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.     

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.     

Anthropometric measures of Spanish children with autism spectrum disorder

We aimed to compare body mass index (BMI) and healthy eating index (HEI) in children with autism spectrum disorder (ASD, n = 105) and typically developing (TD, n = 495) children. They were aged 6–9 years, lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds. In this case–control study, the weight, height and BMI were measured for both groups. Three-day food records were used to assess dietary intake. Although the differences between children with ASD and TD children in raw BMI (p = 0.44), BMI z-score (p = 0.37), HEI (p = 0.43) and total energy intake (p = 0.86) were not significant, children with ASD and the boys subgroup were shorter (p = 0.01), but not the girls subgroup, compared to TD children of the same gender. Using the controls values as a reference, the BMI distribution in children with ASD became distorted, with values below the 5th percentile (11% vs. 4%, p = 0.03) and above the 95th percentile (8% vs. 5%, p = 0.04). The gender- and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39, respectively, vs. TD children. Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits.     

Determinants of gross motor skill performance in children with visual impairments

Children with visual impairments (CWVI) generally perform poorer in gross motor skills when compared with their sighted peers. This study examined the influence of age, sex, and severity of visual impairment upon locomotor and object control skills in CWVI. Participants included 100 CWVI from across the United States who completed the Test of Gross Motor Development II (TGMD-II). The TGMD-II consists of 12 gross motor skills including 6 object control skills (catching, kicking, striking, dribbling, throwing, and rolling) and 6 locomotor skills (running, sliding, galloping, leaping, jumping, and hopping). The full range of visual impairments according to United States Association for Blind Athletes (USABA; B3 = 20/200–20/599, legally blind; B2 = 20/600 and up, travel vision; B1 = totally blind) were assessed. The B1 group performed significantly worse than the B2 (0.000 ≤ p ≤ 0.049) or B3 groups (0.000 ≤ p ≤ 0.005); however, there were no significant differences between B2 and B3 except for the run (p = 0.006), catch (p = 0.000), and throw (p = 0.012). Age and sex did not play an important role in most of the skills, with the exception of boys outperforming girls striking (p = 0.009), dribbling (p = 0.013), and throwing (p = 0.000), and older children outperforming younger children in dribbling (p = 0.002). The significant impact of the severity of visual impairment is likely due to decreased experiences and opportunities for children with more severe visual impairments. In addition, it is likely that these reduced experiences explain the lack of age-related differences in the CWVI. The large disparities in performance between children who are blind and their partially sighted peers give direction for instruction and future research. In addition, there is a critical need for intentional and specific instruction on motor skills at a younger age to enable CWVI to develop their gross motor skills.     

Motor functioning,exploration, visuospatial cognition and language development in preschool children with autism

In order to understand typical and atypical developmental trajectories it is important to assess how strengths or weaknesses in one domain may be affecting performance in other domains. This study examined longitudinal relations between early fine motor functioning, visuospatial cognition, exploration, and language development in preschool children with ASD and children with other developmental delays/disorders. The ASD group included 63 children at T1 (Mage = 27.10 months, SD = 8.71) and 46 children at T2 (Mage = 45.85 months, SD = 7.16). The DD group consisted of 269 children at T1 (Mage = 17.99 months, SD = 5.59), and 121 children at T2 (Mage = 43.51 months, SD = 3.81). A subgroup nested within the total sample was randomly selected and studied in-depth on exploratory behavior. This group consisted of 50 children, 21 children with ASD (Mage = 27.57, SD = 7.09) and 29 children with DD (Mage = 24.03 months, SD = 6.42). Fine motor functioning predicted language in both groups. Fine motor functioning was related to visuospatial cognition in both groups and related to object exploration, spatial exploration, and social orientation during exploration only in the ASD group. Visuospatial cognition and all exploration measures were related to both receptive and expressive language in both groups. The findings are in line with the embodied cognition theory, which suggests that cognition emerges from and is grounded in the bodily interactions of an agent with the environment. This study emphasizes the need for researchers and clinicians to consider cognition as emergent from multiple interacting systems.     

