Autistic Motor issues not thought about enough

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ASPartOfMe
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05 Nov 2019, 4:31 am

Motor problems in autistic people may be grossly underestimated

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At least one in three autistic children has significant movement difficulties, according to a study of more than 2,000 children1. And yet only about 1 percent of autistic children have a diagnosed movement condition.

The study, the largest of its type, suggests that movement difficulties in autistic people are being systematically overlooked.

“That’s not due to any sinister intent, it’s just that we get a bit blinkered on looking for the core features of autism,” says lead investigator Andrew Whitehouse, professor of autism research at the Telethon Kids Institute in Perth, Australia.

Motor impairments have been documented in autistic people since the earliest descriptions of the condition. About 50 to 80 percent of autistic people are thought to have some sort of movement problem, such as clumsiness or an unusual gait, but the exact prevalence varies from study to study.

“We have been talking about motor difficulties in kids with autism for a long time, but no one had really done a study like this with this kind of sample size, which is great,” says Robin Kochel, associate director for research at the Texas Children’s Hospital Autism Center in Houston, who was not involved in the study.

The new findings indicate that movement problems are just as common among autistic children as intellectual disability is. And like intellectual disability, experts say, they belong among the factors clinicians use to define the exact nature of a person’s autism diagnosis.

Whitehouse and his colleagues analyzed records from diagnostic evaluations for 2,084 autistic children aged 6 years or younger. The records come from the Western Australian Register for Autism Spectrum Disorders, which includes information about most people diagnosed with autism in Western Australia since 1999.

The researchers assessed the children’s motor skills using scores on a standard parent questionnaire called the Vineland Adaptive Behavior Scales.

They found that 35 percent of the children have ‘low’ motor skills, meaning they score at least two standard deviations below typical children of the same age. Another 44 percent have ‘moderately low’ motor skills, defined as one standard deviation below the norm.

Only 24 of the children had diagnoses of motor conditions, such as cerebral palsy or low muscle tone.

“We were quite alarmed by that finding,” says Melissa Licari, a postdoctoral fellow on Whitehouse’s team. “Motor difficulties are overlooked during standard diagnostic practice.”

Autistic children who repeat words or movements tend to have lower motor scores than other autistic children, the team found. The finding suggests that repetitive behaviors and motor development are linked in some way.

“It would be interesting to tease that out more,” Kochel says.

The researchers had data on intellectual ability for about half the children in the study. They found that children with intellectual disability are more likely to have motor difficulties than those without it.

Motor difficulties in autistic children may be missed because parents do not voice concerns about the issues, Kochel says. Clinicians may need to specifically ask parents about motor skills.

Researchers should collect detailed, objective data on motor skills in autistic children to determine which types are most prevalent and pose the greatest challenges, says Rujuta Wilson, assistant professor in pediatrics and psychiatry at the University of California, Los Angeles, who was not involved in the study.

“We need to start thinking about ways to evaluate certain types of motor impairments — balance difficulties, gait difficulties, coordination, low tone — and screen for them more routinely,” Wilson says.

Whitehouse plans to gather data on types of motor difficulties in children with autism and explore ways to treat these problems.

While I agree with the Neurodiversity movements idea that a lot of the problems autistic people face are caused correctable societal misunderstanding and discrimination of the way we think and express ourselves via body language, this is why I can’t agree with those that posit autism is just a gift. Motor problems are not a invisible disability, but a traditional physical one that can be mitigated but not eliminated by societal understanding.


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CockneyRebel
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06 Nov 2019, 10:40 pm

I agree with everything that's been written in that article. I also think that motor skills need to be screened more.


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firemonkey
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07 Nov 2019, 12:17 am

The first psych appt I had after moving down here the pdoc had me do some things with my hands, and then declared I was quite dyspraxic . School reports mentioned my poor coordination . It's also been mentioned by my father and sister. My late wife said I walked funny. My stepdaughter has said I'm the clumsiest person she's known , and that I walk like I'm drunk.


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carlos55
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07 Nov 2019, 4:12 am

Autism is a whole body condition, when one includes the high rates of epilepsy ( something that can kill ) GI issues and motor problems. Heart issues are also common unfortunatly.

It goes a long way in explaining our shortened life expectancy.

It does make a mockery of the shallow claims of many in the ND movement that with a few tweaks societal here and there all will be ok.

The main long term salvation for us is through science research and therapy.

Of course better public education, provisions and workplace opportunities are important too.



magz
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07 Nov 2019, 4:41 am

Some motor issues may be hard to spot.
My type of clumsiness - fitting the description of ideomotor dyspraxia but never actually diagnosed as such - does not manifest in any obvious way, just spilling drinks, dropping things, missing touch fields and being unable to play most video games. However, learned movements are okay, I play guitar, I could jump on stairs in the darkness if I knew those stairs.
So, one would need much more than some simple screening to spot any problem.

But it may be okay, all I've read about dyspraxia therapy is learning workarounds and this is exactly what I did just to survive.


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07 Nov 2019, 5:10 am

That’s pretty much my type, too.

What I have a “learning disability” in—is benefiting from visual directions. And the visual in general. I need both words and visual directions, plus hands-on actual experience.



firemonkey
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07 Nov 2019, 5:32 am

CockneyRebel wrote:
I agree with everything that's been written in that article. I also think that motor skills need to be screened more.



