Stability of motor problems in young children with or at risk of autism spectrum disorders, ADHD, and or developmental coordination disorder

Abstract

AIM The aim of this study was to investigate the stability of motor problems in a clinically referred sample of children with, or at risk of, autism spectrum disorders (ASDs), attention-deficit-hyperactivity disorder (ADHD), and ⁄ or developmental coordination disorder (DCD).METHOD Participants were 49 children (39 males, 10 females; mean age 5y 6mo, SD 10mo) with various developmental problems, a Movement Assessment Battery for Children (M-ABC) score on or below the 15th centile, and an IQ of 70 or more. Sixteen children were at risk of developing ADHD, 15 children had a diagnosis of, or were at risk of developing ASD, and 18 children had neither diagnosis. Children were reassessed 2 to 3 years later.RESULTS At follow-up (mean age 7y 11mo; SD 1y), the mean M-ABC score was significantly increased, and in 22 children was no longer below the 15th centile. A general linear model to compare the difference in M-ABC scores in the three groups of children demonstrated a significant difference between groups (p=0.013), with the age at the initial assessment as a significant covariate (p=0.052). The group of children with or at risk of ASD showed less improvement in motor performance.INTERPRETATION Motor problems among preschool age children are not always stable, but appear to be so in most children with ASDs.A number of children exhibit poor motor performance in the first 6 years of life. In some cases the motor problems can be explained by an apparent central nervous system disorder, and these problems are unlikely to resolve. However, some children without a clear neurological disorder present with poor motor abilities before 7 years of age. Some of these children could be considered to have developmental coordination disorder (DCD), according to DSM-IV-TR 1 criteria. However, it appears from the literature that the large majority of children with DCD are identified after starting school.2 In some cases, poor motor performance at preschool age is one of the first clear signs of another (comorbid) developmental disorder with more prominent behavioural features, such as autism spectrum disorders 3 (ASDs), or attention-deficit-hyperactivity disorder 4 (ADHD). Although motor disorders can occur in isolation, many studies have described their frequent co-occurrence with ADHD 5,6 and ASD. 7,8 The purpose of this study was therefore, to determine the stability of poor motor performance among younger children.The most commonly used screening instruments for young children evaluate basic motor skills, referenced against age norms and based on early normative models of motor development. 9 But is motor development really a linear process with a small range of variability? Darrah et al. 10 investigated the stability of outcome on serial motor assessment and found a large variability of scores within individual infants and between infants aged 0 to 18 months. They concluded that motor development in very young children is non-linear, rather than occurring at a constant rate. They suggested that screening of infants should includ...

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