López-Espejo Mauricio A, Núñez Alicia C, Moscoso Odalie C, Escobar Raúl G
Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Red de Salud UC-CHRISTUS, Santiago, Chile.
Andes Pediatr. 2022 Feb;93(1):37-42. doi: 10.32641/andespediatr.v93i1.3455. Epub 2022 Mar 28.
To describe main motor disorders detected in children with autism spectrum disorder (ASD) and analyze associated clinical variables.
A cross-sectional observatio nal study of 96 children with ASD, median age 4 years (range, 3-9), 32.3% girls, and 18.8% preterm. Children were evaluated at the UC-CHRISTUS Clinical Hospital Neurodevelopmental Unit for three years. We analyzed the relationship between motor signs (stereotypies, delayed gait, and hypo/hyper tonia) and spoken language at 4 years of age.
63.5% of children presented a motor disorder, 33.3% had hand or body motor stereotypies at the time of the evaluation, and 28.1% had delayed gait (> 16 months of corrected gestational age). These children had a higher frequency of absence of spoken language at four years of age (OR = 9.36; 95% CI = 2.67-32.78) than patients without delayed gait. 40.6% of children presented alterations in muscle tone during the first two years of life (32.3% generalized hypotonia and 8.3% generalized hypertonia). A history of generalized hypotonia increases the chance of presenting delayed gait (OR = 2.65; 95% CI = 1.08-6.48) and motor stereo typies (OR = 2.63; 95% CI = 1.04-6.65).
Children with ASD usually develop motor disorders that may precede the diagnosis of the condition. In ASD, infant hypotonia may predict the occurrence of other motor disorders, and delayed gait was associated with spoken language absence in preschool age.
描述自闭症谱系障碍（ASD）儿童中检测到的主要运动障碍，并分析相关临床变量。
对96名ASD儿童进行横断面观察性研究，中位年龄4岁（范围3 - 9岁），女孩占32.3%，早产占18.8%。这些儿童在UC - CHRISTUS临床医院神经发育科接受了三年评估。我们分析了运动体征（刻板动作、步态延迟和低/高张力）与4岁时口语之间的关系。
63.5%的儿童存在运动障碍，33.3%在评估时出现手部或身体运动刻板动作，28.1%存在步态延迟（矫正胎龄>16个月）。与步态未延迟的患者相比，这些儿童在4岁时无口语的频率更高（比值比[OR]=9.36；95%置信区间[CI]=2.67 - 32.78）。40.6%的儿童在生命的前两年出现肌张力改变（32.3%为全身性低张力，8.3%为全身性高张力）。全身性低张力病史增加了出现步态延迟（OR = 2.65；95% CI = 1.08 - 6.48）和运动刻板动作（OR = 2.63；95% CI = 1.04 - 6.65）的几率。
ASD儿童通常会出现可能先于该病诊断的运动障碍。在ASD中，婴儿期低张力可能预示其他运动障碍的发生，且步态延迟与学龄前无口语相关。
