Dyspraxia in autism: association with motor, social, and communicative deficits
Dyspraxia in autism: association with motor, social, and communicative deficits
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DOI：
10.1111/j.1469-8749.2007.00734.x
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发表时间：
2007-10-01
影响因子：
3.8
通讯作者：
Mostofsky, S. H.
中科院分区：
文献类型：
--
作者：
Dziuk, M. A.;Larson, J. C. Gidley;Mostofsky, S. H.
在自闭症儿童中，一直有关于熟练手势表现受损（被称为运用障碍）的报道；然而，其神经学基础尚未被充分理解。在自闭症儿童中也观察到基本运动技能缺陷，并且尚不清楚自闭症儿童中观察到的运用障碍是否可由运动技能问题来解释。47名患有自闭症谱系障碍（ASD）、自闭症或阿斯伯格综合征的高功能儿童（43名男孩，4名女孩；平均年龄10岁7个月[标准差1岁10个月]，平均全量表智商（FSIQ）99.4[标准差15.9]）以及47名正常发育（TD）的对照组儿童（41名男孩，6名女孩；平均年龄10岁6个月[标准差1岁5个月]，平均FSIQ 113.8[标准差12.3]，年龄范围8 - 14岁）完成了：（1）《细微体征的身体和神经学评估》，这是一项针对儿童的标准化基本运动技能检查，以及（2）一项实践检查，包括按指令做手势、模仿手势以及使用工具的手势。分层回归被用于检验基本运动技能表现（即完成重复性肢体运动的时间）和实践表现（实践总错误数）之间的关联。在控制年龄和智商后，基本运动技能是实践检查表现的一个显著预测因素。然而，在考虑基本运动技能后，自闭症谱系障碍组在实践方面仍然明显比对照组差。此外，实践表现是自闭症定义特征的一个强有力预测因素（使用《自闭症诊断观察量表》测量），并且在考虑基本运动技能后，这种相关性仍然显著。结果表明，自闭症中的运用障碍不能完全由基本运动技能的损伤来解释，这表明存在其他促成因素。此外，自闭症儿童的实践与定义该疾病的社交、沟通和行为障碍密切相关，这表明运用障碍可能是自闭症的一个核心特征，或者是该疾病潜在神经异常的一个标志。
Impaired performance of skilled gestures, referred to as dyspraxia, is consistently reported in children with autism; however, its neurological basis is not well understood. Basic motor skill deficits are also observed in children with autism and it is unclear whether dyspraxia observed in children with autism can be accounted for by problems with motor skills. Forty-seven high-functioning children with an autism spectrum disorder (ASD), autism, or Asperger syndrome (43 males, four females; mean age 10y 7m [SD 1y 10m], mean Full-scale IQ (FSIQ) 99.4 [SD 15.9]), and 47 typically developing (TD) controls (41 males, six females; mean age 10y 6m [SD 1y 5m], mean FSIQ 113.8 [SD 12.3], age range 8-4y) completed: (1) the Physical and Neurological Assessment of Subtle Signs, an examination of basic motor skills standardized for children, and (2) a praxis examination that included gestures to command, to imitation, and with tool-use. Hierarchical regression was used to examine the association between basic motor skill performance (i.e. times to complete repetitive limb movements) and praxis performance (total praxis errors). After controlling for age and IQ, basic motor skill was a significant predictor of performance on praxis examination. Nevertheless, the ASD group continued to show significantly poorer praxis than controls after accounting for basic motor skill. Furthermore, praxis performance was a strong predictor of the defining features of autism, measured using the Autism Diagnostic Observation Schedule, and this correlation remained significant after accounting for basic motor skill. Results indicate that dyspraxia in autism cannot be entirely accounted for by impairments in basic motor skills, suggesting the presence of additional contributory factors. Furthermore, praxis in children with autism is strongly correlated with the social, communicative, and behavioral impairments that define the disorder, suggesting that dyspraxia may be a core feature of autism or a marker of the neurological abnormalities underlying the disorder.