Adaptive Motor Impairment in Young Children with Autism Spectrum Disorders (ASD)

Background:

During infancy and early childhood, children use their motor skills to explore the environment, engage in physical play, initiate social interactions, and develop basic academic skills, thus playing a significant role in quality of life and social development. Motor delays and deficits have commonly been noted in children with Autism Spectrum Disorder (ASD), yet few studies have investigated adaptive motor function, or the performance of motor activities in daily life.

Objectives :

The objectives of the study are to (1) characterize adaptive motor skills in young children with ASD using a standardized assessment, the Vineland Adaptive Behavior Scales-II (VABS-2) and to (2) investigate the association of motor skills with core deficits, namely language and play.

Methods:

The data collected for this study are part of a larger study of preschoolers with ASD. The final sample included 100 participants with ASD between the ages of 23 and 82 months enrolled in the UCLA Early Childhood Partial Hospitalization Program (ECPHP) at the Resnick Neuropsychiatric Hospital. 30 age-matched, typically developing (TD) children from the greater Los Angeles area were recruited as controls. Adaptive motor function was evaluated by assessing gross and fine motor subscale scores of the ASD and TD groups with VABS-2. Other measures of interest, also collected as part of a clinical assessment prior to enrollment in the program, included the Mullen Scales of Early Learning, Wechsler Preschool and Primary Scale of Intelligence-IV, and the Developmental Play Assessment. Descriptive statistics were performed on adaptive motor function scores, and Pearson correlations were performed to investigate the association of adaptive gross and fine motor function with IQ, language, and play scores.

Results:

While there was a wide distribution in scores, children with ASD as a group demonstrated delays in adaptive gross motor (Mean=11.8; Range 6-18) and adaptive fine motor (Mean=12.0; Range=7-20) assessments of the VABS-2 (subdomain mean = 15; SD=2). Adaptive gross and fine motor function did not correlate with language ability but did correlate with non-verbal IQ and adaptive social function. Furthermore, higher scores on gross motor skills correlated significantly with lower level of functional play activity (p=0.041) with this inverse relationship stronger at higher play assessment levels (p=0.009).

Conclusions:

Although heterogeneity exists in motor ability, this study clearly indicates the presence of adaptive motor deficits in young children with ASD. It suggests the need to explore mediating factors, such as inattention or behavioral dysregulation in the relationship with core deficits, particularly in the inverse relationship with play levels. More comprehensive, prospective studies of adaptive motor function in young children, particularly in the context of targeted interventions may improve not only motor abilities but also core deficits within the autism spectrum.