Sensory-Motor Deficits and Poor Independence : Prevalent Difficulties Not Unique to ASD

Background: In recent years, the sensory-motor domain has gained increased attention among autism researchers. However, very few are addressing its impact on the autonomy or functional independence of children with autism spectrum disorders (ASD). Objectives: 1) To describe the sensory-motor deficits that are specific to preschool and school-aged children with ASD. 2) To compare the sensory-motor skills of the two age groups with selected clinical control groups and children with typical development. 3) To establish the contribution of sensory-motor skills to the functional independence in daily living skills of children with ASD. Methods: This is a clinical descriptive study of 154 children aged 3 to 11 years. Eighty-five (85) children with ASD, 34 with Typical Development (TD), and 37 with Developmental Disabilities such as Intellectual Disability (ID) or Speech Language Impairment (SLI) were recruited. Children were separated in two age groups: 95 preschoolers (3 to 5 y 11m) and 59 school-aged (6 to 11) and were tested with the Peabody Developmental Motor Scales-PDMS-2 or the Movement ABC, the Sensory Profile, the Wee-FIM and the Vineland Adaptive Behavior Scales-VABS-2. Results: Cognitive performance (IQ) of each group of preschoolers was ASD = 61, DD = 68 and TD = 107; the performance of the school-aged groups was ASD = 76, DD = 53, and TD = 105. Sixty-six percent of preschoolers with ASD had abnormal sensory processing skills compared to 47% of children with DD and 20% of children with TD (p < .05). In contrast, 93% of school-aged children with ASD, 63% of children with DD and 25% of children with TD had abnormal sensory processing skills. On the motor performance of the PDMS-2, preschool children with ASD scored at the 4th centile of total motor performance, children with DD were at the 22nd and the TD group at the 46th centile. On the MABC, school-aged children with ASD scored at the 8th centile for total motor impairment, children with DD scored at the 3rd centile and the TD group scored at the 68th centile. Scores for the functional independence of Daily Living Skills on the VABS-2 were: preschoolers ASD : 76, DD : 83, TD : 104; school-aged children with ASD : 80, DD : 75, TD : 95. Regression analyses were conducted to identify predictive variables of autonomy and functional independence on the Wee-FIM and VABS-2. The best predictors for personal skills (DLS) were fine motor and sensory processing skills; they explained nearly 30 (ASD preschoolers) to 46% (ASD school-age) of the variance. Conclusions: Most children with ASD have some sensory-motor deficits; these do not disappear with age but rather seem to get exacerbated. Self-care skills as well as daily living skills of children with ASD and other developmental disabilities are very poor and will require support. Sensory-motor issues are not unique to ASD and should be addressed in all clinical populations, especially ID, presenting such difficulties. Interventions specifically targeting sensory processing and motor skills may lead to greater independence in self-care skills in children with ASD or other developmental disabilities. This study was conducted as part of a post-doctoral fellowship at the Montreal Children's Hospital of McGill University by the first author and was sponsored by the Canadian Child Health Clinician Scientist Program (CCHCSP) and the Autism Research Training (ART) program. Both are training grant initiatives of the Canadian Institutes of Health Research (CIHR).