Mostofsky Stewart H, Dubey Prachi, Jerath Vandna K, Jansiewicz Eva M, Goldberg Melissa C, Denckla Martha B
Department of Developmental Cognitive Neurology, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, 707 N. Broadway, Baltimore, MD 21205, USA.
J Int Neuropsychol Soc. 2006 May;12(3):314-26. doi: 10.1017/s1355617706060437.
Impaired imitation of skilled gestures is commonly reported in autism. Questions, however, remain as to whether impaired imitation is associated with a more generalized deficit in performance of gestures consistent with a dyspraxia and whether the pattern of errors differs from that observed in typically developing children. To address these questions, praxis in 21 high-functioning children with autism spectrum disorders (ASD) was compared with 24 typically developing controls using a traditional approach in which performance was evaluated through detailed examination of error types. Children with ASD produced significantly fewer correct responses not only during Gesture to Imitation, but also during Gesture to Command and with Tool Use. The pattern of errors in ASD was similar to that of controls with spatial errors being most common in both groups; however, body-part-for-tool errors were more common in children with ASD, suggesting dyspraxia is not entirely attributable to motor deficits. The findings suggest that autism is associated with a generalized praxis deficit, rather than a deficit specific to imitation. In a developmental disorder such as autism, the findings may reflect abnormalities in frontal/parietal-subcortical circuits important for acquisition (i.e., learning) of sensory representations of movement and/or the motor sequence programs necessary to execute them.
在自闭症中，熟练手势模仿受损的情况普遍存在。然而，关于模仿受损是否与更广泛的手势执行缺陷（与失用症一致）相关，以及错误模式是否与正常发育儿童中观察到的不同，这些问题仍然存在。为了解决这些问题，使用传统方法对21名高功能自闭症谱系障碍（ASD）儿童和24名正常发育对照儿童的实践能力进行了比较，在该方法中，通过详细检查错误类型来评估表现。ASD儿童不仅在“手势模仿”任务中，而且在“手势指令”任务和“工具使用”任务中产生的正确反应都明显更少。ASD儿童的错误模式与对照组相似，空间错误在两组中最为常见；然而，“用身体部位代替工具”的错误在ASD儿童中更为常见，这表明失用症并不完全归因于运动缺陷。研究结果表明，自闭症与广泛的实践能力缺陷有关，而不是特定于模仿的缺陷。在自闭症这样的发育障碍中，这些发现可能反映了对运动感觉表征获取（即学习）和/或执行这些表征所需的运动序列程序至关重要的额叶/顶叶-皮质下回路的异常。
