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Stania M, Emich-Widera E, Kamieniarz-Olczak A, Kazek B, Swatowska-Wenglarczyk M, Juras G. Postural control before and after transitional locomotor tasks in children on the autism spectrum: A case-control study. Clin Biomech (Bristol, Avon) 2024; 115:106251. [PMID: 38626570 DOI: 10.1016/j.clinbiomech.2024.106251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. METHODS Sixteen autistic children aged 6-10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 - quiet standing before step initiation, phase 2 - transit, and phase 3 - quiet standing until measurement completion. FINDINGS The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. INTERPRETATION Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021).
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Anna Kamieniarz-Olczak
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Vives-Vilarroig J, Ruiz-Bernardo P, García-Gómez A. Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design. J Autism Dev Disord 2024:10.1007/s10803-023-06174-5. [PMID: 38246963 DOI: 10.1007/s10803-023-06174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 01/23/2024]
Abstract
The aim of this research was to study the effect of a horseback-riding programme on postural control in a group of autistic children (ASD). Nine children aged 9 to 12 years participated in this study through a multiple baseline across subjects design. The whole programme took place over nine months. Participants followed a previously developed specific horseback-riding programme, consisting of 45-minute sessions held twice a week for at least three months. To evaluate postural control, the average velocity of the centre of pressure displacement was measured by means of a posturographic platform. Results indicated that this intervention with horses had a positive effect on the postural control in children with ASDs.
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Affiliation(s)
- Juan Vives-Vilarroig
- Universidad Cardenal Herrera, CEU, Castellón, C. Grecia, 31, Castellón de la Plana, 12006, España
| | - Paola Ruiz-Bernardo
- Universidad Jaume I. Castellón, Av. Vicent Sos Baynat, s/n, Castellón de la Plana, 12071, España.
| | - Andrés García-Gómez
- Universidad de Extremadura. Badajoz, Av. de Elvas, s/n, Badajoz, 06006, España
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Mosconi MW, Stevens CJ, Unruh KE, Shafer R, Elison JT. Endophenotype trait domains for advancing gene discovery in autism spectrum disorder. J Neurodev Disord 2023; 15:41. [PMID: 37993779 PMCID: PMC10664534 DOI: 10.1186/s11689-023-09511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with a diverse range of etiological processes, including both genetic and non-genetic causes. For a plurality of individuals with ASD, it is likely that the primary causes involve multiple common inherited variants that individually account for only small levels of variation in phenotypic outcomes. This genetic landscape creates a major challenge for detecting small but important pathogenic effects associated with ASD. To address similar challenges, separate fields of medicine have identified endophenotypes, or discrete, quantitative traits that reflect genetic likelihood for a particular clinical condition and leveraged the study of these traits to map polygenic mechanisms and advance more personalized therapeutic strategies for complex diseases. Endophenotypes represent a distinct class of biomarkers useful for understanding genetic contributions to psychiatric and developmental disorders because they are embedded within the causal chain between genotype and clinical phenotype, and they are more proximal to the action of the gene(s) than behavioral traits. Despite their demonstrated power for guiding new understanding of complex genetic structures of clinical conditions, few endophenotypes associated with ASD have been identified and integrated into family genetic studies. In this review, we argue that advancing knowledge of the complex pathogenic processes that contribute to ASD can be accelerated by refocusing attention toward identifying endophenotypic traits reflective of inherited mechanisms. This pivot requires renewed emphasis on study designs with measurement of familial co-variation including infant sibling studies, family trio and quad designs, and analysis of monozygotic and dizygotic twin concordance for select trait dimensions. We also emphasize that clarification of endophenotypic traits necessarily will involve integration of transdiagnostic approaches as candidate traits likely reflect liability for multiple clinical conditions and often are agnostic to diagnostic boundaries. Multiple candidate endophenotypes associated with ASD likelihood are described, and we propose a new focus on the analysis of "endophenotype trait domains" (ETDs), or traits measured across multiple levels (e.g., molecular, cellular, neural system, neuropsychological) along the causal pathway from genes to behavior. To inform our central argument for research efforts toward ETD discovery, we first provide a brief review of the concept of endophenotypes and their application to psychiatry. Next, we highlight key criteria for determining the value of candidate endophenotypes, including unique considerations for the study of ASD. Descriptions of different study designs for assessing endophenotypes in ASD research then are offered, including analysis of how select patterns of results may help prioritize candidate traits in future research. We also present multiple candidate ETDs that collectively cover a breadth of clinical phenomena associated with ASD, including social, language/communication, cognitive control, and sensorimotor processes. These ETDs are described because they represent promising targets for gene discovery related to clinical autistic traits, and they serve as models for analysis of separate candidate domains that may inform understanding of inherited etiological processes associated with ASD as well as overlapping neurodevelopmental disorders.
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Affiliation(s)
- Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
| | - Cassandra J Stevens
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Kathryn E Unruh
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Robin Shafer
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Deng J, Lei T, Du X. Effects of sensory integration training on balance function and executive function in children with autism spectrum disorder: evidence from Footscan and fNIRS. Front Psychol 2023; 14:1269462. [PMID: 37946875 PMCID: PMC10631781 DOI: 10.3389/fpsyg.2023.1269462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023] Open
Abstract
Introduction This study investigates the efficacy of sensory integration training (SIT) in enhancing balance and executive functions in children with autism spectrum disorder (ASD), with the aim of highlighting its potential for organizing and processing sensory information in the brain. Methods Utilizing Footscan for biomechanical evidence and functional near-infrared spectroscopy (fNIRS) for neural activation, we engaged two participant groups: a control group (n = 9) and an experimental group (n = 9). Assessments involved the Sharpened Romberg Test (SRT) for balance under varied visual conditions and the Go/No-Go task for executive function. Results The SIT intervention significantly improved balance function, particularly in Visual Deprivation (VD) scenarios. Neurophysiological data revealed heightened activation in the right Inferior Frontal Gyrus (R-IFG) and right Middle Frontal Gyrus (R-MFG), suggesting enhanced executive function. The potential of R-IFG/MFG activation as a reliable biomarker for assessing executive function in ASD was identified. Discussion The study provides empirical evidence supporting SIT's effectiveness in enhancing balance and executive functions in children with ASD. The therapy not only improves sensory processing and motor skills but also appears to compensate for sensory deficits, particularly in vision, vestibular perception, and proprioception. Enhanced neural activation in specific PFC regions underscores SIT's role in improving cognitive aspects, including inhibitory control and cognitive flexibility. The multidisciplinary approach adopted for this research highlights the intricate interplay between sensory-motor functions and cognitive control in ASD, paving the way for integrated therapeutic strategies. Despite these advancements, the mechanisms through which SIT exerts these multifaceted effects require further exploration.
