Chisari Donella, Vitkovic Jessica, Clark Ross, Rance Gary
Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC 3010, Australia.
Dizzyology Australia Limited, Melbourne, VIC 3149, Australia.
J Clin Med. 2024 Sep 9;13(17):5323. doi: 10.3390/jcm13175323.
Postural control deficits have been documented in children with autism spectrum disorder (ASD), yet vestibular system contributions to postural control have not been widely considered. The purpose of this study is to explore the relationship between functional balance, postural sway, and vestibular function in children with ASD. Ten children with a confirmed diagnosis of ASD according to DSM-V guidelines along with ten children with no known neurodevelopmental or motor delays participated in the study. Bruininks-Oseretsky Test of Motor Proficiency and the Paediatric Balance Scale measured functional balance ability, and postural sway was measured using static posturography with modified sensory inputs. Peripheral vestibular function was measured using cervical vestibular evoked myogenic potentials and video head impulse testing. Correlations between measures were performed. When visual cues were removed, children with ASD demonstrated larger path velocities indicative of reduced postural control, and different patterns of postural sway. Functional balance was correlated with path velocities for conditions where sensory information was modified. No differences in peripheral vestibular function were noted between groups, and functional balance was not correlated with vestibular function. Findings suggest that while peripheral vestibular function is similar between groups, postural control differences in children with ASD remain, particularly for conditions where sensory information is modified. Furthermore, demonstrated patterns of postural sway suggest sensory system integration is less developed in children with ASD. These findings highlight the importance of utilising a range of clinical tools to quantify balance ability and consideration of postural control measures to inform intervention.
自闭症谱系障碍（ASD）儿童存在姿势控制缺陷，但前庭系统对姿势控制的作用尚未得到广泛关注。本研究旨在探讨ASD儿童的功能性平衡、姿势摆动与前庭功能之间的关系。根据《精神疾病诊断与统计手册》第五版（DSM-V）指南确诊的10名ASD儿童以及10名无已知神经发育或运动迟缓的儿童参与了本研究。使用布鲁宁克斯-奥塞瑞斯基运动熟练度测试和儿童平衡量表测量功能性平衡能力，通过带有改良感觉输入的静态姿势描记法测量姿势摆动。使用颈前庭诱发肌源性电位和视频头脉冲测试测量外周前庭功能。对各项测量指标进行相关性分析。当视觉线索被去除时，ASD儿童表现出更大的路径速度，表明姿势控制能力下降，以及不同的姿势摆动模式。在感觉信息被改变的情况下，功能性平衡与路径速度相关。两组之间在外周前庭功能上未发现差异，并且功能性平衡与前庭功能不相关。研究结果表明，虽然两组之间外周前庭功能相似，但ASD儿童的姿势控制差异仍然存在，特别是在感觉信息被改变的情况下。此外，所呈现的姿势摆动模式表明ASD儿童的感觉系统整合发育较差。这些发现凸显了使用一系列临床工具来量化平衡能力以及考虑姿势控制测量以指导干预的重要性。
