View in EDS HTML Full Text PDF Full Text

The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder

Saved in:
Bibliographic Details
Title: The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder
Language: English
Authors: Ramos-Sánchez, Carlos Pelayo (ORCID 0000-0001-9506-0177), Kortekaas, Dianne, Van Biesen, Debbie, Vancampfort, Davy, Van Damme, Tine
Source: Journal of Autism and Developmental Disorders. Mar 2022 52(3):1189-1199.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 11
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Descriptors: Psychomotor Skills, Intelligence, Children, Autism, Pervasive Developmental Disorders, Attention Deficit Hyperactivity Disorder, Intellectual Disability, Perceptual Motor Coordination, Visual Perception
Assessment and Survey Identifiers: Beery Developmental Test of Visual Motor Integration
DOI: 10.1007/s10803-021-05022-8
ISSN: 0162-3257
Abstract: This study explored the association between intelligence and motor skills in children with ASD after controlling for Attention Deficit and Hyperactivity Disorder (ADHD) and the associations between motor impairment and intellectual disability (ID) in this population. In total, 120 children with ASD (3-16 years; 81.7% boys) completed a standardized intelligence test, the Movement Assessment Battery for Children and Beery-Buktenica Developmental Test of Visual-Motor Integration. Variance in performance IQ was associated with 20.8% of the variance in motor skills while significant associations were found between comorbid ID and motor impairment ([phi] = 0.304). Manual Dexterity and Balance are moderately influenced by performance IQ in children with ASD. Furthermore, presence of ID is also moderately associated with motor impairment in this population.
Abstractor: As Provided
Entry Date: 2022
Accession Number: EJ1327240
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHlXg9pahxcLaX5erK6W3iUAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDJ7Uc371bcdNAYtxbwIBEICBm2bXQChsTGBF4K5NmmJIJu-gONFC-pXK5urWbNBgZhALoUF2SkXvqepKTz13ieFvalj3UCH2o1-wV79vh6_8kJpLZaVQLiEcLLbKKF2cLNIGC20WE3VjQ4rIIxr94lnWewFBuUyrnkKna5lYP8O8hDVPydryzTzMMkfZE28KoODbpac2jMJh-_apjUsJgOUlAoSSiAiyVk2xqHVT
Text:
  Availability: 1
  Value: <anid>AN0155312654;aut01mar.22;2022Feb21.02:05;v2.2.500</anid> <title id="AN0155312654-1">The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder </title> <p>This study explored the association between intelligence and motor skills in children with ASD after controlling for Attention Deficit and Hyperactivity Disorder (ADHD) and the associations between motor impairment and intellectual disability (ID) in this population. In total, 120 children with ASD (3–16 years; 81.7% boys) completed a standardized intelligence test, the Movement Assessment Battery for Children and Beery–Buktenica Developmental Test of Visual-Motor Integration. Variance in performance IQ was associated with 20.8% of the variance in motor skills while significant associations were found between comorbid ID and motor impairment (ɸ = 0.304). Manual Dexterity and Balance are moderately influenced by performance IQ in children with ASD. Furthermore, presence of ID is also moderately associated with motor impairment in this population.</p> <p>Keywords: Autism spectrum disorder; Intelligence; Intellectual disability; Motor skills; Visuomotor integration</p> <p>Carlos Pelayo Ramos Sánchez and Dianne Kortekaas have shared first authorship.</p> <p>Although motor impairments are not part of the diagnostic criteria of autism spectrum disorder (ASD), they occur frequently in children with ASD. In a study in 2084 children with ASD, aged 6 or younger, 79% scored in the low or borderline ranges of the motor domain of the Vineland Scales (Licari et al., [<reflink idref="bib38" id="ref1">38</reflink>]). In particular, the commonly observed limitations in postural stability, balance problems and sensorimotor integration (Bhat et al., [<reflink idref="bib8" id="ref2">8</reflink>]; Downey & Rapport, [<reflink idref="bib22" id="ref3">22</reflink>]; Paquet et al., [<reflink idref="bib48" id="ref4">48</reflink>]; Perin et al., [<reflink idref="bib50" id="ref5">50</reflink>]) negatively affect the gross motor skills and movement preparation and planning (Bhat et al., [<reflink idref="bib8" id="ref6">8</reflink>]; Fournier et al., [<reflink idref="bib24" id="ref7">24</reflink>]; Kaur et al., [<reflink idref="bib31" id="ref8">31</reflink>]). With regards to fine motor skills, children with ASD perform worse in situations which require object handling and grasping (Bhat et al., [<reflink idref="bib8" id="ref9">8</reflink>]; Fournier et al., [<reflink idref="bib24" id="ref10">24</reflink>]; Kaur et al., [<reflink idref="bib31" id="ref11">31</reflink>]; Paquet et al., [<reflink idref="bib48" id="ref12">48</reflink>]). Dyspraxia also occurs frequently since children with ASD require more time to plan and execute goal-directed movements due to a suspected limitation in spatial mapping (Downey & Rapport, [<reflink idref="bib22" id="ref13">22</reflink>]; Kaur et al., [<reflink idref="bib31" id="ref14">31</reflink>]). Furthermore, impairments in visuomotor integration (VMI) and difficulties with visuomotor tasks have been described in children with ASD (Dowd et al., [<reflink idref="bib21" id="ref15">21</reflink>]; Green et al., [<reflink idref="bib25" id="ref16">25</reflink>]). For example, in 56 children with ASD, 21% had scores within the impaired range of the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI) as opposed to only 3% of the sample of typically developing (TD) children of the same study (Green et al., [<reflink idref="bib25" id="ref17">25</reflink>]). Of note, children with an IQ of less than 70 were more impaired in visuomotor skills than those with an IQ more than 70 (Green et al., [<reflink idref="bib25" id="ref18">25</reflink>]).</p> <p>Even though the area of motor skills in ASD has been widely studied, the relation between motor skills and intelligence is still an emerging field. Traditionally, the relation between cognitive and motor development is associated with the bidirectional relation during cognitive and motor tasks between the prefrontal cortex and the cerebellum, involved in cognitive and motor processes, respectively (Diamond, [<reflink idref="bib19" id="ref19">19</reflink>]). Regarding children with ASD, recent literature consistently reports positive correlations, varying from small to moderate, between IQ and motor skills. In fact, a recent study suggests that IQ is better predictor of motor skills than a diagnosis of ASD (Surgent et al., [<reflink idref="bib59" id="ref20">59</reflink>]). Children with intellectual disability (ID) and ASD, aged 4 to 12 years, perform significantly worse on balance, posture and body coordination, gross motor skills (Kaur et al., [<reflink idref="bib31" id="ref21">31</reflink>]) and manual dexterity (Paquet et al., [<reflink idref="bib49" id="ref22">49</reflink>]) compared to children with only ASD. Furthermore, in the previously mentioned study by Licari et al. ([<reflink idref="bib38" id="ref23">38</reflink>]), results showed that children with additional ID are more likely to score low or borderline on the motor domain of the Vineland Scales, with a small positive correlation (r = 0.22) between IQ and motor scores. When analyzing the relation between motor skills and different IQ subscales, children with ASD who have higher Performance IQ (PIQ) seem to perform significantly better on fine motor skills when compared to peers without IQ discrepancy or with higher verbal IQ (VIQ; Lloyd et al., [<reflink idref="bib40" id="ref24">40</reflink>]; Yu et al., [<reflink idref="bib70" id="ref25">70</reflink>]). Conversely, results of another study show that children with ASD and lower VIQ had difficulties maintaining balance on both steady and unsteady surfaces, whereas those who scored lower on PIQ only had issues with the unsteady surface (Travers et al., [<reflink idref="bib60" id="ref26">60</reflink>]). However, in this study children with ID were excluded, resulting in a reduced generalizability of the findings. Moreover, the sample size was small and standing balance was not measured with a standardized test.</p> <p>The abovementioned findings are consistent with the view that motor impairment may arise from neurological alterations at a structural and functional level associated with more severe ASD phenotypes, which might also contribute to ID (Jeste, [<reflink idref="bib30" id="ref27">30</reflink>]). ID is a common characteristic among individuals with ASD, with a prevalence ranging up to 55% (Baio et al., [<reflink idref="bib3" id="ref28">3</reflink>]; Charman et al., [<reflink idref="bib14" id="ref29">14</reflink>]; Grondhuis et al., [<reflink idref="bib28" id="ref30">28</reflink>]; Lai et al., [<reflink idref="bib36" id="ref31">36</reflink>]; Licari et al., [<reflink idref="bib38" id="ref32">38</reflink>]; Mefford et al., [<reflink idref="bib44" id="ref33">44</reflink>]). Attention Deficit and Hyperactivity Disorder (ADHD) is another disorder frequently co-occurring with ASD and may influence motor performance (Kopp et al., [<reflink idref="bib35" id="ref34">35</reflink>]; Leitner, [<reflink idref="bib37" id="ref35">37</reflink>]; Stevens et al., [<reflink idref="bib58" id="ref36">58</reflink>]). It has been suggested that children with a double diagnosis of ASD and ADHD have worse motor skills compared to children with only an ASD diagnosis (Caeyenberghs et al., [<reflink idref="bib12" id="ref37">12</reflink>]; Craig et al., [<reflink idref="bib16" id="ref38">16</reflink>]; Mattard-Labrecque et al., [<reflink idref="bib42" id="ref39">42</reflink>]).</p> <p>Research investigating this IQ-motor performance relation in children with ASD is scarce and shows many limitations including small sample sizes, limited age ranges, exclusion of children with ID or other developmental disorders, and/or only examining certain aspects of motor skills. Therefore, more methodologically rigorous research is needed in order to gain a deeper understanding of interactions between motor skills and IQ in children with ASD. Consequently, the aims of this study are to examine (<reflink idref="bib1" id="ref40">1</reflink>) whether the variance in motor skills is associated with variance in IQ in children with ASD across the full spectrum of cognitive abilities, and (<reflink idref="bib2" id="ref41">2</reflink>) the difference in motor impairment and VMI problems in children with ASD with or without ID. We hypothesize that the variance in VIQ and PIQ will be partially associated with variance in motor skills as assessed by the Movement Assessment Battery for Children, Second edition (MABC-2; Wilson et al., [<reflink idref="bib66" id="ref42">66</reflink>]), and that the presence of ID in children with ASD will be associated with higher rates of motor impairment and visuomotor integration.