L5 Movement and motor coordination

What is motor coordination

control of different muscles to achieve a movement task

How are muscle activated and what does it encompass

in a cooperative way, using multiple motor processes

What is motor control important for in life

daily living and functional tasks, and communication and social activities

Motor coordination – tell me its prevalence, when is it present in the lifespan, what the mechanisms are, which indicate its large impact on autistic people

80% prevalence (or high prevalence), present across the lifespan and mechanisms unknown

What are the 3 categories used to evaluate motor coordination

fine motor control, gross motor control and eye-hand coordination

What is the difference between fine, gross and eye-hand coordination

small vs bigger movements, eye-hand coordination requires both fine and gross motor control

Name 2 objective clinical measures used to assess motor coordination

movement assessment batteries (Movement ABC) and neurological soft signs batteries

Complete info on Movement ABC

children, fine, balance, accuracy, time, ability

Complete info on neurological soft signs

overflow, dysrhythmia, persistence, muscle tone

What do objective research measures aim to assess about motor coordination, and name 4 examples of measures

the quality of movement

Name a subjective clinical vs research measure of motor coordination

quantitative questionnaires vs qualitative interviews/focus groups/questionnaires

Which objective clinical measure is best to use in adults

neurological soft signs

In pointing tasks (objective research measures), what is the nature of autistic peoples responses (time, nature, accuracy)

slower, jerkier, less accurate

In reach to grasp tasks, what is the reaction time and movement speed

longer and slower

What do objective research measures aim to determine about balance (2 things)

centre of pressure and postural sway

When measuring gait, answer whether the following are increased or reduced in autistic people – stride length, cadence (no. of steps), step width and base of support

reduce, increased, increased, wider (increased)

What is the Developmental Coordination checklist

an example of a subjective clinical measure of motor coordination

What do higher scores in the Developmental Coordination checklist indicate

likely Developmental Coordination Disorder

How do autistic groups tend to score compared to non-autistic groups on this checklist

higher

Name 3 fine motor movements autistic adults report difficultly with, according to qualitative studies

sewing, doing up buttons and tying shoelaces

Name 5 eye-hand coordination tasks autistic adults report difficultly with, according to qualitative studies

catching, throwing, pouring liquids, reaching difficult objects, dropping objects

Name 3 gross motor movements autistic adults report difficultly with, according to qualitative studies

walking, balance, bumping/knocking things

How do coordination issues shift over time

they remain throughout life, but some improvement due to strategies (not actual changes in motor coordination)

What is an emotional challenge of motor coordination difficulties

that it is noticed by others

Qualitative studies highlight what variability in motor difficulties

between and within people

Other than differences in motor strengths/weaknesses between people, what also differed between autistic people in this context

levels of awareness

Name 3 fine motor movements autistic children report difficultly with, according to qualitative studies

writing, tying shoelaces and using cutlery

Name 2 eye-hand coordination tasks autistic children report difficultly with, according to qualitative studies

throwing and catching balls

Name 3 gross motor movements autistic children report difficultly with, according to qualitative studies

unstable balance, jumping, climbing stairs

What is Developmental Coordination Disorder (DCD, also known as dyspraxia)

a condition characterised by difficulties with motor coordination

What proportion of children does it affect

Less than 10%

Assessment measures of motor coordination for DCD vs autistic motor coordination can differ – which tools tend to reveal differences between these groups

more standardised, lab-based quantitative measures

What are 3 examples of daily living tasks that autistic people will struggle with due to motor coordination difficulties

getting dressed, handwriting, sports

Trips and falls can be an impact of motor coordination difficulties, why is the particularly concerning for autistic people

they are leading cause of injury, injury-related disability, and death in older people

Why do autistic people show decreased levels of physical activity and increased risk of health conditions/obesity

because they tend to avoid challenging motor activities like physical activity

What are 2 consequences of movement requiring full concentration

active (non-optional) monitoring and extreme fatigue

What is the social impact of motor coordination difficulties

strained relationships due to negative reactions from others, and bullying and exclusion

What are 4 emotions experienced due to motor coordination difficulties

embarrassment, disappointment, frustration and fear

What are 3 impacts of this on emotional well-being

socially outcast, poor self-esteem, low confidence

Summary of impacts of motor coordination difficulties on children (4) vs parents (3)

daily activities, falls, reduced physical activity, and social and emotional well-being vs time, employment and social and emotional well-being

What are 3 time requirements from parents to support motor needs of autistic children

time to prepare, liaise with others and research support and suitable activities

Consider these findings, this points towards a relationship between motor and social difficulties – name 3 mechanisms underling the link between social and motor ability

reduced participation in play and exploration of social contexts, increased attention/effort needed to make movements and exclusion by self and others

Complete the consequences of these mechanisms

caregivers, social, observational, looking, social, attention, behaviour, participation, social

Why are motor coordination difficulties often overlooked in autistic people

not routinely assessed, diagnosed or treated

Are therapies and support more available for children or adults

children

What are 5 examples of motor interventions that have been evaluated for autistic children

motor activity interventions, specific training of motor skills (e.g. balance, throwing), horse riding interventions, exergaming, school physical education programmes

What do motor activity interventions target

sports/recreational activities e.g. gymnastics, table tennis

What is the overall quality of evidence for motor interventions in autistic children

poor, even thought a variety have been assessed

Despite poor evidence, what has been generally observed as a result of these interventions

improvements in strength, motor ability and cardiovascular fitness

Name two examples of target support for children

occupational therapy (OT) and physiotherapy

What is the aim of OT

to promote participant and engagement in daily life activities, not necessarily to improve motor skills specifically

What is an example strategy targeted by OT

cognitive strategies

What is are two examples of exercises in physiotherapy

strength and balance

What are 3 problems with therapies

access, awareness and knowing what is offered

What are 3 personal strategies adopted by adults

practice and learning, practical strategies and avoidance

What is the overall outcome of practice and learning

takes a long time and does not achieve ability of peers but does lead to improvement

What are 3 examples of practical strategies

organising, reducing expectations and breaking up tasks

Consider these motor strength in autistic people, what does the existence of autistic professional sports players illustrate about motor coordination in autism?

It reinforces the spiky profile — motor coordination varies widely within and between autistic people, and significant motor strengths can coexist alongside specific difficulties.