Evidence for Specificity of Motor Impairments in Catching and Balance in Children with Autism

Abstract

To evaluate evidence for motor impairment specificity in autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Children completed performance-based assessment of motor functioning (Movement Assessment Battery for Children: MABC-2). Logistic regression models were used to predict group membership. In the models comparing typically developing and developmental disability (DD), all three MABC sub-scale scores were significantly negatively associated with having a DD. In the models comparing ADHD and ASD, catching and static balance items were associated with ASD group membership, with a 1 point decrease in performance increasing odds of ASD by 36 and 39 %, respectively. Impairments in motor skills requiring the coupling of visual and temporal feedback to guide and adjust movement appear specifically deficient in ASD.

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“…Precisely 49 studies comparing ASC and typically-developing (TD) control groups answer this question in the affirmative. The more methodologically rigorous studies, those which a) either matched for chronological and/or mental age and/or IQ or b) controlled for these in their analyses, and c) had more sizeable groups (>30 per group) demonstrate that motor impairments occur more often than might be expected in TD children (AbuDahab, Skidmore, Holm, Rogers, & Minshew, 2013;Ament et al, 2015;Dewey, Cantell, & Crawford, 2007;Dowell, Mahone, & Mostofsky, 2009;Duffield et al, 2013;Dziuk et al, 2007;Floris et al, 2016;Sumner, Leonard, & Hill, 2016;Travers et al, 2015Travers et al, , 2016. A meta-analysis of 41 studies confirmed that, despite substantial variation, effect sizes are large with TD participants significantly outperforming individuals with autism in motor coordination, arm movements, gait and postural stability (Fournier, Hass, Naik, Lodha, & Cauraugh, 2010), and that these effects did not seem affected by publication bias.…”

“…Many studies addressed this question with movement assessment batteries with normative percentiles for performance and objective scoring: for example, the PANESS (Dowell et al, 2009;Dziuk et al, 2007;Floris et al, 2016;Jansiewicz et al, 2006;Mostofsky, Burgess, & Gidley Larson, 2007), the M-ABC or M-ABC2 (Ament et al, 2015;Green, Baird et al, 2002;Green, Moore, & Reilly, 2002;Green et al, 2009;Hanaie et al, 2013;Hanaie et al, 2014;Kopp, Beckung, & Gillberg, 2010;McPhillips, Finlay, Bejerot, & Hanley, 2014;Miyahara et al, 1997;Sumner et al, 2016;Whyatt & Craig, 2012), or the Bruininks-Oseretsky test (Dewey et al, 2007;Ghaziuddin & Butler, 1998;Hilton, Zhang, Whilte, Klohr, & Constantino, 2012;Pan, 2014). These measures yield total scores which were sometimes analysed alone, but they each assess a range of fine and gross motor skills, including balance and gait, hopping or jumping, repetitive sequential movements of the hands and feet, manual dexterity and ball skills (catching and throwing).…”

“…Ball skills, most notably in catching a ball, are highlighted by numerous reports (Ament et al, 2015;Green et al, 2009, Green, Baird et al, 2002Green, Moore, & Reilly, 2002;Hanaie et al, 2013;Papadopoulos et al, 2012;Staples & Reid, 2010;Whyatt & Craig, 2012). More fine-depth analysis of gait, for example using electronic walkways or infrared cameras and sensors placed on the body (Nobile et al, 2011), corroborate the difficulty that movement batteries report in heel-to-toe walking, and further report gait irregularities (for example greater variance in stride length and velocity), ataxia, reduced range of motion in the joints, and difficulty walking in a straight line.…”

“…Other studies of kinematics in very basic arm movements and reaching and grasping reveal differences between autistic and TD participants (Campione, Piazza, Villa, & Molteni, 2016;Cook, Blakemore, & Press, 2013). Use of more traditional neuropsychological tests reflect poorer performance in the grip strength (Abu-Dahab et al, 2013;Hardan et al, 2003;Travers et al, 2015Travers et al, , 2016, finger tapping (Abu-Dahab et al, 2013;Duffield et al, 2013;Hardan et al, 2003;Travers et al, 2016) and pegboard tasks (Abu-Dahab et al, 2013;Ament et al, 2015;Barbeau, Meilleur, Zeffiro, & Mottron, 2015;Duffield et al, 2013;Hardan et al, 2003). These tests ascend in difficulty, primarily testing muscle strength, simple motor coordination and dexterity respectively.…”

“…Problematically, these studies often involve fairly small groups who may have overlapping comorbidities, do not control for IQ, and may involve multiple comparisons that are uncontrolled for. If we first consider ADHD, the multiple comparison problem is true for Dewey et al (2007), who report significantly better motor (and imitation) skills in children with ADHD, but fortunately not for Mostofsky et al (2007) or for Ament et al (2015), who both report significantly better motor performance in ADHD (most notably for balance and catching a ball in the Ament study). Another study reporting better motor skills in ADHD is stymied by lack of IQ matching (Pan, Tsai, & Chu, 2009).…”