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Affiliation(s)
- Junchen Deng
- College of Sport Arts, Guangzhou Sport University, Guangzhou, China
| | - Ting Lei
- College of Graduate, Guangzhou Sport University, Guangzhou, China
| | - Xiru Du
- College of Sport Arts, Guangzhou Sport University, Guangzhou, China
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Stania M, Emich-Widera E, Kazek B, Kamieniarz A, Swatowska-Wenglarczyk M, Juras G. Modulation of center-of-pressure signal in children on the autism spectrum: A case-control study. Gait Posture 2023; 103:67-72. [PMID: 37119687 DOI: 10.1016/j.gaitpost.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Proper postural and motor control plays a fundamental role in the child's ontogenetic development. So far, the postural control in children on the autism spectrum has mainly been assessed with standard posturographic measurements of center of pressure (COP) displacements. RESEARCH QUESTION What are the differences in postural control between autistic and typically developing children? METHODS The study group comprised 16 autistic children aged 6-10 years, identified by a psychiatrist. The control group consisted of 16 typically developing children aged 6-10 years with no posture deformities, no pervasive developmental disorder and no history of postural control or movement deficits. The data were collected during quiet standing with eyes open using a force plate. To gain a better insight into the postural control processes, the rambling-trembling and sample entropy analyses were used in COP data processing. RESULTS Compared to typically developing children, those with autism spectrum had significantly higher values of COP and rambling trajectory parameters in the antero-posterior direction during quiet standing. The variables of the trembling trajectory did not differ significantly between the groups. The autistic children had significantly lower values of sample entropy in the antero-posterior direction compared to typically developing children. SIGNIFICANCE More advanced measures of COP displacements including the rambling-trembling method and sample entropy revealed differences in postural control between autistic and typically developing children. These methods may therefore contribute to functional assessment of postural control deficits in children on the autism spectrum.
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | - Anna Kamieniarz
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Fears NE, Sherrod GM, Templin TN, Bugnariu NL, Patterson RM, Miller HL. Community-based postural control assessment in autistic individuals indicates a similar but delayed trajectory compared to neurotypical individuals. Autism Res 2023; 16:543-557. [PMID: 36627838 PMCID: PMC10023334 DOI: 10.1002/aur.2889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
Autistic individuals exhibit significant sensorimotor differences. Postural stability and control are foundational motor skills for successfully performing many activities of daily living. In neurotypical development, postural stability and control develop throughout childhood and adolescence. In autistic development, previous studies have focused primarily on individual age groups (e.g., childhood, adolescence, adulthood) or only controlled for age using age-matching. Here, we examined the age trajectories of postural stability and control in autism from childhood through adolescents using standardized clinical assessments. In study 1, we tested the postural stability of autistic (n = 27) and neurotypical (n = 41) children, adolescents, and young adults aged 7-20 years during quiet standing on a force plate in three visual conditions: eyes open (EO), eyes closed (EC), and eyes open with the head in a translucent dome (Dome). Postural sway variability decreased as age increased for both groups, but autistic participants showed greater variability than neurotypical participants across age. In study 2, we tested autistic (n = 21) and neurotypical (n = 32) children and adolescents aged 7-16 years during a dynamic postural control task with nine targets. Postural control efficiency increased as age increased for both groups, but autistic participants were less efficient compared to neurotypical participants across age. Together, these results indicate that autistic individuals have a similar age trajectory for postural stability and control compared to neurotypical individuals, but have lower postural stability and control overall.
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Affiliation(s)
- Nicholas E. Fears
- University of Michigan, 830 N. University Ave., Ann Arbor, Michigan, 48170, USA
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Louisiana State University, 50 Fieldhouse Dr. Baton Rouge, Louisiana, 70802, USA
| | - Gabriela M. Sherrod
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of Alabama at Birmingham, 1720 University Blvd., Birmingham, AL, 35294, USA
| | - Tylan N. Templin
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Southwest Research Institute, 6220 Culebra Rd., San Antonio, TX, 78238, USA
| | - Nicoleta L. Bugnariu
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of the Pacific, School of Health Sciences, 155 Fifth St., San Francisco, CA, 94103, USA
| | - Rita M. Patterson
- University of North Texas Health Science Center, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
| | - Haylie L. Miller
- University of Michigan, 830 N. University Ave., Ann Arbor, Michigan, 48170, USA
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
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7
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Motor signature of autism spectrum disorder in adults without intellectual impairment. Sci Rep 2022; 12:7670. [PMID: 35538115 PMCID: PMC9090847 DOI: 10.1038/s41598-022-10760-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/12/2022] [Indexed: 12/28/2022] Open
Abstract
Motor signs such as dyspraxia and abnormal gait are characteristic features of autism spectrum disorder (ASD). However, motor behavior in adults with ASD has scarcely been quantitatively characterized. In this pilot study, we aim to quantitatively examine motor signature of adults with ASD without intellectual impairment using marker-less visual-perceptive motion capture. 82 individuals (37 ASD and 45 healthy controls, HC) with an IQ > 85 and aged 18 to 65 years performed nine movement tasks and were filmed by a 3D-infrared camera. Anatomical models were quantified via custom-made software and resulting kinematic parameters were compared between individuals with ASD and HCs. Furthermore, the association between specific motor behaviour and severity of autistic symptoms (Autism Diagnostic Observation Schedule 2, Autism Spectrum Quotient) was explored. Adults with ASD showed a greater mediolateral deviation while walking, greater sway during normal, tandem and single leg stance, a reduced walking speed and cadence, a greater arrhythmicity during jumping jack tasks and an impaired manual dexterity during finger tapping tasks (p < 0.05 and |D|> 0.48) compared to HC. Furthermore, in the ASD group, some of these parameters correlated moderately to severity of ASD symptoms. Adults with ASD seem to display a specific motor signature in this disorder affecting movement timing and aspects of balance. The data appear to reinforce knowledge about motor signs reported in children and adolescents with ASD. Also, quantitative motor assessment via visual-perceptive computing may be a feasible instrument to detect subtle motor signs in ASD and perhaps suitable in the diagnosis of ASD in the future.
