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.     

Adaptive behavior profiles in young children with autism spectrum disorder diagnosed under DSM-5 criteria

BackgroundThis study explored adaptive behavior profiles in a clinical sample of well-characterized children aged one to three years with ASD.MethodProfiles were compared to a sample of children with non-ASD developmental delays. Cluster analyses were performed to determine whether differences in adaptive skills effectively distinguished children with ASD from other young children presenting for assessment due to behavioral or other concerns, but who received other non-ASD diagnoses.ResultsA profile of motor > daily living > socialization > communication skills was found in both children with ASD and children with non-spectrum diagnoses, showing that this profile is not unique to young children with ASD. A two-group cluster solution was found which differentiated children by developmental functioning level rather than by diagnosis.DiscussionThe results of this study provide support for two developmental profiles for adaptive functioning in children with ASD: an average to borderline delayed profile and a borderline to more severely delayed profile that may remain stable or worsen over time. They additionally highlight the importance of delivering early targeted interventions to children with ASD who have greater deficits in adaptive functioning due to their association with poorer long-term outcomes.     

Adaptive skill trajectories in infants with fragile X syndrome contrasted to typical controls and infants at high risk for autism

BackgroundAdaptive behaviors are essential for optimal outcomes and independence in individuals with developmental disabilities. This study examined longitudinal trajectories of adaptive behavior in infants with fragile X syndrome (FXS), compared to typical development (TD) and infant siblings of children diagnosed with autism (ASIBs).MethodParticipants included 76 male infants (FXS = 25, ASIBs = 27, TD = 24) assessed up to 4 times between 6 and 24 months of age for a total of 215 assessments of adaptive behavior. A sample of 12 females with FXS was included for a comparative sex analysis.ResultsResults indicate that infant males with FXS displayed lower initial adaptive behavior across all domains that emerged by 9 months-of-age with slower growth rates than both comparison groups. A flat profile across the domains at 24 months was evident. Increased severity of autism symptoms was related to reduced adaptive skills at 24 months-of-age. Females with FXS displayed higher scores than males on the Socialization and Motor domains and equivalent scores on the Communication and Daily Living domains at 9 months-of-age with different rates of growth across domains.ConclusionsThis is the first study to provide evidence of etiological specificity in adaptive behavior profiles during infancy across two populations at high risk for ASD. These findings support targeted adaptive behavior interventions in young children with FXS beginning as early at 9 months of age to reduce identified deficits and the cascading impacts of these early impairments.     

Parent and teacher ratings of adaptive and challenging behaviours in young children with autism spectrum disorders

This study examined parent and teacher rating correspondence of adaptive and challenging behaviours for children with autism spectrum disorders (ASDs) enrolled in an early intervention program. Data were collected on the Behaviour Assessment System for Children, second edition (BASC-2; n = 22), and Vineland Adaptive Behaviour Scales, second edition (VABS-II; n = 28). Adaptive behaviour ratings generally demonstrated high parent–teacher correlations, while challenging behaviour ratings demonstrated relatively low correlations. Only adaptive skills on the BASC-2 showed significant mean parent–teacher differences, with parent ratings suggesting greater impairment. Results suggest that clinicians should consider gaining both parent and teacher perspectives on a child's challenging behaviour, but that a single informant measure of adaptive behaviour, either parent or teacher, may be sufficient after initial assessments are completed.     

The relation among sleep,routines, and externalizing behavior in children with an autism spectrum disorder

The present study examined relations among sleep, routines, and externalizing behavior (based on parent report) in 115 children ages 6 to 12 years in two groups: 58 children with an autism spectrum disorder (age M = 9.0, SD = 2.09) and 57 non-ASD children (age M = 8.25, SD = 1.98). Within the ASD group, sleep hygiene and sleep quality were related to both routines and externalizing behaviors. In the combined sample, a significant interaction was found between diagnostic status and general routines in predicting externalizing behaviors. Specifically, lower levels of routines were related to higher levels of externalizing behaviors for both groups, whereas higher levels of routines were related to lower levels of externalizing behaviors for the non-ASD group. Further research among these constructs may focus on children with an ASD who experience less consistent routines or significant sleep disturbance.     

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.     

