Motor Impairments in Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

This article comprehensively reviews motor impairments in children with autism spectrum disorder (ASD) to: (1) determine the prevalence of motor problems in children with ASD; (2) understand the nature of motor difficulties in ASD and whether they are consistent with developmental coordination disorder (DCD); and (3) determine if the term DCD was used as a co-occurring diagnosis in children with ASD after publication of the DSM-5 in 2013. The following databases were systematically searched: MEDLINE, EMBASE, CINAHL, and PsycINFO from 2010 to December 2021. Articles were included if they: (1) were peer-reviewed and published in a scientific journal; (2) included children with ASD who were between 5 and 12 years; (3) used motor or function measures to assess motor abilities in children with ASD. Studies that included children with intellectual disabilities were excluded. Two independent reviewers reviewed titles, abstracts, and full-text articles for inclusion. Twenty-seven studies met the inclusion criteria and were assessed for quality by two independent reviewers using the Appraisal tool for Cross-Sectional Studies. The majority of articles (92.5%) indicated that 50-88% of children with ASD had significant motor impairments on standardized motor assessments and/or functional questionnaires. The nature of motor and function problems in ASD were consistent with DCD; however, only three out of 20 papers (15%) that were published from 2014 described the motor problems as DCD. One study reported that 15.1% of children with ASD with motor impairments had a co-occurring diagnosis of DCD, suggesting that DCD is under-recognized in this clinical population.

How does brain structure and function on MRI differ in children with autism spectrum disorder, developmental coordination disorder, and/or attention deficit hyperactivity disorder?

AIM: The purpose of this study was to systematically review the neural similarities and differences in brain structure and function, measured by magnetic resonance imaging (MRI), in children with neurodevelopmental disorders that commonly co-occur to understand if and how they have shared neuronal characteristics. METHOD: Using systematic review methodology, the following databases were comprehensively searched: MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, and ProQuest from the earliest record up to December 2021. Inclusion criteria were (1) peer-reviewed studies, case reports, or theses; (2) children under 18 years of age with at least one of the following neurodevelopmental disorders: autism spectrum disorder (ASD), attention hyperactivity deficit disorder (ADHD), developmental coordination disorder (DCD), and their co-occurrence; and (3) studies based on MRI modalities (i.e., structural MRI, diffusion tensor imaging [DTI], and resting-state fMRI). Thirty-one studies that met the inclusion criteria were included for quality assessment by two independent reviewers using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS: Studies compared brain structure and function of children with DCD and ADHD (n = 6), DCD and ASD (n = 1), ASD and ADHD (n = 17), and various combinations of these co-occurring conditions (n = 7). Structural neuroimaging (n = 15) was the most commonly reported modality, followed by resting-state (n = 8), DTI (n = 5), and multimodalities (n = 3). INTERPRETATION: Evidence indicated that the neural correlates of the co-occurring conditions were more widespread and distinct compared to a single diagnosis. The majority of findings (77%) suggested that each neurodevelopmental disorder had more distinct neural correlates than shared neural features, suggesting that each disorder is distinct despite commonly co-occurring with each other. As the number of papers examining the co-occurrence of ASD, DCD, and/or ADHD was limited and most findings were not corrected for multiple comparisons, these results must be interpreted with caution.

Comparison of Quality of Life Following Single- Event Multilevel Surgery (SEMLS) Using Bandaging and Casting Immobilization Methods in Cerebral Palsy Children.

OBJECTIVE: Cerebral palsy (CP) is a non-progressive Neurodevelopmental disorder mainly treated using Single-event multilevel surgery (SEMLS). SEMLS contains using a casting method to immobilize the operated limb. However, in the present study, in addition to casting, the bandaging method was also applied. Bandaging is a newer method compared to casting. No study has used bandage for post-surgery immobilization. According to the best knowledge of the authors, no study has compared the outcome of bandage and cast for postoperative immobilization regarding the rehabilitation and quality of life (QoL) in the first and third months following the surgery, within the recovery period, which is associated with consequences like caring, hygiene, transferring, and mobility that affect the spirit and function of children. As a result, we decided to investigate the effect of these methods on the QoL of children the following surgery to treat CP. MATERIALS & METHODS: Following an analytical cross-sectional design, 100 children (aged 4-12 years) were randomly divided into hemiplegic and diplegic CP. The Cerebral Palsy QoL questionnaire (CP QOL-Child) was filled by parents of the participants. Based on the type of administered immobilizer, 80 children were randomly divided into two groups (40 subjects in each group). All subjects were evaluated using a similar questionnaire in the first and third months after surgery. The non-parametric Mann-Whitney test and ANOVA test were used to compare the study groups. RESULTS: The mean ratio of QoL changes, based on the CP QoL-Child questionnaire, was significantly increased in the bandage group during the first month after surgery. However, for the cast group, this parameter was significantly decreased (P<0.001). In the third month after surgery, the mean ratio of QoL changes was significantly increased in both groups, but the difference in the mean ratio of QoL changes between the two methods wasn't significant (P=0.64). CONCLUSION: In the first month after surgery, the bandaging method was more effective than the casting method, but in the third month, the outcomes were similar for both groups.