Movement patterns and physical activity in children with neurodevelopmental disorders

Abstract

Autism Spectrum Disorder (ASD) is a group of complex neurodevelopmental disorders characterised by difficulty with social communication and restricted and repetitive behaviours. Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterised by motor impairments which interfere with activities of daily living. Children with ASD and/or DCD exhibit signs of poor motor function, with potential impacts on physical activity, and are at higher risk of overweight/obesity than typically developing (TD) children. Methods: Two literature reviews were carried out: one examining gait deviations in ASD and one examining physical activity (PA) in children with ASD or DCD. Study 1 measured PA levels in children with ASD and/or DCD in comparison to TD peers through survey means. Study 2 objectively measured PA and fitness in children with ASD and/or DCD compared to TD children. Study 3 determined gait patterns and motor function in children with ASD and/or DCD compared to TD children. Study 4 assessed barriers, benefits and motivators for PA and exercise in children with neurodevelopmental disorders. Results: Children with ASD and/or DCD were found to be less active, more sedentary and less fit than TD peers. Several differences in gait parameters between children with ASD and comorbid DCD and TD controls were noted including increased step width, reduced step length, and increased knee flexion and foot progression angle. Significant differences in motor function scores were evident with the TD controls scoring consistently higher on all categories of the coordination test. These results indicated barriers to PA in children with neurodevelopmental disorders. When this was examined further, children with neurodevelopmental disorders were found to face similar barriers to TD children (as described in published research) and additional barriers. Those specific to children with neurodevelopmental disorders included tactile sensitivity and unsupportive environments. Discussion: This thesis highlighted deficits in physical activity and fitness in children with neurodevelopmental disorders that indicate risk of poor health outcomes. Some deficits in gait were detected that appear to be more pronounced in the dual diagnosis group. This study added to the literature by examining the impact of comorbidity. Significant additional barriers to exercise exist for individuals with neurodevelopmental disorders that are clearly impacting their ability to meet recommended levels of physical activity. Conclusion: This research has investigated a relatively understudied topic which has the potential to increase risks for significant negative health outcomes. Further studies would help to clarify how best to encourage engagement with exercise in order to promote physical health and wellbeing, and to investigate the relationship between motor impairment and physical activity.