Motor skills,visual perception,and visual-motor integration in children and youth with Autism Spectrum Disorder

BackgroundMotor skill deficits are prevalent among children with Autism Spectrum Disorder (ASD) however, little is known about the underlying mechanism of these deficits. In response to this gap, this study investigated how visual perception (VP) and visual-motor integration (VMI) are associated with motor skills among children and youth with ASD.MethodsSixty-seven individuals with ASD and sixty-seven age- and gender-matched individuals without ASD (age range: 9.83–15.13 years) participated. Motor skills were assessed with the Movement Assessment Battery for Children-2 (MABC-2) and VP and VMI with the respective components of the Beery-Buktenica Developmental Test of Visual-Motor Integration-6 (Beery VMI-6).ResultsSignificantly more children and youth with ASD were in the red and orange zone of the MABC-2 traffic-lighting system for the total MABC-2 and the Aiming and Catching and Balance components compared to the children and youth without ASD. Both groups did not differ on the VP and VMI components of the Beery VMI-6. Pearson correlations between VP and VMI, and motor skills were weak but significant for the individuals without ASD, but not for the ASD group.ConclusionThe current study added to the evidence about motor skill deficits among children and youth with ASD. VP and VMI were not related to motor skills, suggesting that these functions – as measured in the current study – are no underlying mechanisms of motor skill deficits of children with ASD and average intelligence. Diagnostic implications are provided for the evidence of motor skill deficits among children and youth with ASD.     

Gross motor skills are related to postural stability and age in children with autism spectrum disorder

Motor skill and postural stability deficits are commonly reported for children with autism spectrum disorder (ASD), however the relationship between these variables is not well established. We explored the relationship between motor skills, postural stability, restricted and repetitive patterns of behavior, diagnosis, age, and sex. Children (11 with and 11 without ASD), 5–12 years of age, participated in the study. The Test of Gross Motor Development-3 (TGMD-3) was used to assess fundamental motor skills. Postural sway was measured on a force plate during quiet standing on a solid and compliant surface. Center of pressure was calculated and used to compute sway area. Linear regression analysis showed that sway area on a solid surface, age, and diagnosis were significant predictors of motor skill performance (R² = .854). Severity of ASD, as assessed by the Repetitive Behavior Scale-Revised (RBS-R), was not predictive of motor skills. Children with ASD exhibited deficits in postural stability compared to children without ASD. Postural stability appears to influence the ability of children to perform gross motor skills. However, the RBS-R does not seem to be a useful tool for identifying those children with ASD who exhibit the greatest deficits in motor skills.     

Étude des altérations des habilités sociales chez des enfants ayant un Trouble Déficit de l’Attention/Hyperactivité : comparatif avec des sujets contrôles et des sujets présentant un Trouble du Spectre de l’Autisme

ObjectivesDifferent studies centered on social relationship issues among ADHD children struggled to provide a unicist explanation between primary social cognition process alteration on the one hand and a mere symptomatic outcome of the disorder triad on the other. Some authors support the idea of a potential “social phenotype” shared at a different intensity by Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). The point of the study is to characterize this possible social disability in a French ADHD population and compare it to control subjects and subjects with Autism Spectrum Disorder (ASD).MethodsThree groups, composed of 319 subjects aged 6 to 12 years, were recruited in Bordeaux: 88 untreated ADHD subjects, 24 ASD subjects and 207 control subjects. The main measure was the social skill disruption through the rating of the Social Responsiveness Scale (SRS). The ADHD-RS-IV, WFIRS-P and CBCL scales were also used.ResultsAsignificant alteration in social abilities in ADHD children in comparison with controls was noted, with an average raw total SRS score intermediary between the control group and the ASD group (respectively 65.31 ± 20.99, 37.15 ± 16.37 and 95 75 ± 30.83, P < 0.05). When the 5 sub-scores of the SRS were taken into account, if the ASD subjects showed the highest average scores, the alteration pattern appeared qualitatively similar between the ADHD and TSA groups, with also an intermediate dispersion for the ADHD group between the control group and the group with ASD. Finally, more severe impairment of social skills in children with ADHD was associated with increased severity of the disorder (on ADHD-RS-IV scale cotation), higher daily functional impact (WFIRS-P scale), and more frequent behavioral issues (according to CBCL).ConclusionsOur results suggest the presence of social disturbances in ADHD and characterize a symptomatic profile qualitatively similar to that of ASD, but of less intensity. Overall results promote a need for a systematic dimensional assessment of social disability in ADHD.     

