Motor and multisystem symptom clusters in children with Autism Spectrum Disorder (ASD): A SPARK dataset study

项目摘要 运动障碍在患有自闭症谱系障碍（ASD）的学龄儿童中很普遍;然而， 往往被忽视，得不到诊断和治疗。大约87%的SPARK儿童队列 自闭症谱系障碍（ASD）是美国最大的ASD队列，有运动障碍/DCD的风险 基于发展协调障碍（DCD）问卷调查（Bhat，2020）的结果。然而，马达 根据诊断和统计手册，损伤不是ASD诊断标准或说明的一部分 《精神疾病诊断与统计手册》第五版（DSM-V） 虽然运动领域被添加到NIMH研究领域标准（RDoC）的精神障碍， 今年，运动问题尚未作为ASD RDoC的一部分进行讨论。目前尚不清楚是否存在一种独特的模式 运动障碍和多系统障碍（运动、社交和重复行为）是 ASD患儿中存在。这些损伤模式是否在ASD频谱中发生变化， 表型或它们是否在性别、年龄、共病诊断和损伤水平上普遍存在？ 在拟议的项目中，我们将研究运动障碍，自闭症严重程度， ASD患儿的合并症具体来说，我们将确定运动障碍儿童的风险， ASD及其如何随着社交障碍、重复行为严重程度的增加而变化， 合并症和使用父母报告指标的损害水平：DCD-Q，社交沟通 问卷（SCQ）和重复行为量表修订版（RBS-R）。我们的分析还将提供进一步的 ASD儿童普遍但独特的运动障碍模式的证据，如果存在， ASD的多系统症状簇和亚表型的存在。 我们还将强调儿童有不同的机会获得各种治疗（OT，PT，娱乐）的问题。 ASD以及这些与儿童运动障碍的风险无关，从而揭示了诊断不足， 使用PT和娱乐疗法治疗ASD中的运动问题。随着COVID危机的演变， 我们等待可靠的治疗方法和疫苗，恢复儿科面对面研究将需要很长时间。使用 因此，像SPARK研究数据集这样的大型数据库来回答关键的研究问题是及时的， 具有本质意义

PROJECT SUMMARY Motor impairments are pervasive in school-age children with Autism Spectrum Disorder (ASD); however, they are often ignored and remain undiagnosed and untreated. Approximately 87% of the SPARK cohort of children with Autism Spectrum Disorder (ASD), the largest ASD cohort in the US, is at-risk for a motor impairment/DCD based on findings from the Developmental Coordination Disorder (DCD) Questionnaire (Bhat, 2020). Yet, motor impairments are not part of the diagnostic criteria or specifiers for ASD per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V). Although motor domain was added to the NIMH research domain criteria (RDoC) for mental disorders only last year, motor issues have not been discussed as part of the RDoC for ASD. It is unclear if a unique pattern of motor impairments and multisystem impairments (motor, social communication, and repetitive behavior) are present in children with ASD. Do these patterns of impairment change across the ASD spectrum for certain sub- phenotypes or are they generalized across sex, age, comorbid diagnoses, and levels of impairment? In the proposed project, we will study the associations between motor impairment, autism severity, and comorbidities in children with ASD. Specifically, we will determine the risk for motor impairment in children with ASD and how that changes with increasing social communication impairment, repetitive behavior severity, comorbidities, and levels of impairment using parent report measures: DCD-Q, Social Communication Questionnaire (SCQ), and Repetitive Behavior Scale-Revised (RBS-R). Our analyses will also provide further evidence for generalized but unique patterns of motor impairments in children with ASD and if present, the presence of multisystem symptom clusters and sub-phenotypes of ASD. We will also highlight the issue of differential access to various therapies (OT, PT, recreational) for children with ASD and how those do not relate to a child’s risk for motor impairment, thus revealing under-diagnosis and under-treatment for motor issues in ASD using PT and recreational therapies. As the COVID crisis evolves and we wait for reliable treatments and vaccines, resuming pediatric face to face research will take a long time. Using large databases such as the SPARK study dataset to answer critical research questions is therefore, timely and essential.