Impairment in movement skills of children with autistic spectrum disorders

Abstract

Aim We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. Method Movement skills were measured using the Movement Assessment Battery for Children (M‐ABC) in a large, well defined, population‐derived group of children (n=101: 89 males,12 females; mean age 11y 4mo, SD 10mo; range 10y–14y 3mo) with childhood autism and broader ASD and a wide range of IQ scores. Additionally, we tested whether a parent‐completed questionnaire, the Developmental Coordination Disorder Questionnaire (DCDQ), was useful in identifying children who met criteria for movement impairments after assessment (n=97 with complete M‐ABCs and DCDQs). Results Of the children with ASD, 79% had definite movement impairments on the M‐ABC; a further 10% had borderline problems. Children with childhood autism were more impaired than children with broader ASD, and children with an IQ less than 70 were more impaired than those with IQ more than 70. This is consistent with the view that movement impairments may arise from a more severe neurological impairment that also contributes to intellectual disability and more severe autism. Movement impairment was not associated with everyday adaptive behaviour once the effect of IQ was controlled for. The DCDQ performed moderately well as a screen for possible motor difficulties. Interpretation Movement impairments are common in children with ASD. Systematic assessment of movement abilities should be considered a routine investigation.

Motor Deficits in Children With Autism Spectrum Disorder: A Cross‐Syndrome Study

“…Green et al [2009] used a standardised motor battery, the Movement ABC [Henderson & Sugden, 1992], in a large, populationderived study of school-aged children with childhood autism and broader ASD, and found that 79% of the children with an ASD had definite motor impairments with a further 10% having borderline problems. Children with childhood autism (who had a lower average IQ) were more impaired than children with broader ASD, and children with an IQ of less than 70 were almost universally impaired in contrast to two-thirds of the children with an IQ of more than 70.…”

What can autism teach us about the role of sensorimotor systems in higher cognition? New clues from studies on language, action semantics, and abstract emotional concept processing

“…A risk with these studies is that the validity of their findings relies on initial, accurate categorization of participants; the lack of differentiation between AS and HFA, in the case of Manjiviona and Prior (1995), is likely to reflect invalid categorization based on the diagnostic manuals of the time. Some studies find greater motor deficits in individuals with HFA than those with AS (Behere, Shahani, Noggle, & Dean, 2012;Ghaziuddin & Butler, 1998;Green et al, 2009;Papadopoulos et al, 2012;Rinehart, Bellgrove, et al, 2006), others find the opposite picture (Iwanaga, Kawasaki, & Tsuchida, 2000), some find deficits of different types in both groups (Rinehart et al, 2001), and some find no statistical difference between groups (Jansiewicz et al, 2006;Noterdaeme, Mildenberger, Minow, & Amorosa, 2002). Some of these studies have very small samples (Behere et al, 2012;Ghaziuddin & Butler, 1998;Iwanaga et al, 2000;Rinehart, Bellgrove, et al, 2006;Rinehart et al, 2001), casting doubt on their findings.…”

“…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.…”

“…This practice suggests it may be more prudent to look instead for differences related to language development, autistic regression, or IQ (/mental age). IQ is strongly related to motor skills, with lower IQ associated with poorer performance across a range of measures (Barbeau et al, 2015;Dewey et al, 2007;Dowell et al, 2009;Dziuk et al, 2007;Ghaziuddin & Butler, 1998;Green et al, 2009;Hilton et al, 2012;Kopp et al, 2010); unsurprisingly, where studies classify participants as having low functioning autism (or low IQ), they unanimously perform worse than those with HFA or AS (or autistic participants with high IQ) in many motor tasks (Papadopoulos et al, 2012;Paquet, Olliac, Bouvard, Golse, & Vaivre-Douret, 2016;Vanvuchelen et al, 2007). Failing to match groups of HFA and AS individuals on IQ casts further doubt on supposed differences between them (Ghaziuddin & Butler, 1998), and on the findings of studies which do not control for IQ between groups or consider it in their analysis (problematically, this is not always reported).…”