Postural sway patterns in children with autism spectrum disorder compared with typically developing children

Postural control is a fundamental building block of each child's daily activities. The aim of this study was to compare patterns of postural sway in children with autism spectrum disorder (ASD) with typically developing children (TD). We recruited 21 schoolchildren diagnosed with ASD aged 9–14 and 30 TD pupils aged 8–15. Postural sway parameters in composite, anteroposterior and mediolateral axis were reported. Furthermore we examined the impact of age and characteristics of autism on postural sway. Children with ASD exhibited higher amount of sway in anteroposterior range (p < 0.001), mediolateral range (p = 0.002), root mean square (p = 0.001), mean velocity (p = 0.03), and sway area (p = 0.007) compared with their TD peers. Children with ASD showed higher instability in mediolateral than anteroposterior axis though TD children demonstrated higher sway scores in anteroposterior than mediolateral direction. The rate of autism symptom severity significantly affected the postural sway in children with ASD (p < 0.05). In conclusion, patterns of postural control seem to be different in children with ASD compared with TD counterparts. This could be partially due to clinical features were underlying in ASD.     

A longitudinal study on gross motor development in children with learning disorders

This longitudinal study examined the development of gross motor skills, and sex-differences therein, in 7- to 11-years-old children with learning disorders (LD) and compared the results with typically developing children to determine the performance level of children with LD.In children with LD (n = 56; 39 boys, 17 girls), gross motor skills were assessed with the Test of Gross Motor Development-2 and measured annually during a 3-year period. Motor scores of 253 typically developing children (125 boys, 112 girls) were collected for references values.The multilevel analyses showed that the ball skills of children with LD improved with age (p < .001), especially between 7 and 9 years, but the locomotor skills did not (p = .50). Boys had higher ball skill scores than girls (p = .002) and these differences were constant over time. Typically developing children outperformed the children with LD on the locomotor skills and ball skills at all ages, except the locomotor skills at age 7. Children with LD develop their ball skills later in the primary school-period compared to typically developing peers. However, 11 year-old children with LD had a lag in locomotor skills and ball skills of at least four and three years, respectively, compared to their peers.     

Visual tasks and postural sway in children with and without autism spectrum disorders

We investigated the influences of two different suprapostural visual tasks, visual searching and visual inspection, on the postural sway of children with and without autism spectrum disorder (ASD). Sixteen ASD children (age = 8.75 ± 1.34 years; height = 130.34 ± 11.03 cm) were recruited from a local support group. Individuals with an intellectual disability as a co-occurring condition and those with severe behavior problems that required formal intervention were excluded. Twenty-two sex- and age-matched typically developing (TD) children (age = 8.93 ± 1.39 years; height = 133.47 ± 8.21 cm) were recruited from a local public elementary school. Postural sway was recorded using a magnetic tracking system (Flock of Birds, Ascension Technologies, Inc., Burlington, VT). Results indicated that the ASD children exhibited greater sway than the TD children. Despite this difference, both TD and ASD children showed reduced sway during the search task, relative to sway during the inspection task. These findings replicate those of Stoffregen et al. (2000), Stoffregen, Giveans, et al. (2009), Stoffregen, Villard, et al. (2009) and Prado et al. (2007) and extend them to TD children as well as ASD children. Both TD and ASD children were able to functionally modulate postural sway to facilitate the performance of a task that required higher perceptual effort.     

Spatial and temporal analysis of postural control in children with high functioning Autism Spectrum Disorder

BackgroundChildren with autism spectrum disorders (ASD) have poor postural stability. The objective of our study was to explore further postural capabilities in ASD children by measuring spatial as well as temporal displacement of the center of pressure using wavelet analysis.MethodThirty children with ASD (12.1 ± 2.9 years) and 30 sex-, age- and IQ-matched typically developing children participated in the study. We recorded postural control using Multitest, also called Balance Quest, Equilibre from Framiral^® in three viewing conditions (eyes open, eyes closed and with perturbed vision) and in two postural conditions (stable and unstable).ResultsOur results show that children with ASD displayed a deficit in postural stability in comparison with typically developing children, especially when sensory inputs are not all available.ConclusionSuch poor postural control in children with ASD could be due to both an impairment in using sensorial inputs appropriately and a deficit in the ability to compensate for sensorial changes.     