</p> <hd id="AN0155312654-2">Methods</hd> <p></p> <hd id="AN0155312654-3">Participants</hd> <p>The participants were retrospectively selected from an existing database including data of children who were referred and assessed for a possible ASD diagnosis at the Expertise Centre for Autism, University Psychiatric Centre Leuven (UPC Z.Org KU Leuven) between 2017 and 2019. The ASD diagnosis was based on the Autism Diagnostic Observation Schedule second edition (ADOS-2), a standardized semi-structured test battery for the evaluation of communication, social interaction and imaginative play (Randall et al., [<reflink idref="bib53" id="ref43">53</reflink>]). The ADOS-2 is a golden-standard in the diagnosis of ASD and has a high reliability and validity (Chojnicka & Pisula, [<reflink idref="bib15" id="ref44">15</reflink>]; Medda et al., [<reflink idref="bib43" id="ref45">43</reflink>]; Zander et al., [<reflink idref="bib71" id="ref46">71</reflink>]). In order to set a diagnosis, a multidisciplinary team consisting of child psychiatrists, speech therapists, remedial educationalists, psychologists, and physiotherapists assessed the participants.</p> <p>The inclusion criteria were: (<reflink idref="bib1" id="ref47">1</reflink>) age between 3 and 16 years, (<reflink idref="bib2" id="ref48">2</reflink>) IQ estimation based on a mentioned IQ-test and (<reflink idref="bib3" id="ref49">3</reflink>) full and reliable assessment of the MABC-2. Children were excluded when presenting one of the following conditions: (<reflink idref="bib1" id="ref50">1</reflink>) major neurological disorder, (<reflink idref="bib2" id="ref51">2</reflink>) metabolic or autoimmune disorder, (<reflink idref="bib3" id="ref52">3</reflink>) severe musculoskeletal injury, or (<reflink idref="bib4" id="ref53">4</reflink>) severe visual/ auditory impairment, since these might limit the ability to carry out a standardized assessment of motor performance (Henderson et al., [<reflink idref="bib29" id="ref54">29</reflink>]). The total database contained 176 children, of whom 143 children were diagnosed with ASD. For this study, 23 children with ASD were excluded. For eight of them, either the IQ test used for assessment was not mentioned or IQ assessment was not conducted. For seven children it was not possible to administer a full MABC-2 assessment and for seven other children different measurement tools of motor performance were used. Lastly, one child was excluded based on age, leading to a final database of 120 children with an ASD diagnosis.</p> <hd id="AN0155312654-4">Assessment Instruments</hd> <p></p> <hd id="AN0155312654-5">Assessment of IQ</hd> <p>The IQ data were derived from the following IQ tests: (<reflink idref="bib1" id="ref55">1</reflink>) Wechsler Intelligence Scale for Children 5th edition (WISC-V), (<reflink idref="bib2" id="ref56">2</reflink>) Wechsler Intelligence Scale for Children 3rd edition (WISC-III), (<reflink idref="bib3" id="ref57">3</reflink>) Wechsler Preschool and Primary Scale of Intelligence 3rd edition (WPPSI-III), (<reflink idref="bib4" id="ref58">4</reflink>) Snijders-Oomen Non-verbal intelligence test Revised (SON-R), (<reflink idref="bib5" id="ref59">5</reflink>) Cattell-Horn-Carroll Model (CHC-Model) and (<reflink idref="bib6" id="ref60">6</reflink>) Wechsler Non Verbal intelligence test (WNV). Based on these IQ-tests, a Full Scale IQ (FSIQ) was determined. In the majority of children (76.7%), who were assessed with the WISC-V, WISC-III and WPPSI-III, the Performance and Verbal IQ score was also calculated. The Wechsler scales are commonly used to measure intelligence in children with ASD and researchers have conducted validity studies for this clinical group (Ozonoff et al., [<reflink idref="bib47" id="ref61">47</reflink>]; Wechsler, [<reflink idref="bib63" id="ref62">63</reflink>], [<reflink idref="bib64" id="ref63">64</reflink>]). In the WISC-III and WPPSI-III, the FSIQ is based on Verbal and Performance subtests whereas the WISC-V gives a more comprehensive estimation of the FSIQ with a wider range of indexes such as visual spatial, fluid reasoning and working memory (Canivez & Watkins, [<reflink idref="bib13" id="ref64">13</reflink>]; Gordon, [<reflink idref="bib27" id="ref65">27</reflink>]; Woolger, [<reflink idref="bib67" id="ref66">67</reflink>]). For the purpose of this study, visual spatial index was used as reference measure of PIQ and verbal comprehension as measure of VIQ for children assessed with the WISC-V. Furthermore, 16.6% of the participants were assessed with non-verbal IQ tests (WNV or SON-R). These tests require less language-based skills and are regularly used in children with ASD and limited verbal capacities (Aitken, [<reflink idref="bib1" id="ref67">1</reflink>]; Goldstein, [<reflink idref="bib26" id="ref68">26</reflink>]). Lastly, a few participants were tested with the CHC-model, an extensive model that evaluates intelligence in terms of general, broad and narrow cognitive abilities (Verschueren, [<reflink idref="bib61" id="ref69">61</reflink>]). This model is currently used in different IQ-tests, and empirical studies imply that it is a promising foundation for IQ-tests (Benson et al., [<reflink idref="bib7" id="ref70">7</reflink>]; Keith & Reynolds, [<reflink idref="bib32" id="ref71">32</reflink>]; Verschueren, [<reflink idref="bib61" id="ref72">61</reflink>]).</p> <hd id="AN0155312654-6">Movement Assessment Battery for Children – 2nd Edition (MABC-2)</hd> <p>The MABC-2 measures motor skills in children between 3 and 16 years old (Wilson et al., [<reflink idref="bib66" id="ref73">66</reflink>]). The test consists of a checklist filled out by the parents with regard to the child's motor skills and a performance test that analyses both qualitative and quantitative aspects of motor skills (Brown & Lalor, [<reflink idref="bib10" id="ref74">10</reflink>]). For this study, only the performance test was used. Across three different age bands (3-6y, 7-10y, and 11-16y), the qualitative and quantitative performance of age-related motor tasks is evaluated in three domains, i.e., (a) manual dexterity, (b) aiming and catching, and (c) balance (Smits-Engelsman, [<reflink idref="bib56" id="ref75">56</reflink>]). Both the component scores and a total test score can be calculated and transformed into standard scores and percentiles (Smits-Engelsman, [<reflink idref="bib56" id="ref76">56</reflink>]). The Dutch translation and validation based on a Flemish-Dutch norm sample allows a comparison of the results with peers, concluding either a normal development, at risk for developing atypical motor performance (Smits-Engelsman, [<reflink idref="bib56" id="ref77">56</reflink>]). The MABC-2 is one of the most applied measurements to evaluate motor skills in this clinical group (Aitken, [<reflink idref="bib1" id="ref78">1</reflink>]; Wilson et al., [<reflink idref="bib66" id="ref79">66</reflink>]).</p> <hd id="AN0155312654-7">Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (Beery-VMI-6)</hd> <p>The Beery-VMI-6 is used to assess the integration and coordination of visual perception and finger-hand movements in children aged 2–18 years old (Beery et al., [<reflink idref="bib4" id="ref80">4</reflink>]). The Beery-VMI-6 consists of three 30-item subtests, i.e., (a) visual motor integration (VMI), (b) visual perception, and (c) motor coordination, allowing to investigate whether inadequate visual perception- and/or motor coordination-skills are related to VMI difficulties (Beery et al., [<reflink idref="bib4" id="ref81">4</reflink>]). In the VMI subtest, 30 geometric figures need to be copied as accurate as possible (Simons, [<reflink idref="bib55" id="ref82">55</reflink>]). The visual perception part is a timed subtest in which the child is asked to identify the exact same figure as the figure placed above a column of several slightly different geometric figures (Simons, [<reflink idref="bib55" id="ref83">55</reflink>]). The motor coordination subtest is also timed, where the child needs to connect points in order to create the geometric figure stated within double-lined paths (Beery et al., [<reflink idref="bib4" id="ref84">4</reflink>]).</p> <hd id="AN0155312654-8">Statistical Analysis</hd> <p>Data were tested for normality with the Shapiro-Wilks and found to be normally distributed. Demographic variables, namely age of diagnosis, gender, and presence of ADHD, and clinical variables, namely Total Score of the MABC-2, Manual Dexterity, Aiming and Catching, Balance, VIQ and PIQ were added for correlation analysis. The extent to which the variance in motor performance (i.e. MABC-2 scores) is associated with variance in PIQ and VIQ was explored through multiple stepwise linear regression models. In the first step of the model the significant correlates in the univariate analyses were included as possible moderators. In the second step, both VIQ and PIQ scores were added into the model. This approach allowed an estimation of the independent contribution of the VIQ and PIQ above and beyond the variance accounted for by demographic and clinical variables. To examine differences in motor performance of participants with or without ID, the total dataset was divided into two subgroups. The MABC-2 and Beery-VMI scores were converted into categorical variables, indicating either no motor impairment or motor impairment for each motor domain, which was defined as scores of at least one SD below average. A group comparison for categorical variables was conducted using a 2 × 2 contingency table for the calculation of Chi-square (<emph>X</emph><sups><emph>2</emph></sups>). Additionally, a Phi Coefficient (Φ) was assessed to determine the level of association between ID/No ID and motor impairment/no motor impairment for the different motor subscales. IBM SPSS statistics version 20 was used to analyse the data, with a statistical significance set at p < 0.05.</p> <hd id="AN0155312654-9">Results</hd> <p>An overview of the descriptive statistics of the included participants (n = 120) and the subsample with known VIQ/PIQ scores (n = 93) is presented in Table 1. Co-occurring developmental disorders were present in 48% (n = 58) of the children of whom 15.8% (n = 19) were diagnosed with multiple co-occurring disorders, defined as one or more of the other mentioned disorders (i.e., Developmental Coordination Disorder, ADHD, ID, and Developmental Dysphasia; Developmental Delay). In the subsample, 48% (n = 45) of the children had a co-occurring disorder, of whom 19.4% (n = 18) were diagnosed with multiple co-occurring disorders. The Beery VMI-6 was assessed in 96% (n = 115; No ID = 99; ID = 16) of all the participants and 98% (n = 91; No ID = 78; ID = 13) of the subsample.