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8
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Fears NE, Templin TN, Sherrod GM, Bugnariu NL, Patterson RM, Miller HL. Autistic Children Use Less Efficient Goal-Directed Whole Body Movements Compared to Neurotypical Development. J Autism Dev Disord 2022:10.1007/s10803-022-05523-0. [PMID: 35441912 DOI: 10.1007/s10803-022-05523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/26/2022]
Abstract
Autistic children have differences in their movements which impact their functional performance. Virtual-reality enables researchers to study movement in safe, engaging environments. We used motion-capture to measure how 7-13-year-old autistic and neurotypical children make whole-body movements in a virtual-reality task. Although children in both groups were successful, we observed differences in their movements. Autistic children were less efficient moving to the target. Autistic children did not appear to use a movement strategy. While neurotypical children were more likely to overshoot near targets and undershoot far targets, autistic children did not modulate their strategy. Using kinematic data from tasks in virtual-reality, we can begin to understand the pattern of movement challenges experienced by autistic children.
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Affiliation(s)
- Nicholas E Fears
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- School of Kinesiology, University of Michigan, 830 N. University Ave., Ann Arbor, MI, 48170, USA
| | - Tylan N Templin
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Southwest Research Institute, 6220 Culebra Rd., San Antonio, TX, 78238, USA
| | - Gabriela M Sherrod
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of Alabama at Birmingham, 1720 University Blvd., Birmingham, AL, 35294, USA
| | - Nicoleta L Bugnariu
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- School of Health Sciences, University of the Pacific, 155 Fifth St., San Francisco, CA, 94103, USA
| | - Rita M Patterson
- University of North Texas Health Science Center, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
| | - Haylie L Miller
- School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA.
- School of Kinesiology, University of Michigan, 830 N. University Ave., Ann Arbor, MI, 48170, USA.
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Fears NE, Palmer SA, Miller HL. Motor skills predict adaptive behavior in autistic children and adolescents. Autism Res 2022; 15:1083-1089. [PMID: 35322578 PMCID: PMC9167704 DOI: 10.1002/aur.2708] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/20/2022] [Accepted: 03/10/2022] [Indexed: 11/10/2022]
Abstract
It is well-documented that intelligence quotient (IQ) is a poor predictor of adaptive behavior scores in autism, with autistic children having lower adaptive behavior scores than would be predicted based on their IQ scores. Differences in motor skills may explain the variability in their adaptive behavior scores. The current study examined how motor skills might explain autistic individuals' low adaptive behavior scores and which individual components of IQ (i.e., verbal comprehension and perceptual reasoning) and motor skills (i.e., manual dexterity, aiming and catching, and balance) may drive this effect. We examined the associations between IQ, motor skills, calibrated severity, and adaptive behavior scores in 45 autistic children and adolescents. Using a t-test, we found a significant difference (p <0.001) between full-scale IQ and adaptive behavior scores, indicating that our participants' adaptive behavior scores were lower than would be expected given their full-scale IQ. Using a linear regression, we investigated whether motor skills predicted adaptive behavior in autistic children and adolescents and found that motor skills scores were associated with adaptive behavior scores (p = 0.022). To further investigate these associations, we used another linear regression to examine how individual components of IQ and motor skills predicted adaptive behavior scores in autistic children and adolescents. Our results indicated that manual dexterity scores were associated with adaptive behavior scores (p = 0.036). These findings clearly illustrate the need for further understanding of autistic individuals' difficulties with adaptive behavior and the potential role of motor skill difficulties that may underlie these difficulties. LAY SUMMARY: Autistic children have lower adaptive behavior scores (e.g., daily living skills, social skills, communication) than intelligence scores (e.g., verbal and perceptual skills) along with difficulties with motor skills. Motor skills may explain the gap between adaptive behavior and intelligence. We found motor skills were associated with adaptive behavior in autistic children and adolescents. In particular, hand coordination was associated with adaptive behavior. We need to better understand how autistic individuals' motor skills impact their adaptive behavior to provide effective supports.
