Abstract
This study examined motor behaviors in a longitudinal cohort of infant siblings of children with autism. Stereotypic movements and postures occurring during standardized observational assessments at 12 and 18 months were coded from videotapes. Participants included eight infant siblings later diagnosed with autism spectrum disorder (ASD), a random sample of nine non-diagnosed siblings, and 15 controls. Videos were coded blind to diagnostic group. At 12 and 18 months the ASD group “arm waved” more frequently and at 18 months, one posture (“hands to ears”) was more frequently observed in the ASD and non-diagnosed group compared to the controls. Overall, the siblings subsequently diagnosed with ASD and the comparison groups had considerable overlap in their repertoires of stereotyped behaviors.
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References
AAP Committee on Children with Disabilities (2001). Technical report: The pediatrician’s role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107, E85.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th edn). Washington, DC: Author.
Baranek, G. T. (1999). Autism during infancy: A retrospective video analysis of sensory-motor and social behaviors at 9–12 months of age. Journal of Autism and Developmental Disorders, 29, 213–224.
Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243.
Bryson, S. E., McDermott, C., Rombough, V., Brian, J., & Zwaigenbaum, L. (2004). The Autism Observation Scale for Infants: scale development and reliability data. Manuscript submitted for publication.
Cuccaro, M. L., Shao, Y., Grubber, J., Slifer, M., Wolpert, C. M., Donnelly, S. L., et al. (2003). Factor analysis of restricted and repetitive behaviors in autism using the Autism Diagnostic Interview-R. Child Psychiatry Human Development, 34, 3–17.
Filipek, P. A., Accardo, P. J., Ashwal, S., Baranek, G. T., Cook, E. H. Jr., Dawson, G., et al. (2000). Practice parameter: Screening and diagnosis of autism: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology, 55, 468–479.
Gritti, A., Bove, D., Di Sarno, A. M., D’Addio, A. A., Chiapparo, S., & Bove, R. M. (2003). Stereotyped movements in a group of autistic children. Functional Neurology, 18, 89–94.
Johnson, M. H., Posner, M. I., & Rothbart, M. K. (1991). Components of visual orienting in early infancy: contingency learning, anticipatory looking, and disengaging. Journal of Cognitive Neuroscience, 3, 335–344.
Landry, R., & Bryson, S. E. (2004). Impaired disengagement of attention in young children with autism. Journal of Child Psychology and Psychiatry, 45, 1115–1122.
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview—Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.
Lord, C. (1995). Follow-up of two-year olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365–1685.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H. Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.
Mahone, E. M., Bridges, D., Prahme, C., & Singer, H. S. (2004). Repetitive arm and hand movements (complex motor stereotypies) in children. Journal of Pediatrics, 145, 391–395.
Militerni, R., Bravaccio, C., Falco, C., Fico, C., & Palermo, M. T. (2002). Repetitive behaviors in autistic disorder. European Journal of Child & Adolescent Psychiatry, 11, 210–218.
Mink, J. W. (1996). The basal ganglia: focused selection and inhibition of competing motor programs. Progress in Neurobiology, 50, 381–425.
Mooney, E. L., Gray, K. M., & Tonge, B. J. (2006). Early features of autism. Repetitive behaviors in young children. European Journal of Child and Adolescent Psychiatry, 15, 12–18.
Mullen, E. (1995). Mullen scales of early learning. American Guidance Service, Circle Pines, MN.
Osterling, J. A., Dawson, G., & Munson, J. A. (2002). Early recognition of 1 year old infants with autism spectrum disorder versus mental retardation. Development and Psychopathology, 14, 239–251.
Pierce, K., & Courchesne, E. (2001). Evidence for a cerebellar role in reduced exploration and stereotyped behavior in autism. Biological Psychiatry, 49, 655–664.
Risi, S., Lord, C., Corsello, C., Chrysler, C., Szatmari, P., Cook, E. H., Leventhal, B. L., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of Autism Spectrum Disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1084–1103.
Smith, I. M. (2004). Motor problems in children with autistic spectrum disorders. In D. Dewey & D. E. Tupper (Eds.), Developmental motor disorders (pp. 152–168). NY: Guilford.
