study examines the one-year diagnostic stability of autism spectrum disorder diagnosis in a clinical sample of 147 children diagnosed between 18 and 48 months of age. The ADOS-2 scores were used in order to stratify children in three levels of symptom severity: Autism (AD; comparison score 5–7), Autism Spectrum Disorder (ASD; comparison score 3–4), and Sub-Threshold Symptoms; (STS; comparison score 1–2). Results: Overall, the largest part of children and toddlers diagnosed with autism spectrum disorder between 18 and 48 months continued to show autistic symptoms at one-year follow-up evaluation. Nevertheless, a significant percentage of children with higher ADOS severity scores exhibited a reduction of symptom severity and, therefore, moved towards a milder severity class one year later. Conversely, the number of subjects of the STS group meaningfully increased. Therefore, at one-year follow-up a statistically significant (χ2(2) = 181.46, p < 0.0001) percentage of subjects (25.2% of the total) who had received a categorical diagnosis of Autistic Disorder or Autism Spectrum Disorder in baseline no longer met the criteria for a categorical diagnosis. Furthermore, children who no longer met the criteria for autism spectrum disorder continue to show delays in one or more neurodevelopmental areas, possibly related to the emergence of other neurodevelopmental/neuropsychiatric disorders. Overall, the comprehensive results of the study account for a high sensibility but a moderate stability of ASD early diagnosis.
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The Challenging Heterogeneity of Autism: Editorial for Brain Sciences Special Issue "Advances in Autism Research". Brain Sci 2020; 10:brainsci10120948. [PMID: 33297430 PMCID: PMC7762320 DOI: 10.3390/brainsci10120948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
My personal experience as Guest Editor of the Special Issue (SI) entitled "Advances in Autism Research" began with a nice correspondence with Andrew Meltzoff, from the University of Washington, Seattle (WA, USA), which, in hindsight, I consider as a good omen for the success of this Special Issue: "Dear Antonio… [...].
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