Reduced relative volume in motor and attention regions in developmental coordination disorder: A voxel-based morphometry study

Background and objectivesDevelopmental coordination disorder (DCD) is a prevalent childhood movement disorder, impacting the ability to perform movement skills at an age appropriate level. Although differences in grey matter (GM) volumes have been found in related developmental disorders, no such evidence has been linked with DCD to date. This cross-sectional study assessed structural brain differences in children with and without DCD.MethodsHigh-resolution structural images were acquired from 44 children aged 7.8–12 years, including 22 children with DCD (≤16th percentile on MABC-2; no ADHD/ASD), and 22 typically developing controls (≥20th percentile on MABC-2). Structural voxel-based morphology analysis was performed to determine group differences in focal GM volumes.ResultsChildren with DCD were found to have significant, large, right lateralised reductions in grey matter volume in the medial and middle frontal, and superior frontal gyri compared to controls. The addition of motor proficiency as a covariate explained the between-group GM volume differences, suggesting that GM volumes in motor regions are reflective of the level of motor proficiency. A positive correlation between motor proficiency and relative GM volume was also identified in the left posterior cingulate and precuneus.ConclusionsGM volume reductions in premotor frontal regions may underlie the motor difficulties characteristic of DCD. It is possible that intervention approaches targeting motor planning, attention, and executive functioning processes associated with the regions of reduced GM volume may result in functional improvements in children with DCD.     

Comparing social skill profiles of children with autism spectrum disorders versus children with attention deficit hyperactivity disorder: Where the deficits lie

Marked socialization impairment is evident in both individuals with autism spectrum disorders (ASD) and individuals with attention deficit/hyperactivity disorder (ADHD). The current study utilizes the Matson Evaluation of Social Skills for Youngsters-II (MESSY-II) to explore similarities and discrepancies in the social skill profiles of children with ASD and children with ADHD ages 6–9 years old and 10–16 years old. Children with ASD and children with ADHD were both found to be significantly deficient in social skills compared to atypically developing peers without an Axis I or Axis II diagnosis; however, specific skill deficits vary between the groups. In particular, children with ASD exhibited a lack of adaptive social skills whereas children with ADHD demonstrated social skill knowledge but an increased level of maladaptive social behavior. The trends of socialization impairment over time were also found to differ in children with ASD versus children with ADHD. While children with ASD remained at similar levels of adaptive social skill impairment over age groups, children with ADHD were found to become more socially impaired in more areas over time. The distinct patterns and trends of social skill deficit found in children with ASD and children with ADHD can inform treatments targeted toward the specific deficits observed within each disorder.     

School-based social skills training for young people with autism spectrum disorders

ABSTRACT

Background: The Secret Agent Society (SAS) Program, an intervention to enhance social–emotional skills, was provided by schools for children with autism spectrum disorder (ASD). The program was assessed to determine if it improved social skills at school and home, and whether improvements were maintained.

Methods: Eighty-four students participated. Key outcomes were parent and teacher ratings of emotion regulation, social skills, and direct child social problem-solving measures. The standard school curriculum served as the control condition. Phase 1 was a two-group waitlist-control comparison of SAS versus the standard curriculum. Phase 2 was a follow up of all participants before and after the intervention and at 12-months post-intervention.

Results: Parent and child measures improved after the intervention but not in the waitlist condition. Improvements in parent, child, and teacher measures were apparent at 12 months.

Conclusions: The SAS Program warrants further research as a potential program for schools that serve children with ASD.     

