Jill C. Heathcock, Kelly Tanner, Danielle Robson, Robyn Young, Alison E. Lane; Retrospective Analysis of Motor Development in Infants at High and Low Risk for Autism Spectrum Disorder. Am J Occup Ther 2015;69(5):6905185070. https://doi.org/10.5014/ajot.2015.017525
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© 2020 American Occupational Therapy Association
OBJECTIVE. To measure upper-extremity and gross motor skill development in infants with and without risk factors for autism spectrum disorder (ASD).
METHOD. Data were coded retrospectively from 39 infants who participated in longitudinal structured early developmental assessments. Twenty-five infants were at high risk for ASD, and the remaining 14 infants were classified as low risk. Upper-extremity and motor skill development were coded at ages 2, 4, and 6 mo. Five infants went on to receive an ASD diagnosis at age 2–4 yr.
RESULTS. Infants at high risk for ASD demonstrated fewer midline behaviors with the upper extremities and delayed motor skill development than the low-risk group. Differences in motor skills were most apparent at age 4 mo.
CONCLUSION. Early monitoring for motor delay in infants at high risk for ASD is warranted. Midline control and play with the upper extremities and overall motor skill development are possible assessment and therapeutic targets.
Significant change for LR but not HR
HR trajectory appears attenuated
LR visually higher at 2 and 4 mo
No significant delays detected
4 mo: 2 of 3 infants with ASD spent no time in midline
6 mo: 3 of 5 infants with ASD spent no time in midline
Significant change for HR but not LR
HR starts low but quickly increases
4 mo: 3 of 3 infants with ASD scored higher than the HR mean
6 mo: 4 of 5 infants with ASD scored lower than the HR mean and 1 of 5 scored higher than the HR mean
4 mo: 2 of 3 infants with ASD scored lower than the HR mean
6 mo: 4 of 5 infants with ASD scored lower than the HR mean and 1 of 5 scored 2 SDs higher
Both groups increased AIMS score over time
LR outperformed HR
4 mo: 3 of 3 infants with ASD scored lower than the HR mean
4 mo: 0 of 3 infants with ASD demonstrated head lag
6 mo: 0 of 4 infants with ASD demonstrated head lag
Close monitoring of early motor development in infants with risk factors for ASD and developmental delay is warranted.
Interventions targeting the development of gross motor skills and midline play may support the acquisition of later cognitive, language, and gestural skills in infants at high risk for ASD.
Refined assessment protocols of motor skills in the first year of life may improve our ability to isolate salient features of ASD and enhance early diagnostic efforts and could be a focus for future research.
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