</p> <p>Table 1 Descriptive statistics of the participants</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left" colspan="3"><p>All participants (n = 120)</p></th><th align="left" colspan="3"><p>Subsample regression analyses (n = 93)</p></th></tr><tr><th align="left" /><th align="left"><p>n (%)</p></th><th align="left"><p>Mean ± SD</p></th><th align="left"><p>Min.-Max</p></th><th align="left"><p>n (%)</p></th><th align="left"><p>Mean ± SD</p></th><th align="left"><p>Min.-Max</p></th></tr></thead><tbody><tr><td align="left"><p>Age (Years)</p></td><td char="." align="char" /><td char=" ± " align="char"><p>8.59 ± 2.65</p></td><td char="–" align="char"><p>3.83–16.58</p></td><td char="." align="char" /><td char=" ± " align="char"><p>8.62 ± 2.52</p></td><td char="–" align="char"><p>3.83–16.58</p></td></tr><tr><td align="left"><p> Age of diagnosis</p></td><td char="." align="char" /><td char=" ± " align="char"><p>7.31 ± 2.70</p></td><td char="–" align="char"><p>2.00–16.00</p></td><td char="." align="char" /><td char=" ± " align="char"><p>7.51 ± 2.91</p></td><td char="–" align="char"><p>2.00–16.00</p></td></tr><tr><td align="left"><p>Male</p></td><td char="(" align="char"><p>98 (81.7)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>74 (79.6)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Comorbidity</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> DCD</p></td><td char="(" align="char"><p>10 (8.3)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>8 (8.6)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ADHD</p></td><td char="(" align="char"><p>15 (12.5)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>10 (10.8)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> DD</p></td><td char="(" align="char"><p>5 (4.2)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>3 (3.2)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ID</p></td><td char="(" align="char"><p>9 (7.5)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>6 (6.5)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>IQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Total IQ</p></td><td char="(" align="char"><p>120 (100)</p></td><td char=" ± " align="char"><p>92.99 ± 17.65</p></td><td char="–" align="char"><p>47–136</p></td><td char="(" align="char"><p>93 (100)</p></td><td char=" ± " align="char"><p>92.16 ± 16.75</p></td><td char="–" align="char"><p>47–136</p></td></tr><tr><td align="left"><p> PIQ</p></td><td char="(" align="char"><p>93 (78)</p></td><td char=" ± " align="char"><p>94.18 ± 15.55</p></td><td char="–" align="char"><p>51–141</p></td><td char="(" align="char"><p>93 (100)</p></td><td char=" ± " align="char"><p>94.18 ± 15.55</p></td><td char="–" align="char"><p>51–141</p></td></tr><tr><td align="left"><p> VIQ</p></td><td char="(" align="char"><p>93 (78)</p></td><td char=" ± " align="char"><p>95.22 ± 17.60</p></td><td char="–" align="char"><p>55–145</p></td><td char="(" align="char"><p>93 (100)</p></td><td char=" ± " align="char"><p>95.22 ± 17.60</p></td><td char="–" align="char"><p>55–145</p></td></tr><tr><td align="left"><p>Type IQ test</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> WISC-V</p></td><td char="(" align="char"><p>35 (29.2)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>35 (37.6)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> WISC-III</p></td><td char="(" align="char"><p>38 (31.7)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>38 (40.9)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> WPPSI-III</p></td><td char="(" align="char"><p>19 (15.8)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>19 (20.4)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> SON-R</p></td><td char="(" align="char"><p>10 (8.3)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>0 (0)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> CHC-Model</p></td><td char="(" align="char"><p>10 (8.3)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>1 (1.1)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> WNV</p></td><td char="(" align="char"><p>8 (6.7)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>0 (0)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>MABC-2</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Total</p></td><td char="." align="char" /><td char=" ± " align="char"><p>5.86 ± 3.63</p></td><td char="–" align="char"><p>1–14</p></td><td char="." align="char" /><td char=" ± " align="char"><p>5.62 ± 3.67</p></td><td char="–" align="char"><p>1–14</p></td></tr><tr><td align="left"><p> Manual dexterity</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.45 ± 3.40</p></td><td char="–" align="char"><p>1–15</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.32 ± 3.41</p></td><td char="–" align="char"><p>1–14</p></td></tr><tr><td align="left"><p> Aiming and catching</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.68 ± 3.62</p></td><td char="–" align="char"><p>1–15</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.48 ± 3.61</p></td><td char="–" align="char"><p>1–15</p></td></tr><tr><td align="left"><p> Balance</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.94 ± 3.69</p></td><td char="–" align="char"><p>1–15</p></td><td char="." align="char" /><td char=" ± " align="char"><p>6.77 ± 3.80</p></td><td char="–" align="char"><p>1–15</p></td></tr><tr><td align="left"><p>Beery VMI-6th</p></td><td char="(" align="char"><p>115 (96)</p></td><td char="." align="char" /><td char="." align="char" /><td char="(" align="char"><p>91 (98)</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Visuomotor integration</p></td><td char="." align="char" /><td char=" ± " align="char"><p>88.37 ± 13.62</p></td><td char="–" align="char"><p>48–116</p></td><td char="." align="char" /><td char=" ± " align="char"><p>88.16 ± 13.71</p></td><td char="–" align="char"><p>54–116</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>DCD</emph> Developmental coordination disorder, <emph>ADHD</emph> Attention deficit hyperactivity disorder, <emph>DD</emph> Developmental dysphasia, <emph>ID</emph> Intellectual disability, <emph>PIQ</emph> Performance IQ, <emph>VIQ</emph> Verbal IQ, <emph>WISC-V</emph> Wechsler intelligence scale for children 5th edition, <emph>WISC-III</emph> Wechsler intelligence scale for children 3rd edition, <emph>WPPSI-III</emph> Wechsler preschool and primary scale of intelligence 3rd edition, <emph>SON-R</emph> Snijders-Oomen non-verbal intelligence test revised, <emph>CHC-Model</emph> Cattell-Horn-Carroll model, <emph>WNV</emph> Wechsler non verbal intelligence test, <emph>MABC-2</emph> Movement assessment battery for children, second edition, <emph>Beery VMI – 6th</emph> Beery-Buktenica developmental test of visual motor integration, 6th edition</p> <hd id="AN0155312654-10">Correlations and Regression Models Regarding the MABC-2 Scores, IQ, Presence of ADHD, and Dem...</hd> <p>Correlation analysis between IQ, MABC-2 scores and demographical and clinical variables (i.e., age of diagnosis, gender, co-occurring ADHD) can be found in Table 2. PIQ and presence of co-occurring ADHD were significantly correlated with the total MABC-2 score and with the Manual Dexterity, Aiming and Catching, and Balance subscales. VIQ was significantly correlated with all dependent variables but Aiming and Catching, and male gender had a negative significant correlation with the Balance subscale. Age of ASD diagnosis was not significantly correlated to any motor score. Plots of the correlations between VIQ and PIQ with the motor scores can be found in the supplementary material.</p> <p>Table 2 Correlation of PIQ and IQ with demographical and clinical variables (n = 93)</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left"><p>PIQ</p></th><th align="left"><p>VIQ</p></th><th align="left"><p>Gender</p></th><th align="left"><p>Age of diagnosis</p></th><th align="left"><p>ADHD</p></th></tr></thead><tbody><tr><td align="left"><p>Total MABC-2</p></td><td align="left"><p>.496**</p></td><td align="left"><p>.376**</p></td><td align="left"><p>−.089</p></td><td align="left"><p>.109</p></td><td align="left"><p>−344**</p></td></tr><tr><td align="left"><p> PIQ</p></td><td align="left"><p>–</p></td><td align="left"><p>.627**</p></td><td align="left"><p>.022</p></td><td align="left"><p>−.072</p></td><td align="left"><p>−.147</p></td></tr><tr><td align="left"><p> VIQ</p></td><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.033</p></td><td align="left"><p>.102</p></td><td align="left"><p>−.128</p></td></tr><tr><td align="left"><p> Gender</p></td><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.197</p></td><td align="left"><p>−.019</p></td></tr><tr><td align="left"><p> Age of diagnosis</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.109</p></td></tr><tr><td align="left"><p> ADHD</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Manual dexterity</p></td><td align="left"><p>.476**</p></td><td align="left"><p>.355**</p></td><td align="left"><p>−.086</p></td><td align="left"><p>.043</p></td><td align="left"><p>−312**</p></td></tr><tr><td align="left"><p> PIQ</p></td><td align="left"><p>–</p></td><td align="left"><p>.627**</p></td><td align="left"><p>.022</p></td><td align="left"><p>−.072</p></td><td align="left"><p>−.147</p></td></tr><tr><td align="left"><p> VIQ</p></td><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.033</p></td><td align="left"><p>.102</p></td><td align="left"><p>−.128</p></td></tr><tr><td align="left"><p> Gender</p></td><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.197</p></td><td align="left"><p>−.019</p></td></tr><tr><td align="left"><p> Age of diagnosis</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.109</p></td></tr><tr><td align="left"><p> ADHD</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Aiming and catching</p></td><td align="left"><p>.329**</p></td><td align="left"><p>.200</p></td><td align="left"><p>.128</p></td><td align="left"><p>.048</p></td><td align="left"><p>−.209*</p></td></tr><tr><td align="left"><p> PIQ</p></td><td align="left"><p>–</p></td><td align="left"><p>.627**</p></td><td align="left"><p>.022</p></td><td align="left"><p>−.072</p></td><td align="left"><p>−.147</p></td></tr><tr><td align="left"><p> VIQ</p></td><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.033</p></td><td align="left"><p>.102</p></td><td align="left"><p>−.128</p></td></tr><tr><td align="left"><p> Gender</p></td><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.197</p></td><td