Rates of psychotropic medication use in children with ASD compared to presence and severity of problem behaviors

There is a scarcity of research on the relationship between presence of problem behaviors and psychotropic medication use in children with autism spectrum disorder (ASD). Participants in the current study were children and adolescents ages 3–17 years who were sorted into four groups: ASD on psychotropic medication (N = 100), ASD not on psychotropic medication (N = 147), typically developing on medication (N = 48), and typically developing not on medication (N = 168). A one-way multivariate analysis of covariance (MANCOVA) was conducted to determine the relationship between medication use and rates of internalizing and externalizing behaviors. Post hoc analyses revealed that children with ASD on psychotropic medication evinced significantly more externalizing behaviors than children with ASD not on medication. However, the two groups did not significantly differ on rates of internalizing behaviors. These results suggest that psychotropic medications may often be prescribed to manage externalizing behaviors. Implications of these findings are discussed in relation to the existing literature.     

Do children with autism and Asperger's disorder have difficulty controlling handwriting size? A kinematic evaluation

Children with autism spectrum disorders (ASD) often show difficulties in controlling letter size and consistent letter formation during handwriting; however, there has been little research into the underlying nature of handwriting impairments in this group. The aim of this study was to assess the ability of children with ASD to regulate the size and consistency of fundamental handwriting movements when using writing guides, and determine whether the kinematic profile during writing is different to typically developing children. Twenty-six boys with ASD (16 with high-functioning autism, 10 with Asperger's disorder) aged 8–13 years (IQ > 75), and 17 typically developing children wrote a series of four cursive letter l's using 10 mm and 40 mm writing guides, using a graphics tablet and stylus. Movement size and consistency was comparable between groups when the writing guides were set at 10 mm; however, handwriting movements of children with ASD were significantly faster and more fluent than typically developing children when writing guides were set at 40 mm. Neuromotor noise was comparable to that of typically developing children across both writing sizes. Clinically, our findings indicate that children with ASD have a well-automated motor plan for simple handwriting movements when writing guides are present and that problems of handwriting legibility in ASD are likely to arise from other factors, such as complex motor chaining (i.e. writing whole words and sentences), or attentional, working memory and linguistic demands when writing.     

Physical fitness and overweight in Israeli children with and without developmental coordination disorder: Gender differences

Physical fitness and overweight among children has become paramount in the general population and more so in children with developmental coordination disorder (DCD). The purpose of the current study was to examine the association between physical fitness and overweight in a sample of Israeli children in comparison to typical children, and to examine gender differences. DCD was identified through total scores on the movement assessment battery for children 2 (MABC-2) equal to or less than the 16th percentile as well as parents’ report that the child's deficits in motor skills interfered with at least two daily life activities. The sample included a group of children with DCD (n = 22, M age = 8.70 [SD = 1.36], 16 boys [73%]) and a control group of typical children (n = 47, M age = 8.90 [SD = 1.52], 34 boys [72%]). Measures included the strength subtest of the Bruininks–Oseretsky test of motor proficiency (BOT-2), the six minutes’ walk test (6MWT) with heart rate measure, BMI and the percentage of body fat. Significant differences between DCD and typical children were found on all variables of physical fitness and weight. A two-way analysis of variance (ANOVA) analysis (group/gender) also revealed significant interactions for the percentage of body fat (F = 8.51, p < .005) and BMI (F = 4.50, p < .038) meaning that less fit children are more obese. The current study supports previous findings that children with DCD are less physically fit and more overweight compared to typically developing children. Moreover, in comparing between the genders, the girls in the study sample weighed more and had a significantly higher percentage of body fat than boys, it is essential to further our understanding of the relationships between obesity, physical fitness and gender among children with and without DCD.     

Autistic children do not exhibit an own-race advantage as compared to typically developing children

The characteristics of aberrant face processing in individuals with autism spectrum disorder (ASD) have been extensively studied, but the aspect regarding sensitivity to race is relatively unexplored. The present study hypothesized that the magnitude of the other-race effect shall be reduced in individuals with ASD owing to their inattention to faces since infancy. Using a sequential face discrimination task, we tested the other-race effect of 18 ASD (mean age = 7.5 years) and 13 age-matched typically developing (TD) children (mean age = 7.6 years). The stimuli were cropped Asian and African faces, each with four levels of difficulty: easy (change identity), medium (replaced eyes), hard-eye (widen eye spacing), and hard-mouth (moved up mouth). The TD children showed a significant own-race advantage such that the best performance was found in the Asian easy condition. The ASD children did not exhibit such advantage at all. Moreover, ASD children showed the highest error rates in the hard-eye condition instead of the hard-mouth condition, indicating insensitivity to eyes region. In sum, our findings support the hypothesis that the other-race effect is reduced in ASD children, reflecting an incomplete development of an expert face system.     

