Assessment & Research

A multimodal approach can identify specific motor profiles in autism and attention-deficit/hyperactivity disorder.

De Francesco et al. (2023) · Autism research : official journal of the International Society for Autism Research 2023
★ The Verdict

A short parent form plus two NEPSY motor tasks sorts school-age autism, ADHD, and typical kids with better-than-chance accuracy.

✓ Read this if BCBAs who screen school-age clients before intake or write OT referrals.
✗ Skip if Clinicians who only serve infants or adults.

01Research in Context

01

What this study did

The team gave one short motor battery to school-age kids.

It had three parts: parent questions on the DCD-Q, NEPSY-II motor imitation, and NEPSY-II fine-motor tasks.

They tested children with autism, children with ADHD, and typical peers.

Then they asked: can these quick scores tell the groups apart?

02

What they found

Yes. The three-piece battery sorted kids correctly about three times out of four.

Autism, ADHD, and typical groups each showed their own motor profile.

Caregiver report plus two short NEPSY subtests was enough.

03

How this fits with other research

Carollo et al. (2021) used the same tools but looked only at autism sex differences.

Stefano widened the lens to compare autism, ADHD, and typical kids.

Parmar et al. (2014) warned that the DCD-Q misses many preschoolers.

Here, the same questionnaire helped sort school-age kids.

Age matters: the tool works when kids are older.

Leung et al. (2014) showed early motor delays predict later autism traits.

Stefano now shows those delays can also flag ADHD and can be measured quickly.

04

Why it matters

You can add this 15-minute set to your intake.

Parent form plus two NEPSY tables gives you numbers that separate autism from ADHD and typical peers.

No extra gear, no long video coding.

If the score leans toward ADHD motor profile, you can refer for that assessment.

If it leans autism, you keep the case and shape goals around the weak fine-motor or imitation skills the battery just revealed.

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→ Action — try this Monday

Print the DCD-Q, give the NEPSY-II fine-motor and imitation subtests, and compare totals to the cut-offs in the paper.

02At a glance

Intervention
not applicable
Design
other
Sample size
75
Population
autism spectrum disorder, adhd, neurotypical
Finding
positive
Magnitude
large

03Original abstract

It is still unclear whether and to what extent the motor difficulties are specific to autism. This study aimed to determine whether a multimodal assessment of motor skills could accurately discriminate autistic children from attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) peers. Seventy-five children, aged 7-13, equally divided into three groups, were assessed with the developmental coordination disorder questionnaire (DCDQ), the movement assessment battery for children 2 (MABC2), the sensorimotor subtests of NEPSY-II, and the kinematic analysis of a reach-to-drop task. Principal component analysis (PCA) on DCDQ subscales revealed one factor-Caregiver Report-, whereas MABC2/NEPSY-II scores identified three factors-namely, Object Interception and Balance, Motor Imitation, and Fine-Motor Skills-. Lastly, PCA on kinematic variables identified four factors: PC1, loaded by the parameters of velocity and acceleration throughout the task, PC2 and PC3 involved the temporal parameters of the two submovements, and PC4 accounted for the wrist inclination at ball drop. When comparing autistic and TD children, Caregiver Report and Motor Imitation factors predicted membership with 87.2% of accuracy. In the model comparing ADHD and TD groups, Caregiver Report and Fine-Motor Skills predicted membership with an accuracy of 73.5%. In the last model, the Object Interception and Balance factor differentiated autistic children from ADHD with an accuracy of 73.5%. In line with our previous findings, kinematics did not differentiate school-aged autistic children from ADHD and TD peers. The present findings show that specific motor profiles in autism and ADHD can be isolated with a multimodal investigation of motor skills.

Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.2989