align="left"><p>−.019</p></td></tr><tr><td align="left"><p> Age of diagnosis</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.109</p></td></tr><tr><td align="left"><p> ADHD</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Balance</p></td><td align="left"><p>.449**</p></td><td align="left"><p>.409**</p></td><td align="left"><p>−.305**</p></td><td align="left"><p>.158</p></td><td align="left"><p>−229*</p></td></tr><tr><td align="left"><p> PIQ</p></td><td align="left"><p>–</p></td><td align="left"><p>.627**</p></td><td align="left"><p>.022</p></td><td align="left"><p>−.072</p></td><td align="left"><p>−.147</p></td></tr><tr><td align="left"><p> VIQ</p></td><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.033</p></td><td align="left"><p>.102</p></td><td align="left"><p>−.128</p></td></tr><tr><td align="left"><p> Gender</p></td><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.197</p></td><td align="left"><p>−.019</p></td></tr><tr><td align="left"><p> Age of diagnosis</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td><td align="left"><p>−.109</p></td></tr><tr><td align="left"><p> ADHD</p></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left"><p>–</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>PIQ</emph> Performance IQ, <emph>VIQ</emph> Verbal IQ, <emph>ADHD</emph> Attention deficit hyperactivity disorder *<emph>p</emph> < 0.05 **<emph>p</emph> < 0.01</p> <p>Results show that children with ASD and co-occurring ADHD score on average 2.9 points less on the total standard score of the MABC-2 compared to children with ASD without co-occurring ADHD. The presence of an ADHD diagnosis was associated with 11.8% of the variability in the total score. Further introducing VIQ and PIQ in the model equations increases this relation by 20.8% (<emph>p</emph> < 0.001). However, only PIQ is significantly associated with motor scores, leading to a final model with ADHD and PIQ accounting for 32.6% of the variation in the total MABC-2 score.</p> <p>Further analyses regarding the subscales of the MABC-2 show that the presence of ADHD is associated with 9.7% of the variability in Manual Dexterity scores, where children with ASD and co-occurring ADHD score on average 2.4 points less than children with ASD without an ADHD diagnosis. Introducing VIQ and PIQ into the model results in an increase in this relation of 19.3% (<emph>p</emph> < 0.001) with VIQ being non-significant, leading to a final model with ADHD and PIQ accounting for 29% of the variation in the Manual Dexterity subscale.</p> <p>With regards to the Aiming and Catching subscale, the presence of ADHD is associated with 4.4% of the variability, where children with ASD and co-occurring ADHD score on average 1.7 points less than children with ASD without an ADHD diagnosis. Further adding VIQ and PIQ into the model, increases this relation by 9.1% (<emph>p</emph> = 0.011) with VIQ being non-significant, leading to a final model with ADHD and PIQ accounting for 13.5% of the variation in the Aiming and Catching subscale.</p> <p>Regarding the Balance subscale, both ADHD and gender are included in the first step of the analysis, being associated with 14.8% of the variability. For this subscale, children with co-occurring ADHD scored on average two points less than children without co-occurring ADHD, and male participants scored 2.9 points less when compared to female participants. The introduction of both VIQ and PIQ further increases this relation by 20% (<emph>p</emph> = <emph>0.0</emph>00) with VIQ adding no significant value. Hence, these results lead to a final model where ADHD, gender and PIQ account for 34.9% of the variation in the Balance subscale. More detailed information regarding the regression analyses can be found in Table 3.</p> <p>Table 3 Stepwise regression analyses (n = 93)</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Total MABC-2</p></th><th align="left"><p>R<sup>2</sup></p></th><th align="left"><p>Adjusted R<sup>2</sup></p></th><th align="left"><p>△R<sup>2</sup></p></th><th align="left"><p><italic>B</italic></p></th><th align="left"><p>SE</p></th><th align="left"><p><italic>β</italic></p></th></tr></thead><tbody><tr><td align="left"><p>Step 1</p></td><td char="." align="char"><p>.118</p></td><td char="." align="char"><p>.109</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ADHD</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−2.908</p></td><td char="." align="char"><p>.832</p></td><td char="." align="char"><p>−.344**</p></td></tr><tr><td align="left"><p>Step 2</p></td><td char="." align="char"><p>.326</p></td><td char="." align="char"><p>.304</p></td><td char="." align="char"><p>.208</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> VIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.019</p></td><td char="." align="char"><p>.023</p></td><td char="." align="char"><p>.092</p></td></tr><tr><td align="left"><p> PIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.094</p></td><td char="." align="char"><p>.026</p></td><td char="." align="char"><p>.398**</p></td></tr><tr><td align="left"><p>Manual dexterity</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 1</p></td><td char="." align="char"><p>.097</p></td><td char="." align="char"><p>.087</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ADHD</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−2.450</p></td><td char="." align="char"><p>.782</p></td><td char="." align="char"><p>−.312**</p></td></tr><tr><td align="left"><p>Step 2</p></td><td char="." align="char"><p>.290</p></td><td char="." align="char"><p>.266</p></td><td char="." align="char"><p>.193</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> VIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.015</p></td><td char="." align="char"><p>.022</p></td><td char="." align="char"><p>.078</p></td></tr><tr><td align="left"><p> PIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.086</p></td><td char="." align="char"><p>.025</p></td><td char="." align="char"><p>.391**</p></td></tr><tr><td align="left"><p>Aiming and catching</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 1</p></td><td char="." align="char"><p>.044</p></td><td char="." align="char"><p>.033</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ADHD</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−1.740</p></td><td char="." align="char"><p>.853</p></td><td char="." align="char"><p>−.209*</p></td></tr><tr><td align="left"><p>Step 2</p></td><td char="." align="char"><p>.135</p></td><td char="." align="char"><p>.106</p></td><td char="." align="char"><p>.091</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> VIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−.004</p></td><td char="." align="char"><p>.026</p></td><td char="." align="char"><p>−.021</p></td></tr><tr><td align="left"><p> PIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.074</p></td><td char="." align="char"><p>.029</p></td><td char="." align="char"><p>.318*</p></td></tr><tr><td align="left"><p>Balance</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 1</p></td><td char="." align="char"><p>.148</p></td><td char="." align="char"><p>.130</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> ADHD</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−2.061</p></td><td char="." align="char"><p>.853</p></td><td char="." align="char"><p>−.235*</p></td></tr><tr><td align="left"><p> Gender</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−2.904</p></td><td char="." align="char"><p>.913</p></td><td char="." align="char"><p>−.310**</p></td></tr><tr><td align="left"><p>Step 2</p></td><td char="." align="char"><p>.349</p></td><td char="." align="char"><p>.319</p></td><td char="." align="char"><p>.200</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> VIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>−.038</p></td><td char="." align="char"><p>.024</p></td><td char="." align="char"><p>.177</p></td></tr><tr><td align="left"><p> PIQ</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>.078</p></td><td char="." align="char"><p>.027</p></td><td char="." align="char"><p>.321**</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>*p</emph> < 0.05 <emph>**p</emph> < 0.01</p> <hd id="AN0155312654-11">Group Comparison between Children with ASD with or without Intellectual Disability</hd> <p>The total sample was divided into a subgroup of children with ID (n = 17) and a subgroup of children with an FSIQ score higher than 75 (n = 103). Chi-square tests revealed significant differences between both subgroups with a lower performance of children with ID on all motor scales. More detailed information regarding this group comparison can be found in Table 4.</p> <p>Table 4 Group comparison of motor impairment between participants with and without ID</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left"><p>ASD without ID</p><p>n (%)</p></th><th align="left"><p>ASD with ID</p><p>n (%)</p></th><th align="left"><p>X<sup>2</sup></p></th><th align="left"><p>Φ</p></th><th align="left"><p><italic>p</italic></p></th></tr></thead><tbody><tr><td align="left"><p>Total MABC-2</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>11.060</p></td><td char="." align="char"><p>.304</p></td><td char="." align="char"><p>.001*</p></td></tr><tr><td align="left"><p> No impairment</p></td><td char="(" align="char"><p>43 (41.7)</p></td><td char="(" align="char"><p>0 (0)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Impairment</p></td><td char="(" align="char"><p>60 (58.3)</p></td><td char="(" align="char"><p>17 (100)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Manual dexterity</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>11.467</p></td><td char="." align="char"><p>.309</p></td><td char="." align="char"><p>.001*</p></td></tr><tr><td align="left"><p> No impairment</p></td><td char="(" align="char"><p>44 (42.7)</p></td><td char="(" align="char"><p>0 (0)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Impairment</p></td><td char="(" align="char"><p>59 (57.3)</p></td><td char="(" align="char"><p>17 (100)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Aiming and catching</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>7.286</p></td><td char="." align="char"><p>.246</p></td><td char="." align="char"><p>.007*</p></td></tr><tr><td align="left"><p> No impairment</p></td><td char="(" align="char"><p>48 (46.6)</p></td><td char="(" align="char"><p>2 (11.8)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Impairment</p></td><td char="(" align="char"><p>55 (53.4)</p></td><td char="(" align="char"><p>15 (88.2)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Balance</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>14.293</p></td><td