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

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition that adversely impacts motor skills, sensory processing, and daily activity participation. Telerehabilitation has recently emerged as a promising method to improve therapy access and foster family involvement. This study investigated the effects of integrating telerehabilitation with sensory-based intervention on motor performance, sensory processing, and participation in children with DCD. This randomized controlled trial included 20 children aged 3-7 years with a confirmed diagnosis of DCD. Participants were randomly assigned to either a sensory-based intervention (SBI) group or a telerehabilitation sensory-based intervention (TBSI) group. Both groups received weekly face-to-face sensory-based therapy for eight weeks. Additionally, the TBSI group participated in 30-minute weekly home-based telerehabilitation sessions. Outcome measures included the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure for Children (WeeFIM), and the Dunn Sensory Profile. Both groups demonstrated statistically significant improvements; however, the TBSI group showed greater gains in WeeFIM motor, cognitive, and total scores as well as COPM performance and satisfaction scores (p < 0.01). Furthermore, larger improvements and greater effect sizes were observed in the sensory processing subdomains of the TBSI group. Parental training and active participation appeared to enhance the effectiveness of the telerehabilitation program. Telerehabilitation is an effective intervention for improving motor and cognitive functions, sensory processing, and daily life participation in children with DCD. The findings support the integration of telerehabilitation into sensory-based approaches as part of a holistic model of care in occupational therapy practice. Clinicaltrials.gov NCT06977256.

IPX066 is an oral, extended-release, capsule formulation of carbidopa-levodopa. We aimed to assess this extended-release formulation versus immediate-release carbidopa-levodopa in patients with Parkinson's disease and motor fluctuations. We did a phase 3, randomised, double-blind, double-dummy study at 68 academic and clinical centres in North America and Europe. Patients with Parkinson's disease who had at least 2·5 h per day of off-time underwent 3 weeks of open-label immediate-release carbidopa-levodopa dose adjustment followed by 6 weeks of open-label extended-release carbidopa-levodopa dose conversion. These patients were then randomly allocated (1:1), by use of an interactive web-response system, to 13 weeks of double-blind treatment with extended-release or immediate-release carbidopa-levodopa plus matched placebos. The primary efficacy measure was off-time as a percentage of waking hours in all patients randomly allocated to treatment groups, adjusted for baseline value. This study is registered with ClinicalTrials.gov, number NCT00974974. Between Sept 29, 2009, and Aug 16, 2010, we enrolled 471 participants, of whom 393 (83%) were randomly allocated in the double-blind maintenance period and were included in the main efficacy analyses. As a percentage of waking hours, 201 patients treated double-blind with extended-release carbidopa-levodopa (mean 3·6 doses per day [SD 0·7]) had greater reductions in off-time than did 192 patients treated double-blind with immediate-release carbidopa-levodopa (mean 5·0 doses per day [1·2]). Covariate-adjusted end-of-study means were 23·82% (SD 14·91) for extended-release carbidopa-levodopa and 29·79% (15·81) for immediate-release carbidopa-levodopa (mean difference −5·97, 95% CI −9·05 to −2·89; p<0·0001). Extended-release carbidopa-levodopa reduced daily off-time by, on average, an extra −1·17 h (95% CI −1·69 to −0·66; p<0·0001) compared with immediate-release carbidopa-levodopa. During dose conversion with extended-release carbidopa-levodopa, 23 (5%) of 450 patients withdrew because of adverse events and 13 (3%) withdrew because of a lack of efficacy. In the maintenance period, the most common adverse events were insomnia (seven [3%] of 201 patients allocated extended-release carbidopa-levodopa vs two [1%] of 192 patients allocated immediate-release carbidopa-levodopa), nausea (six [3%] vs three [2%]), and falls (six [3%] vs four [2%]). Extended-release carbidopa-levodopa might be a useful treatment for patients with Parkinson's disease who have motor fluctuations, with potential benefits including decreased off-time and reduced levodopa dosing frequency. Impax Laboratories.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Developmental Coordination Disorder (DCD) are two prevalent neurodevelopmental disorders among children. Both of these diseases, occurring independently or in combination, can result in significant motor skill deficits. The purpose of this study was to observe the improvement in motor performance and skill acquisition of children with ADHD + DCD in comparison with their peers with ADHD or DCD, through repeated practice in the MTSI game. A total of 139 children (37 ADHD, 33 ADHD + DCD, 34 DCD, 35 TD: Typically Developing) participated in the MTSI (Multi-task Sensorimotor Intervention), which involved five sensorimotor intervention tasks. The change of motor performance scores provided by the MTSI system was assessed with repeated measurements, and the skill acquisition in gross & fine motor skills before and after intervention was analyzed with a mixed-design repeated measures ANOVA with post hoc analysis. All groups of children demonstrated a significant increase in motor performance during repeated practice in MTSI and displayed great improvements in gross and fine motor skills, with ADHD + DCD children benefiting more in the magnitude. Multi-task sensorimotor intervention (MTSI) can effectively improve gross and fine motor skills for children with ADHD or DCD, and particularly for those with ADHD and DCD comorbidity, with tailored, multidimensional intervention strategies.

