Gait Analysis, Physical Activity and Motor Coordination in Children with Autism Spectrum Disorders and Developmental Coordination Disorder

Background:  

Children with Autism Spectrum Disorder (ASD) may demonstrate motor stereotypies such as pacing, jumping/hopping, skipping and spinning and it has been suggested that these may be considered restricted and repetitive behaviours. Studies examining gait in children with ASD suggest a tendency to augment walking stability with a wider base of support and decreased range of motion, which may imply a motor deficit. To date, no study has investigated gait in children with Developmental Coordination Disorder (DCD). Furthermore, children with ASD or DCD may be less physically active than typically developing peers, and no study has compared physical activity in the two groups or a group with a dual-diagnosis of both conditions.

Objectives:  

To describe gait patterns, physical activity and motor coordination in children with ASD when compared to children with DCD and typically developing peers.

Methods:  

Children with a diagnosis of ASD and/or DCD aged 6-14 years with no other conditions altering gait patterns were included. Height, weight, bodyfat and leg dimensions were measured. Gait analysis was carried out using the Codamotion system on a treadmill at preferred speed and a set speed of 3k/h. Actigraph GT3X tri-axial accelerometers measured physical activity. Motor coordination was assessed using the Movement Assessment Battery for Children, 2^nd Edition (MovementABC-2). One-way ANOVA evaluated between-group differences.

Results: (Preliminary)

Thirty four children were recruited into four groups: ASD-only (n=8), DCD-only (n=10), Dual-diagnosis ASD&DCD (n=8), and typically developing (TD) controls (n=8). There were no between-group differences in age or height and no gender effects (p>0.05). A larger proportion of children with neurodevelopmental disorders were overweight/obese than controls (ASD: 50%; DCD: 30%; ASD&DCD: 50%; TD: 12.5%).

Children with ASD-only spent a significantly shorter period of time in single stance than the other groups (p=0.0454). Knee extension was reduced in the ASD-only, DCD-only and dual-diagnosis groups compared to controls, with a p-value approaching significance (p=0.054).

The percentages of time spent in sedentary activity, light activity and the combined moderate-to-vigorous physical activity (MVPA), the total time spent in MVPA, number of Freedson bouts (bouts of MVPA lasting at least ten minutes) and the total duration of these bouts did not show any between-group differences.

The control group scored significantly higher than the other groups in the three categories of the Movement ABC-2 (Manual Dexterity p=0.000489, Aiming & Catching p=0.018992, and Balance p=0.034859). Controls also ranked highest in total test score percentiles at 44.75, DCD group at 7.6, ASD group at 6.2125 and the dual-diagnosis group at 5.825 (p=0.00001).

Conclusions:  

Preliminary findings suggest that children with ASD and/or DCD may have different physical attributes to typically developing peers, but it is unclear whether children with ASD have defining physical and movement characteristics which may be useful in diagnosis and treatment planning. Children with ASD seem to have poorer coordination than their typically developing peers, as has been noted in published research (Ghaziuddin & Butler, 1998; Fournier et al., 2010).  Further research with larger sample size may have implications for clinical practice in areas such as physiotherapy or occupational therapy.