Early Motor Function of Children With Autism Spectrum Disorder: A Systematic Review

Lim, Yi Huey; Licari, Melissa K.; Spittle, Alicia J; Watkins, Rochelle; Zwicker, Jill G.; Downs, Jenny; Finlay‐Jones, Amy

doi:10.1542/peds.2020-011270

Cited by 29 publications

(29 citation statements)

References 65 publications

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“…First, prospective longitudinal studies are needed to investigate the directionality and temporal progression of the relationship between gross motor, social, and brain development in both typical development and ASD by collecting fine-grained, densely measured data on these variables in infants at high and low risk for ASD early in life. Second, our findings indicate that gross motor impairment is associated with the core social symptoms of ASD, and past research has indicated that gross motor deficits are detectable during the first year of life for children with ASD, prior to observable social symptoms (Estes et al, 2015; Lim et al, 2021; West, 2019). Future research is needed to investigate whether efforts to improve early prediction of later ASD outcomes might benefit from integrating measures of gross motor ability as an additional risk marker.…”

Section: Discussionsupporting

confidence: 67%

Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses.

Wang

Petrulla²,

Zampella

et al. 2022

Psychological Bulletin

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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. Public Significance StatementThese meta-analyses reveal that individuals on the autism spectrum exhibit a large deficit in gross motor skills compared to neurotypical individuals, regardless of the individual's age, sex, or cognitive ability. Further, gross motor impairment is modestly associated with social impairment for autistic individuals.

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Section: Discussionsupporting

confidence: 67%

Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses.

Wang

Petrulla²,

Zampella

et al. 2022

Psychological Bulletin

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“…However, the diagnosis of ASD was found to have no association with delayed motor development. In a systematic review, Lim et al 35 reported a result of a meta-analysis showing a significant association between the diagnosis of ASD and abnormal motor development in the first 18 months of life. However, there were variations among the different studies.…”

Section: Discussionmentioning

confidence: 99%

“…The value on the curve is the cutoff value (specificity, sensitivity) at the maximal Youden Index. 35 reported a result of a meta-analysis showing a significant association between the diagnosis of ASD and abnormal motor development in the first 18 months of life. However, there were variations among the different studies.…”

mentioning

confidence: 99%

How Accurately Does the Information on Motor Development Collected During Health Checkups for Infants Predict the Diagnosis of Neurodevelopmental Disorders? – A Bayesian Network Model-Based Study

Hatakenaka¹,

Hachiya²,

Ikezoe³

et al. 2022

NDT

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Purpose We investigated to what extent early motor development problems predict a future diagnosis of neurodevelopmental disorders (NDDs)/Early Symptomatic Syndromes Eliciting Neurodevelopmental Examinations (ESSENCE) by using a Bayesian network model (BN). Subjects and methods Subjects were the children who had participated in the 18- and 36-month checkups in two cities in Japan between April 2014 and March 2015. Their motor development data at the 4-, 10- and 18-month-checkups were collected with ethical consideration. The diagnosis was confirmed at the age of six, after regular assessment in all developmental areas at a neurodevelopmental clinic. The accuracy of prediction of NDD based on posterior probabilities determined using the BN was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The posterior probability (the optimal cut-off value) yielding the maximum Youden Index (sensitivity + specificity – 1) is determined with the ROC curve, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and utility index (UI) were computed. Results BN models showed associations between early motor items and developmental coordination disorders, borderline intelligence/intellectual disability, and speech and language disorder. The ROC curve for any NDD had an AUC of 0.735. The posterior probability with the maximal Youden Index was 0.138; at the optimal cut-off value, the sensitivity, specificity, PPV, NPV, UI+, and UI- were 0.619, 0.761, 0.250, 0.940, 0.155 and 0.715, respectively. Conclusion We utilized a novel approach in detailing the associations between certain early motor problems and specific NDDs. We showed that the presence of motor development problems early in development increases the probability of a future diagnosis of any NDD. Still, the sensitivity of early motor development problems as a screening tool was not high enough to be the sole instrument for detecting NDDs. The need for a broad, holistic ESSENCE perspective when looking at the course of motor development problems was stressed.

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“…Infants with ASD may also show impaired motor development. Currently, it is unclear whether or not abnormal general movements may assist the prediction of ASD because the limited data available are contradictory 7 . It is conceivable that infants with ASD have a higher prevalence of poor repertoire general movements or fidgety movements with an abnormal quality, but most likely these signs have limited predictive power for ASD 7 .…”

Section: Signs Of Asd During Infancymentioning

confidence: 99%

“…From 12 months onwards, delays in achieving motor skills and the presence of repetitive, ritualistic behaviour (e.g. simple motor strategies or lining up of toys) are more prominent 6,7 …”

Section: Signs Of Asd During Infancymentioning

confidence: 99%

Emerging signs of autism spectrum disorder in infancy: Putative neural substrate

Hadders‐Algra

2022

Develop Med Child Neuro

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Autism spectrum disorder (ASD) is characterized by altered development of the social brain with prominent atypical features in the fronto‐temporo‐parietal cortex and cerebellum. Early signs of ASD emerge between 6 and 12 months: reduced social communication, slightly less advanced motor development, and repetitive behaviour. The fronto‐temporo‐parietal cortex and cerebellum play a prominent role in the development of social communication, whereas fronto‐parietal‐cerebellar networks are involved in the planning of movements, that is, movement selection. Atypical sensory responsivity, a core feature of ASD, may result in impaired development of social communication and motor skills and/or selection of atypical repetitive behaviour. In the first postnatal year, the brain areas involved are characterized by gradual dissolution of temporary structures: the fronto‐temporo‐parietal cortical subplate and cerebellar external granular layer. It is hypothesized that altered dissolution of the transient structures opens the window for the expression of early signs of ASD arising in the impaired developing permanent networks. What this paper adds The early social and motor signs of autism spectrum disorder emerge between the ages of 6 and 12 months. Altered dissolution of transient brain structures in the fronto‐temporo‐parietal cortex and cerebellum may underlie the emergence of these early signs.

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Early Motor Function of Children With Autism Spectrum Disorder: A Systematic Review

Cited by 29 publications

References 65 publications

Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses.

Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses.

How Accurately Does the Information on Motor Development Collected During Health Checkups for Infants Predict the Diagnosis of Neurodevelopmental Disorders? – A Bayesian Network Model-Based Study

Emerging signs of autism spectrum disorder in infancy: Putative neural substrate

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