Clumsiness in autism and Asperger syndrome: a further report

Abstract

Clumsiness has been proposed as a diagnostic feature of Asperger syndrome (AS), a type of pervasive developmental disorder recently introduced in the ICD-10 and DSM-IV. However, the extent to which this symptom is specific to AS is not clear. To investigate this issue, we compared a sample of AS children with age- and sex-matched groups of children with autistic disorder and pervasive developmental disorder not otherwise specified (PDDNOS). Twelve subjects with AS (ICD-10/DSM-IV; 11 males; average age 11.4 years; mean full-scale IQ 104.9) were compared with 12 subjects with autistic disorder (DSM-III-R; II males; average age 10.3 years; mean full-scale IQ 78.4) and 12 subjects with PDDNOS (DSM-III-R; 10 males; average age 10.1 years; mean full-scale IQ 78.2). The BruininksOseretsky test, a standardized test of motor coordination, was administered blind by the same investigator to all the three groups. While coordination deficits were found in all three groups, children with AS were found to be less impaired than those with autistic disorder and PDDNOS. However, no significant relationship was found between coordination scores and diagnosis after adjusting for the level of intelligence. These findings suggest that some patients with AS may be less clumsy than those with autistic disorder and that this difference may be the result of their higher level of intelligence. Studies based on larger samples using multiple measures of coordination are needed to further clarify the role of clumsiness in the classification of pervasive developmental disorders.

Immune Dysfunction in Autism: A Pathway to Treatment

“…For example, antibodies against glutamate receptors have been implicated in childhood seizure disorders, 112 a common comorbidity of ASD, 111,112 whereas antibodies against GABA recep- tors are associated with motor disorders, 113 which are widely reported in ASD. 114 Although antibodies for either receptor family have not been detected in ASD, numerous unknown targets for autoantibodies exist, and it is possible that these could include subunits of the GABA or glutamate receptors. Dysregulation of neurotransmitter systems could further drive aberrant immune responses in ASD and could thus point to possible targets for therapeutic intervention.…”

Motor Deficits in Children With Autism Spectrum Disorder: A Cross‐Syndrome Study

“…Behavioural studies have shown that children with autism display a range of motor deficits [e.g., Ghaziuddin & Butler, 1998;Jansiewicz, Goldberg, Newschaffer, Denckla, Landa, & Mostofsky, 2006]. Green et al [2009] used a standardised motor battery, the Movement ABC [Henderson & Sugden, 1992], in a large, populationderived study of school-aged children with childhood autism and broader ASD, and found that 79% of the children with an ASD had definite motor impairments with a further 10% having borderline problems.…”

What can autism teach us about the role of sensorimotor systems in higher cognition? New clues from studies on language, action semantics, and abstract emotional concept processing

“…A risk with these studies is that the validity of their findings relies on initial, accurate categorization of participants; the lack of differentiation between AS and HFA, in the case of Manjiviona and Prior (1995), is likely to reflect invalid categorization based on the diagnostic manuals of the time. Some studies find greater motor deficits in individuals with HFA than those with AS (Behere, Shahani, Noggle, & Dean, 2012;Ghaziuddin & Butler, 1998;Green et al, 2009;Papadopoulos et al, 2012;Rinehart, Bellgrove, et al, 2006), others find the opposite picture (Iwanaga, Kawasaki, & Tsuchida, 2000), some find deficits of different types in both groups (Rinehart et al, 2001), and some find no statistical difference between groups (Jansiewicz et al, 2006;Noterdaeme, Mildenberger, Minow, & Amorosa, 2002). Some of these studies have very small samples (Behere et al, 2012;Ghaziuddin & Butler, 1998;Iwanaga et al, 2000;Rinehart, Bellgrove, et al, 2006;Rinehart et al, 2001), casting doubt on their findings.…”

“…Many studies addressed this question with movement assessment batteries with normative percentiles for performance and objective scoring: for example, the PANESS (Dowell et al, 2009;Dziuk et al, 2007;Floris et al, 2016;Jansiewicz et al, 2006;Mostofsky, Burgess, & Gidley Larson, 2007), the M-ABC or M-ABC2 (Ament et al, 2015;Green, Baird et al, 2002;Green, Moore, & Reilly, 2002;Green et al, 2009;Hanaie et al, 2013;Hanaie et al, 2014;Kopp, Beckung, & Gillberg, 2010;McPhillips, Finlay, Bejerot, & Hanley, 2014;Miyahara et al, 1997;Sumner et al, 2016;Whyatt & Craig, 2012), or the Bruininks-Oseretsky test (Dewey et al, 2007;Ghaziuddin & Butler, 1998;Hilton, Zhang, Whilte, Klohr, & Constantino, 2012;Pan, 2014). These measures yield total scores which were sometimes analysed alone, but they each assess a range of fine and gross motor skills, including balance and gait, hopping or jumping, repetitive sequential movements of the hands and feet, manual dexterity and ball skills (catching and throwing).…”