Motor skills of children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication

Motor difficulties are common in children with Attention Deficit Hyperactivity Disorder (ADHD). Although preliminary evidence has suggested that methylphenidate can improve the motor skills in children with ADHD and Developmental Coordination Disorder (DCD), the effect of stimulant medication on motor performance in children newly diagnosed with ADHD with or without motor impairment remains unclear. A cohort study of 49 medication-naïve children (39 male; mean age 8.4 ± 1.3 years) with ADHD was conducted. Children were evaluated using the Movement Assessment Battery for Children and the developmental test of visual motor integration at diagnosis and again three months following daily treatment with a stimulant medication. Motor difficulties were highly present at baseline (73.5%) but resolved in a subset after treatment with stimulant medication, suggesting that their motor difficulties may be attributed in part to their attentional problems. Nevertheless, motor impairment persisted in 55.1% of the sample. The severity of the behavioural symptoms was significantly associated with balance skills in children without motor impairments (r² = 0.30, p < 0.01) and with visual motor integration skills in children with persisting motor difficulties (r² = 0.27, p < 0.01). Attentional difficulties negatively affect the motor skills of children with ADHD. Following the use of stimulant medication, an important subset continued to demonstrate motor difficulties. The improvement in behaviour was insufficient to resolve motor problems and these children should therefore be targeted for rehabilitation services.     

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.     

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

ObjectiveTo determine the relationship of motor skills and adaptive behavior skills in young children with autism.DesignA multiple regression analysis tested the relationship of motor skills on the adaptive behavior composite, daily living, adaptive social and adaptive communicative skills holding constant age, non-verbal problem solving, and calibrated autism severity.SettingMajority of the data collected took place in an autism clinic.ParticipantsA cohort of 233 young children with ASD (n = 172), PDD-NOS (n = 22) and non-ASD (developmental delay, n = 39) between the ages of 14–49 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity.InterventionsNot applicable.Main outcome measuresThe primary outcome measures in this study were adaptive behavior skills.ResultsFine motor skills significantly predicted all adaptive behavior skills (p < 0.01). Gross motor skills were predictive of daily living skills (p < 0.05). Children with weaker motor skills displayed greater deficits in adaptive behavior skills.ConclusionsThe fine and gross motor skills are significantly related to adaptive behavior skills in young children with autism spectrum disorder. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.     

The relationship between autism spectrum disorders and anxiety: The moderating effect of communication

Communication skills have been shown to have differing effects on levels of anxiety depending on whether or not a child has an autism spectrum disorder (ASD) or is typically developing. This article examined whether or not communication deficits differentially affect children with ASD compared to those without ASD. Ninety-nine children with autistic disorder (n = 33), Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; n = 33), and no diagnosis (n = 33) were examined using the Autism Spectrum Disorders Diagnostic for Children and Comorbidity for Children scales to determine their level of anxiety and degree of communication deficits. Results indicated that anxiety decreased as communication deficits increased for those with autistic disorder compared to those with PDD-NOS or no diagnosis; however, for those with PDD-NOS anxiety increased as communication deficits increased compared to those with no diagnosis. The importance and differential impact of communication deficits on anxiety for different groups is highlighted.     

Pilot randomized controlled trial of a Functional Behavior Skills Training program for young children with Autism Spectrum Disorder who have significant early learning skill impairments and their families

Many children with Autism Spectrum Disorder (ASD) possess early learning skill deficits and, do not achieve significant cognitive and adaptive gains following intensive behavioral intervention. This pilot randomized controlled trial investigated the effectiveness of a Functional Behavior Skills Training (FBST) program in improving children's performance on functional skills and communication, mitigating children's problem behaviors, and improving parents’ strain, sense of competence, and, knowledge of Applied Behavior Analysis (ABA). Fifteen children with ASD who demonstrated early, learning skill impairments (ages between 38 and 82 months) were recruited from a community-based, IBI program or its waitlist. Children and their parents were randomized to a treatment group who, received FBST for four months or a control group who received their treatment as usual. Children who, received FBST improved on targeted functional skills and communication and demonstrated lower, levels of disruptive behavior. Meanwhile, parents who received FBST improved in their knowledge of, ABA. Overall, preliminary findings suggest that FBST is a feasible and promising behavioral, intervention for children with ASD who have early learning skill impairments. FBST promotes the, development of functional behavior and communication which can direct children onto a path of, appropriate skill development and meaningful interactions in the real world.     

Assessment of social behavior in children with autism: The development of the Behavioral Assessment of Social Interactions in Young Children

There are a limited number of assessments available to examine social skills deficits in young children with Autism Spectrum Disorders (ASDs). The Behavioral Assessment of Social Interactions in Young Children (BASYC) was developed as a direct assessment of social deficits in young children with ASD relative to children without ASD. The BASYC is a semi-structured assessment designed to be administered by clinicians and teachers working with children with a possible ASD. The purpose of this study was to determine whether the BASYC discriminates social behaviors between children with and without ASD. There were 77 participants (n = 48 children with ASD; n = 29 children without ASD) in this study. Scores on the BASYC significantly predict group membership. Sensitivity and specificity of the BASYC was .977 and .871, respectively. Item discrimination indices revealed that the majority of items on the Social Responsivity scale discriminated well between groups; however, this was not the case for the Social Initiation scale. Although additional research is required, the BASYC is currently an instrument that is easy to administer, discriminates well between children with and without ASD based on social behaviors and may assist in goal planning and monitoring of social skills treatment progress.     