Symons, F. J., Sperry, L. A., Dropik, P. L., & Bodfish, J. W. (2005). The early development of stereotypy and self injury: A review of research methods. Journal of Intellectual Disability Research, 49, 144–158.
Szatmari, P., Zwaigenbaum, L., Bryson, S. (2004). Genetic epidemiology of autism spectrum disorders: Issues in matching. Journal of Autism and Developmental Disabilities, 34, 49–57.
Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Mahoney, W., Roberts, W., Goldberg, J., & Tuff, L. (2006). Redefining the restricted, repetitive behaviors and interests domain of the ADI-R: An empirical approach. Journal of Child Psychology and Psychiatry, 47, 582–590.
Tan, A., Salgado, M., & Fahn, S. (1997). The characterization and outcome of stereotypical movements in nonautistic children. Movement Disorders, 12, 47–52.
Thelen, E. (1979). Rhythmical stereotypies in normal human infants. Animal Behavior, 27, 699–715.
Thelen, E. (1981). Kicking, rocking, and waving: contextual analysis of rhythmical stereotypies in normal human infants. Animal Behavior, 29, 3–11.
Volkmar, F., Cook, E. H. Jr., Pomeroy, J., Realmuto, G., Tanguay, P. (1999). Practice parameters for the assessment and treatment of children, adolescents, and adults with autism and other pervasive developmental disorders. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 32S–54S.
Werner, E., & Dawson, G. (2005). Validation of the phenomenon of autistic regression using home videotapes. Archives of General Psychiatry, 62, 889–895. .
Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23, 143–152.
Acknowledgments
This research was supported by grants from the National Alliance for Autism Research and the Canadian Institutes of Health Research. Dr. Zwaigenbaum is supported by a New Investigator fellowship from the Canadian Institutes of Health Research. We thank the families who have participated in this research for their ongoing support and dedication.
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Appendix
Appendix
Description of the Motor Mannerisms (seen in at least one child)
Motor Item | Description |
---|---|
Postures | |
Finger Flexion (P) | Fingers move from mild flexion and held in full flexion |
Finger Extension (P) | Fingers fully extended usually with some degree of hand extension |
Finger claw (P) | Fingers abducted (spread out) with some flexion at the proximal and distal interphalangeal joints |
Hand extension (P) | Fingers mildly flexed with hand in full extension, usually with some elbow flexion |
Hand Flexion (P) | Fingers mildly flexed with hand in full flexion |
Forearm extension (P) | Forearm fully extended, often with some hand and finger extension |
Forearm out (P) | Humerus in external rotation with elbows a few inches lateral to lower ribcage, , forearm in 45–90 degrees of flexion and pronated with forearm and hands pointing away from midline |
Forearm out with supination (W) | Same as “forearm out” except forearm is in supination, with palms facing upward |
Forearm flexion (P) | Humerus in external rotation with elbow a few inches lateral to lower ribcage, forearm in 90 degrees to full flexion and pronated |
Forearm flexion tense (W) | Same as forearm flexion but position change to forearm flexion was abrupt and posture was held with apparent tension |
Arm up (W) | Shoulder extension with elbows clearly above shoulder |
Arm Tense with overflow (W) | Similar to Forearm out except position held with tension and dysrhythmic small amplitude movements |
Hands to ears (P) | Arms out to side in abduction and external rotation, full forearm flexion, with hands close to the ears, elbows pointing outward to the right and left“with hand extension” describes additional posture of “hands to ears” with hand extension |
Arch head and trunk (P) | In sitting position, extension of the head with some hyperextension of the trunk, most often associated with becoming upset |
Head abduction (P) | Head tilted to left or right with one ear closer to the shoulder |
Tongue Protrusion (W) | Tongue stuck out of the mouth for more than one second |
Mouth Open (W) | Mouth held open for longer than a few seconds. Yawning was not coded here |
Stereotypies | |
Finger flexion (T) | Fingers and thumb flexion altogether and then extension of fingers and thumb altogether, repeatedly, sometimes when scratching an object or the air- “alternate” codes for flexion of one finger, followed by another and then another in rapid succession, as opposed to at the same time, with a repeat of the cycle. The movement was similar to rapid drumming of fingers, or playing a scale on the piano, with a repeat in the cycle |
