The Semiology of Motor Disorders in Autism Spectrum Disorders as Highlighted from a Standardized Neuro-Psychomotor Assessment.
BACKGROUND
Altered motor performance has been described in Autism Spectrum Disorders (ASD) with disturbances in walking; posture, coordination, or arm movements, but some individuals with ASD show no impairment of motor skills. The neuro-developmental processes that underpin the performance of neuro-psychomotor functions have not been widely explored, nor is it clear whether there are neuro-psychomotor functions specifically affected in ASD. Our objective was to focus on the semiology of motor disorders among children with ASD using a neuro-developmental assessment tool.


METHODS
Thirty-four children with ASD, with or without intellectual deficit (ID) were recruited in a child psychiatry department and Autism Resource Centers. Initial standard evaluations for diagnosis (psychiatric; psychological; psychomotor) were supplemented by a standardized assessment battery for neuro-developmental psychomotor functions (NP-MOT).


RESULTS
The results of some NP-MOT tests differed between children with ASD with ID and those without. However, on the NP-MOT battery, neither of the two groups did well in the bi-manual and finger praxia tests (36 and 52% respectively failed). Manual and digital gnosopraxia showed some deficit (63 and 62% respectively failed). Postural deficits were found in tests for both static equilibrium (64%) and dynamic (52%). There were also difficulties in coordination between the upper and lower limbs in 58% of children. We found 75% failure in motor skills on the M-ABC test. Concerning muscular tone, significant laxity was observed in distal parts of the body (feet and hands), but hypertonia was observed in the proximal muscles of the lower limbs (reduced heel-ear angle).


CONCLUSIONS
The results of manual and digital gnosopraxia tests point to a planning deficit in children with autism. A gesture programming deficit is also highlighted by the poor results in manual praxis, and by failures in the M-ABC tests despite prior training of the child. However, concerning global motor function, a significant difference was observed between children with and without ID. Our findings suggest a semiology of tone deregulation between proximal versus distal muscles, indeterminate tonic laterality, postural control deficit (proprioceptive), impairment of inter-hemispheric coordination (corpus callosum), and neurological soft signs such asdysdiadochokinesia, which leads us to hypothesize a general impairment of motor functions.
Faculty of Medicine, Paris Descartes University, Sorbonne Paris-CitéParis, France; Department of Child Psychiatry, AP-HP Necker-Enfants Malades University HospitalParis, France; Institut National de la Santé Et de la Recherche Médicale UMR 1018 and CESP, Universities of Paris-Saclay and Paris-Sud, UVSQVillejuif, France; Department of Child and the Adolescent Psychiatry, Esquirol HospitalLimoges, France.
Aude
A
Paquet
Department of Child and the Adolescent Psychiatry, Esquirol HospitalLimoges, France; INSERM UMR 1094, Tropical Neuroepidemiology, University of LimogesLimoges, France.
Bertrand
B
Olliac
Department of Child and the Adolescent Psychiatry, Perrens Hospital, Université de BordeauxBordeaux, France; Centre National de la Recherche Scientifique UMR 5287, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of BordeauxBordeaux, France.
Manuel-Pierre
MP
Bouvard
Faculty of Medicine, Paris Descartes University, Sorbonne Paris-CitéParis, France; Department of Child Psychiatry, AP-HP Necker-Enfants Malades University HospitalParis, France.
Bernard
B
Golse
Faculty of Medicine, Paris Descartes University, Sorbonne Paris-CitéParis, France; Department of Child Psychiatry, AP-HP Necker-Enfants Malades University HospitalParis, France; Institut National de la Santé Et de la Recherche Médicale UMR 1018 and CESP, Universities of Paris-Saclay and Paris-Sud, UVSQVillejuif, France; Department of Pediatrics, Child development, Cochin-Port Royal University Hospitals, Assistance Publique-Hôpitaux de ParisParis, France; Endocrinology Laboratory, Imagine Institut, Necker-Enfants Malades University HospitalParis, France.
Laurence
L
Vaivre-Douret
Autism Spectrum Disorders (ASD); children; motor disorder; neuro-psychomotor functions; neurodevelopmental assessment
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