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Affiliation(s)
- Nicholas E Fears
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, Texas, USA.,School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Haylie L Miller
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, Texas, USA.,School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
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10
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Wang LAL, Petrulla V, Zampella CJ, Waller R, Schultz RT. Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychol Bull 2022; 148:273-300. [PMID: 35511567 PMCID: PMC9894569 DOI: 10.1037/bul0000358] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges' g = -1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Leah A. L. Wang
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania
| | | | - Casey J. Zampella
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | | | - Robert T. Schultz
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
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11
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Lepping RJ, McKinney WS, Magnon GC, Keedy SK, Wang Z, Coombes SA, Vaillancourt DE, Sweeney JA, Mosconi MW. Visuomotor brain network activation and functional connectivity among individuals with autism spectrum disorder. Hum Brain Mapp 2021; 43:844-859. [PMID: 34716740 PMCID: PMC8720186 DOI: 10.1002/hbm.25692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 09/08/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
Sensorimotor abnormalities are common in autism spectrum disorder (ASD) and predictive of functional outcomes, though their neural underpinnings remain poorly understood. Using functional magnetic resonance imaging, we examined both brain activation and functional connectivity during visuomotor behavior in 27 individuals with ASD and 30 typically developing (TD) controls (ages 9–35 years). Participants maintained a constant grip force while receiving visual feedback at three different visual gain levels. Relative to controls, ASD participants showed increased force variability, especially at high gain, and reduced entropy. Brain activation was greater in individuals with ASD than controls in supplementary motor area, bilateral superior parietal lobules, and contralateral middle frontal gyrus at high gain. During motor action, functional connectivity was reduced between parietal‐premotor and parietal‐putamen in individuals with ASD compared to controls. Individuals with ASD also showed greater age‐associated increases in functional connectivity between cerebellum and visual, motor, and prefrontal cortical areas relative to controls. These results indicate that visuomotor deficits in ASD are associated with atypical activation and functional connectivity of posterior parietal, premotor, and striatal circuits involved in translating sensory feedback information into precision motor behaviors, and that functional connectivity of cerebellar–cortical sensorimotor and nonsensorimotor networks show delayed maturation.
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Affiliation(s)
- Rebecca J Lepping
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Walker S McKinney
- Schiefelbusch Institute for Life Span Studies, Clinical Child Psychology Program, and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, Kansas, USA
| | - Grant C Magnon
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Zheng Wang
- Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA.,Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Stephen A Coombes
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies, Clinical Child Psychology Program, and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, Kansas, USA
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12
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Unruh KE, McKinney WS, Bojanek EK, Fleming KK, Sweeney JA, Mosconi MW. Initial action output and feedback-guided motor behaviors in autism spectrum disorder. Mol Autism 2021; 12:52. [PMID: 34246292 PMCID: PMC8272343 DOI: 10.1186/s13229-021-00452-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sensorimotor issues are common in autism spectrum disorder (ASD), related to core symptoms, and predictive of worse functional outcomes. Deficits in rapid behaviors supported primarily by feedforward mechanisms, and continuous, feedback-guided motor behaviors each have been reported, but the degrees to which they are distinct or co-segregate within individuals and across development are not well understood. METHODS We characterized behaviors that varied in their involvement of feedforward control relative to feedback control across skeletomotor (precision grip force) and oculomotor (saccades) control systems in 109 individuals with ASD and 101 age-matched typically developing controls (range: 5-29 years) including 58 individuals with ASD and 57 controls who completed both grip and saccade tests. Grip force was examined across multiple force (15, 45, and 85% MVC) and visual gain levels (low, medium, high). Maximum grip force also was examined. During grip force tests, reaction time, initial force output accuracy, variability, and entropy were examined. For the saccade test, latency, accuracy, and trial-wise variability of latency and accuracy were examined. RESULTS Relative to controls, individuals with ASD showed similar accuracy of initial grip force but reduced accuracy of saccadic eye movements specific to older ages of our sample. Force variability was greater in ASD relative to controls, but saccade gain variability (across trials) was not different between groups. Force entropy was reduced in ASD, especially at older ages. We also find reduced grip strength in ASD that was more severe in dominant compared to non-dominant hands. LIMITATIONS Our age-related findings rely on cross-sectional data. Longitudinal studies of sensorimotor behaviors and their associations with ASD symptoms are needed. CONCLUSIONS We identify reduced accuracy of initial motor output in ASD that was specific to the oculomotor system implicating deficient feedforward control that may be mitigated during slower occurring behaviors executed in the periphery. Individuals with ASD showed increased continuous force variability but similar levels of trial-to-trial saccade accuracy variability suggesting that feedback-guided refinement of motor commands is deficient specifically when adjustments occur rapidly during continuous behavior. We also document reduced lateralization of grip strength in ASD implicating atypical hemispheric specialization.
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Affiliation(s)
- Kathryn E Unruh
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Walker S McKinney
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Erin K Bojanek
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | | | - John A Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Matthew W Mosconi
- Life Span Institute, University of Kansas, Lawrence, KS, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
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13
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Sustainable Service-Learning in Physical Education Teacher Education: Examining Postural Control to Promote ASD Children's Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105216. [PMID: 34068915 PMCID: PMC8155850 DOI: 10.3390/ijerph18105216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/02/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022]
Abstract
As classrooms become more and more diverse, it is imperative to provide physical education teacher education (PETE) students with opportunities to develop competencies that promote quality education for all students. In this study, PETE students applied a physical education service-learning (SL) program aimed at enhancing Autism Spectrum Disorder (ASD) children’s motor domain and general well-being—objectives that are connected to the third focus of the United Nations’ Sustainable Development Goals (SDGs). Traditionally, research on SL has focused on students’ outcomes, and there is a call to examine SL’s effects on service receivers, which is the gap this paper aspires to fill. The aim of this study was to measure the postural control of children with ASD who were involved in a 6-month SL program in comparison to ASD peers in a control group. A quasi-experimental design was used in which a total of 29 children with ASD participated. The results of the experimental group showed a significant improvement in the vestibular pathways, an improvement trend in the somatosensorial and visual pathways and improvements in the dynamic tests. This study provides valuable feedback about how SL programs can benefit ASD children to improve their postural control, thus contributing to the third SDG concerned with well-being promotion.