Totally agree also.


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blazingstar
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07 Nov 2019, 6:31 am

kraftiekortie wrote:
That’s pretty much my type, too.

What I have a “learning disability” in—is benefiting from visual directions. And the visual in general. I need both words and visual directions, plus hands-on actual experience.


This would apply to me also. Like mags, I can do learned physical things, play banjo and dance. But otherwise am klutzy. I know I have impaired fine motor control. I cannot play fast.

I work in the larger developmental disabilities community in which a lot of people have physical disabilities. The larger culture does need more societal acceptance of accommodations and applicable/desired treatments for all disabilities.


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07 Nov 2019, 7:06 am

This is very interesting. I am a bit clumsy, but like some of you, my motor issues aren’t necessarily very obvious. I feel like we could add muscle strength impairment to this list too. I was never as strong as my peers growing up. But I could play instruments and draw, skip, hop, etc.

I could never throw a basketball as far as my classmates did, or hit a volleyball for a proper serve. I was just not as strong or very coordinated with my gross motor skills relating to sports.

Growing up, every now and then I would have decreased strength on my hands in the morning. So much so I could not open the cap on the toothpaste. My mom thought I was joking or imagining things, so nobody really looked into it. The strength would come back to my regular level after some time, but I never knew why it had happened in the first place. I’m convinced now it has something to do with my autism.


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07 Nov 2019, 7:22 am

I did 5 years of piano as an extra curricular activity at prep school . I was so bad at it I never even took the grade 1 exam. My drawing ability is around an average 6-7 year old level.

At school I was usually the last one picked for a team at sports . I've never been a strong person .


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carlos55
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07 Nov 2019, 10:57 am

magz wrote:
Some motor issues may be hard to spot.
My type of clumsiness - fitting the description of ideomotor dyspraxia but never actually diagnosed as such - does not manifest in any obvious way, just spilling drinks, dropping things, missing touch fields and being unable to play most video games. However, learned movements are okay, I play guitar, I could jump on stairs in the darkness if I knew those stairs.
So, one would need much more than some simple screening to spot any problem.

But it may be okay, all I've read about dyspraxia therapy is learning workarounds and this is exactly what I did just to survive.


Magz - While i know its not everyone's thing have you tried to persevere with computer games?

Seems like an easy thing to practice on and would be interesting if the similar concept of regular practice leads to improvement works from an autism perspective.



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07 Nov 2019, 11:09 am

carlos55 wrote:
Magz - While i know its not everyone's thing have you tried to persevere with computer games?
I can learn controls of one game but slightly different controls of another game and I'm lost again. If synchronization of both hands is required, the case is lost anyway.

carlos55 wrote:
Seems like an easy thing to practice on and would be interesting if the similar concept of regular practice leads to improvement works from an autism perspective.
No, it's not easy, it's hopelessly frustrating. Not any better than forcing people to practice sports they suck at.


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07 Nov 2019, 12:15 pm

I was diagnosed with dyspraxia as part of my assessment screened for any other conditions I could have. While I am traditionally clumsy I have problems with many of the things the people above have said they do not. I would never be able to play an instrument and having to learn both the recorder and violin in my primary education was horrific. I was awful at them. I also tend to randomly drop things and walk into things/people.

It's so important things like this are picked up on because they often have other symptoms alongside the clumsiness that can cause problems. I also wonder how many of our health problems are caused by stress because every health issue I've had in the recent years, including an autoimmune disorder were all linked to stress. If the ND movement made things less stressful (ie. less need to mask, more understanding of sensory needs etc.) I wonder what else would be affected because I do think some parts of autism can be beneficial.



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07 Nov 2019, 12:58 pm

I have always walked erratically, struggled to run because my feet feel too far away, struggled to catch balls, had dreadful writing, poor typing skills etc etc always last to be chosen for sports etc etc not enough to be considered a disability but not normal either.

My eldest son didn't walk until he was nearly three and only then with lots of physio. He has never been able to run or climb or use a pen or a fork or do anything requiring fine motor control. He had a physical therapist who was absolutely determined to teach him to ride a tricycle and dedicated loads of time to it but he didn't even get close to achieving it. He also has seizures, a diagnosed movement disorder and severe learning difficulties. MS who is the least autistic of us all walked at 9 months and is good at sport, particularly skating, and had no trouble with riding a bike.YS, who has aspergers like I do with a high IQ, has hyperflexible joints and has a hard time even walking and is really slow and extremely clumsy, much worse than me, he never managed to ride a bike, couldn't catch, and still can't write properly although he can type a mile a minute. I am really worried for him about the future as I am afraid he could lose the mobility he has.

So I am not at all surprised by this.


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08 Nov 2019, 3:23 pm

ASPartOfMe wrote:
While I agree with the Neurodiversity movements idea that a lot of the problems autistic people face are caused correctable societal misunderstanding and discrimination of the way we think and express ourselves via body language, this is why I can’t agree with those that posit autism is just a gift. Motor problems are not a invisible disability, but a traditional physical one that can be mitigated but not eliminated by societal understanding.

Very few people (and only a small minority of neurodiversity paradigm advocates, as far as I can tell) actually claim that "autism is just a gift," although many of us do feel that autism entails (for many of us, at least) strengths as well as disabilities.


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