Implicit and explicit motor learning: Application to children with Autism Spectrum Disorder (ASD)

Aims and objectivesThis study aims to determine whether children with Autism Spectrum Disorder (ASD) are capable of learning a motor skill both implicitly and explicitly.MethodsIn the present study, 30 boys with ASD, aged 7–11 with IQ average of 81.2, were compared with 32 typical IQ- and age-matched boys on their performance on a serial reaction time task (SRTT). Children were grouped by ASD and typical children and by implicit and explicit learning groups for the SRTT.ResultsImplicit motor learning occurred in both children with ASD (p = .02) and typical children (p = .01). There were no significant differences between groups (p = .39). However, explicit motor learning was only observed in typical children (p = .01) not children with ASD (p = .40). There was a significant difference between groups for explicit learning (p = .01).DiscussionThe results of our study showed that implicit motor learning is not affected in children with ASD. Implications for implicit and explicit learning are applied to the CO-OP approach of motor learning with children with ASD.     

The effects of balance training intervention on postural control of children with autism spectrum disorder: Role of sensory information

PurposeThe aim of this study was to investigate the effect of balance training intervention in children with autism spectrum disorder (ASD), and to explore the relative role of the sensory systems in such kids.MethodologyWe recruited 20 school children (IQ > 80) diagnosed with ASD, and categorized them in two groups; a 10-member training group (average age: 7.70 ± 1.05) and a 10-member control group (average age: 7.90 ± 1.10). Thus, following a six-week-long balance training intervention in four conditions of bipedal upright stance [compliant (Foam) vs. non-compliant (Hard) with eyes-open (EO) vs. eyes-closed (EC)], we examined measures such as mean velocity (V), anteroposterior (AP) and mediolateral (ML) axis displacement, and compared the results to those calculated prior to the initiation of the intervention using MANOVA test.ResultsThis study showed that the balance training program efficiently improved the postural control in ASD suffering children, and that removing the visual and plantar proprioceptive information led to increased sway in both groups. The training group performed significantly better than the control group in all conditions.ConclusionIt is thus concludable that children suffering from ASD can benefit from such balance training programs to improve their balance and postural control.     

Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder?

Aim of the study was to investigate whether 7–9 year old children with severe motor difficulties are more at risk of additional difficulties in activities in daily living, academic skills, attention and social skills than children with moderate motor difficulties. Children (N = 6959) from a population based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were divided into three groups based on their scores on the ALSPAC Coordination Test at age 7: control children (scores above 15th centile; N = 5719 [82.1%]); children with moderate (between 5th and 15th centile; N = 951 [13.7%]); and children with severe motor difficulties (below 5th centile N = 289 [4.2%]). Children with neurological disorders or an IQ < 70 were excluded. Logistic regression was used to compare children with moderate and severe motor coordination difficulties with each other and with control children regarding their risk of co-morbidity defined as significant (<10th centile) difficulties with activities of daily living (ADL); academic skills (reading, spelling and handwriting); attention; social skills (social cognition and nonverbal skills). Children with severe motor difficulties demonstrated a higher risk of difficulties in ADL, handwriting, attention, reading, and social cognition than children with moderate motor difficulties, who in turn had a higher risk of difficulties than control children in five out of seven domains. Screening and intervention of co-morbid problems is recommended for children with both moderate and severe motor difficulties.     

Visual feedback increases postural stability in children with autism spectrum disorder

Autism spectrum disorders (ASD) are often associated with poor motor control, which depends greatly on postural stability. Firstly, this study examined postural stability in young children with ASD, as little is known about early postural skills in this population. Children with ASD are known to depend considerably on visual cues when maintaining balance. We therefore wished to explore whether visual stimuli would in turn improve postural stability. We recruited 18 children with ASD (aged 6–11) and also 12 age-matched typically developing (TD) children. We measured their baseline postural stability and their ability to maintain balance when provided contingent visual feedback of the movements of their center of pressure. Postural performances were measured with a force platform. Baseline postural stability of children with ASD was significantly reduced compared to TD children, as indicated by higher sway scores. When provided visual feedback, children with ASD improved their balance significantly. We conclude that although deficient postural control in ASD is present in childhood, this may be improved in facilitating settings where children with ASD can rely on visual cues.     

