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自闭症谱系障碍中运动障碍的性质:与发育性协调障碍的比较。

Nature of motor impairments in autism spectrum disorder: A comparison with developmental coordination disorder.

机构信息

a Faculty of Medicine , University of Paris Descartes , Sorbonne Paris Cité , Paris , France.

b CESP/Inserm U1018 , University Paris-Sud and University Paris Descartes , Paris , France.

出版信息

J Clin Exp Neuropsychol. 2019 Feb;41(1):1-14. doi: 10.1080/13803395.2018.1483486. Epub 2018 Jun 20.

Abstract

INTRODUCTION

Several authors have suggested the existence of motor disorders associated with developmental coordination disorder (DCD) in individuals with autism spectrum disorder (ASD). However, there are few comparative studies of psychomotor profiles that include assessments of neurological soft signs in children with ASD or DCD. We used a neuropsychomotor assessment for children with ASD from a standardized neurodevelopmental examination to understand the nature of the difficulties these children encounter. To uncover the differences and similarities in psychomotor profiles, we compared the profiles of children with ASD with those of children with DCD and focused on two recently described DCD subgroups: visuospatial-constructional (VSC) and mixed (MX).

METHODS

We compared 18 children with ASD and 58 children with DCD (33 with VSC-DCD and 25 with MX-DCD) who were assessed with a battery of French-language tests (the NP-MOT) to evaluate the neuropsychomotor functions associated with visual perception and visual-spatial-motor structuring.

RESULTS

Although there were similarities between the profiles of children with ASD and those with DCD (VSC-DCD or MX-DCD), these similarities were not associated with the predictive diagnostic markers that characterized subtypes of DCD. Instead, many variables (visuospatial-motor structuration, synkinetic movements, dynamic balance, manual dexterity, coordination, praxis, bodily spatial integration, and digital perception) differed among the three groups; the best performance was observed in the children with ASD.

CONCLUSION

The neuropsychomotor profiles of children with ASD and those with VSC-DCD or MX-DCD differed, and these differences are discussed. Our results highlight that impairments of ASD are specific about lateralization disturbances and support the hypothesis of proprioceptive impairment due to visual fixation problems influenced by muscular tone in relation to the subcortical and cortical structures and possible interhemispheric disorder. Thus, some neuropsychomotor functions that underpin both gestures and a set of motor skills are affected.

摘要

简介

一些作者提出,在自闭症谱系障碍(ASD)个体中存在与发育性协调障碍(DCD)相关的运动障碍。然而,关于包括神经系统软体征评估的心理运动特征的比较研究很少,这些研究涉及 ASD 或 DCD 儿童。我们使用标准化神经发育检查中的神经心理运动评估来了解这些儿童所面临的困难的性质。为了揭示心理运动特征的差异和相似之处,我们比较了 ASD 儿童和 DCD 儿童的特征,并重点关注最近描述的 DCD 两个亚组:视空间建构(VSC)和混合(MX)。

方法

我们比较了 18 名 ASD 儿童和 58 名 DCD 儿童(33 名 VSC-DCD 和 25 名 MX-DCD),他们接受了一系列法语测试(NP-MOT)的评估,以评估与视觉感知和视觉空间运动结构相关的神经心理运动功能。

结果

尽管 ASD 儿童和 DCD 儿童(VSC-DCD 或 MX-DCD)的特征存在相似之处,但这些相似之处与特征性的 DCD 亚型的预测诊断标志物无关。相反,许多变量(视觉运动结构、同步运动、动态平衡、手灵巧性、协调性、动作技能、身体空间整合和数字感知)在三组之间存在差异;最好的表现出现在 ASD 儿童中。

结论

ASD 儿童和 VSC-DCD 或 MX-DCD 儿童的神经心理运动特征存在差异,这些差异进行了讨论。我们的结果强调,ASD 的损伤是特定于侧化障碍的,并支持由于视觉固定问题导致的本体感受损伤的假说,这与肌肉张力有关,与皮质下和皮质结构有关,可能与大脑两半球之间的障碍有关。因此,一些支撑手势和一系列运动技能的神经心理运动功能受到影响。

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