Validation of Social Responsiveness Scale for Korean Preschool Children With Autism

ObjectiveThis cross-cultural study aims to examine the psychometric properties of the Social Responsiveness Scale (SRS) and to determine the best-estimate-cut-off scores for the diagnosis of autism spectrum disorder (ASD) in Korean preschool children. MethodsA total of 563 children was recruited from multiple sources, including Seoul National University Bundang Hospital. Participants were assessed by a multidisciplinary research team using multiple diagnostic tools based on DSM-5 diagnostic criteria. Discriminative validity was tested by comparing the difference in SRS scores between ASD and non-ASD groups. Convergent validity was tested by examining correlations between SRS scores with other diagnostic instruments. A receiver operation characteristic curve analysis was conducted to test the sensitivity and specificity of SRS and to determine the best-estimate-cut-off scores for screening ASD in Korean preschool children. ResultsThere were significant differences in the total SRS scores between the ASD (n=242) and non-ASD group (n=321) (p<0.01, 95% confidence interval [CI]: 14.08–17.24). The differences were significant even after adjusting for age. SRS scores were significantly correlated with other prescreening diagnostic tools for ASD. The best-estimate cut-off score to screen ASD was 55 (area under curve=0.88, sensitivity 78.1%, specificity 86.6%).ConclusionThe SRS is a valid and reliable instrument to screen and aid in the diagnosis of ASD in Korean preschool children. The adjusted cut-off scores, notably lower than in the original U.S. version, may yield a more accurate diagnosis by reflecting transcultural differences.     

Mixed martial arts training improves social skills and lessens problem behaviors in boys with Autism Spectrum Disorder

BackgroundDifficulties with social functioning are a defining core characteristic among children with Autism Spectrum Disorder (ASD). Fortunately, adaptive social skills can be acquired. Physical exercise has gained interest among researchers as a practical way to improve social functioning in children with ASD. The present study evaluated the effectiveness of a Mixed Martial Arts (MMA) intervention for improving social skills and lessening problematic social behaviors in school-aged boys with ASD.MethodThirty-four boys and girls (n = 28 boys, 6 girls) with ASD were randomly assigned to either a community-based MMA intervention or a Waitlist Control (WLC) condition. Randomization resulted in an intervention group of all boys. Assessments of child functioning were conducted pre- and post-intervention. The 26-session MMA intervention consisted of learning and practicing increasingly challenging motor movements in a structured class with ASD and typically-developing peers. The WLC group did not participate in any intervention between pre- and post-test. Measures of implementation fidelity were included.ResultsResults indicated significant interactions between group and predicted social functioning over time. Compared to the control group, parents of boys with ASD in the martial arts group reported significantly higher positive social behaviors and significantly lower negative social behaviors between pre- and post-test.ConclusionsThe results of this study increase our understanding of the benefits of martial arts training for boys with ASD within a community setting. Practical implications highlight the importance of providing a social component with physical exercise, helping to address the physical needs of children with ASD and perhaps conferring social benefits as well.     

Auditory-motor rhythm synchronization in children with autism spectrum disorder

BackgroundAutism spectrum disorder (ASD) is characterized by difficulties in social and communication skills as well as atypical sensory perception and motor skills. Sensorimotor abilities such as auditory-motor integration are essential for social interaction and communication. The goal of this research was to investigate the development of auditory-motor rhythm synchronization for the first time in ASD versus typically-developing (TD) children.MethodsParticipants were 31 boys with ASD and 23 TD boys that were matched in age and IQ. Participants were tested on an auditory-motor rhythm synchronization task in which they tapped in synchrony with rhythms of varying metrical complexity.ResultsBoth children with ASD and TD performed similarly on this task and both groups performed better with age.ConclusionsThis work demonstrates that non-verbal rhythm synchronization is intact in ASD over the course of childhood development. This research serves to better understand sensorimotor interactions in ASD and to better define sensory phenotypes in ASD.     