Are motor coordination deficits an underlying cardinal feature of Autism Spectrum Disorders (ASD)? Database searches identified 83 ASD studies focused on motor coordination, arm movements, gait, or postural stability deficits. Data extraction involved between-group comparisons for ASD and typically developing controls ( N  = 51). Rigorous meta-analysis techniques including random effects models, forest and funnel plots, I 2 , publication bias, fail-safe analysis, and moderator variable analyses determined a significant standardized mean difference effect equal to 1.20 (SE = 0.144; p  < 0.0001; Z  = 10.49). This large effect indicated substantial motor coordination deficits in the ASD groups across a wide range of behaviors. The current overall findings portray motor coordination deficits as pervasive across diagnoses, thus, a cardinal feature of ASD.

Transfer of motor skills is the ultimate goal of motor training in rehabilitation practice. In children with Developmental Coordination Disorder (DCD), very little is known about how skills are transferred from training situations to real life contexts. In this study we examined the influence of two types of practice on transfer of motor skills acquired in a virtual reality (VR) environment. One hundred and eleven children with DCD and their typically developing (TD) peers, aged 6-10 years (M = 8.0 SD = 1.0) were randomly assigned to either variable (n = 56) or repetitive practice (n = 55). Participants in the repetitive practice played the same exergame (ski slalom) twice weekly for 20 minutes, over a period of 5 weeks, while those in the variable group played 10 different games. Motor skills such as balance tasks (hopping), running and agility tasks, ball skills and functional activities were evaluated before and after 5 weeks of training. ANOVA repeated measures indicated that both DCD and TD children demonstrated transfer effects to real life skills with identical and non-identical elements at exactly the same rate, irrespective of the type of practice they were assigned to. Based on these findings, we conclude that motor skills acquired in the VR environment, transfers to real world contexts in similar proportions for both TD and DCD children. The type of practice adopted does not seem to influence children's ability to transfer skills acquired in an exergame to life situations but the number of identical elements does.

Autism spectrum disorders (ASDs) are the most common pediatric diagnoses in the United States. In this perspective article, we propose that a diverse set of motor impairments are present in children and adults with ASDs. Specifically, we will discuss evidence related to gross motor, fine motor, postural control, and imitation/praxis impairments. Moreover, we propose that early motor delays within the first 2 years of life may contribute to the social impairments of children with ASDs; therefore, it is important to address motor impairments through timely assessments and effective interventions. Lastly, we acknowledge the limitations of the evidence currently available and suggest clinical implications for motor assessment and interventions in children with ASDs. In terms of assessment, we believe that comprehensive motor evaluations are warranted for children with ASDs and infants at risk for ASDs. In terms of interventions, there is an urgent need to develop novel embodied interventions grounded in movement and motor learning principles for children with autism.

Developmental Coordination Disorder (DCD) is an under-recognized and often trivialized neurodevelopmental condition impacting five to six percent of children. This study aimed to map the impact of DCD on children and their families in Belgium. The Australian 'Impact for DCD' questionnaire was translated and adapted to suit the Belgian context. Parents of 4-to-18-year-old children living in Belgium with movement difficulties consistent with DCD were invited to complete the online survey covering diagnosis, activities, school, therapy, and social and emotional impact. A total of 491 children were included in the analyses. First concerns emerged primarily at home (61.4%) at age 3.3 ± 2.25y, with help sought at age 4.7 ± 2.57y. Formal diagnosis occurred at age 6.9 ± 2.36y, with DCD (76.5%) and/or dyspraxia (38.4%) the most frequently received terms. DCD was generally unknown, especially within school settings. Nearly one in four children (23.2%) repeated a year of school. Reduced sleep quality (50.6%), fatigue after school (76.0%), difficulties with toilet training (47.9%) and speech articulation (52.3%), as well as elevated emotional problems (52.7%) and peer-related issues (46.4%), were prevalent. Most children received therapy (89.2%) but 59.1% of parents did not feel adequately supported to assist their child. Moreover, 37.5% of parents regularly took time off work to facilitate their child's therapy attendance, while 49.1% had reduced their working hours or were contemplating doing so (16.7%). Parents expressed concerns about their child's future and well-being, with a prominent plea for guidance on supporting their child and increased awareness. Parents reported important strengths in their children, including empathy, creativity, cognitive abilities, perseverance, and good social and/or language skills. These results highlight the significant impact of DCD from parents' perspectives. The next step is to explore ways to empower and support parents, raise awareness, and collaborate with policymakers to address these challenges.