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14
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Hao Z, Yang Y, Hua A, Gao Y, Wang J. Age-Related Changes in Standing Balance in Preschoolers Using Traditional and Nonlinear Methods. Front Physiol 2021; 12:625553. [PMID: 33692702 PMCID: PMC7937647 DOI: 10.3389/fphys.2021.625553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Considerable disagreement exists on the linearity of the development of standing balance in children. This study aimed to use different traditional and nonlinear methods to investigate age-related changes in standing balance in preschoolers. A sample of 118 preschoolers took part in this study. A force platform was used to record the center of pressure during standing balance over 15 s in three conditions: eyes open, eyes closed, and/or head extended backward. Detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and traditional measures were used to evaluate standing balance. The main results are as follows: (1) Higher range and SD in the anterior-posterior (AP) direction were observed for 5-year-old than for 4-year-old children, while higher DFA coefficient (at shorter time scales) and higher determinism and laminarity in the AP direction were found for 5-year-old children compared to 3- and 4-year-old children; and (2) as sensory conditions became more challenging, all traditional measures increased and DFA coefficients (at shorter and longer time scales) decreased in the AP and mediolateral directions, while determinism and laminarity significantly declined in the AP direction. In conclusion, although increased postural sway, 5-year-old preschool children's balance performance improved, and their control strategy changed significantly compared with the younger preschoolers. Sensory perturbation (eye closure and/or head extension) changed preschoolers' balance performance and control strategy. Moreover, both traditional and nonlinear methods provided complementary information on the control of standing balance in preschoolers.
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Affiliation(s)
- Zengming Hao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Yi Yang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Anke Hua
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Ying Gao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China.,Center for Psychological Sciences, Zhejiang University, Hangzhou, China
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15
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Baldwin I, Shafer RL, Hossain WA, Gunewardena S, Veatch OJ, Mosconi MW, Butler MG. Genomic, Clinical, and Behavioral Characterization of 15q11.2 BP1-BP2 Deletion (Burnside-Butler) Syndrome in Five Families. Int J Mol Sci 2021; 22:1660. [PMID: 33562221 PMCID: PMC7914695 DOI: 10.3390/ijms22041660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/02/2021] [Indexed: 01/07/2023] Open
Abstract
The 15q11.2 BP1-BP2 deletion (Burnside-Butler) syndrome is emerging as the most common cytogenetic finding in patients with neurodevelopmental or autism spectrum disorders (ASD) presenting for microarray genetic testing. Clinical findings in Burnside-Butler syndrome include developmental and motor delays, congenital abnormalities, learning and behavioral problems, and abnormal brain findings. To better define symptom presentation, we performed comprehensive cognitive and behavioral testing, collected medical and family histories, and conducted clinical genetic evaluations. The 15q11.2 BP1-BP2 region includes the TUBGCP5, CYFIP1, NIPA1, and NIPA2 genes. To determine if additional genomic variation outside of the 15q11.2 region influences expression of symptoms in Burnside-Butler syndrome, whole-exome sequencing was performed on the parents and affected children for the first time in five families with at least one parent and child with the 15q1l.2 BP1-BP2 deletion. In total, there were 453 genes with possibly damaging variants identified across all of the affected children. Of these, 99 genes had exclusively de novo variants and 107 had variants inherited exclusively from the parent without the deletion. There were three genes (APBB1, GOLGA2, and MEOX1) with de novo variants that encode proteins evidenced to interact with CYFIP1. In addition, one other gene of interest (FAT3) had variants inherited from the parent without the deletion and encoded a protein interacting with CYFIP1. The affected individuals commonly displayed a neurodevelopmental phenotype including ASD, speech delay, abnormal reflexes, and coordination issues along with craniofacial findings and orthopedic-related connective tissue problems. Of the 453 genes with variants, 35 were associated with ASD. On average, each affected child had variants in 6 distinct ASD-associated genes (x¯ = 6.33, sd = 3.01). In addition, 32 genes with variants were included on clinical testing panels from Clinical Laboratory Improvement Amendments (CLIA) approved and accredited commercial laboratories reflecting other observed phenotypes. Notably, the dataset analyzed in this study was small and reported results will require validation in larger samples as well as functional follow-up. Regardless, we anticipate that results from our study will inform future research into the genetic factors influencing diverse symptoms in patients with Burnside-Butler syndrome, an emerging disorder with a neurodevelopmental behavioral phenotype.
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Affiliation(s)
- Isaac Baldwin
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA; (I.B.); (W.A.H.); (O.J.V.)
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA
| | - Robin L. Shafer
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training, University of Kansas, Lawrence, KS 66045, USA; (R.L.S.); (M.W.M.)
| | - Waheeda A. Hossain
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA; (I.B.); (W.A.H.); (O.J.V.)
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA
| | - Sumedha Gunewardena
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Olivia J. Veatch
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA; (I.B.); (W.A.H.); (O.J.V.)
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Matthew W. Mosconi
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training, University of Kansas, Lawrence, KS 66045, USA; (R.L.S.); (M.W.M.)
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS 66045, USA
| | - Merlin G. Butler
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA; (I.B.); (W.A.H.); (O.J.V.)
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4015, Kansas City, KS 66160, USA
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16
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Cordeiro ESG, Aprígio LCS, Azoni CAS, Gazzola JM. Postural balance in children with Autism Spectrum Disorders. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212350921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to characterize the performance of children with autism spectrum disorders in two postural balance assessment scales. Methods: an observational cross-sectional study with a descriptive, analytical profile. Seven to 11-year-old children with mild autism spectrum disorder, diagnosed by an interdisciplinary team, according to the DSM-5, were assessed. The protocols used were the Sensory Organization Test and Pediatric Balance Scale. Results: all the children obtained maximum performance in the Sensory Organization Test. As for the Pediatric Balance Scale, the participants had similar responses in 8 out of its 14 items; in the other 6, there was a standard deviation. Conclusion: the participants did not have difficulties performing the Pediatric Balance Scale and Sensory Organization Test, scoring quite close to the maximum value.