Autism spectrum disorder and the student teacher relationship: A comparison study with peers with intellectual disability and typical development

This study examined relations among behavior problems, social skills, and student–teacher relationships within a sample of children (mean age 8) with autism spectrum disorders or ASD (n = 36) and comparison samples of children with typical development (n = 91) or with intellectual disability (n = 38.) Student–teacher relationships (STRs) for children with ASD appeared to be qualitatively different from those of similarly aged children with ID or typical development. The STRs for children with ASD were considerably poorer, with less closeness and more conflict, than in the two comparison groups. Within the group with ASD, teacher-reported child externalizing behavior and social skills accounted for significant variance in the total score on the Student Teacher Relationship Scale. Conflict was predicted only by externalizing behavior, whereas closeness was predicted by social skills; level of autistic mannerisms negatively related to the teacher's perception of closeness. Findings address the implications for transition to early schooling for children with ASD.     

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.     

Do children with ASD have difficulty handwriting under time pressure?

BackgroundChildren with autism spectrum disorder (ASD) often experience significant handwriting impairment, however the influence of time pressure on overall performance is unclear. The aim of the current study was to characterise the handwriting profile of children with ASD across both non-speeded and speeded conditions, with particular focus given to spacing difficulties and handwriting errors. A further aim was to explore the relationships between handwriting and both intellectual and motor skills under different task conditions.MethodBoys with ASD (n = 23) and matched controls (n = 20) aged 8–12 years completed a modified version of the speed subtest of the Handwriting Performance Test, which allowed for both an ecologically valid and relatively simple motoric task. Participants wrote a simple phrase (cat and dog) five times in each condition.ResultsNo significant group differences were identified for handwriting errors or spacing between words in either condition, however the ASD group demonstrated greater variability relative to controls, particularly in the speeded condition. Significant negative associations were identified between motor proficiency and handwriting errors in the non-speeded condition.ConclusionsWhile motor processes are shown to have a significant role in overall handwriting proficiency, it appears that motor ability may influence the handwriting process to different degrees, depending on the nature of the task employed. A lack of group differences with respect to handwriting errors and spacing between words may suggest that children with ASD have the ability to compensate for underlying motor impairment when completing a well-practiced writing task.     

Prenatal pregnancy complications and psychiatric symptoms: Children with ASD versus clinic controls

The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a DSM-IV-referenced rating scale and developmental history questionnaire. Participants were classified as having ≥1 PPC (+PPC) versus none (?PPC). Children with ASD were significantly more likely to have PPC than Controls. Intra-group comparisons demonstrated that children in the ASD + PPC group had more severe anxiety than ASD/?PPC group. The Control + PPC group obtained higher symptom ratings of inattention, hyperactivity, and oppositional behavior than Control/?PPC. Children in the ASD + PPC group were rated as having more severe anxiety and depression symptoms than Control + PPC. Dissimilar associations in ASD and non-ASD samples were found, suggesting divergent pathogenic processes in different clinical phenotypes.     

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.     

Treatment approach,autism severity and intervention outcomes in young children

The current study examined the relation between autism severity at baseline, type of intervention employed and outcomes in young children with autism spectrum disorder (ASD). Seventy-eight children with ASD, aged 15–35 months (M = 25.4, SD = 4.2), received either applied behavioral analysis (ABA) or integration of several intervention approaches (Eclectic) in community center-based programs. Outcome was measured after 1 year of intervention using standardized autism diagnostic tests, and cognitive and adaptive skills evaluations. ASD diagnosis was highly stable (99%). Both intervention groups improved significantly in verbal cognitive abilities and in socialization and communication adaptive skills, but no significant difference between the intervention groups was documented. Less severe autism symptoms at baseline were associated with better progress in adaptive skills and in cognitive abilities. Within the group with less severe autism symptoms, those who received Eclectic intervention had a better outcome than those who received ABA in communication and socialization adaptive skills as reported by the parents, but not in the standardized cognitive test results. The child's baseline social abilities and deficits appear to be crucial variables for intervention outcomes and should be considered in treatment approach decision-making.     

Effects of overweight and obese body mass on motor planning and motor skills during obstacle crossing in children

Little is known about how obesity relates to motor planning and skills during functional tasks. We collected 3-D kinematics and kinetics as normal weight (n = 10) and overweight/obese (n = 12) children walked on flat ground and as they crossed low, medium, and high obstacles. We investigated if motor planning and motor skill impairments were evident during obstacle crossing. Baseline conditions showed no group differences (all ps > .05). Increased toe clearance was found on low obstacles (p = .01) for the overweight/obese group and on high obstacles (p = .01) for the normal weight group. With the crossing leg, the overweight/obese group had larger hip abduction angles (p = .01) and medial ground reaction forces (p = .006) on high obstacles and high anterior ground reaction forces on low obstacles (p = .001). With the trailing leg, overweight/obese children had higher vertical ground reaction forces on high obstacles (p = .005) and higher knee angles (p = .01) and anterior acceleration in the center of mass (p = .01) on low obstacles. These findings suggest that differences in motor planning and skills in overweight/obese children may be more apparent during functional activities.     

