Cross‐replicating findings on unique motor impairments of children with ASD using confirmatory factor analysis and a novel SPARK study sample

Abstract

A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder‐Questionnaire (DCD‐Q) is a widely used motor screening tool, yet scant evidence exists regarding its psychometric properties in children with ASD. In a recent Exploratory Factor Analysis (EFA) of the 15‐item DCD‐Q in a large sample of children with ASD (SPARK study), we found a 5‐factor latent structure that identified unique motor impairments in a large sample of children with ASD (Bhat et al., 2022). In the current study, we extend this work by cross‐replicating the EFA findings of unique ASD‐related motor issues using Confirmatory Factor Analysis (CFA) in a new, more recent wave of children with ASD from the SPARK study (N = 9721). The fits and interpretability of 11 hypothesis‐driven CFA models, including 8 correlated‐factors, 1 second‐order, and 2 bifactor models were compared. Our findings supported the previous 5‐factor model with 2 gross motor subdomains, 1 fine motor domain (similar to the original DCD‐Q) and 2 general coordination subdomains. This model demonstrated acceptable fit in the new sample as well as superior fit compared to several other parsimonious correlated‐factors models. However, the second‐order and bifactor models fit slightly better and supported the presence of a general motor skills factor, although 38% of the common variance in the DCD‐Q items remained attributable to the 5 subdomains. Using one of the bifactor models, measurement invariance was also supported for DCD‐Q across sex, race, and co‐occurring conditions of language disorder and intellectual disability. Only partial invariance was supported when testing DCD‐Q scores across different age groups. These findings reveal a more complex dimensional picture of the DCD‐Q in children with ASD. Results suggest that the DCD‐Q can be used in two ways, total scores adequately assess general motor skills for brief screening and subdomain scores offer unique information on the multidimensional motor problems of children with ASD. If subdomain data are of interest, our findings call into question the practice of relying on 3 original subscales of the DCD‐Q when screening for ASD‐related motor difficulties, whereas 4 out of 5 subscale scores may better highlight domain‐specific motor problems. Future studies should continue to further validate DCD‐Q's ability to screen for multidimensional motor problems.

Developmental Differences in Reaching-and-Placing Movement and Its Potential in Classifying Children with and without Autism Spectrum Disorder: Deep Learning Approach

“…Although not included in the primary diagnostic criteria which mainly include social communication di culties and presence of repetitive behaviors, children with ASD exhibit challenges in both gross and ne motor performance, including motor incoordination, de cient posture control, as well as poor upper limb motor control/dexterity [16][17][18][19]. Recent insights gleaned from parent screening questionnaires in the SPARK database reveal that over 85% of children with ASD are at risk for motor di culties, underscoring the critical importance of recognizing and addressing these motor issues within this population [20].…”

Level of autistic traits in neurotypical adults predicts kinematic idiosyncrasies in their biological movements

“…Although descriptions of idiosyncratic movements in autistic children date back to the writings of Kanner, 1971 and Asperger (1944) , interest in understanding the links between movement and ASD has burgeoned in the recent decade. A significant proportion of adults and children diagnosed with ASD present with differences in gross motor movements ( Bhat, 2020 ; Bhat, 2021 ; Wang et al, 2022 ; Bhat et al, 2023 ), gait ( Hallett et al, 1993 ; Esposito et al, 2011 ; Nobile et al, 2011 ; Weiss et al, 2013 ), the planning, control, and execution of goal-directed movements ( Hughes, 1996 ; Glazebrook et al, 2006 , 2009 ; Stoit et al, 2013 ), and fine motor movements ( Beversdorf et al, 2001 ; Fuentes et al, 2009 ; Fournier et al, 2010 ; Johnson et al, 2013 ; Alaniz et al, 2015 ). Movement differences have also been associated with social, emotional, and behavioral disturbances ( Freitag et al, 2007 ; Hilton et al, 2007 ; Sipes et al, 2011 ; Papadopoulos et al, 2012 ; Wang et al, 2022 ).…”