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17
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Perin C, Valagussa G, Mazzucchelli M, Gariboldi V, Cerri CG, Meroni R, Grossi E, Cornaggia CM, Menant J, Piscitelli D. Physiological Profile Assessment of Posture in Children and Adolescents with Autism Spectrum Disorder and Typically Developing Peers. Brain Sci 2020; 10:brainsci10100681. [PMID: 32992546 PMCID: PMC7601261 DOI: 10.3390/brainsci10100681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 02/05/2023] Open
Abstract
A sound postural system requires sensorimotor integration. Evidence suggests that individuals with Autism Spectrum Disorder (ASD) present sensorimotor integration impairments. The Physiological Profile Assessment (PPA) can be used to evaluate postural capacity assessing five physiological subsets (i.e., vision, reaction time, peripheral sensation, lower limb strength, balance); however, no studies applied the PPA in young individuals. Therefore, this study aimed to investigate the PPA in children and adolescents with ASD compared with age-matched typically developing (TD) individuals and examine the relationship between the PPA subset within the ASD and TD participants according to different age groups. Percentiles from the PPA were obtained from the TD children and adolescents (n = 135) for each test. Performances of the individuals with ASD (n = 18) were examined relative to the TD percentiles. ASD participants' scores were above the 90th percentile (i.e., poor performance) in most sensory, motor and balance parameters. Performance in most of the PPA tests significantly improved with older age in the TD group but not in the ASD group. The study findings support the use of the PPA in TD children and adolescents while further research should investigate postural capacity in a larger ASD sample to enhance the understanding of sensorimotor systems contributing to compromised postural control.
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Affiliation(s)
- Cecilia Perin
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- Correspondence: ; Tel.: +39-0362-986-446; Fax: +39-0362-986-439
| | - Giulio Valagussa
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Como, Italy;
| | - Miryam Mazzucchelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Valentina Gariboldi
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- ASST Rhodense, Ospedale “G. Salvini”, 20024 Milan, Italy
| | - Cesare Giuseppe Cerri
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Roberto Meroni
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, 4671 Luxembourg, Luxembourg;
| | - Enzo Grossi
- Autism Research Unit, “Villa Santa Maria” Foundation, 22038 Como, Italy;
| | - Cesare Maria Cornaggia
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
| | - Jasmine Menant
- Neuroscience Research Australia and School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy; (G.V.); (M.M.); (V.G.); (C.G.C.); (C.M.C.); (D.P.)
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
- School of Physical Therapy and Athletic Training, Pacific University, Hillsboro, OR 97123, USA
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18
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Odeh CE, Gladfelter AL, Stoesser C, Roth S. Comprehensive motor skills assessment in children with autism spectrum disorder yields global deficits. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:290-300. [PMID: 35602998 PMCID: PMC9122380 DOI: 10.1080/20473869.2020.1764241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 05/31/2023]
Abstract
PURPOSE Although children with autism spectrum disorder (ASD) often display motor deficits, the nature of these motor deficits remains unspecified. The purpose of this study was to establish a robust motor profile in children with ASD across a wider range of motor skills by using two professionally administered standardized motor assessments alongside a parent report measure to capture a comprehensive view of motor performance compared to a group of neurotypical peers. METHODS Complex motor skills, balance and global motor performance were compared in twenty-four children, between the ages of 5-12 years, split into two groups: ASD and typically developing. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) and the Movement Assessment Battery for Children, Second Edition (MABC-2) were used to examine skill performance. Motor proficiency was also collected using the parent/caregiver form of the Vineland Adaptive Behavior Scales, 3rd edition (Vineland-3). RESULTS Children with ASD presented with significant differences in complex motor skills, balance skills, and global motor performance when compared to their neurotypical peers across all three measures. CONCLUSION This preliminary study indicated that the children with ASD had greater difficulty with global motor performance, including more difficulty performing complex motor tasks and balance tasks compared to their neurotypical peers. The parents of the children with ASD reported decreased proficiency of motor skills. Overall, the children with ASD demonstrated deficits performing tasks that targeted strength, speed, agility, coordination and both static and dynamic balance. While manifestations of motor skill deficits specific to the ASD population are variable, physical therapists should be included in the ongoing assessment and implementation of comprehensive therapeutic plans for children with ASD.
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Affiliation(s)
- Christina E. Odeh
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Allison L. Gladfelter
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Carolyn Stoesser
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
| | - Sarah Roth
- Physical Therapy, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
- Speech-Language Pathology, School of Allied Health & Communicative Disorders, Northern Illinois University, DeKalb, IL, USA
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19
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Bojanek EK, Wang Z, White SP, Mosconi MW. Postural control processes during standing and step initiation in autism spectrum disorder. J Neurodev Disord 2020; 12:1. [PMID: 31906846 PMCID: PMC6945692 DOI: 10.1186/s11689-019-9305-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background Individuals with autism spectrum disorder (ASD) show a reduced ability to maintain postural stability, though motor control mechanisms contributing to these issues and the extent to which they are associated with other gross motor activities (e.g., stepping) are not yet known. Methods Seventeen individuals with ASD and 20 typically developing (TD) controls (ages 6–19 years) completed three tests of postural control during standing. During the neutral stance, individuals stood with their feet shoulder width apart. During the Romberg one stance, they stood with feet close together. During the circular sway, participants stood with feet shoulder width apart and swayed in a circular motion. The standard deviation (SD) of their center of pressure (COP) in the mediolateral (ML) and anteroposterior (AP) directions and the COP trajectory length were examined for each stance. We also assessed mutual information (MI), or the shared dependencies between COP in the ML and AP directions. Participants also completed a stepping task in which they stepped forward from one force platform to an adjacent platform. The amplitude and duration of anticipatory postural adjustments (APAs) were examined, as were the maximum lateral sway, duration, and velocity of COP adjustments following the initial step. We examined stepping variables using separate one-way ANCOVAs with height as a covariate. The relationships between postural control and stepping measures and ASD symptom severity were assessed using Spearman correlations with scores on the Autism Diagnostic Observation Schedule–Second Edition (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R). Results Individuals with ASD showed increased COP trajectory length across stance conditions (p = 0.05) and reduced MI during circular sway relative to TD controls (p = 0.02). During stepping, groups did not differ on APA amplitude (p = 0.97) or duration (p = 0.41), but during their initial step, individuals with ASD showed reduced ML sway (p = 0.06), reduced body transfer duration (p < 0.01), and increased body transfer velocity (p = 0.02) compared to controls. Greater neutral stance COPML variability (r = 0.55, p = 0.02) and decreased lateral sway (r = − 0.55, p = 0.02) when stepping were associated with more severe restricted and repetitive behaviors in participants with ASD. Conclusions We found that individuals with ASD showed reduced MI during circular sway suggesting a reduced ability to effectively coordinate joint movements during dynamic postural adjustments. Additionally, individuals with ASD showed reduced lateral sway when stepping indicating that motor rigidity may interfere with balance and gait. Postural control and stepping deficits were related to repetitive behaviors in individuals with ASD indicating that motor rigidity and key clinical issues in ASD may represent overlapping pathological processes.
