An investigation of upper limb motor function in high functioning autism and Asperger's disorder using a repetitive Fitts’ aiming task

doi:10.1016/j.rasd.2011.05.010

Research in Autism Spectrum Disorders

Volume 6, Issue 1, January–March 2012, Pages 286-292

https://doi.org/10.1016/j.rasd.2011.05.010 Get rights and content

Abstract

There is now a growing body of research examining movement difficulties in children diagnosed with high functioning autism (HFA) and Asperger's disorder (AD). Despite this, few studies have investigated the kinematic components of movement that may be disrupted in children diagnosed with these disorders. The current study investigated rapid aiming movements in 19 individuals diagnosed with HFA, 20 individuals diagnosed with AD and 18 typically developing (TD) controls. A novel touchscreen version of a Fitts’ aiming task was administered that required participants to make 10 reciprocal aiming movements between targets. Task difficulty was manipulated by varying the size and distance between targets. Movement time in the HFA and AD groups was comparable to TD controls. Children with HFA displayed more constant and variable error across repeated aiming attempts compared to the TD group that may be attributed to deficits in feedforward online refinement of movement. These findings are in accordance with previous gait, ocular motor, upper limb and neuroimaging studies that suggest that the cerebellum may underlie movement disturbance in individuals diagnosed with HFA. Additionally, differences in the nature of upper limb motor disturbance in HFA may serve as a useful future adjunct to clinical measures.

Highlights

► This study investigated movement in children with autism and Asperger's disorder. ► Children with HFA displayed more errors on upper limb task compared to controls. ► Errors in autism group may reflect deficits in online control of movement. ► Upper limb motor disturbance in HFA may serve as a useful future adjunct to clinical measures.

Section snippets

Participants

This study was approved by the Monash Human Research Ethics Committee and all parents of participants provided informed consent. Twenty individuals diagnosed with AD (14 male and 6 female), 19 individuals diagnosed with HFA (15 male and 4 female) and 18 aged-matched typically developing controls (11 male and 7 female) took part in this study (see Table 1 for participant characteristics). Eligible participants were recruited from the Australian Child to Adult Development (ACAD) study at Monash

Movement time

Mauchly's test indicated that the assumption of sphericity had been violated (chi-square = 40.48, p < 0.05), therefore degrees of freedom were corrected using Greenhouse-Geisser estimates of sphericity (epsilon = 0.593). The results revealed a main effect of index of difficulty (ID) [F(2.098, 113.28) = 111.51, p < 0.0001]. There was no significant main effect of diagnosis and no significant interaction effect (see Fig. 2).

Constant error

Mauchly's test indicated that the assumption of sphericity had been violated

Discussion

This study aimed to investigate the kinematic movement profile of individuals with ASD. Our results indicated that whilst MTs did not differ, children with HFA displayed more variability in their movements reflected in greater “scatter” of their end-points whilst performing the Fitts’ aiming task, compared to TD children. It is widely accepted that when unimpaired individuals perform repeated upper limb movements they execute each movement in a similar fashion, which is indicative of a well