Preschool predictors of school-age academic achievement in autism spectrum disorder

Abstract

Objective: Characterization of academic functioning in children with autism spectrum disorder (ASD), particularly predictors of achievement, may have important implications for intervention. The current study aimed to characterize achievement profiles, confirm associations between academic ability and concurrent intellectual and social skills, and explore preschool predictors of school-age academic achievement in a sample of children with ASD. Method: Children with ASD (n = 26) were evaluated at the approximate ages of two, four, and ten. Multiple regression was used to predict school-age academic achievement in reading and mathematics from both concurrent (i.e. school-age) and preschool variables. Results: Children with ASD demonstrated a weakness in reading comprehension relative to word reading. There was a smaller difference between mathematics skills; math reasoning was lower than numerical operations, but this did not quite reach trend level significance. Concurrent IQ and social skills were associated with school-age academic achievement across domains. Preschool verbal abilities significantly predicted school-age reading comprehension, above and beyond concurrent IQ, and early motor functioning predicted later math skills. Conclusions: Specific developmental features of early ASD predict specific aspects of school-age achievement. Early intervention targeting language and motor skills may improve later achievement in this population.     

How children with autism spectrum disorder behave and explore the 4-dimensional (spatial 3D + time) environment during a joint attention induction task with a robot

We aimed to compare, during a joint attention (JA) elicitation task, how children with autism spectrum disorder (ASD) and children with typical development (TD) behave and explore their 4 dimensional (meaning spatial 3D + time) when interacting with a human or with a robotic agent.We built a system that employed a Nao robot and a perception system based on a RGB-D sensor (Kinect) to capture social engagement cues. A JA induction experiment was performed in which children with ASD (N = 16) and matched TD children (N = 16) had a 3-min interaction with the robot or with a therapist. Nao induced JA by gazing; by gazing and pointing; and by gazing, pointing and vocalizing at pictures. Both groups of children performed well with the therapist. However, with Nao, both groups had lower JA scores, and the children with ASD had a significantly lower score than the TD children. We found that (i) multimodal JA induction was more efficient in both groups; (ii) the 3D spatial world gaze exploration showed less accuracy; and (iii) the trunk position in ASD showed less stability in the 4 dimensions compared to TD controls.We conclude that, in ASD, JA skill depends on the interaction partner, and implies a higher motor and cognitive cost.     

Friendship interventions and measurements in children with ASD: A systematic review

BackgroundFriendships are vital to children's social well-being and overall development, and they can also serve as a protector factor from peer victimization and bullying. For children with ASD, friendship development can be an area of challenge. Friendship interventions may help children and adolescents with ASD in developing the skills for making and keeping friends.MethodThis systematic review examined friendship interventions for children and adolescents with autism spectrum disorder (ASD). It also explored measures of friendship skills in children with ASD. Twenty-seven studies met the inclusion criteria: (a) experimental intervention studies focused on improving friendships of individuals with ASD, (b) the measurement of friendship outcomes, and (c) strong or acceptable methodological ratings.ResultsFifteen unique interventions were tested across the 27 studies. Thirteen interventions included strategies specifically focused on improving (making and maintaining) friendships in the participants with ASD. Friendship interventions were primarily focused on behaviorally based social skills building and varied in implementation settings. Friendship measures included the use of parent reports, child and adolescent surveys and questionnaires, peer nominations, and sociometric ratings.ConclusionThe results highlighted the benefit of including targeted friendship-building strategies in social and friendship interventions and the value of multiple perspectives when measuring friendship. The findings of the study can influence how families and practitioners collaborate to support children and adolescents with ASD in the development and maintenance of their friendships.     

The relationship between atypical visual processing and social skills in young children with autism

The present study examined whether atypical visual processing is related to the level of social skills in children with autism spectrum disorder (ASD). Thirty-eight young children with ASD (29 boys, 9 girls) were included. Atypical visual processing was assessed by coding the number of lateral glances and the amount of object grouping behavior on videotaped observations of the ADOS (aged 35 ± 9 months). The level of social skills was measured using the subscale interpersonal relationships of the Vineland SEEC (32 ± 7 months). A negative relationship with a medium effect size was found between lateral glances and interpersonal relationships. Object grouping behavior and interpersonal relationships were not related. This study suggests that visual perception may be a mechanism in the development of interpersonal relationships in ASD, which is in accordance with an embodied approach to social cognition.     