Role of serum levels of neurotensin in children with autism spectrum disorder

AimNeuroinflammation may play a role in the pathogenesis of autism in some patients. The aim of this study was to measure serum levels of neurotensin (NTS) in relation to the degree of the severity of autism.MethodsSerum NTS was measured in autistic children (n = 38; mean age 7.02 ± 2.03 years) and healthy, unrelated sex matched controls (n = 39); mean age 7.25 ± 1.64 years). The severity of autism symptoms was assessed using Childhood Autism Rating Scale (CARS) scores.ResultsThe serum level of NTS was significantly (P < 0.001) lower in autistic children (mean ± S.D. = 54.71 ± 12.4 pg/ml) than control group (mean ± S.D. = 77.58 ± 10.29 pg/ml). Children with severe autism had significantly lower serum NTS levels than patients with mild to moderate autism (P < 0.002). There was significant negative correlation between serum levels of NTS and CARS SCORES (r² = 0.79, P = 0.001).ConclusionsSerum NTS levels were elevated in some autistic children and they were significantly correlated with the severity of autism. However, this is an initial report that warrants further research to determine the pathogenic role of NTS and its possible link to neuroinflammation in autism.     

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.     

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

BackgroundAttention deficits in young children with autism spectrum disorder (ASD) are not well understood. This study sought to determine: 1) the prevalence of ADHD symptoms in young children with ASD, typical development (TD), and developmental delay (DD) and 2) the association between ADHD symptoms and cognitive and behavioral functioning in children with ASD.MethodADHD symptoms, defined according to Aberrant Behavior Checklist (ABC) hyperactivity subscale scores, were compared across children aged 2–5 from a large case-control study with ASD (n = 548), TD (n = 423), and DD (n = 180). Inattention and hyperactivity items within this subscale were also explored. Within the ASD group, linear and logistic regression were used to examine how ADHD symptoms were associated with cognition as assessed by the Mullen Scales of Early Learning and adaptive functioning as assessed by the Vineland Adaptive Behavior Scales.ResultsMean hyperactivity subscale scores were lowest in children with TD (mean = 3.19), higher in children with DD (12.3), and highest in children with ASD (18.2; between-group p < 0.001). Among children with ASD, significant associations were observed with higher ADHD symptoms and poorer adaptive and cognitive functioning (adjusted beta for hyperactivity score in association with: Vineland composite = −5.63, p = 0.0005; Mullen visual reception scale = −2.94, p = 0.02; for the highest vs. lowest quartile of hyperactivity score, odds of lowest quintile of these scores was approximately doubled). Exploratory analyses highlighted associations with inattention-related items specifically.ConclusionThese results suggest ADHD symptoms may play a key role in the functioning of young children with 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-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.     

Sensorimotor function in preschool-aged children with expressive language disorder

AimThe aim of the study was to evaluate functional motor performance and haptic object recognition in 5-year-old children with mild expressive language disorder (ELD) in comparison with age- and gender-matched healthy children.MethodsThe subjects were classified by speech-language pathologist using The Reynell Developmental Language Scales III and Boehm Test of Basic Concepts: Preschool as children with mild ELD (n = 29, incl. 23 boys and 6 girls) and children with typical language development as controls (n = 29, incl. 23 boys and 6 girls). The children were examined for manual dexterity, ball skills, static and dynamic balance by Movement-ABC, haptic object recognition (HOR), hand-grip strength (HGS) and vertical jumping performance.ResultsChildren with mild ELD demonstrated significantly higher scores (i.e., inferior performance) in all subtests of M-ABC (all p values <0.05), in haptic object recognition (p < 0.01) and vertical jumping height (p < 0.05) compared to controls. However, no statistically significant differences (p > 0.05) emerged from HGS. Boys with mild ELD demonstrated higher results in impairment score (p < 0.001), ball skills (p < 0.01) and balance (p < 0.01) of M-ABC, as well as in HOR (p < 0.05). Girls with mild ELD showed higher impairment score (p < 0.05) with lower percentile (p < 0.05) in M-ABC, indicating inferior motor performance, and lower HGS for the non-dominant hand (p < 0.05). Seven out of 29 (24.1%) children with mild ELD had definite or borderline motor difficulties, while only one child in control group (3.4%) demonstrated borderline motor difficulties.ConclusionsChildren with mild expressive language disorder do not perform as well as controls in tests of functional motor skills, but their results in tests demanding maximal muscle force generation are in level with typically developing children. Boys and girls with mild ELD demonstrated higher impairment scores in M-ABC, indicating the need to follow their overall development more closely.