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This scoping review identified methodological parameters affecting evaluation when administering standardized motor assessment tools among children with autism spectrum disorder (ASD).
PubMed, CINAHL, PsycINFO, Scopus, ERIC and Web of Science were searched for English-language articles published 1/1990–8/2022. Studies of children with ASD, 3–18-years old, using performance-based standardized motor assessment tools, were included. ASD sample characteristics, enrollment criteria, accommodations and missing motor outcome data were synthesized.
Among 5,432 references, 180 studies using 11 assessments were included. The most frequently used tools were the Movement Assessment Battery for Children, Bruininks-Oseretsky Test of Motor Proficiency and the Test of Gross Motor Development. Large-scale studies were lacking, and girls underrepresented. Low cognitive level was an exclusion criterion explicitly or as a related criterion in 87 (48%) studies. Behavioral issues were noted anecdotally. Methodological detail varied, particularly regarding missing data, administrators’ professions, training and inter-rater reliability. Seventy-four studies reported a total of 197 accommodations, related mainly to modifications of the tasks, accommodations to the testing procedure and changes in the physical setting in which the test was conducted.
The findings, building on previous reports, indicate that children and adolescents with ASD cannot be approached uniformly over the entire spectrum of intelligence (IQ) and behavioral profiles in motor assessments. Administration challenges may stem from ASD characteristics beyond cognitive ability. Inconsistency relating to the IQ variable and incomplete methodological reports continue to be obstacles to comparative conclusions. ASD-specific versions of the tools with a supplementary report, describing cooperation, off-task behaviors and engagement, and combining several tools are recommended. This review could inform development of guidelines regarding motor assessments for children with ASD.
Comparing motor performance, praxis, coordination, and interpersonal synchrony between children with and without Autism Spectrum Disorder (ASD)
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However, this amounts to selective sampling of a highly heterogeneous population and does not provide a holistic overview of the range of impairments observed across the autism spectrum. Out of the studies that systematically assessed the impact of IQ on motor skills in ASD, some studies found a significant positive correlation between IQ and motor function (Ghaziuddin & Butler, 1998; Green et al., 2009; Manjiviona & Prior, 1995; Mari et al., 2003; Papadopoulos, McGinley, Tonge, Bradshaw, Saunders, & Rinehart, 2012), whereas other studies found motor impairments in individuals with ASD regardless of their IQ scores (Dziuk et al., 2007; Mostofsky et al., 2006; Vanvuchelen et al., 2007; Barbeau et al., 2015). Fournier et al. (2010) in their meta-analysis of motor coordination deficits in this population also acknowledged this lack of consensus pertaining to the association between motor and cognitive skills in ASD.
Children with Autism Spectrum Disorder (ASD) have basic motor impairments in balance, gait, and coordination as well as autism-specific impairments in praxis/motor planning and interpersonal synchrony. Majority of the current literature focuses on isolated motor behaviors or domains. Additionally, the relationship between cognition, symptom severity, and motor performance in ASD is unclear. We used a comprehensive set of measures to compare gross and fine motor, praxis/imitation, motor coordination, and interpersonal synchrony skills across three groups of children between 5 and 12 years of age: children with ASD with high IQ (HASD), children with ASD with low IQ (LASD), and typically developing (TD) children. We used the Bruininks-Oseretsky Test of Motor Proficiency and the Bilateral Motor Coordination subtest of the Sensory Integration and Praxis Tests to assess motor performance and praxis skills respectively. Children were also examined while performing simple and complex rhythmic upper and lower limb actions on their own (solo context) and with a social partner (social context). Both ASD groups had lower gross and fine motor scores, greater praxis errors in total and within various error types, lower movement rates, greater movement variability, and weaker interpersonal synchrony compared to the TD group. In addition, the LASD group had lower gross motor scores and greater mirroring errors compared to the HASD group. Overall, a variety of motor impairments are present across the entire spectrum of children with ASD, regardless of their IQ scores. Both, fine and gross motor performance significantly correlated with IQ but not with autism severity; however, praxis errors (mainly, total, overflow, and rhythmicity) strongly correlated with autism severity and not IQ. Our study findings highlight the need for clinicians and therapists to include motor evaluations and interventions in the standard-of-care of children with ASD and for the broader autism community to recognize dyspraxia as an integral part of the definition of ASD.
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A decreased number of PCs (Kemper and Bauman, 1998; Kern, 2003) and abnormal sizes and shapes of neurons of the deep cerebellar nuclei were observed in autism spectrum disorders (ASD) (Amaral et al., 2008; Palmen and van Engeland, 2004). High incidence of cerebellar movement disorders such as limb dysmetria were observed in children diagnosed with ASD (Papadopoulos et al., 2012). Disrupted-In-Schizophrenia 1 (DISC1) is a psychiatric gene disrupted by the balanced (1:11) (q42.1; q14.3) translocation, segregating in the Scottish family with several major psychiatric disorders, including schizophrenia, depression, and bipolar disorder (Blackwood et al., 2001; Millar et al., 2000; St Clair et al., 1990).
In addition to motor function, the cerebellum has been implicated in cognitive and social behaviors. Various structural and functional abnormalities of Purkinje cells (PCs) have been observed in schizophrenia and autism. As PCs express the gene Disrupted-In-Schizophrenia-1 (DISC1), and DISC1 variants have been associated with neurodevelopmental disorders, we evaluated the role of DISC1 in cerebellar physiology and associated behaviors using a mouse model of inducible and selective expression of a dominant-negative, C-terminus truncated human DISC1 (mutant DISC1) in PCs. Mutant DISC1 male mice demonstrated impaired social and novel placement recognition. No group differences were found in novelty-induced hyperactivity, elevated plus maze test, spontaneous alternation, spatial recognition in Y maze, sociability or accelerated rotarod. Expression of mutant DISC1 was associated with a decreased number of large somata PCs (volume: 3000–5000 μm³) and an increased number of smaller somata PCs (volume: 750–1000 μm³) without affecting the total number of PCs or the volume of the cerebellum. Compared to control mice, attached loose patch recordings of PCs in mutant DISC1 mice revealed increased spontaneous firing of PCs; and whole cell recordings showed increased amplitude and frequency of mEPSCs without significant changes in either R_input or parallel fiber EPSC paired-pulse ratio. Our findings indicate that mutant DISC1 alters the physiology of PCs, possibly leading to abnormal recognition memory in mice.
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^☆: This research was funded by the National Health and Medical Research Council (NHMRC #436609).

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An investigation of upper limb motor function in high functioning autism and Asperger's disorder using a repetitive Fitts’ aiming task☆

Abstract

Highlights

Section snippets

Participants

Movement time

Constant error

Discussion

Current Opinion in Neurology

Trends in Cognitive Science

Journal of Neurological Science

Diagnostic and statistical manual of mental disorders IV-TR

Neuroanatomical observations of the brain in autism

Advances in Biological Psychiatry

Action prediction in the cerebellum and in the parietal lobe

Experimental Brain Research

Disturbances in programming goal-directed arm movement in children with ADHD

Developmental Medicine and Child Neurology

The information processing capacity of the human motor system in controlling amplitude of movement

Journal of Experimental Psychology

Clumsiness in autism and Asperger syndrome: A further report

Journal of Intellectual Disability Research

A kinematic analysis of how young adults with and without autism plan and control goal-directed movements

Motor Control

Impairment in movement skills of children with autistic spectrum disorders

Developmental Medicine and Child Neurology

Movement Assessment Battery for Children

Motor signs distinguish children with high functioning autism and Asperger's syndrome from controls

Journal of Autism and Developmental Disorders