char="." align="char"><p>.345</p></td><td char="." align="char"><p>.000*</p></td></tr><tr><td align="left"><p> No impairment</p></td><td char="(" align="char"><p>57 (55.3)</p></td><td char="(" align="char"><p>1 (5.9)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Impairment</p></td><td char="(" align="char"><p>46 (44.7)</p></td><td char="(" align="char"><p>16 (94.1)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>VMI standard score</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>21.506</p></td><td char="." align="char"><p>.432</p></td><td char="." align="char"><p>.000*</p></td></tr><tr><td align="left"><p> No impairment</p></td><td char="(" align="char"><p>67 (67.7)</p></td><td char="(" align="char"><p>1 (6.3)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Impairment</p></td><td char="(" align="char"><p>32 (32.3)</p></td><td char="(" align="char"><p>15 (93.7)</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr></tbody></table> </ephtml> </p> <p> <emph>ASD</emph> Autism spectrum disorder, <emph>ID</emph> Intellectual disability, <emph>MABC-2</emph> Movement assessment battery for children, <emph>VMI</emph> Visual motor integration <emph>*p</emph> < <emph>0.05</emph></p> <hd id="AN0155312654-12">Discussion</hd> <p>This study examined whether the variance in motor skills of individuals with ASD is related to variance in IQ. We demonstrate that both VIQ and PIQ are significantly correlated with Total MABC-2, Manual Dexterity, Aiming and Catching, and Balance scores. However, only the variance in PIQ was a significantly associated with the variance in motor performance of the MABC-2 across all motor domains. Our findings are in contrast with previous research (Travers et al., [<reflink idref="bib60" id="ref85">60</reflink>]) where a significant correlation was found between balance and VIQ, but not between balance and PIQ. The results of this study show that VIQ was only significantly associated with balance in the univariate but not in the multivariate analyses. Discrepancies with previous research might be explained by a difference in statistical analyses used, i.e., previous research only conducted correlation analyses. Besides this, whereas in this study a standardized motor assessment tool was used, including items that assess both static and dynamic balance, previous research used bipodal standing assessment on both stable and unstable surfaces (Travers et al., [<reflink idref="bib60" id="ref86">60</reflink>]). This indicates that the variance in PIQ might only be relevant when the complexity of the balance tasks increases. Furthermore, in the study of Travers et al. ([<reflink idref="bib60" id="ref87">60</reflink>]) there was no visual guidance in performing and explaining the balance tasks, whereas the MABC-2 includes a physical demonstration of the item. This aspect is important as it is known that additional visual support leads to better and more accurate scores when assessing motor performance in children with ASD (Allen et al., [<reflink idref="bib2" id="ref88">2</reflink>]; Breslin & Rudisill, [<reflink idref="bib9" id="ref89">9</reflink>]; Liu & Breslin, [<reflink idref="bib39" id="ref90">39</reflink>]).</p> <p>Another study showed a relation between lower levels of PIQ and poor fine motor skills, but not between PIQ and gross motor skills (Yu et al., [<reflink idref="bib70" id="ref91">70</reflink>]). These findings are partially inconsistent with our results and it can be considered that even though a discrepancy between VIQ and PIQ scores is not associated with worse gross motor skills, PIQ scores are. Moreover, co-occurring ADHD was not controlled for in this study (Yu et al., [<reflink idref="bib70" id="ref92">70</reflink>]), and it is known that children with ADHD are more likely to have impaired fine motor skills compared to gross motor skills (Bünger et al., [<reflink idref="bib11" id="ref93">11</reflink>]). The results of the current study show that co-occurring ADHD is a significant factor, associated with a small proportion of variance in motor performance of the MABC-2 across all motor domains and indicating worse motor performance in children with ASD and co-occurring ADHD. Similar results were found in other studies and might be explained by more severe difficulties with working memory, global executive functioning and attentional deficits in children with ASD and ADHD compared to children with only an ASD diagnosis (Craig et al., [<reflink idref="bib16" id="ref94">16</reflink>]; Mattard-Labrecque et al., [<reflink idref="bib42" id="ref95">42</reflink>]; Visser et al., [<reflink idref="bib62" id="ref96">62</reflink>]; Yerys et al., [<reflink idref="bib68" id="ref97">68</reflink>]). This could suggest that the attention span moderates the relation between intelligence and motor skills regardless of the direction of this relationship.</p> <p>The regression analyses on subscale level for each motor domain of the MABC-2 allowed an extensive examination of the relation between IQ and several motor skills. PIQ is weakly associated with aiming and catching, accounting for 9% of the variation, and moderately associated with balance, manual dexterity and the total MABC-2 score, being related to 20% of the variation. These results are in line with the findings from a study in TD children (Smits-Engelsman & Hill, [<reflink idref="bib57" id="ref98">57</reflink>]). A noteworthy finding is that the variance explained by PIQ in aiming and catching is substantially lower than in the other motor domains. Results of another study showed that, compared to a PIQ matched control group, children with ASD performed significantly worse only on the aiming and catching domain of the MABC-2 (Whyatt & Craig, [<reflink idref="bib65" id="ref99">65</reflink>]). This suggests that other variables outside the scope of this study might play a more pronounced role in aiming and catching skills, explaining the lower percentage of variance found in the model. Similar results were found in other studies, indicating that aiming and catching has a higher demand on social skills in children with ASD (Craig et al., [<reflink idref="bib17" id="ref100">17</reflink>]; Quintas et al., [<reflink idref="bib52" id="ref101">52</reflink>]). While in the past less participation in ball games with peers was believed to cause poorer ball skills, nowadays there is more evidence that deficits in understanding and imitating other's actions in combination with difficulties in the integration of visual information and generating an adequate response causes problems with aiming and catching in children with ASD (Craig et al., [<reflink idref="bib17" id="ref102">17</reflink>]; Whyatt & Craig, [<reflink idref="bib65" id="ref103">65</reflink>]). Moreover, not only object control but also manual dexterity is correlated to social deficits in the ASD population (Ohara et al., [<reflink idref="bib46" id="ref104">46</reflink>]). There is a need for further research in this area due to a lack of consistent evidence and the broad variety in study methods (Ohara et al., [<reflink idref="bib46" id="ref105">46</reflink>]).</p> <p>Regarding balance skills, gender was together with ADHD a significant factor, with boys performing worse. It is well established that girls perform significantly better on balance-related tasks when compared to boys in TD populations (Behan et al., [<reflink idref="bib6" id="ref106">6</reflink>]; Kelly et al., [<reflink idref="bib33" id="ref107">33</reflink>]; Kokštejn et al., [<reflink idref="bib34" id="ref108">34</reflink>]). However, little is known about gender differences in motor skills within the ASD population, probably due to the dominance of males in this group. There is only one population study that, contrary to our results, described no significant difference between males and females with ASD in the motor domain of the Vineland Adaptive Behavioural Scales (Licari et al., [<reflink idref="bib38" id="ref109">38</reflink>]). However, this scale assesses motor development rather than motor skills. Moreover, our smaller sample size and lower percent of female participants might also explain the inconsistent results.</p> <p>The second aim of this study was to evaluate associations between the presence of motor impairment in children with ASD with and without ID. Subgroup analyses showed moderate significant associations between the presence of ID and the presence of motor impairment, with the strongest associations being observed between ID and balance impairment. Our findings are in line with recent research (Licari et al., [<reflink idref="bib38" id="ref110">38</reflink>]) demonstrating that children with ASD and co-occurring ID scored in the low and borderline ranges of The Vineland (87.3%) when compared to children with ASD without co-occurring ID. This is similar to the results of the current study, where all of the children with ID showed co-occurring motor impairment based on the total score of the MABC-2. However, there is some inconsistency among the different domains of the MABC-2. One study indicated significant differences across all motor domains (Craig et al., [<reflink idref="bib17" id="ref111">17</reflink>]), whereas another study only showed a significant worse performance on the total MABC-2 score and ball skills (Paquet et al., [<reflink idref="bib49" id="ref112">49</reflink>]). Our study also explored associations between VMI issues and ID, which is in agreement with previous research finding worse VMI performance in children with ID compared to TD peers (Memisevic & Djordjevic, [<reflink idref="bib45" id="ref113">45</reflink>]).