Is Motor Impairment in Autism Spectrum Disorder Distinct From Developmental Coordination Disorder? A Report From the SPARK Study
Is Motor Impairment in Autism Spectrum Disorder Distinct From Developmental Coordination Disorder? A Report From the SPARK Study
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DOI：
10.1093/ptj/pzz190
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发表时间：
2020-04-01
期刊：
影响因子：
3.2
通讯作者：
Bhat, Anjana Narayan
中科院分区：
文献类型：
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作者：
Bhat, Anjana Narayan
背景资料。运动障碍在自闭症谱系障碍(ASD)中普遍存在；然而，患有自闭症谱系障碍的儿童很少被诊断为发育协调障碍(DCD)。西蒙斯基金会的火花研究通过一项在线研究对受ASD影响的家庭进行了调查。使用DCD父母问卷(DCDQ)评估5至15岁ASD儿童运动障碍或DCD风险的患病率。这项研究利用了患有自闭症儿童的大型数据库中的父母报告。共有16,705名患有自闭症儿童的父母完成了DCDQ。在过滤掉无效数据，使用更强的截断值来确认ASD特征，并排除患有一般神经运动障碍/智力延迟的儿童后，我们获得了最终的SPARK数据集(n=11,814)。我们比较了来自SPARK数据集的DCDQ总分和分量表得分与公布的5至15岁各年龄段的常模。自闭症儿童有运动障碍的风险比例非常高，为86.9%。患有自闭症的儿童即使在青春期也没有摆脱他们的运动障碍，并继续存在患DCD的风险。然而，只有31.6%的儿童接受了物理治疗服务。局限性：我们使用DCDQ对父母报告的结果进行的大型数据库分析没有涉及后续的临床评估。利用ASD儿童的大样本，这项研究表明，大多数ASD儿童存在运动障碍或DCD的风险，并持续到青春期；然而，只有一小部分ASD儿童接受物理治疗师干预。ASD的诊断必须触发物理和职业治疗师的运动筛查、评估和适当的干预，以解决ASD儿童的功能障碍，同时也对他们的社交、认知和行为产生积极影响。使用有效的运动测量方法，未来的研究必须确定运动障碍是否是ASD的基本特征。
Background. Motor impairments are pervasive in Autism Spectrum Disorder (ASD); however, children with ASD rarely receive a dual diagnosis of Developmental Coordination Disorder (DCD). The Simons Foundation SPARK study engaged families affected by ASD through an online study.Objectives. The DCD parent questionnaire (DCDQ) was used to assess the prevalence of a risk for motor impairment or DCD in children with ASD between 5 and 15 years of age.Design. This study utilizes parent reports from a large database of children with ASD.Methods. A total of 16,705 parents of children with ASD completed the DCDQ. We obtained our final SPARK dataset (n = 11,814) after filtering out invalid data, using stronger cut-offs to confirm ASD traits, and excluding children with general neuromotor impairments/intellectual delays. We compared DCDQ total and subscale scores from the SPARK dataset with published norms for each age between 5 and 15 years.Results. The proportion of children with ASD at risk for a motor impairment was very high at 86.9%. Children with ASD did not outgrow their motor impairments and continued to present with a risk for DCD even into adolescence. Yet, only 31.6% of children were receiving physical therapy services.Limitations .Our analysis of a large database of parent-reported outcomes using the DCDQ did not involve follow-up clinical assessments.Conclusions. Using a large sample of children with ASD, this study shows that a risk for motor impairment or DCD was present in most children with ASD and persists into adolescence; however, only a small proportion of children with ASD were receiving physical therapist interventions. A diagnosis of ASD must trigger motor screening, evaluations, and appropriate interventions by physical and occupational therapists to address the functional impairments of children with ASD while also positively impacting their social communication, cognition, and behavior. Using valid motor measures, future research must determine if motor impairment is a fundamental feature of ASD.