Motor Challenges and the impact on cognition and perceptual skills

Autism is associated with a wide range of motor challenges including:  difficulties with gait, postural control, balance, coordination, skilled movement, praxis, oral motor, and imitation. According to Miller-Kuhaneck (3rd edition), “motor symptoms are the earliest observable behaviors that currently are considered reliable in helping to diagnose autism” (pg165).   Children with autism frequently have trouble with pre-planning, planning, and programming which leads to difficulty with the movements listed above.  This is because of the difficulty perceiving and correctly processing sensations.

 In the article by Schmitz (2003), we learned how children with an ASD were slow to unload and used feedback rather than feedforward control to maintain postural stability. In the articles by Vernazza-Martin (2005) and Rhineheart et al (2006), we learned that children with an ASD have difficulty with motor planning.  Rhineheart (2006), also demonstrated the phenomenon known as kenesia paradoxa.   Kenesia paradoxa is increased motor impairments during tasks that require the least amounts of cognitive input.  This taught us to think differently about task analysis and breaking tasks into small parts as OT’s!

It is obvious that cognition plays a major role in motor actions because of not only the executive functions (planning) that are required for a successful task to be completed but also the ability to learn a new task.  This is another area where children with autism have had difficulties.  They also have difficulty retaining information from those new tasks so when the task is attempted again they have difficulty using that motor memory.  This is frequently why these children appear clumsy, unorganized, or inattentive.  If a child is cognitively motivated to participate in a task the performance and effort will also improve.

Perception is a major contributor to successful motor-planning.  Intersensory integration of visual, vestibular, and proprioception inputs guide motor execution.  When there are deficits in motor actions because of sensory processing we call children dyspraxic ( Miller-Kuhaneck ,3rd edition). 

Cognition and perception are closely related because to accomplish an action requires sustained attention.  This depends on the ability to maintain an alert state.   Sensory modulation and emotional responsiveness can impact whether a child responds hyper or hyporesponsivity.

Social aspects also play a role in motor execution.  We have all seen the positive response when using a peer to model a task and ask our students to then imitate the movement.  In Schultz article (2003), he stated that “repetitive behaviors are believed to have an important function in reducing the stress that results from the social deprivation” (pg.127).  

References:

·         Autism: A Comprehensive Occupational Therapy Approach 3rd edition Miller-Kuhaneck & Watling

·         Rinehart, Bellgrove, Tonge, Brereton, Howells-Rankin, and Bradshaw (2006) An examination of movement kinematics in young people with high functioning autism and asperger’s disorder: Further evidence for a motor planning deficit. Journal of Autism andDevelopmental Disorders. 36: 757-76.

·         Schmitz, Martineau, Barthelemy, and Assaiante (2003) Motor control and children with autism: deficit in anticipatory function? Neuroscience Letters, 348: 17-20.

I love the understanding this mother has of her son and how well she can articulate the difficulties he has.