Thursday, June 18, 2015

Gross Motor Performance in Children on the Autism Spectrum

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in (a) social communication and (b) restricted and/or repetitive behaviors or interests that varies in severity of symptoms, age of onset, and association with other disorders. Although motor impairment is not a part of the diagnostic criteria for ASD, research suggests that many children with ASD experience delays in motor development. Gross motor skills are fundamental skills necessary for movement competence and considered the basic building blocks for more complex motor skill development. When present, gross motor problems may interfere with performance in many developmental and functional domains across home and school contexts. Consequently, researchers are increasingly considering the importance of motor function in the assessment and treatment of children with ASD.
                                                                          
           Research

A study published in the Journal of Child and Adolescent Behavior focused on assessing the gross motor skill performance of 21 children with ASD (M=7.57 years) and 21 age matched typically developing children (M=7.38 years) using the Test of Gross Motor Development-2 (TGMD-2). The TGMD-2 is a norm and criterion-referenced test that measures performance of 12 gross motor skills. Scores are recorded on two subtests, locomotor subtest (run, gallop, hop, leap, jump, and slide) and object-control subtest (strike, dribble, catch, kick, throw, and roll), An overall gross motor quotient score (combination of all 12 gross motor skills) can also obtained. Scores are described as very superior, superior, above average, average, below average, poor, and very poor. The researchers hypothesized that children with ASD would show motor delays in overall gross motor quotient scores, and locomotor and object control standard scores when compared to their age matched typically developing peers as measured with TGMD-2.
                                                                                Results

Statistical analysis revealed a significant performance difference between children with ASD and typically developing children on the TGMD-2. For the locomotor subtest, 67% children with ASD received poor standard scores and 40% of scores were very poor. Approximately 60% children with ASD had poor standard scores and 33% of scores were very poor on object control skills. For overall gross motor quotient scores, 81% children with ASD were below 79 and classified as poor, and approximately 76% children scored below 70 and received very poor ratings. Children scoring at or below the 30th percentile were considered developmentally delayed as indicated in the Individuals with Disabilities Education Act (IDEA). Based on this criterion, 91% of children with ASD in the current study were considered developmentally delayed in terms of their gross motor skill performance and in need of early supportive interventions. In contrast, the majority of typically developing children’s standard scores (96%) fell in the average or higher range.

                                                                            Implications
According to the authors, the results of this study have several important implications for educators, therapists, and practitioners and the design of effective early intervention programs for children with ASD. For example, locomotion and object control skills are fundamental motor skills in which children interact with their environment and other children. Developing a therapeutic intervention that includes these gross motor skills may have a positive effect on children’s cognitive functioning, language development, social communicative skills, and contribute positively to daily life skills. Consequently, it is vital that we understand the gross motor performance of children with ASD. Finally, the significance of motor proficiency for children with ASD should not be overlooked in assessment practice. Clinicians and practitioners should give increased attention to the assessment of motor skills and their impact on the adaptive behavior and well-being of children with ASD. A comprehensive discussion of assessment domains (e.g. communication, social, motor, sensory, academic) can be found in A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Liu T, Hamilton M, Davis L, ElGarhy S (2014) Gross Motor Performance by Children with Autism Spectrum Disorder and Typically Developing Children on TGMD-2. J Child Adolesc Behav 2: 123. doi:10.4172/jcalb.1000123
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. Dr. Wilkinson is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)

1 comment:

Kim Matthews said...

I could have told you this. I was never good at baseball, hockey or other sports and as a result was left out of play by other kids. I wonder if this was a chicken or egg situation - was I shunned because I couldn't play well or could I not play well because I didn't get a chance to practice these skills along with other kids my age? One only has to be the last one picked for a team a few times to realize he doesn't belong with the others and becomes further outcast and withdrawn.

A safe venue to practice and develop gross motor skills with proper training and supervision would go a long way to helping ASD kids to become accepted by their peers.

Being included would obviously also help with social awareness and development which is lacking when kids are shunned by others and would help lessen bullying, etc. Teachers need to also understand that normal methods for teaching NT children will not necessarily work for Spectrum kids and should adjust their methods accordingly.

Oddly enough, this piece does not address fine motor skills. I notice that I always had good hand coordination ( although I can't catch a ball to save me ) and was good at drawing, building things ( like model cars and planes ) and playing a musical instrument ( although I seem to lack the ability to fully phrase music properly ). This is another area which could stand some study and perhaps provide a useful outlet for creativity for ASD kids.

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