Visual-motor integration,visual perception,and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder

BackgroundVisual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits.MethodsVMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5–9.6 years, n = 108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established.ResultsMean VMI scores were ‘below average’ (M = 87.8 ± 9.6), and visual perception scores were ‘average’ (M = 97.6 ± 12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M = 87.9 ± 12.5; 66.7%) than children without PAE (M = 95.1 ± 10.7; 23.3%) and PAE (no FASD) (M = 96.1 ± 10.9; 15.4%).ConclusionsAboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments.     

Role of fruits,grains, and seafood consumption in blood cadmium concentrations of Jamaican children with and without Autism Spectrum Disorder

Human exposure to cadmium has adverse effects on the nervous system. Utilizing data from 110 age- and sex-matched case–control pairs (220 children) ages 2–8 years in Kingston, Jamaica, we compared the 75th percentile of blood cadmium concentrations in children with and without Autism Spectrum Disorder (ASD). In both univariable and multivariable Quantile Regression Models that controlled for potential confounding factors, we did not find any significant differences between ASD cases and typically developing (TD) controls with respect to the 75th percentile of blood cadmium concentrations (P > 0.22). However, we found a significantly higher 75th percentile of blood cadmium concentrations in TD Jamaican children who consumed shellfish (lobsters, crabs) (P < 0.05), fried plantain (P < 0.01), and boiled dumpling (P < 0.01). We also observed that children living in Jamaica have an arithmetic mean blood cadmium concentration of 0.16 μg/L which is similar to that of the children in developed countries and much lower than that of children in developing countries. Although our results do not support an association between blood cadmium concentrations and ASD, to our knowledge, this study is the first to report levels of blood cadmium in TD children as well as those with ASD in Jamaica.     

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.     

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 efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit training

Neuromotor Task Training (NTT) and Nintendo Wii Fit Training (Wii training) are both task-based interventions used to improve performance in children with motor coordination problems. The aim of this study was to compare the efficacy of these two interventions on the motor performance, isometric strength and cardiorespiratory fitness (aerobic and anaerobic capacity) of children with Developmental Coordination Disorder (DCD) attending mainstream schools in a low-income setting. A pragmatic, quasi-experimental study design was utilized. Children between the ages of 6–10 years, who scored at or below the 16th percentile on the Movement Assessment Battery for Children-2 (MABC-2) and whose teacher reported a functional motor problem, were allocated to either NTT (n = 37) or Wii training (n = 19) groups depending on school of attendance. The MABC-2, a hand-held dynamometer, the Functional Strength Measure, the Muscle Power Sprint Test and the 20 m Shuttle Run Test were used to assess performance at baseline and after the intervention. The main findings show that the mean motor performance scores of both groups improved over the study period. However, significant differences in improvement were detected between groups, with the NTT group showing greater improvement in motor performance, functional strength and cardiorespiratory fitness. No improvements in isometric strength were seen in either group. The Wii training group showed significant improvement in anaerobic performance. This study provides evidence to support the use of both the Wii Training and NTT for children with DCD. However, in comparison to Wii training, the NTT approach yields superior results across measures of motor proficiency, cardiorespiratory fitness and functional strength. The decision to use either approach may be influenced by resources and time constraints.     

Motor competence assessment in children: Convergent and discriminant validity between the BOT-2 Short Form and KTK testing batteries

This study investigated convergent and discriminant validity between two motor competence assessment instruments in 2485 Flemish children: the Bruininks-Oseretsky Test of Motor Proficiency 2 Short Form (BOT-2 Short Form) and the KörperKoördinationsTest für Kinder (KTK). A Pearson correlation assessed the relationship between BOT-2 Short Form total, gross and fine motor composite scores and KTK Motor Quotient in three age cohorts (6–7, 8–9, 10–11 years). Crosstabs were used to measure agreement in classification in children scoring below percentile 5 and 15 and above percentile 85 and 95. Moderately strong positive (r = 0.44–0.64) associations between BOT-2 total and gross motor composite scores and KTK Motor Quotient and weak positive correlations between BOT-2 Short Form fine motor composite and KTK Motor Quotient scores (r = 0.25–0.37) were found. Levels of agreement were fair to moderate. Therefore, some proof of convergent and discriminant validity between BOT-2 Short Form and KTK was established in this study, underlining the notion that the evaluation of motor competence should not be based upon a single assessment instrument.     

