BackHome
Refresh: OffView Personal Schedule
Individual Submission Summary
Share...

Direct link:

Developmental trajectory of sensorimotor integration for postural stability in Autism Spectrum Disorder

Fri, April 9, 11:45am to 12:45pm EDT (11:45am to 12:45pm EDT), Virtual

Abstract

Introduction
Although Autism Spectrum Disorder (ASD) is primarily associated with social communication differences and restricted interests/repetitive behaviors, children with ASD also exhibit significant sensorimotor differences. Postural stability is a foundational motor skill that requires integration of input from multiple sensory systems (visual, somatosensory, vestibular) into motor plans. Children with ASD show more postural instability during quiet standing compared to typically developing (TD) children. When lacking a sensory modality (i.e., eyes closed) or receiving distorted sensory input (e.g., vision without environmental spatial cues), children with ASD experience increased postural instability. Despite substantial differences in sensorimotor integration for postural stability in ASD, there has been little work on how these differences change across development from childhood into adolescence.

Here, we examined the development of sensorimotor integration and postural stability from middle childhood to early adulthood using the Clinical Test of Sensory Integration in Balance. We examined how differences in postural stability between children and adolescents with ASD and TD change across development. We also examined how postural stability was influenced by changes in visual input. Finally, we used cluster analysis to determine potential developmental stages in postural stability.

Method
We tested the postural stability of children and adolescents with ASD (n=27, Mage=12.44, SDage=3.18, range=8-20) or TD (n=41, Mage=10.89, SDage=3.50, range=7-20). Participants assumed a comfortable stance with feet approximately shoulder-width apart on the hard surface of a Biodex BioSway force plate and remained still for 30-second intervals in each of the following conditions: eyes open, eyes closed, and eyes open in a translucent paper sphere (dome) placed on the participant’s head. The eyes open condition provides a measure of quiet standing postural stability with all relevant sensory inputs. Eyes closed measures postural stability when participants do not have visual input for maintaining balance and must rely more heavily on proprioceptive (a modality of the somatosensory system) and vestibular input. In the dome condition, participants have visual input, but the input does not include visuospatial cues from the environment that would typically be used to aid in maintaining balance.

Results
A linear mixed-effects model for postural sway variability (Figure 1) indicated significant main effects of group (F(1,67.90)=10.60, p=.002), age (F(1,68.10)=28.59, p<.001), and condition (F(2,134.60)=44.83, p<.001). Participants with ASD (M=1.24) showed increased sway variability compared to TD participants (M=0.94). Participants showed more sway variability in the eyes closed (M=1.23) and dome (M=1.25) conditions than the eyes open condition (M=0.82). Sway variability decreased as age increased (β=-0.06). K-means clustering indicated four distinct developmental stages of postural stability: 7-9 (M=8.15), 10-12 (M=10.85), 13-16 (M=14.43), 17-20 (M=19.33) years with between cluster sum of squares explaining 88.9% of the total variance (Figure 2).

Conclusions
These results indicate that individuals with ASD follow a similar developmental trajectory of postural stability as TD individuals, but exhibit more instability overall. These results also demonstrate that for individuals with ASD, differences in postural stability persist across childhood into adulthood. These clinically-significant findings can be used for the development of targeted interventions for the unique pattern of sensorimotor problems observed in children with ASD.

Authors