Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects social communication and behavior. Many people with ASD also have motor problems, such as difficulties with balance, coordination, posture, and fine and gross motor skills. But are these motor problems just a co-occurring condition, or are they a core feature of ASD?
This is the question that a team of researchers tried to answer in their paper, “Motor problems in autism: Co-occurrence or feature?”. They reviewed the existing literature on motor problems in ASD and proposed a new framework to understand how motor and social skills are related in ASD.
What are the motor problems in ASD?
The researchers identified four types of motor problems that are commonly reported in ASD:
- Motor planning problems: These are difficulties with planning and executing complex or novel movements, such as catching a ball, tying shoelaces, or riding a bike. Motor planning problems are also known as dyspraxia or developmental coordination disorder (DCD).
- Motor control problems: These are difficulties with controlling the speed, accuracy, and timing of movements, such as walking, running, or writing. Motor control problems can result in clumsiness, poor balance, and low muscle tone.
- Motor learning problems: These are difficulties with acquiring and improving new motor skills, such as learning to swim, play an instrument, or drive a car. Motor learning problems can affect the ability to adapt to changing environments and feedback.
- Motor stereotypies: These are repetitive and rhythmic movements, such as rocking, flapping, or spinning. Motor stereotypies can be voluntary or involuntary, and can serve various functions, such as self-regulation, stimulation, or expression.
How common are motor problems in ASD?
The researchers found that motor problems are very common in ASD, affecting up to 80% of children and adults with the condition. However, the prevalence and severity of motor problems vary depending on the type of motor problem, the age of the person, the method of assessment, and the diagnostic criteria used.
The researchers also noted that motor problems are often overlooked or underdiagnosed in ASD, because they are not part of the official diagnostic criteria, and because they can be masked by other factors, such as intellectual disability, sensory issues, or medication.
How are motor and social skills related in ASD?
The researchers proposed a new framework to explain how motor and social skills are related in ASD. They suggested that motor and social skills share common neural and cognitive mechanisms, such as:
- Action observation and imitation: These are the abilities to observe and copy the actions of others, which are essential for learning and social interaction. People with ASD often have impairments in action observation and imitation, which can affect their motor and social development.
- Action prediction and anticipation: These are the abilities to predict and anticipate the actions of others, which are important for coordination and cooperation. People with ASD often have difficulties in action prediction and anticipation, which can lead to poor motor and social synchronization.
- Action understanding and empathy: These are the abilities to understand and empathize with the intentions and emotions of others, which are crucial for communication and social bonding. People with ASD often have deficits in action understanding and empathy, which can result in social misunderstandings and isolation.
The researchers argued that these common mechanisms link motor and social skills in a bidirectional way, meaning that motor problems can affect social skills, and vice versa. For example, motor problems can make it harder to engage in social activities, such as playing games, sports, or music, which can reduce social opportunities and feedback. On the other hand, social problems can make it harder to learn from others, such as parents, teachers, or peers, which can hinder motor skill acquisition and improvement.
What are the implications of the framework?
The researchers suggested that their framework has several implications for the diagnosis, assessment, and intervention of ASD. They recommended that:
- Motor problems should be considered as a core feature of ASD, rather than a co-occurring condition, and should be included in the diagnostic criteria and screening tools.
- Motor skills should be assessed in a comprehensive and standardized way, using both objective and subjective measures, and taking into account the context and the function of the movements.
- Motor interventions should be integrated with social interventions, and should target the underlying mechanisms of action observation, imitation, prediction, anticipation, understanding, and empathy.
The researchers concluded that their framework provides a new perspective on the nature and role of motor problems in ASD, and that it can help to improve the quality of life and well-being of people with ASD and their families.
FAQ
What are the possible causes of motor problems in ASD?
The paper suggests that motor problems in ASD may result from a combination of genetic, environmental, and developmental factors that affect the structure and function of the brain regions involved in motor and social skills. The paper also proposes that motor problems may arise from impairments in the common mechanisms of action observation, imitation, prediction, anticipation, understanding, and empathy.
How do motor problems affect the quality of life and well-being of autistic people and their families?
The paper indicates that motor problems can have negative impacts on various aspects of development and well-being, such as physical health, fitness, self-esteem, confidence, independence, participation, engagement, communication, interaction, bonding, cognition, emotion, and behavior. The paper also acknowledges that motor problems can pose challenges and burdens for the families and caregivers of autistic people.
What are the current gaps and challenges in the research on motor problems in ASD?
The researchers pointed out several gaps and challenges, such as:
- The lack of longitudinal and cross-sectional studies that track the development and progression of motor problems in ASD across the lifespan.
- The lack of studies that examine the causal and correlational relationships between motor and social skills in ASD, and the underlying neural and cognitive mechanisms.
- The lack of studies that compare different types of motor problems and interventions in ASD, and their effects on various outcomes and domains.
- The lack of studies that involve the perspectives and experiences of autistic individuals and their families regarding motor problems and their impact.
How does the paper differ from previous studies on motor problems in ASD?
The paper differs from previous studies by providing a more comprehensive and updated overview of the types, prevalence, and severity of motor problems in ASD. It also differs by proposing a new framework that links motor and social skills in a bidirectional way, and by highlighting the need for more research and clinical attention on motor problems in ASD.
How did the researchers review the literature on motor problems in ASD?
The researchers searched for relevant studies published between 2000 and 2020 using various databases and keywords. They selected 77 studies that met their inclusion criteria, such as having a clear definition and measurement of motor problems, and having a comparison group of typical or non-autistic individuals. They then analyzed the studies for their methods, results, and quality.
What are the challenges and limitations of assessing motor problems in ASD?
The researchers identified several challenges and limitations, such as:
- The lack of standardized and validated tools that are specific and sensitive to motor problems in ASD.
- The variability and heterogeneity of motor problems across individuals and age groups.
- The influence of other factors, such as intelligence, language, attention, motivation, and sensory issues, on motor performance.
- The difficulty of distinguishing between primary and secondary motor problems, and between motor problems and repetitive behaviors.
What are the potential benefits of addressing motor problems in ASD?
The researchers suggested that addressing motor problems in ASD could have positive effects on various aspects of development and well-being, such as:
- Enhancing self-esteem, confidence, and independence.
- Improving physical health, fitness, and quality of life.
- Increasing participation and engagement in social, educational, and recreational activities.
- Facilitating communication, interaction, and bonding with others.
- Promoting cognitive, emotional, and behavioral regulation and flexibility.
What are the best practices and recommendations for assessing and treating motor problems in ASD?
The researchers suggested some best practices and recommendations, such as:
- Using a multidisciplinary and collaborative approach that involves professionals from different fields, such as neurology, psychology, physiotherapy, occupational therapy, and education.
- Using a person-centered and holistic approach that considers the individual’s strengths, needs, preferences, and goals, as well as the environmental and contextual factors that influence motor performance and participation.
- Using a combination of objective and subjective measures that capture the quality and quantity of motor skills, as well as the functional and social implications of motor problems.
- Using evidence-based and tailored interventions that target the specific motor problems and mechanisms of the individual, and that are integrated with other interventions for ASD, such as social skills training, cognitive-behavioral therapy, or sensory integration therapy.
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