</p> <p>This study extends previous research by investigating whether the variance in IQ is associated with variance in motor skills, by exploring a broad range of motor skills by means of standardized assessment tools. The study sample was extensively evaluated by experienced examiners with thorough knowledge of the assessment tools. Moreover, the methodology allowed analysis that went beyond correlation analysis, allowing for deeper insight. Moreover, the large sample size is exceptional for research on this topic, including participants with ID and across a wide age range, increasing the opportunity to generalize the conclusions. Yet, there are several limitations that should be considered when interpreting the results. First, the cross-sectional design of this study does not allow a thorough evaluation of the direction of the relationship between IQ and motor skills in this population. On the one hand, it could be argued that children with poor motor skills will perform worse on the tasks of the IQ assessment that demand higher motor proficiency and that are time limited, influencing the outcome of the IQ assessment. Particularly, scales related to performance IQ require adequate gross and fine motor skills and visual motor coordination (Fennel & Dikel, [<reflink idref="bib23" id="ref114">23</reflink>]). More specifically, subscales such as Coding, Block Design and Symbol Search demand a certain level of manual skills for manipulating the blocks, which can be difficult for children with fine motor impairments (Piovesana et al., [<reflink idref="bib51" id="ref115">51</reflink>]). Studies suggest that the impact of motor performance on IQ testing should be considered, not only in children with motor disorders, such as Cerebral Palsy, but also in children without clear motor impairments (Foo et al., [<reflink idref="bib69" id="ref116">69</reflink>]; Losch & Dammann, [<reflink idref="bib41" id="ref117">41</reflink>]; Sherwell et al., [<reflink idref="bib54" id="ref118">54</reflink>]). On the other hand, difficulties in visual spatial comprehension, working memory deficits, and fluid reasoning are likely to have a negative impact on performance of children undertaking a motor assessment beyond the limitations in motor skills. It has been shown that non-verbal reasoning and visual-spatial attention significantly contribute to the performance of visual-motor integration tasks beyond age-related maturation (Decker et al., [<reflink idref="bib18" id="ref119">18</reflink>]). Additionally, tasks of the M-ABC-2 such as constructing a triangle might be influenced by visual-spatial abilities and working memory. Secondly, even though the majority of children were assessed and diagnosed at UPC Z. Org KU Leuven, some participants received an ASD diagnosis and/or IQ assessment prior to referral to the UPC Z. Org KU Leuven. Additionally, children were assessed by expert psychologists who chose the IQ test considering the strengths of the child. This has led to a high heterogeneity in IQ measurement tools and differences in timing of assessment up to two years. Within the IQ-tests, both FSIQ and PIQ/VIQ scores have different underlying subtests and it is questionable whether they measure the same construct of IQ. Moreover, due to the differences in length of the IQ tests, attention span might have influenced the performance on the tasks. Nevertheless, even though this heterogeneity is closer to what is found in clinical reality, results should be interpreted cautiously. Although changes in IQ score are likely in the younger age group, longitudinal studies still report a stable IQ throughout childhood in children with ASD (Begovac et al., [<reflink idref="bib5" id="ref120">5</reflink>]; Dietz et al., [<reflink idref="bib20" id="ref121">20</reflink>]). Thirdly, there is no golden standard to assess the motor abilities of individuals with ASD. Although the MABC-2 is often used in this population, reliability and normative data is lacking. It is a general issue in this heterogeneous group that cognitive and social interaction deficits interfere to a variable extent with the comprehension and performance of motor tasks, leading to difficulties in discriminating between actual motor impairment and inadequate understanding in case of poor performance (Wilson et al., [<reflink idref="bib66" id="ref122">66</reflink>]). Especially, given the marked role of PIQ and VIQ in this group, it is likely that children who are verbally stronger perform better than children with a non-verbal preference. However, the administration of the assessments was conducted by an experienced physiotherapist who is familiar with the necessary adaptations to ensure understanding of the tasks by the participants. Lastly, unreliable assessments of the MABC-2 that were excluded from the study were performed by children in the lower ranges of IQ, which may have caused selection bias. These children were most likely to have incomplete assessments, implying exclusion of a group of children with more severe symptomatology. Therefore, it is questionable whether the included participants with a low IQ are representative for the population, since it was not possible to examine motor skills in a reliable manner below a certain intellectual threshold.</p> <p>As research on this topic is only just starting to rise, several suggestions for further research can be made based on the outcomes of this study. It might be of interest to investigate interactions between IQ, motor skills and other developmental domains such as language development, social skills and executive functioning to get a better understanding of the relations between those domains in children with ASD. In this study, we did not include the Beery-VMI as a variable in our regression analysis, since it has a motor component, it would have multicollinearity with other variables. An interesting area for further research would be to understand the role of visuo-motor integration and visual perception in motor skills. Additionally, researchers should engage in large longitudinal prospective studies where more complex models predicting the likelihood of motor impairment in children with ASD based on several important variables such as IQ, comorbidity and severity of autistic features can be generated. This can contribute to the generalization of knowledge in this heterogeneous population.</p> <p>In light of the results, it can be concluded that motor skills, especially manual dexterity and balance, are moderately associated with PIQ in children with ASD. Furthermore, a co-occurring diagnosis of ID is also moderately associated with motor impairment in this population.</p> <hd id="AN0155312654-13">Acknowledgments</hd> <p>We would like to acknowledge the work of Anoushka Thoen in the data collection.</p> <hd id="AN0155312654-14">Declarations</hd> <p></p> <hd id="AN0155312654-15">Conflict of interest</hd> <p>The authors declare that there was no conflict of interest.</p> <hd id="AN0155312654-16">Ethical Approval</hd> <p>All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.</p> <hd id="AN0155312654-17">Supplementary Information</hd> <p>Below is the link to the electronic supplementary material.</p> <p>Graph: Supplementary file1 (DOCX 429 kb)</p> <hd id="AN0155312654-18">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0155312654-19"> <title> References </title> <blist> <bibl id="bib1" idref="ref40" type="bt">1</bibl> <bibtext> Aitken KJ. Evidence-based assessment in autism spectrum disorder: What is available, what is appropriate and what is 'Fit-for-Purpose'. 2018; Jessica Kingsley Publishers</bibtext> </blist> <blist> <bibl id="bib2" idref="ref41" type="bt">2</bibl> <bibtext> Allen KA, Bredero B, Van Damme T, Ulrich DA, Simons J. Test of gross motor development-3 (TGMD-3) with the use of visual supports for children with autism spectrum disorder: Validity and reliability. Journal of Autism and Developmental Disorders. 2017; 47; 3: 813-833. 28091840</bibtext> </blist> <blist> <bibl id="bib3" idref="ref28" type="bt">3</bibl> <bibtext> Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z. Prevalence of autism spectrum disorder among children aged 8 years - Autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveillance Summaries. 2018; 67; 6: 1-23. 10.15585/mmwr.ss6706a1. 5919599</bibtext> </blist> <blist> <bibl id="bib4" idref="ref53" type="bt">4</bibl> <bibtext> Beery KE, Beery NA, Buktenica NA. Beery VMI administration, scoring and teaching manual. 20106; NCS Pearson Inc.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref59" type="bt">5</bibl> <bibtext> Begovac I, Begovac B, Majić G, Vidović V. Longitudinal studies of IQ stability in children with childhood autism–literature survey. Psychiatria Danubina. 2009; 21; 3: 310-319. 19794347</bibtext> </blist> <blist> <bibl id="bib6" idref="ref60" type="bt">6</bibl> <bibtext> Behan S, Belton S, Peers C, O'Connor NE, Issartel J. Moving well-being well: Investigating the maturation of fundamental movement skill proficiency across sex in Irish children aged five to twelve. Journal of Sports Sciences. 2019; 37; 22: 1-9</bibtext> </blist> <blist> <bibl id="bib7" idref="ref70" type="bt">7</bibl> <bibtext> Benson NF, Kranzler JH, Floyd RG. Examining the integrity of measurement of cognitive abilities in the prediction of achievement: Comparisons and contrasts across variables from higher-order and Bifactor models. Journal of School Psychology. 2016; 58: 1-19. 27586067</bibtext> </blist> <blist> <bibl id="bib8" idref="ref2" type="bt">8</bibl> <bibtext> Bhat AN, Landa RJ, Galloway JC. Current perspectives on motor functioning in infants, children, and adults with autism spectrum disorders. Physical Therapy. 2011; 91; 7: 1116. 10.2522/ptj.20100294. 21546566</bibtext> </blist> <blist> <bibl id="bib9" idref="ref89" type="bt">9</bibl> <bibtext> Breslin CM, Rudisill ME. The effect of visual supports on performance of the TGMD-2 for children with autism spectrum disorder. Adapted Physical Activity Quarterly. 2011; 28; 4: 342-353. 21914906</bibtext> </blist> <blist> <bibtext> Brown T, Lalor A. The movement assessment battery for children-second edition (MABC-2): A review and critique. Physical and Occupational Therapy in Pediatrics. 2009; 29; 1: 86-103. 19197761</bibtext> </blist> <blist> <bibtext> Bünger A, Urfer-Maurer N, Grob A. Multimethod assessment of attention, executive functions, and motor skills in children with and without ADHD: Children's performance and parents' perceptions. Journal of Attention Disorders. 2019; 25; 4: 596-606. 30700232</bibtext> </blist> <blist> <bibtext> Caeyenberghs K, Taymans T, Wilson PH, Vanderstraeten G, Hosseini H, Waelvelde H. Neural signature of developmental coordination disorder in the structural connectome independent of comorbid autism. Developmental Science. 2016; 19; 4: 599-612. 10.1111/desc.12424. 27147441</bibtext> </blist> <blist> <bibtext> Canivez GL, Watkins MWKaufman AS, Raiford SE, Coalson DL. Review of the Wechsler intelligence scale for children-fifth edition: Critique, commenary, and independent analyses. Intelligent testing with the WISC–V. 2016: Hoboken, NJ; Wiley: 683-702</bibtext> </blist> <blist> <bibtext> Charman T, Pickles A, Simonoff E, Chandler S, Loucas T, Baird G. IQ in children with autism spectrum disorders: Data from the special needs and autism project (SNAP). Psychological Medicine. 2011; 41; 3: 619-627. 10.1017/S0033291710000991. 21272389</bibtext> </blist> <blist> <bibtext> Chojnicka I, Pisula E. Adaptation and validation of the ADOS-2, polish version. Frontiers in Psychology. 2017; 8: 1916. 29163293. 5681938</bibtext> </blist> <blist> <bibtext> Craig F, Lamanna AL, Margari F, Matera E, Simone M, Margari L. Overlap between autism spectrum disorders and attention deficit hyperactivity disorder: Searching for distinctive/common clinical features. Autism Research. 