Children suspected of autism spectrum disorder (ASD) should be evaluated for co-occurring motor and structural language deficits, according to study findings published in Research in Developmental Disabilities.
ASD is a neurodevelopmental disorder marked by highly heterogenous symptomology, with persistent deficits in social interaction and communication combined with atypical behavior sufficient enough to cause functional impairment. Currently guidelines recommend for children with suspected ASD to be evaluated for comorbidities, but there remains no specific recommendations about motor and structural language deficits.
In this cross-sectional study, children (N=20) referred for ASD evaluation at 4 outpatient clinics in Norway were recruited. Patients underwent the Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview-Revised (ADI-R), or both. In addition, the patients were evaluated by the Developmental Coordination Disorder Questionnaire 2007 (DCDQ’07), Movement Assessment Battery for Children-2 (MABC-2), Children’s Communication Checklist Second Edition (CCC-2), Social Responsiveness Scale (SRS) , and Developmental Disability-Children’s Global Assessment Scale (DD-CGAS).
Patients were aged mean 10.7 (standard deviation [SD]3.4) years, 6 were girls, 50.0% had 2 or more neurodevelopmental disorder comorbidities, 45.0% had 1 or more somatic disorder, 25.0% had 1 or more psychiatric disorder, and 75.0% were currently taking medication.
During the evaluation, 75.0% were diagnosed with ASD. The ASD subtypes were Asperger syndrome (40.0%), childhood autism (26.7%), pervasive developmental disorder not otherwise specified (26.7%), and atypical autism (6.7%).
Most caregivers (80.0%) reported their child had some motor deficits on the DCDQ’07. They reported limitations in control during movement, fine motor or handwriting, and general coordination. In the standardized assessment, 38.9% of children had total MABC-2 scores indicating motor deficits. The most affected domains were manual dexterity and aiming and catching. DCDQ’07 and MABC-2 scores were correlated, although not significantly (r, 0.211).
Most children (75.0%) had CCC-2 scores indicating language impairment and most (55.0%) had structural language deficits in speech, syntax, semantics, and coherence.
Altogether, all but 3 children had motor and/or language deficits.
DD-CGAS scores were highly variable (range, 43-73) with all but 2 children having scores in the clinical range. The most affected functional domains were social behavior, school functioning, and communication.
Significant correlations were observed between Structural Language Score and SRS total (ρ, -0.691; P <.001), DD-GAS and ADI-R verbal total score (ρ, -0.657; P = .006), MABC-2 and Structural Language Score (ρ, 0.618; P=.006), and MABC-2 and SRS total (ρ, -0.521; P=.027).
This study was limited by its small sample size.
These data indicated that most children being evaluated for suspected ASD had co-occurring motor and/or language deficits. “The extent of this co-occurrence, as well as the potential role and timing of specific interventions targeting motor and language skills in children with autistic symptoms should be addressed in future studies,” the researchers concluded.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Reindal L, Nærland T, Sund AM, Glimsdal BA, Andreassen OA, Weidle B. The co-occurrence of motor and language impairments in children evaluated for autism spectrum disorder. An exploratory study from Norway. Res Dev Disabled. Published online May 14, 2022. doi:10.1016/j.ridd.2022.104256