Finger flexion object (T) | Finger flexion as above but while squeezing a noisy squeaky toy or a quiet soft toy |
Finger rotate (T) | As if fingers are turning a large dial in the clockwise then counterclockwise directions, 2nd and 3rd fingers flexed at distal interphalangeal joints (DIPs) with mild extension at the proximal interphalangeal joints (PIPs), and 4th and 5th fingers flexed at DIP joints with mild flexion at PIP joints, followed by flexion of the 2nd and 3rd fingers and extension of 4th and 5th fingers at PIPs, with mild flexion in fingers at the DIPs |
Finger Point repetitively (W) | Pointing repeatedly at a picture in a book or object, without looking to others for joint attention |
Hand rotation (T) | Supination and pronation of hand alone- “with object” codes for the movement occurring when an object is held |
Hand flexion extension (T) | Flexion and extension of hand at wrist, “With object” codes for the movement occurring while an object is held |
Arms | |
Arm Shake (T – Arm wave) | With forearm in 0–90 degrees of flexion, and humerus in 45–90 degrees of extension and in 0–60 degrees of abduction; movement of humerus with extension and flexion repeatedly, often with an amplitude of a few inches |
Arm flap (P) | With forearm in 0–90 degrees of flexion (at elbow) and some pronation,, and humerus in extension and greater than 60 degrees abduction (90 degrees abduction meaning the elbows are pointing to each side, 0 degrees meaning both elbows pointing straight ahead.); Movement of arm at humerus, with abduction and adduction, with an amplitude of a few inches, and no movement at the elbow joint - “with object” and “with a noisy object” |
Arm wave (P) | With forearm usually in 60–120 degrees of flexion at elbow and some pronation of forearm, humerus in extension (about 30–60 degrees) and abduction (30–90 degrees); movement of arm at humerus with internal and external rotation, with the wrists and hands kept fairly stable- “With hand flexion and extension” denotes movement of hand flexion and extension with “arm wave” |
Arm bang surface (T) | forearm in mild flexion, extension and flexion at the humerus with hand in contact with surface, similar movement to “arm shake” but with arm now banging a table or surface |
Arm bang surface with object (T) | Same movement as arm bang surface but holding an object. Silent and noisy objects were not additionally specified |
Arm sway (T) | Forearm with mild flexion at elbow, and mild extension of humerus; movement at shoulder, sideways with rubbing of hand on table |
Arm push pull (T – elbow bend) | With forearm parallel to floor; movement at elbow of forearm flexion and extension with appearance of a push and pull of hand back and forth, on a surface (table), often holding an object |
Arms clap (T) | With forearms in mild flexion, and humerus extension so that arms in front of child, adduction to contact and midline and abduction, repeatedly |
Arm bang object together (T) | Similar to arm clap with objects in hand |
Torso | |
Trunk Sit bounce (T) | Torso straight: up and down movement, mostly from hip extension, |
Trunk Sit sway (T) | Slow side to side movement with torso straight |
Trunk Sit wiggle (T) | Quick sideways movements of lateral flexion of spine in one direction then the other, (curved like a “C” and then like a reverse “C”) |
Trunk Sit Arch Rock (T) | Position: back arched, followed by movement of trunk rocking back and forth |
Trunk Sit rotate (P) | Torso straight, rotation of spine along its vertical axis in one direction and then the opposite |
Trunk Sit flexion extension (T) | Arching and relaxing of back |
Trunk Stand bounce (T) | In Standing position, then flexion and extension of knees resulting in up and down movement of body |
Head | |
Head shake (T) | Rotation of head about vertical axis, scored only if not in context of communication |
Head nod (T) | flexion and extension of head, scored only if not in context of communication |
Tongue protrusion (T) | Tongue pushed out of the mouth and retracted back into the mouth repeatedly, without any object being touched by the tongue |
Tongue swipe (T) | Tongue protruded and moved from side to side |
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Loh, A., Soman, T., Brian, J. et al. Stereotyped Motor Behaviors Associated with Autism in High-risk Infants: A Pilot Videotape Analysis of a Sibling Sample. J Autism Dev Disord 37, 25–36 (2007). https://doi.org/10.1007/s10803-006-0333-5
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DOI: https://doi.org/10.1007/s10803-006-0333-5