Comparison of parent report and direct assessment of child skills in toddlers

BackgroundThere are unique challenges associated with measuring development in early childhood. Two primary sources of information are used: parent report and direct assessment. Each approach has strengths and weaknesses, particularly when used to identify and diagnose developmental delays. The present study aimed to evaluate consistency between parent report and direct assessment of child skills in toddlers with and without Autism Spectrum Disorder (ASD) across receptive language, expressive language, and fine motor domains.Method109 children were evaluated at an average age of two years; data on child skills were collected via parent report and direct assessment. Children were classified into three groups (i.e., ASD, Other Developmental Disorder, or Typical Development) based on DSM-IV-TR diagnosis. Mixed design ANOVAs, with data source as a within subjects factor and diagnostic group as a between subjects factor, were used to assess agreement. Chi square tests of agreement were then used to examine correspondence at the item level.ResultsResults suggested that parent report of language and fine motor skills did not significantly differ from direct assessment, and this finding held across diagnostic groups. Item level analyses revealed that, in most cases of significant disagreement, parents reported a skill as present, but it was not seen on direct testing.ConclusionsResults indicate that parents are generally reliable reporters of child language and fine motor abilities in toddlerhood, even when their children have developmental disorders such as ASD. However, the fullest picture may be obtained by using both parent report and direct assessment.     

Nature of motor impairments in autism spectrum disorder: A comparison with developmental coordination disorder

Introduction: Several authors have suggested the existence of motor disorders associated with developmental coordination disorder (DCD) in individuals with autism spectrum disorder (ASD). However, there are few comparative studies of psychomotor profiles that include assessments of neurological soft signs in children with ASD or DCD. We used a neuropsychomotor assessment for children with ASD from a standardized neurodevelopmental examination to understand the nature of the difficulties these children encounter. To uncover the differences and similarities in psychomotor profiles, we compared the profiles of children with ASD with those of children with DCD and focused on two recently described DCD subgroups: visuospatial–constructional (VSC) and mixed (MX).

Methods: We compared 18 children with ASD and 58 children with DCD (33 with VSC-DCD and 25 with MX-DCD) who were assessed with a battery of French-language tests (the NP-MOT) to evaluate the neuropsychomotor functions associated with visual perception and visual–spatial–motor structuring.

Results: Although there were similarities between the profiles of children with ASD and those with DCD (VSC-DCD or MX-DCD), these similarities were not associated with the predictive diagnostic markers that characterized subtypes of DCD. Instead, many variables (visuospatial–motor structuration, synkinetic movements, dynamic balance, manual dexterity, coordination, praxis, bodily spatial integration, and digital perception) differed among the three groups; the best performance was observed in the children with ASD.

Conclusion: The neuropsychomotor profiles of children with ASD and those with VSC-DCD or MX-DCD differed, and these differences are discussed. Our results highlight that impairments of ASD are specific about lateralization disturbances and support the hypothesis of proprioceptive impairment due to visual fixation problems influenced by muscular tone in relation to the subcortical and cortical structures and possible interhemispheric disorder. Thus, some neuropsychomotor functions that underpin both gestures and a set of motor skills are affected.     

Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder

ObjectivesThe Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis).MethodSRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n = 32), ASD + ADHD (n = 30), ASD (n = 31) and typical neurodevelopment (TD; n = 30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC).ResultsSRS Social cognition (AUC = 0.73) and Autistic mannerisms (AUC = 0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC = 0.70), and Social communication (AUC = 0.66) and Autistic mannerisms (AUC = 0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children.ConclusionThe SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.     

A systematic review of peer-mediated interventions for children with autism spectrum disorder

BackgroundPeer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.MethodThe current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.ResultsFour of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.ConclusionPMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.