Associations of Postural Knowledge and Basic Motor Skill With Dyspraxia in Autism: Implication for Abnormalities in Distributed Connectivity and Motor Learning

Laboratory for Neurocognitive and Imaging Research, Kennedy Krieger Institute, Baltimore, MD 21205, USA.
Neuropsychology (Impact Factor: 3.27). 10/2009; 23(5):563-70. DOI: 10.1037/a0015640
Source: PubMed


Children with autism often have difficulty performing skilled movements. Praxis performance requires basic motor skill, knowledge of representations of the movement (mediated by parietal regions), and transcoding of these representations into movement plans (mediated by premotor circuits). The goals of this study were (a) to determine whether dyspraxia in autism is associated with impaired representational ("postural") knowledge and (b) to examine the contributions of postural knowledge and basic motor skill to dyspraxia in autism. Thirty-seven children with autism spectrum disorder (ASD) and 50 typically developing (TD) children, ages 8-13, completed (a) an examination of basic motor skills, (b) a postural knowledge test assessing praxis discrimination, and (c) a praxis examination. Children with ASD showed worse basic motor skill and postural knowledge than did controls. The ASD group continued to show significantly poorer praxis than did controls after accounting for age, IQ, basic motor skill, and postural knowledge. Dyspraxia in autism appears to be associated with impaired formation of spatial representations, as well as transcoding and execution. Distributed abnormality across parietal, premotor, and motor circuitry, as well as anomalous connectivity, may be implicated.

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    • "If the actual sensory feedback is different from predicted, the resulting prediction error drives motor learning by updating an internal model (Donchin et al., 2003). Individuals with ASD present a broad range of motor impairments, including impairments in simple timed movements (Jansiewicz et al., 2006), handwriting (Fuentes et al., 2009), skilled gestures (Mostofsky et al., 2006; Dowell et al., 2009) and imitation (Dziuk et al., 2007). Potentially, this broad spectrum of motor impairments, present even in infancy (Provost et al., 2007), is related to the inability of individuals with ASD to appropriately learn internal models, a lifelong developmental process. "
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    ABSTRACT: Autism spectrum disorder is a developmental disorder characterized by deficits in social and communication skills and repetitive and stereotyped interests and behaviours. Although not part of the diagnostic criteria, individuals with autism experience a host of motor impairments, potentially due to abnormalities in how they learn motor control throughout development. Here, we used behavioural techniques to quantify motor learning in autism spectrum disorder, and structural brain imaging to investigate the neural basis of that learning in the cerebellum. Twenty children with autism spectrum disorder and 20 typically developing control subjects, aged 8-12, made reaching movements while holding the handle of a robotic manipulandum. In random trials the reach was perturbed, resulting in errors that were sensed through vision and proprioception. The brain learned from these errors and altered the motor commands on the subsequent reach. We measured learning from error as a function of the sensory modality of that error, and found that children with autism spectrum disorder outperformed typically developing children when learning from errors that were sensed through proprioception, but underperformed typically developing children when learning from errors that were sensed through vision. Previous work had shown that this learning depends on the integrity of a region in the anterior cerebellum. Here we found that the anterior cerebellum, extending into lobule VI, and parts of lobule VIII were smaller than normal in children with autism spectrum disorder, with a volume that was predicted by the pattern of learning from visual and proprioceptive errors. We suggest that the abnormal patterns of motor learning in children with autism spectrum disorder, showing an increased sensitivity to proprioceptive error and a decreased sensitivity to visual error, may be associated with abnormalities in the cerebellum.
    Brain 01/2015; 138(3). DOI:10.1093/brain/awu394 · 9.20 Impact Factor
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    • "It is likely that mechanisms involved in the abnormal development of motor skills in ASD also contribute to the impaired development of social and communicative abilities in these individuals (Mostofsky et al., 2000; Ullman, 2004). The severity of motor impairments experienced by children with ASD relates to the severity of the communicative/social deficits at the core of their diagnosis (Dziuk et al., 2007; Dowell et al., 2009), and better early motor control has been shown to be related to decreased severity of ASD in later life (Sutera et al., 2007). Considered together, these converging lines of evidence suggest that a purely cognitive explanation for ASD is shortsighted and underscore the need for systematic examination of the neural underpinnings of motor development in individuals with ASD. "
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    ABSTRACT: Motor impairments are prevalent in children with autism spectrum disorders (ASD) and are perhaps the earliest symptoms to develop. In addition, motor skills relate to the communicative/social deficits at the core of ASD diagnosis, and these behavioral deficits may reflect abnormal connectivity within brain networks underlying motor control and learning. Despite the fact that motor abnormalities in ASD are well-characterized, there remains a fundamental disconnect between the complexity of the clinical presentation of ASD and the underlying neurobiological mechanisms. In this study, we examined connectivity within and between functional subregions of a key component of the motor control network, the precentral gyrus, using resting state functional Magnetic Resonance Imaging data collected from a large, heterogeneous sample of individuals with ASD as well as neurotypical controls. We found that the strength of connectivity within and between distinct functional subregions of the precentral gyrus was related to ASD diagnosis and to the severity of ASD traits. In particular, connectivity involving the dorsomedial (lower limb/trunk) subregion was abnormal in ASD individuals as predicted by models using a dichotomous variable coding for the presence of ASD, as well as models using symptom severity ratings. These findings provide further support for a link between motor and social/communicative abilities in ASD.
    Frontiers in Systems Neuroscience 05/2014; 8:80. DOI:10.3389/fnsys.2014.00080
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    • "Other studies have suggested that underlying factors may include problems with sensory feedback [18] [48] [53] or reduced connectivity among networks controlling praxis [51] [54]—a hypothesis that is consistent with more general models of reduced long-distance structural and functional connectivity in autism [55] [56] [57] [58] [59]. A review of 21 praxis studies done over 30 years with 281 ASD children implicated visuo-motor " coupling " mechanisms as a contributing factor [44]. Problems with sensory–motor integration are quite consistent with a large literature suggesting more general deficits in the long-distance connectivity that supports associative or integrative processes [55–57,60–63]. "
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    ABSTRACT: This project assessed dyspraxia in high-functioning school aged children with autism with a focus on Ideational Praxis. We examined the association of specific underlying motor function including eye movement with ideational dyspraxia (sequences of skilled movements) as well as the possible role of visual-motor integration in dyspraxia. We found that compared to IQ-, sex- and age-matched typically developing children, the children with autism performed significantly worse on: Ideational and Buccofacial praxis; a broad range of motor tests, including measures of simple motor skill, timing and accuracy of saccadic eye movements and motor coordination; and tests of visual-motor integration. Impairments in individual children with autism were heterogeneous in nature, although when we examined the praxis data as a function of a qualitative measure representing motor timing, we found that children with poor motor timing performed worse on all praxis categories and had slower and less accurate eye movements while those with regular timing performed as well as typical children on those same tasks. Our data provide evidence that both motor function and visual-motor integration contribute to dyspraxia. We suggest that dyspraxia in autism involves cerebellar mechanisms of movement control and the integration of these mechanisms with cortical networks implicated in praxis.
    Behavioural brain research 04/2014; 269. DOI:10.1016/j.bbr.2014.04.011 · 3.03 Impact Factor
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