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Affiliation(s)
- Erin K Bojanek
- Life Span Institute and Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA.,Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical Center, Overland Park, KS, 66213, USA
| | - Zheng Wang
- Department of Occupational Therapy, University of Florida, 1225 Center Drive PO Box 100164, Gainesville, FL, 32611, USA
| | - Stormi P White
- Marcus Autism Center, Department of Pediatrics, Emory University School of Medicine, 1920 Briarcliff Road, Atlanta, GA, 30329-4010, USA
| | - Matthew W Mosconi
- Life Span Institute and Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA. .,Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical Center, Overland Park, KS, 66213, USA.
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20
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Unruh KE, Martin LE, Magnon G, Vaillancourt DE, Sweeney JA, Mosconi MW. Cortical and subcortical alterations associated with precision visuomotor behavior in individuals with autism spectrum disorder. J Neurophysiol 2019; 122:1330-1341. [PMID: 31314644 DOI: 10.1152/jn.00286.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In addition to core deficits in social-communication abilities and repetitive behaviors and interests, many patients with autism spectrum disorder (ASD) experience developmental comorbidities, including sensorimotor issues. Sensorimotor issues are common in ASD and associated with more severe clinical symptoms. Importantly, sensorimotor behaviors are precisely quantifiable and highly translational, offering promising targets for neurophysiological studies of ASD. We used functional MRI to identify brain regions associated with sensorimotor behavior using a visually guided precision gripping task in individuals with ASD (n = 20) and age-, IQ-, and handedness-matched controls (n = 18). During visuomotor behavior, individuals with ASD showed greater force variability than controls. The blood oxygen level-dependent signal for multiple cortical and subcortical regions was associated with force variability, including motor and premotor cortex, posterior parietal cortex, extrastriate cortex, putamen, and cerebellum. Activation in the right premotor cortex scaled with sensorimotor variability in controls but not in ASD. Individuals with ASD showed greater activation than controls in left putamen and left cerebellar lobule VIIb, and activation in these regions was associated with more severe clinically rated symptoms of ASD. Together, these results suggest that greater sensorimotor variability in ASD is associated with altered cortical-striatal processes supporting action selection and cortical-cerebellar circuits involved in feedback-guided reactive adjustments of motor output. Our findings also indicate that atypical organization of visuomotor cortical circuits may result in heightened reliance on subcortical circuits typically dedicated to motor skill acquisition. Overall, these results provide new evidence that sensorimotor alterations in ASD involve aberrant cortical and subcortical organization that may contribute to key clinical issues in patients.NEW & NOTEWORTHY This is the first known study to examine functional brain activation during precision visuomotor behavior in autism spectrum disorder (ASD). We replicate previous findings of elevated force variability in ASD and find these deficits are associated with atypical function of ventral premotor cortex, putamen, and posterolateral cerebellum, indicating cortical-striatal processes supporting action selection and cortical-cerebellar circuits involved in feedback-guided reactive adjustments of motor output may be key targets for understanding the neurobiology of ASD.
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Affiliation(s)
- Kathryn E Unruh
- Schiefelbusch Institute for Life Span Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas.,Kansas Center for Autism Research and Training, University of Kansas Medical School, Kansas City, Kansas
| | - Laura E Martin
- Hoglund Brain Imaging Center and Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas
| | - Grant Magnon
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - John A Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio
| | - Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas.,Kansas Center for Autism Research and Training, University of Kansas Medical School, Kansas City, Kansas
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21
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Belnap SC, Currea JP, Lickliter R. Prenatal incubation temperature affects neonatal precocial birds' locomotor behavior. Physiol Behav 2019; 206:51-58. [DOI: 10.1016/j.physbeh.2019.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 02/06/2023]
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22
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Wang Z, Khemani P, Schmitt LM, Lui S, Mosconi MW. Static and dynamic postural control deficits in aging fragile X mental retardation 1 (FMR1) gene premutation carriers. J Neurodev Disord 2019; 11:2. [PMID: 30665341 PMCID: PMC6341725 DOI: 10.1186/s11689-018-9261-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/26/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Individuals with premutation alleles of the fragile X mental retardation 1 (FMR1) gene are at risk of developing fragile X-associated tremor/ataxia syndrome (FXTAS) during aging. Characterization of motor issues associated with aging in FMR1 premutation carriers is needed to determine neurodegenerative processes and establish new biobehavioral indicators to help identify individuals at greatest risk of developing FXTAS. METHODS We examined postural stability in 18 premutation carriers ages 46-77 years and 14 age-matched healthy controls. Participants completed a test of static stance and two tests of dynamic postural sway on a force platform to quantify postural variability and complexity. CGG repeat length was measured for each premutation carrier, and MRI and neurological evaluations were conducted to identify carriers who currently met criteria for FXTAS. Of the 18 premutation carriers, seven met criteria for definite/probable FXTAS (FXTAS+), seven showed no MRI or neurological signs of FXTAS (FXTAS-), and four were inconclusive due to insufficient data. RESULTS Compared to controls, premutation carriers showed increased center of pressure (COP) variability in the mediolateral (COPML) direction during static stance and reduced COP variability in the anterior-posterior (COPAP) direction during dynamic AP sway. They also showed reductions in COPML complexity during each postural condition. FXTAS+ individuals showed reduced COPAP variability compared to FXTAS- carriers and healthy controls during dynamic AP sway. Across all carriers, increased sway variability during static stance and decreased sway variability in target directions during dynamic sways were associated with greater CGG repeat length and more severe neurologically rated posture and gait abnormalities. CONCLUSION Our findings indicate that aging FMR1 premutation carriers show static and dynamic postural control deficits relative to healthy controls implicating degenerative processes of spinocerebellar and cerebellar-brainstem circuits that may be independent of or precede the onset of FXTAS. Our finding that FXTAS+ and FXTAS- premutation carriers differed on their level of intentional AP sway suggests that neural mechanisms of dynamic postural control may be differentially impacted in patients with FXTAS, and its measurement may be useful for rapidly and precisely identifying disease presence and onset.
