Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis

Abstract

When motor difficulties continue into adolescence/adulthood, they could negatively impact an individual with autism spectrum disorder (ASD)'s daily living skills, physical fitness, as well as physical and mental health/well-being. Few studies have examined motor difficulties in children with ASD as a function of sex or age; however, greater cognitive challenges are associated with worse general motor performance. Based on the Developmental Coordination Disorder-Questionnaire (DCD-Q) data from the SPARK study sample, 87%-88% children with ASD were at-risk for a general motor impairment that persisted until 15 years and was related to their core and co-occurring difficulties. Bhat et al. confirmed motor difficulties in children with ASD on multiple motor dimensions that predicted core and co-occurring conditions after accounting for age and sex. However, presence of intellectual disability (ID) or cognitive delay was not controlled in the previous analysis. Additionally, the effects of age, sex, and cognitive ability on multidimensional motor difficulties of the SPARK sample have not been discussed before. Therefore, this analysis examines the effects of age, sex, and cognitive ability (presence of ID or level of cognitive delay) on the motor performance of children from the SPARK sample using the DCD-Q. Except fine motor skills, multiple motor domains did not change with age in children with ASD. Females without ID improved their fine motor scores with age, and performed better compared to males without ID. Children with ASD and ID had greater motor difficulties across multiple motor domains than those without ID. Even after controlling for age, sex, and presence of ID/cognitive delay; motor performance was predictive of social communication skills, repetitive behavior severity, as well as language and functional delays. Gross motor skills contributed more than fine motor and general motor competence skills in predicting social communication delay. However, fine motor and general motor competence skills contributed more than gross motor skills in predicting repetitive behavior severity and language delay. Both, fine and gross motor skills predicted functional delay. In light of consistent findings on motor difficulties in children with ASD, adding motor issues as a specifier within the ASD definition could provide a clear clinical route for movement clinicians to address motor difficulties of individuals with ASD. Lay SummaryThis study examined the effects of age, sex, and cognitive ability on multiple motor domains of children with autism spectrum disorder (ASD). For the most

Enhanced motor noise in an autism subtype with poor motor skills

“…Rather than looking to core SC and RRB features, it seems that a constellation of related features that do not represent the core features of autism, such as motor, language, intellectual, and adaptive functioning, may better separate out important clinical and biological distinctions within the autism population. Supporting this statement, there is evidence showing that motor difficulties in autism tend to highly co-occur with language delay 6-8 , cognitive impairment [9][10][11] , poorer developmental outcomes, and reduced life quality 12,14 . Similarly, individuals with very poor early language outcome tend to also have extensive issues in motor, non-verbal cognitive ability, and adaptive functioning, and also have very different structural and functional neural mechanisms underpinning their difficulties [79][80][81][82] .…”

“…It has been estimated that anywhere from 34-80% of autistic individuals show some form of motor impairment and/or delay [1][2][3][4][5] . Motor difficulties in autism are often associated with language delay [6][7][8] , cognitive impairment [9][10][11] , poorer developmental outcomes, and reduced life quality [12][13][14] . Because motor difficulties may affect such a large percentage of autistic individuals, a recent debate has emerged regarding whether these issues should be added to the diagnostic criteria 1,[15][16][17][18] .…”

Altered engagement of the speech motor network is associated with reduced phonological working memory in autism

“…Related to speech and language, better fine motor skills in autistic children are associated with stronger receptive and expressive language skills ( Mody et al, 2017 ). Visuomotor, general coordination, and fine motor skills have been shown to predict language delays in autistic children ( Bhat, 2022 ). Similarly, oromotor, manual motor skills, and fine motor skills have been shown to be strong indicators of speech development ( Gernsbacher et al, 2008 , Bal et al, 2019 ).…”

Motor problems in autism: Co‐occurrence or feature?

“…Current evidence from large sample studies indicate that motor difficulties are present in children with ASD with and without intellectual disability and they continue to predict autistic traits and language and functional delays even after controlling for cognitive delays. Therefore, while it is true that motor difficulties are greater in individuals with ASD and intellectual disability, they continue to negatively impact communication and functioning in the majority of autistic individuals, including autistic children without intellectual disability 33 …”