Motor Impairment Increases in Children With Autism Spectrum Disorder as a Function of Social Communication, Cognitive and Functional Impairment, Repetitive Behavior Severity, and Comorbid Diagnoses: A SPARK Study Report

Abstract

Eighty-seven percent of a large sample of children with autism spectrum disorder (ASD) are at risk for motor impairment (Bhat, Physical Therapy, 2020, 100, 633-644). In spite of the high prevalence for motor impairment in children with ASD, it is not considered among the diagnostic criteria or specifiers within DSM-V. In this article, we analyzed the SPARK study dataset (n = 13,887) to examine associations between risk for motor impairment using the Developmental Coordination Disorder-Questionnaire (DCD-Q), social communication impairment using the Social Communication Questionnaire (SCQ), repetitive behavior severity using the Repetitive Behaviors Scale-Revised (RBS-R), and parent-reported categories of cognitive, functional, and language impairments. Upon including children with ASD with cognitive impairments, 88.2% of the SPARK sample was at risk for motor impairment. The relative risk ratio for motor impairment in children with ASD was 22.2 times greater compared to the general population and that risk further increased up to 6.2 with increasing social communication (5.7), functional (6.2), cognitive (3.8), and language (1.6) impairments as well as repetitive behavior severity (5.0). Additionally, the magnitude of risk for motor impairment (fine-and gross-motor) increased with increasing severity of all impairment types with medium to large effects. These findings highlight the multisystem nature of ASD, the need to recognize motor impairments as one of the diagnostic criteria or specifiers for ASD, and the need for appropriate motor screening and assessment of children with ASD. Interventions must address not only the social communication and cognitive/behavioral challenges of children with ASD but also their motor function and participation.

Analysis of the SPARK study COVID‐19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services

“…The total final score is calculated as a sum of the individual subscale scores with higher scores indicating better motor coordination/functioning. Further details on DCD‐Q performance in the SPARK sample can be obtained from Bhat, 2020 , 2021 .…”

“…The complex, multisystem nature of ASD along with its co‐occurring comorbidities requires children with ASD to access various medical, therapeutic, and mental health services (American Psychiatric Association, 2013 ; Bhat, 2020 , 2021 ; Bhat et al, 2011 , 2018 ; Shield et al, 2017 ; van Etten et al, 2017 ). Children with ASD utilize substantially more healthcare and therapeutic services compared to children with other disabilities or no disabilities.…”

Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review

“…On the other hand, developmental approaches facilitate age-appropriate developmental skills such as joint attention, play, and imitation using child-preferred, play-based therapeutic activities within naturalistic settings ( 67 , 70 , 72 ). However, interestingly, both conventional and developmental approaches do not focus on addressing the sensorimotor impairments that are clearly highly prevalent in ASD ( 22 , 46 ). This highlights a dire need to expand therapeutic interventions to address not just the core impairments but also the multiple co-morbidities in ASD.…”

Functional and Neuropathological Evidence for a Role of the Brainstem in Autism

“…Motor symptoms are prevalent enough that some authors have proposed that motor deficits should be considered among the core symptoms of ASD ( Mosconi and Sweeney, 2015 ). The severity of motor symptoms may correlate with impairments in cognitive and language domains ( Bhat, 2021 ), suggesting that they reflect the overall atypical brain development. The wide range of motor symptoms again reflects the heterogeneity of ASD.…”