2015; 8; 3: 328-337. 10.1002/aur.1449. 25604000. 4654237</bibtext> </blist> <blist> <bibtext> Craig F, Lorenzo A, Lucarelli E, Russo L, Fanizza I, Trabacca A. Motor competency and social communication skills in preschool children with autism spectrum disorder. Autism Research. 2018; 11; 6: 893-902. 29493892</bibtext> </blist> <blist> <bibtext> Decker SL, Englund JA, Carboni JA, Brooks JH. Cognitive and developmental influences in visual-motor integration skills in young children. Psychological Assessment. 2011; 23; 4: 1010-1016. 21707185</bibtext> </blist> <blist> <bibtext> Diamond A. Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Development. 2000; 71; 1: 44-56. 10.1111/1467-8624.00117. 10836557</bibtext> </blist> <blist> <bibtext> Dietz C, Swinkels SH, Buitelaar JK, Van Daalen E, Van Engeland H. Stability and change of IQ scores in preschool children diagnosed with autistic spectrum disorder. European Child and Adolescent Psychiatry. 2007; 16; 6: 405-410. 17401607</bibtext> </blist> <blist> <bibtext> Dowd AM, McGinley JL, Taffe JR, Rinehart NJ. Do planning and visual integration difficulties underpin motor dysfunction in autism? A kinematic study of young children with autism. Journal of Autism and Developmental Disorders. 2011; 42; 8: 1539-1548. 10.1007/s10803-011-1385-8</bibtext> </blist> <blist> <bibtext> Downey R, Rapport MJ. Motor activity in children with autism: A review of current literature. Pediatric Physical Therapy. 2012; 24; 1: 2-20. 10.1097/PEP.0b013e31823db95f. 22207460</bibtext> </blist> <blist> <bibtext> Fennell EB, Dikel TN. Cognitive and neuropsychological functioning in children with cerebral palsy. Journal of Child Neurology. 2001; 16; 1: 58-63. 11225958</bibtext> </blist> <blist> <bibtext> Fournier KA, Hass CJ, Naik SK, Lodha N, Cauraugh JH. Motor coordination in autism spectrum disorders: A synthesis and meta-analysis. Journal of Autism and Developmental Disorders. 2010; 40; 10: 1227-1240. 10.1007/s10803-010-0981-3. 20195737</bibtext> </blist> <blist> <bibtext> Green RR, Bigler ED, Froehlich A, Prigge MB, Travers BG, Cariello AN. Beery VMI performance in autism spectrum disorder. Child Neuropsychology. 2016; 22; 7: 795-817. 10.1080/09297049.2015.1056131. 26292997</bibtext> </blist> <blist> <bibtext> Goldstein SOS. Assessment of autism spectrum disorder. 20182; The Guilford Press</bibtext> </blist> <blist> <bibtext> Gordon B. Test review: Wechsler, D. (2002). The Wechsler preschool and primary scale of intelligence, (WPPSI-III). San Antonio, TX: The psychological corporation. Canadian Journal of School Psychology. 2004; 19; 1–2: 205-220</bibtext> </blist> <blist> <bibtext> Grondhuis SN, Lecavalier L, Arnold LE, Handen BL, Scahill L, McDougle CJ. Differences in verbal and nonverbal IQ test scores in children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2018; 49: 47-55. 10.1016/j.rasd.2018.02.001</bibtext> </blist> <blist> <bibtext> Henderson SE, Sugden DA, Barnett AL. Movement assessment battery for children-2. 20072; Pearson Assessment</bibtext> </blist> <blist> <bibtext> Jeste SS. The neurology of autism spectrum disorders. Current Opinion in Neurology. 2011; 24; 2: 132. 21293268. 3160764</bibtext> </blist> <blist> <bibtext> Kaur M, Srinivasan SM, Bhat AN. Comparing motor performance, praxis, coordination, and interpersonal synchrony between children with and without autism spectrum disorder (ASD). Research in Developmental Disabilities. 2018; 72: 79-95. 10.1016/j.ridd.2017.10.025. 29121516</bibtext> </blist> <blist> <bibtext> Keith TZ, Reynolds MR. Cattell–Horn–Carroll abilities and cognitive tests: What we've learned from 20 years of research. Psychology in the Schools. 2010; 47; 7: 635-650</bibtext> </blist> <blist> <bibtext> Kelly, L, O'Connor, S, Harrison, A. J, & Ní Chéilleachair, N. J. (2018). Does fundamental movement skill proficiency vary by sex, class group or weight status? Evidence from an Irish primary school setting. Journal of Sports Sciences, 1–9.</bibtext> </blist> <blist> <bibtext> Kokštejn J, Musálek M, Tufano JJ. Are sex differences in fundamental motor skills uniform throughout the entire preschool period?. PLoS ONE. 2017; 12; 4: e0176556. 28448557. 5407840</bibtext> </blist> <blist> <bibtext> Kopp S, Beckung E, Gillberg C. Developmental coordination disorder and other motor control problems in girls with autism spectrum disorder and/or attention-deficit/hyperactivity disorder. Research in Developmental Disabilities. 2010; 31; 2: 350-361. 10.1016/j.ridd.2009.09.017. 19910158</bibtext> </blist> <blist> <bibtext> Lai MC, Lombardo MV, Baron-Cohen S. Autism. Lancet. 2014; 383; 9920: 896-910. 10.1016/S0140-6736(13)61539-1. 24074734</bibtext> </blist> <blist> <bibtext> Leitner Y. The co-occurrence of autism and attention deficit hyperactivity disorder in children - What do we know?. Frontiers in Human Neuroscience. 2014; 8; 1: 268-268. 10.3389/fnhum.2014.00268. 24808851. 4010758</bibtext> </blist> <blist> <bibtext> Licari MK, Alvares GA, Varcin K, Evans KL, Cleary D, Reid SL. Prevalence of motor difficulties in autism spectrum disorder: Analysis of a population-based cohort. Autism Research. 2020; 13; 2: 298-306. 31625694</bibtext> </blist> <blist> <bibtext> Liu T, Breslin CM. The effect of a picture activity schedule on performance of the MABC–2 for children with autism spectrum disorder. Research Quarterly for Exercise and Sport. 2013; 84; 2: 206-212. 23930546</bibtext> </blist> <blist> <bibtext> Lloyd M, MacDonald M, Lord C. Motor skills of toddlers with autism spectrum disorders. Autism. 2013; 17; 2: 133-146. 10.1177/1362361311402230. 21610184</bibtext> </blist> <blist> <bibtext> Losch H, Dammann O. Impact of motor skills on cognitive test results in very-low-birthweight children. Journal of Child Neurology. 2004; 19; 5: 318-322. 15224703</bibtext> </blist> <blist> <bibtext> Mattard-Labrecque C, Ben Amor L, Couture MM. Children with autism and attention difficulties: A pilot study of the association between sensory, motor, and adaptive behaviors. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2013; 22; 2: 139. 23667360. 3647630</bibtext> </blist> <blist> <bibtext> Medda JE, Cholemkery H, Freitag CM. Sensitivity and specificity of the ADOS-2 algorithm in a large German sample. Journal of Autism and Developmental Disorders. 2019; 49; 2: 750-761. 30238180</bibtext> </blist> <blist> <bibtext> Mefford HC, Batshaw ML, Hoffman EP. Genomics, intellectual disability, and autism. The New England Journal of Medicine. 2012; 366; 8: 733-743. 10.1056/NEJMra1114194. 22356326. 4107681</bibtext> </blist> <blist> <bibtext> Memisevic H, Djordjevic M. Visual-motor integration in children with mild intellectual disability: A meta-analysis. Perceptual and Motor Skills. 2018; 125; 4: 696-717. 29726747</bibtext> </blist> <blist> <bibtext> Ohara R, Kanejima Y, Kitamura M, Izawa PK. Association between social skills and motor skills in individuals with autism spectrum disorder: A systematic review. European Journal of Investigation in Health, Psychology and Education. 2020; 10; 1: 276-296</bibtext> </blist> <blist> <bibtext> Ozonoff S, Goodlin-Jones BL, Solomon M. Evidence-based assessment of autism spectrum disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology. 2005; 34; 3: 523-540. 16083393</bibtext> </blist> <blist> <bibtext> Paquet A, Olliac B, Golse B, Vaivre-Douret L. Current knowledge on motor disorders in children with autism spectrum disorder (ASD). Child Neuropsychology. 2016; 22; 7: 763-794. 26416608</bibtext> </blist> <blist> <bibtext> Paquet A, Olliac B, Bouvard MP, Golse B, Vaivre-Douret L. The semiology of motor disorders in autism spectrum disorders as highlighted from a standardized neuro-psychomotor assessment. Frontiers in Psychology. 2016; 7: 1292. 10.3389/fpsyg.2016.01292. 27672371. 5018946</bibtext> </blist> <blist> <bibtext> Perin C, Valagussa G, Mazzucchelli M, Gariboldi V, Cerri CG, Meroni R, Grossi E, Cornaggia CM, Menant J, Piscitelli D. Physiological profile assessment of posture in children and adolescents with autism spectrum disorder and typically developing peers. Brain Sciences. 2020; 10; 10: 681. 10.3390/brainsci10100681. 7601261</bibtext> </blist> <blist> <bibtext> Piovesana AM, Harrison JL, Ducat JJ. The development of a motor-free short-form of the Wechsler intelligence scale for children-fifth edition. Assessment. 2019; 26; 8: 1564-1572. 29284274</bibtext> </blist> <blist> <bibtext> Quintas R, Blascovi-Assis S, Santos D, Santos C. Motor performance in children and adolescents with autism spectrum disorders. International Journal for Innovation Education and Research. 2018; 6; 10: 273-286</bibtext> </blist> <blist> <bibtext> Randall M, Egberts KJ, Samtani A, Scholten RJ, Hooft L, Livingstone N. Diagnostic tests for autism spectrum disorder (ASD) in preschool children. Cochrane Database of Systematic Reviews. 2018. 10.1002/14651858.CD009044.pub2</bibtext> </blist> <blist> <bibtext> Sherwell S, Reid SM, Reddihough DS, Wrennall J, Ong B, Stargatt R. Measuring intellectual ability in children with cerebral palsy: Can we do better?. Research in Developmental Disabilities. 2014; 35; 10: 2558-2567. 25005064</bibtext> </blist> <blist> <bibtext> Simons J. Introductie tot de psychomotoriek. 20147; Garant</bibtext> </blist> <blist> <bibtext> Smits-Engelsman B. Movement assessment battery for children-2. Dutch standardization. 2010; Pearson Education</bibtext> </blist> <blist> <bibtext> Smits-Engelsman B, Hill EL. The relationship between motor coordination and intelligence across the IQ range. Pediatrics. 2012; 130; 4: e950-e956. 22987872</bibtext> </blist> <blist> <bibtext> Stevens T, Peng L, Barnard-Brak L. The comorbidity of ADHD in children diagnosed with autism spectrum disorder. Research in Autism Spectrum Disorders. 2016; 31: 11-18. 10.1016/j.rasd.2016.07.003</bibtext> </blist> <blist> <bibtext> Surgent OJ, Walczak M, Zarzycki O, Ausderau K, Travers BG. IQ and sensory symptom severity best predict motor ability in children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders. 2021; 51; 1: 243-254. 10.1007/s10803-020-04536-x. 32410096. 7665981</bibtext> </blist> <blist> <bibtext> Travers BG, Mason AH, Gruben KG, Dean DC, McLaughlin K. Standing balance on unsteady surfaces in children on the autism spectrum: The effects of IQ. Research in Autism Spectrum Disorders. 2018; 51: 9-17. 10.1016/j.rasd.2018.03.008. 30333859. 6186444</bibtext> </blist> <blist> <bibtext> Verschueren K. Het CHC-model van intelligentie: Een introductie. TOKK: Tijdschrift Voor Orthopedagogiek. Kinderpsychiatrie En Klinische Kinderpsychologie. 