Nutritional deficiencies and overweight prevalence among children with autism spectrum disorder

Children with autism spectrum disorder (ASD) are at risk of developing nutritional deviations. Three to six year old children with ASD were compared to their typically developing siblings and to a typically developing age and gender matched control group, in order to evaluate their intake and body mass index.Nutrient intake was compared to the Dietary Reference Intake using three-day diet diaries completed by the parents. The sum percentage of nutritional deficiencies in the ASD group compared to the typical development group was 342.5% (±122.9%) vs. 275.9% (±106.8%), respectively (P = 0.026). A trend toward higher deficiency in the ASD group was observed as compared to the sibling group 363% (±122.9%) vs. 283.2% (±94.7%) (P = 0.071). A higher body mass index was found in the ASD group compared to their counterparts, despite their nutritional deficiencies. In conclusion, children with ASD are more likely to suffer from nutritional deficiencies despite higher body mass index.     

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.     

Comparison of VO2 maximum obtained from 20 m shuttle run and cycle ergometer in children with and without developmental coordination disorder

Oxygen consumption at peak physical exertion (VO₂ maximum) is the most widely used indicator of cardiorespiratory fitness. The purpose of this study was to compare two protocols for its estimation, cycle ergometer testing and the 20 m shuttle run, among children with and without probable developmental coordination disorder (pDCD).The shuttle run test was conducted during regular school hours, usually in the gymnasium. Children were then invited to a lab to complete the cycle ergometer protocol. Children were categorized as possible cases of DCD using the Movement-ABC-2. The analysis was performed using cut-points at both the 5th (n = 38) and 15th (n = 51) percentiles. The average age of children in the study was 12 years (SD = 0.5). Children with pDCD had poorer VO₂ maximum when compared to typically developing children based on both the shuttle run and the cycle ergometer. The correlation between tests is in the moderate to high range (r = 0.71, p < 0.001); 0.78 for girls, and 0.73 for boys. The overall difference in correlations between typically developing children and children with pDCD based on the 15th percentile was 0.12 (p = 0.27). For children with pDCD based on the 5th percentile however, the difference between groups was larger (difference in r = 0.25), and was statistically significant (p = 0.02). In multivariate analyses, there was no difference in the effect of the shuttle run results in predicting VO₂ maximum obtained through the cycle ergometer test for children with pDCD compared to those without the condition. Regardless of the test, the patterns of association between children with pDCD and typically developing children were the same reinforcing the findings of previous field-based reports. Moderate to good correlations, at the 15th percentile cut-point, between tests suggests that the shuttle run test is a reliable substitute in this population when lab based assessments of VO₂ maximum are not feasible.     

Understanding macrographia in children with autism spectrum disorders

It has been consistently reported that children with autism spectrum disorders (ASD) show considerable handwriting difficulties, specifically relating to accurate and consistent letter formation, and maintaining appropriate letter size. The aim of this study was to investigate the underlying factors that contribute to these difficulties, specifically relating to motor control. We examined the integrity of fundamental handwriting movements and contributions of neuromotor noise in 26 children with ASD aged 8–13 years (IQ > 75), and 17 typically developing controls. Children wrote a series of four cursive letter l's using a graphics tablet and stylus. Children with ASD had significantly larger stroke height and width, more variable movement trajectory, and higher movement velocities. The absolute level of neuromotor noise in the velocity profiles, as measured by power spectral density analysis, was significantly higher in children with ASD; relatively higher neuromotor noise was found in bands >3 Hz. Our findings suggest that significant instability of fundamental handwriting movements, in combination with atypical biomechanical strategies, contribute to larger and less consistent handwriting in children with ASD.     

Early motor development of children with a congenital cytomegalovirus infection

BackgroundCongenital cytomegalovirus (cCMV) infection is the most important etiology of non-hereditary childhood hearing loss and an important cause of neurodevelopmental delay. The current study aimed to investigate the early motor development of symptomatic and asymptomatic cCMV infected children with and without sensorineural hearing loss (SNHL).MethodsSixty-four children with a cCMV infection, without cerebral palsy, were compared to a control group of 107 normal hearing children. They were assessed around the ages of 6, 12, and 24 months with the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS), and Ghent Developmental Balance Test (GDBT). The cCMV infected children were subdivided into a symptomatic (n = 26) and asymptomatic cCMV group (n = 38) but also into a cCMV group with SNHL (n = 19) and without SNHL (n = 45).ResultsSymptomatic cCMV infected children and cCMV infected children with SNHL performed significantly weaker for all gross motor outcome measures.ConclusionA congenital CMV infection is a risk factor for a delay in the early motor development. Follow-up will be necessary to gain insight into the exact cause of this motor delay and to define the predictive value of early motor assessment of cCMV infected children.