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Affiliation(s)
- Zheng Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL, 32611, USA. .,University of Florida, 1225 Center Drive, PO Box 100164, Gainesville, FL, 326100164, USA.
| | - Pravin Khemani
- Department of Neurology, Swedish Neuroscience Institute, Seattle, WA, 98121, USA
| | - Lauren M Schmitt
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Su Lui
- Huaxi Magnetic Resonance Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
| | - Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, 66045, USA.,Clinical Child Psychology Program, University of Kansas, Lawrence, KS, 66045, USA.,Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, 66045, USA
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Travers BG, Mason A, Gruben KG, Dean DC, McLaughlin K. Standing Balance on Unsteady Surfaces in Children on the Autism Spectrum: The Effects of IQ. RESEARCH IN AUTISM SPECTRUM DISORDERS 2018; 51:9-17. [PMID: 30333859 PMCID: PMC6186444 DOI: 10.1016/j.rasd.2018.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Postural stability difficulties are commonly reported in people on the autism spectrum. However, it is unclear whether unsteady surfaces may exacerbate postural stability difficulties in children and adolescents with autism spectrum disorder (ASD). Understanding balance on unsteady surfaces is important because uneven surfaces are commonly encountered in daily life. METHODS Twenty-one youth on the autism spectrum and 16 youth with typical development (ages 6-16 years, IQ ≥ 79) stood on both a fixed and unsteady (tiltable) platform, and center of pressure was measured. RESULTS The group with ASD exhibited differentially more postural sway on the unsteady surface compared to the group with typical development. However, there was substantial variability within the ASD group. Follow-up analyses suggested that much of the variability in postural sway in the ASD group was accounted for by IQ. CONCLUSIONS Clinically, these findings suggest that not all individuals with ASD struggle more with postural stability on unsteady surfaces. Instead children and adolescents with ASD and below-average IQ may have particular difficulty on unsteady surfaces and may require accommodations. Further, these findings lay the groundwork for future research to investigate the underlying mechanisms of poorer balance across the autism spectrum.
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Affiliation(s)
- Brittany G. Travers
- Kinesiology Department, University of Wisconsin-Madison
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison
- Waisman Center, University of Wisconsin-Madison
| | - Andrea Mason
- Kinesiology Department, University of Wisconsin-Madison
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Wang Z, Kwon M, Mohanty S, Schmitt LM, White SP, Christou EA, Mosconi MW. Increased Force Variability Is Associated with Altered Modulation of the Motorneuron Pool Activity in Autism Spectrum Disorder (ASD). Int J Mol Sci 2017; 18:E698. [PMID: 28346344 PMCID: PMC5412284 DOI: 10.3390/ijms18040698] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 11/20/2022] Open
Abstract
Force control deficits have been repeatedly documented in autism spectrum disorder (ASD). They are associated with worse social and daily living skill impairments in patients suggesting that developing a more mechanistic understanding of the central and peripheral processes that cause them may help guide the development of treatments that improve multiple outcomes in ASD. The neuromuscular mechanisms underlying force control deficits are not yet understood. Seventeen individuals with ASD and 14 matched healthy controls completed an isometric index finger abduction test at 60% of their maximum voluntary contraction (MVC) during recording of the first dorsal interosseous (FDI) muscle to determine the neuromuscular processes associated with sustained force variability. Central modulation of the motorneuron pool activation of the FDI muscle was evaluated at delta (0-4 Hz), alpha (4-10 Hz), beta (10-35 Hz) and gamma (35-60 Hz) frequency bands. ASD patients showed greater force variability than controls when attempting to maintain a constant force. Relative to controls, patients also showed increased central modulation of the motorneuron pool at beta and gamma bands. For controls, reduced force variability was associated with reduced delta frequency modulation of the motorneuron pool activity of the FDI muscle and increased modulation at beta and gamma bands. In contrast, delta, beta, and gamma frequency oscillations were not associated with force variability in ASD. These findings suggest that alterations of central mechanisms that control motorneuron pool firing may underlie the common and often impairing symptoms of ASD.
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Affiliation(s)
- Zheng Wang
- Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical School, Overland Park, KS 66213, USA.
| | - Minhyuk Kwon
- Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical School, Overland Park, KS 66213, USA.
| | - Suman Mohanty
- Center for Autism and Developmental Disabilities, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Lauren M Schmitt
- Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical School, Overland Park, KS 66213, USA.
| | - Stormi P White
- Center for Autism and Developmental Disabilities, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.
| | - Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas Medical School, Overland Park, KS 66213, USA.
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