The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders

This study evaluated the efficacy of a 14-week aquatic program on physical fitness and aquatic skills for children with autism spectrum disorders (ASD) and their siblings without a disability. Children with ASD (n = 15) and their siblings (n = 15), between 7 and 12 years (8.55 ± 2.19 years) participated. In the first 14-week phase, 14 children (group A: ASD, n = 7; siblings, n = 7) received the aquatic program while 16 children (group B: ASD, n = 8; siblings, n = 8) did not. The arrangement was reversed in the second phase of another 14 weeks. Both groups continued their regular treatments/activities throughout the study. Improvements were seen in aquatic skills and physical fitness components except subtest body composition for group A and group B subsequent to aquatic program. The results provide evidence that intervention can be developed to promote motor skills and physical fitness components for children with ASD and their siblings.     

Gross motor skill performance in children with and without visual impairments—Research to practice

The aim of this study was to provide an empirical basis for teaching gross motor skills in children with visual impairments. For this purpose, gross motor skill performance of 23, 6–12 year old, boys and girls who are blind (ICD-10 H54.0) and 28 sighted controls with comparable age and gender characteristics was compared on six locomotor and six object control tasks using the Test of Gross Motor Development-Second Edition. Results indicate that children who are blind perform significantly (p < .05) worse in all assessed locomotor and object control skills, whereby running, leaping, kicking and catching are the most affected skills, and corresponding differences are related to most running, leaping, kicking and catching component. Practical implications are provided.     

Relationship between brain lesion characteristics and communication in preschool children with cerebral palsy

BackgroundMRI shows promise as a prognostic tool for clinical findings such as gross motor function in children with cerebral palsy(CP), however the relationship with communication skills requires exploration.AimsTo examine the relationship between the type and severity of brain lesion on MRI and communication skills in children with CP.Methods and procedures131 children with CP (73 males(56%)), mean corrected age(SD) 28(5) months, Gross Motor Functional Classification System distribution: I = 57(44%), II = 14(11%), III = 19(14%), IV = 17(13%), V = 24(18%). Children were assessed on the Communication and Symbolic Behavioral Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Structural MRI was analysed with reference to type and semi-quantitative assessment of the severity of brain lesion. Children were classified for motor type, distribution and GMFCS. The relationships between type/severity of brain lesion and communication ability were analysed using multivariable tobit regression.Outcomes and resultsChildren with periventricular white matter lesions had better speech than children with cortical/deep grey matter lesions (β = −2.6, 95%CI = −5.0, −0.2, p = 0.04). Brain lesion severity on the semi-quantitative scale was related to overall communication skills (β = −0.9, 95%CI = −1.4, −0.5, p < 0.001). Motor impairment better accounted for impairment in overall communication skills than brain lesion severity.ImplicationsStructural MRI has potential prognostic value for communication impairment in children with CP.What this paper adds?This is the first paper to explore important aspects of communication in relation to the type and severity of brain lesion on MRI in a representative cohort of preschool-aged children with CP. We found a relationship between the type of brain lesion and communication skills, children who had cortical and deep grey matter lesions had overall communication skills > 1 SD below children with periventricular white matter lesions. Children with more severe brain lesions on MRI had poorer overall communication skills. Children with CP born at term had poorer communication than those born prematurely and were more likely to have cortical and deep grey matter lesions. Gross motor function better accounted for overall communication skills than the type of brain lesion or brain lesion severity.     

Basic reading skills in Swedish children with late developing language and with or without autism spectrum disorder or ADHD

Reading skills at age 7–8 years were examined in a community-representative sample of 21 screened and clinically examined children with language delay (LD) followed prospectively from 2.5 years of age. The present study aimed to (1) determine whether these children with a history of LD had deficits in basic reading skills, i.e. decoding and comprehension, compared to the age norms of standardized tests, (2) analyze if there was a relationship between reading outcome and neuropsychiatric diagnosis by comparing three subgroups of children, LD pure, LD + ASD (autism spectrum disorder) and LD + ADHD, and, (3) determine what language measures at age 6 years were associated with the 7–8-year reading outcome. Both decoding and comprehension of single word reading were significantly below the norm for the whole LD group, where children with LD + ASD scored lowest, and children with LD highest. However, the differences between the three groups did not reach significance. Two reader groups were identified according to the results of word decoding and comprehension, respectively, resulting in the same 7 children. ANOVA revealed that the only differences on the 6-year language tests between the two groups were found on color naming and word memory. This study has shown that children with LD and subsequently identified neurodevelopmental problems such as ASD and ADHD experience continued deficits, demonstrated also in reading skills and that the picture of the reading problems seemed to resemble those of typically developing children.