Is clumsiness a marker for Asperger syndrome?
Standard motor scores cannot split Asperger from high-functioning autism, so fold broader, sex-aware tools into your intake.
01Research in Context
What this study did
The team gave the Bruininks-Oseretsky motor test to two groups of autistic students.
One group had Asperger syndrome. The other had high-functioning autism.
They wanted to see if clumsy scores only showed up in the Asperger group.
What they found
Both groups earned the same coordination scores.
Clumsiness did not sort the labels.
Motor scores could not tell Asperger and HFA apart.
How this fits with other research
Wilkinson et al. (1998) ran the same test four years later and got the same null result.
When they added IQ as a control, the tiny gap vanished.
De Francesco et al. (2023) looks like it clashes. Their new motor battery hit 73-87% accuracy sorting ASD from ADHD and typical peers.
The trick is scope: the 1994 paper asked if clumsiness splits two autism subtypes. The 2023 paper asked if a broad motor mix can flag autism versus other diagnoses. Both answers can be true.
Carollo et al. (2021) add another layer: girls with autism show special motor anticipation deficits that boys do not. The old null finding may hide sex quirks no one checked.
Why it matters
Do not count on a single clumsiness score to decide Asperger versus HFA. Use a wider motor battery and track sex-specific signs. If you see motor delays, treat them, but keep your diagnostic lens wide.
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02At a glance
03Original abstract
Although Asperger syndrome (AS) has been included in the ICD-10 as a distinct category within the pervasive developmental disorders, it is still unclear to what extent it differs from normal-intelligence autism (high-functioning autism; HFA). Persons with AS are said to be particularly clumsy. To test the hypothesis that clumsiness can reliably distinguish AS from autism, the present authors compared 11 patients with AS (ICD-10; 10 males; mean age, 13.6 years; mean IQ, 98) with nine patients with HFA (ICD-10/DSM-III-R; eight males; mean age, 12.9 years; mean IQ, 84). Clumsiness was assessed by the Bruininks-Oseretsky test. Both groups showed problems with coordination and the distribution of standard scores was virtually identical. This suggests that motor clumsiness, as measured by tests of coordination, may not reliably distinguish AS from HFA. However, qualitative differences may occur between the two groups in the manner in which movements are performed. Further research with larger samples may elicit differences into the pattern of motor deficits that occur in autism and AS.
Journal of intellectual disability research : JIDR, 1994 · doi:10.1111/j.1365-2788.1994.tb00440.x