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      Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review

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          Abstract

          In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children.

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          Most cited references53

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          Motor coordination in autism spectrum disorders: a synthesis and meta-analysis.

          Are motor coordination deficits an underlying cardinal feature of Autism Spectrum Disorders (ASD)? Database searches identified 83 ASD studies focused on motor coordination, arm movements, gait, or postural stability deficits. Data extraction involved between-group comparisons for ASD and typically developing controls (N = 51). Rigorous meta-analysis techniques including random effects models, forest and funnel plots, I (2), publication bias, fail-safe analysis, and moderator variable analyses determined a significant standardized mean difference effect equal to 1.20 (SE = 0.144; p <0.0001; Z = 10.49). This large effect indicated substantial motor coordination deficits in the ASD groups across a wide range of behaviors. The current overall findings portray motor coordination deficits as pervasive across diagnoses, thus, a cardinal feature of ASD.
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            Motor abilities in autism: a review using a computational context.

            Altered motor behaviour is commonly reported in Autism Spectrum Disorder, but the aetiology remains unclear. Here, we have taken a computational approach in order to break down motor control into different components and review the functioning of each process. Our findings suggest abnormalities in two areas--poor integration of information for efficient motor planning, and increased variability in basic sensory inputs and motor outputs. In contrast, motor learning processes are relatively intact and there is inconsistent evidence for deficits in predictive control. We suggest future work on motor abilities in autism should focus on sensorimotor noise and on higher level motor planning, as these seem to have a significant role in causing motor difficulties for autistic individuals.
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              Motor skills of toddlers with autism spectrum disorders.

              With increased interest in the early diagnosis and treatment of children with autism spectrum disorders (ASD), more attention has been called to the motor skills of very young children with ASD. This study describes the gross and fine motor skills of a cross-sectional group of 162 children with ASD between the ages of 12 and 36 months, as well as a subset of 58 children followed longitudinally. Gross motor and fine motor age equivalent scores were obtained for all children. A 'motor difference' variable was calculated for each child's gross and fine motor skills by taking the absolute difference of the children's age equivalent motor score and their respective chronological age. In Study 1 (the cross-sectional analysis), ANCOVA (co-varied for nonverbal problem solving) revealed significant group differences in the gross motor and fine motor age difference variables. Post-hoc analysis revealed that gross motor and fine motor differences became significantly greater with each 6-month period of chronological age. In Study 2, 58 children were measured twice, an average of 12 months apart. Results indicate that the gross motor and fine motor difference scores significantly increased between the first and second measurements. The importance of addressing motor development in early intervention treatments is discussed.
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                Author and article information

                Journal
                Children (Basel)
                Children (Basel)
                children
                Children
                MDPI
                2227-9067
                23 November 2020
                November 2020
                : 7
                : 11
                : 250
                Affiliations
                [1 ]Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy; silvia.busti@ 123456lanostrafamiglia.it (S.B.C.); maria.nobile@ 123456lanostrafamiglia.it (M.N.); massimo.molteni@ 123456lanostrafamiglia.it (M.M.)
                [2 ]Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; c.ferrante1@ 123456campus.unimib.it (C.F.); e.gazzola1@ 123456campus.unimib.it (E.G.); gianmarco.marzocchi@ 123456unimib.it (G.M.M.)
                Author notes
                [* ]Correspondence: alessandro.crippa@ 123456lanostrafamiglia.it ; Tel.: +39-031-877593
                Author information
                https://orcid.org/0000-0002-3497-2022
                https://orcid.org/0000-0002-9917-4275
                https://orcid.org/0000-0002-3407-0352
                Article
                children-07-00250
                10.3390/children7110250
                7700578
                33238562
                a31373f4-1e1b-455f-9c96-59cc3ad35b62
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 14 October 2020
                : 21 November 2020
                Categories
                Review

                autism spectrum disorder,fundamental motor skills,intervention,treatment,rehabilitation

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