2016; 3: 97-111</bibtext> </blist> <blist> <bibtext> Visser JC, Rommelse NN, Greven CU, Buitelaar JK. Autism spectrum disorder and attention-deficit/hyperactivity disorder in early childhood: A review of unique and shared characteristics and developmental antecedents. Neuroscience and Biobehavioral Reviews. 2016; 65: 229-263. 27026637</bibtext> </blist> <blist> <bibtext> Wechsler D. WPPSI-IV technical and interpretive manual supplement: Special group validity studies with other measures. 2012; NCS Pearson</bibtext> </blist> <blist> <bibtext> Wechsler D. WISC-5 technical and interpretive manual supplement: Special group validity studies with other measures and additional tables San Antonio. 2014; NCS Pearson</bibtext> </blist> <blist> <bibtext> Whyatt CP, Craig CM. Motor skills in children aged 7–10 years, diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders. 2012; 42; 9: 1799-1809. 22180003</bibtext> </blist> <blist> <bibtext> Wilson RB, McCracken JT, Rinehart NJ, Jeste SS. What's missing in autism spectrum disorder motor assessments?. Journal of Neurodevelopmental Disorders. 2018; 10; 1: 33. 30541423. 6292106</bibtext> </blist> <blist> <bibtext> Woolger CDorfman WI, Hersen M. Wechsler intelligence scale for children-third edition (wisc-iii). Understanding psychological assessment. Perspectives on individual differences. 2001; Springer</bibtext> </blist> <blist> <bibtext> Yerys BE, Wallace GL, Sokoloff JL, Shook DA, James JD, Kenworthy L. Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Research. 2009; 2; 6: 322-333. 19998356. 3012375</bibtext> </blist> <blist> <bibtext> Yin Foo R, Guppy M, Johnston LM. Intelligence assessments for children with cerebral palsy: A systematic review. Developmental Medicine and Child Neurology. 2013; 55; 10: 911-918. 23662850</bibtext> </blist> <blist> <bibtext> Yu TY, Chou W, Chow JC, Lin CH, Tung LC, Chen KL. IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders. Neuropsychiatric Disease and Treatment. 2018; 14: 597. 29503543. 5824747</bibtext> </blist> <blist> <bibtext> Zander E, Willfors C, Berggren S, Choque-Olsson N, Coco C, Elmund A. The objectivity of the autism diagnostic observation schedule (ADOS) in naturalistic clinical settings. European Child and Adolescent Psychiatry. 2016; 25; 7: 769-780. 26584575</bibtext> </blist> </ref> <aug> <p>By Carlos Pelayo Ramos-Sánchez; Dianne Kortekaas; Debbie Van Biesen; Davy Vancampfort and Tine Van Damme</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib38" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib22" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib48" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib50" firstref="ref5"></nolink> <nolink nlid="nl5" bibid="bib24" firstref="ref7"></nolink> <nolink nlid="nl6" bibid="bib31" firstref="ref8"></nolink> <nolink nlid="nl7" bibid="bib21" firstref="ref15"></nolink> <nolink nlid="nl8" bibid="bib25" firstref="ref16"></nolink> <nolink nlid="nl9" bibid="bib19" firstref="ref19"></nolink> <nolink nlid="nl10" bibid="bib59" firstref="ref20"></nolink> <nolink nlid="nl11" bibid="bib49" firstref="ref22"></nolink> <nolink nlid="nl12" bibid="bib40" firstref="ref24"></nolink> <nolink nlid="nl13" bibid="bib70" firstref="ref25"></nolink> <nolink nlid="nl14" bibid="bib60" firstref="ref26"></nolink> <nolink nlid="nl15" bibid="bib30" firstref="ref27"></nolink> <nolink nlid="nl16" bibid="bib14" firstref="ref29"></nolink> <nolink nlid="nl17" bibid="bib28" firstref="ref30"></nolink> <nolink nlid="nl18" bibid="bib36" firstref="ref31"></nolink> <nolink nlid="nl19" bibid="bib44" firstref="ref33"></nolink> <nolink nlid="nl20" bibid="bib35" firstref="ref34"></nolink> <nolink nlid="nl21" bibid="bib37" firstref="ref35"></nolink> <nolink nlid="nl22" bibid="bib58" firstref="ref36"></nolink> <nolink nlid="nl23" bibid="bib12" firstref="ref37"></nolink> <nolink nlid="nl24" bibid="bib16" firstref="ref38"></nolink> <nolink nlid="nl25" bibid="bib42" firstref="ref39"></nolink> <nolink nlid="nl26" bibid="bib66" firstref="ref42"></nolink> <nolink nlid="nl27" bibid="bib53" firstref="ref43"></nolink> <nolink nlid="nl28" bibid="bib15" firstref="ref44"></nolink> <nolink nlid="nl29" bibid="bib43" firstref="ref45"></nolink> <nolink nlid="nl30" bibid="bib71" firstref="ref46"></nolink> <nolink nlid="nl31" bibid="bib29" firstref="ref54"></nolink> <nolink nlid="nl32" bibid="bib47" firstref="ref61"></nolink> <nolink nlid="nl33" bibid="bib63" firstref="ref62"></nolink> <nolink nlid="nl34" bibid="bib64" firstref="ref63"></nolink> <nolink nlid="nl35" bibid="bib13" firstref="ref64"></nolink> <nolink nlid="nl36" bibid="bib27" firstref="ref65"></nolink> <nolink nlid="nl37" bibid="bib67" firstref="ref66"></nolink> <nolink nlid="nl38" bibid="bib26" firstref="ref68"></nolink> <nolink nlid="nl39" bibid="bib61" firstref="ref69"></nolink> <nolink nlid="nl40" bibid="bib32" firstref="ref71"></nolink> <nolink nlid="nl41" bibid="bib10" firstref="ref74"></nolink> <nolink nlid="nl42" bibid="bib56" firstref="ref75"></nolink> <nolink nlid="nl43" bibid="bib55" firstref="ref82"></nolink> <nolink nlid="nl44" bibid="bib39" firstref="ref90"></nolink> <nolink nlid="nl45" bibid="bib11" firstref="ref93"></nolink> <nolink nlid="nl46" bibid="bib62" firstref="ref96"></nolink> <nolink nlid="nl47" bibid="bib68" firstref="ref97"></nolink> <nolink nlid="nl48" bibid="bib57" firstref="ref98"></nolink> <nolink nlid="nl49" bibid="bib65" firstref="ref99"></nolink> <nolink nlid="nl50" bibid="bib17" firstref="ref100"></nolink> <nolink nlid="nl51" bibid="bib52" firstref="ref101"></nolink> <nolink nlid="nl52" bibid="bib46" firstref="ref104"></nolink> <nolink nlid="nl53" bibid="bib33" firstref="ref107"></nolink> <nolink nlid="nl54" bibid="bib34" firstref="ref108"></nolink> <nolink nlid="nl55" bibid="bib45" firstref="ref113"></nolink> <nolink nlid="nl56" bibid="bib23" firstref="ref114"></nolink> <nolink nlid="nl57" bibid="bib51" firstref="ref115"></nolink> <nolink nlid="nl58" bibid="bib69" firstref="ref116"></nolink> <nolink nlid="nl59" bibid="bib41" firstref="ref117"></nolink> <nolink nlid="nl60" bibid="bib54" firstref="ref118"></nolink> <nolink nlid="nl61" bibid="bib18" firstref="ref119"></nolink> <nolink nlid="nl62" bibid="bib20" firstref="ref121"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1327240
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ramos-Sánchez%2C+Carlos+Pelayo%22">Ramos-Sánchez, Carlos Pelayo</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-9506-0177">0000-0001-9506-0177</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kortekaas%2C+Dianne%22">Kortekaas, Dianne</searchLink><br /><searchLink fieldCode="AR" term="%22Van+Biesen%2C+Debbie%22">Van Biesen, Debbie</searchLink><br /><searchLink fieldCode="AR" term="%22Vancampfort%2C+Davy%22">Vancampfort, Davy</searchLink><br /><searchLink fieldCode="AR" term="%22Van+Damme%2C+Tine%22">Van Damme, Tine</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Autism+and+Developmental+Disorders%22"><i>Journal of Autism and Developmental Disorders</i></searchLink>. Mar 2022 52(3):1189-1199.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 11
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2022
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Psychomotor+Skills%22">Psychomotor Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Intelligence%22">Intelligence</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Autism%22">Autism</searchLink><br /><searchLink fieldCode="DE" term="%22Pervasive+Developmental+Disorders%22">Pervasive Developmental Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Intellectual+Disability%22">Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Perceptual+Motor+Coordination%22">Perceptual Motor Coordination</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Perception%22">Visual Perception</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Beery+Developmental+Test+of+Visual+Motor+Integration%22">Beery Developmental Test of Visual Motor Integration</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s10803-021-05022-8
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0162-3257
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: This study explored the association between intelligence and motor skills in children with ASD after controlling for Attention Deficit and Hyperactivity Disorder (ADHD) and the associations between motor impairment and intellectual disability (ID) in this population. In total, 120 children with ASD (3-16 years; 81.7% boys) completed a standardized intelligence test, the Movement Assessment Battery for Children and Beery-Buktenica Developmental Test of Visual-Motor Integration. Variance in performance IQ was associated with 20.8% of the variance in motor skills while significant associations were found between comorbid ID and motor impairment ([phi] = 0.304). Manual Dexterity and Balance are moderately influenced by performance IQ in children with ASD. Furthermore, presence of ID is also moderately associated with motor impairment in this population.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2022
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1327240
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1327240
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10803-021-05022-8
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 1189
    Subjects:
      – SubjectFull: Psychomotor Skills
        Type: general
      – SubjectFull: Intelligence
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Autism
        Type: general
      – SubjectFull: Pervasive Developmental Disorders
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Intellectual Disability
        Type: general
      – SubjectFull: Perceptual Motor Coordination
        Type: general
      – SubjectFull: Visual Perception
        Type: general
      – SubjectFull: Beery Developmental Test of Visual Motor Integration
        Type: general
    Titles:
      – TitleFull: The Relationship between Motor Skills and Intelligence in Children with Autism Spectrum Disorder
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ramos-Sánchez, Carlos Pelayo
      – PersonEntity:
          Name:
            NameFull: Kortekaas, Dianne
      – PersonEntity:
          Name:
            NameFull: Van Biesen, Debbie
      – PersonEntity:
          Name:
            NameFull: Vancampfort, Davy
      – PersonEntity:
          Name:
            NameFull: Van Damme, Tine
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 03
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 0162-3257
          Numbering:
            – Type: volume
              Value: 52
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Journal of Autism and Developmental Disorders
              Type: main
ResultId 1