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Dyspraxia and Autistic Traits in Adults with and Without Autism Spectrum Conditions Cassidy, S.; Hannant, P.; Tavassoli, T.; Allison, C.; Smith, P.; Baron-Cohen, S

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Dyspraxia and Autistic Traits in Adults with and Without Autism Spectrum Conditions Cassidy, S.; Hannant, P.; Tavassoli, T.; Allison, C.; Smith, P.; Baron-Cohen, S View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by University of Birmingham Research Portal University of Birmingham Dyspraxia and autistic traits in adults with and without autism spectrum conditions Cassidy, S.; Hannant, P.; Tavassoli, T.; Allison, C.; Smith, P.; Baron-Cohen, S. DOI: 10.1186/s13229-016-0112-x License: Creative Commons: Attribution (CC BY) Document Version Publisher's PDF, also known as Version of record Citation for published version (Harvard): Cassidy, S, Hannant, P, Tavassoli, T, Allison, C, Smith, P & Baron-Cohen, S 2016, 'Dyspraxia and autistic traits in adults with and without autism spectrum conditions', Molecular Autism, vol. 7, 48. https://doi.org/10.1186/s13229-016-0112-x Link to publication on Research at Birmingham portal Publisher Rights Statement: Checked for eligibility: 29/07/2019 General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. •Users may freely distribute the URL that is used to identify this publication. •Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. •User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) •Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive. If you believe that this is the case for this document, please contact [email protected] providing details and we will remove access to the work immediately and investigate. Download date: 01. Mar. 2020 Cassidy et al. Molecular Autism (2016) 7:48 DOI 10.1186/s13229-016-0112-x RESEARCH Open Access Dyspraxia and autistic traits in adults with and without autism spectrum conditions Sarah Cassidy1,2* , Penelope Hannant1, Teresa Tavassoli2,3, Carrie Allison2, Paula Smith2 and Simon Baron-Cohen2,4 Abstract Background: Autism spectrum conditions (ASC) are frequently associated with motor coordination difficulties. However, no studies have explored the prevalence of dyspraxia in a large sample of individuals with and without ASC or associations between dyspraxia and autistic traits in these individuals. Methods: Two thousand eight hundred seventy-one adults (with ASC) and 10,706 controls (without ASC) self- reported whether they have been diagnosed with dyspraxia. A subsample of participants then completed the Autism Spectrum Quotient (AQ; 1237 ASC and 6765 controls) and the Empathy Quotient (EQ; 1147 ASC and 6129 controls) online through the Autism Research Centre website. The prevalence of dyspraxia was compared between those with and without ASC. AQ and EQ scores were compared across the four groups: (1) adults with ASC with dyspraxia, (2) adults with ASC without dyspraxia, (3) controls with dyspraxia, and (4) controls without dyspraxia. Results: Adults with ASC were significantly more likely to report a diagnosis of dyspraxia (6.9%) than those without ASC (0.8%). In the ASC group, those with co-morbid diagnosis of dyspraxia did not have significantly different AQ or EQ scores than those without co-morbid dyspraxia. However, in the control group (without ASC), those with dyspraxia had significantly higher AQ and lower EQ scores than those without dyspraxia. Conclusions: Dyspraxia is significantly more prevalent in adults with ASC compared to controls, confirming reports that motor coordination difficulties are significantly more common in this group. Interestingly, in the general population, dyspraxia was associated with significantly higher autistic traits and lower empathy. These results suggest that motor coordination skills are important for effective social skills and empathy. Keywords: Autism spectrum conditions, Dyspraxia, Co-morbidity, Autistic traits, Social skills Background been recently confirmed in a number of research studies Is ability to effectively coordinate, plan and carry out [6, 7]. Children (without ASC), who have dyspraxia, also movements associated with successful social function- exhibit social and emotional difficulties [8]. However, lit- ing? Dyspraxia is characterized by pronounced difficul- tle research in ASC or the general population has ex- ties in the selection, timing and spatial organization of plored the association between dyspraxia and social or purposeful movement and coordination [1] and is emotional skills in adulthood [9]. This is the purpose of thought to arise from atypical neural connections in the the current study. cerebral cortex [2]. Individuals with autism spectrum Studies of children with ASC have demonstrated sig- conditions (ASC), who have pronounced difficulties with nificant motor difficulties in these individuals [10, 11]. social interaction, also exhibit atypical motor movements Motor skill scores for children with ASC often fall 1.5 [3]. In fact, original clinical reports of ASC reported gen- standard deviations below the typical mean [12, 13], and eral ‘clumsiness’ in these individuals [4, 5], which have approximately 80% have definite pronounced motor dif- ficulties with 10% being borderline [6, 14–18]. Atypical * Correspondence: [email protected] motor skills in ASC are present from early infancy 1Centre for Psychology, Behaviour and Achievement, Coventry University, [19–21] and reported by parents as one of their first Priory Street, Coventry CV1 5FB, UK areas of concern (average age 14.7 months) prior to 2Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK seeking an ASC diagnosis [22]. Motor difficulties in Full list of author information is available at the end of the article © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Cassidy et al. Molecular Autism (2016) 7:48 Page 2 of 6 children with ASC may be associated with their social individuals (without ASC) who have dyspraxia may also and communicative difficulties. For example, children have significantly higher autistic traits than those without with ASC show significant difficulties in skilled motor dyspraxia or ASC. If this were the case, then this would gestures, such as imitation [23]. Empathic ability is suggest that movement difficulties are associated with aut- also reduced in children (without ASC) who exhibit istic traits in those with and without ASC and could be a motor difficulties [8], and research has shown correlations prime target for intervention to improve social skills in between motor coordination and social communication these groups. skills in children with ASC [24–26]. Approximately 2–6% of children (without ASC) from the general population Methods have dyspraxia [27]. These children exhibit difficulties in Participants social skills, social phobia, empathy [8, 28], maintaining Participants completed questionnaires online through peer relationships and increased anxiety [29–31]. This one of two websites (www.autismresearchcentre.com suggests that children without ASC, but with dyspraxia, or www.cambridgepsychology.com). Controls (without exhibit traits associated with ASC, particularly in social ASC) were only included if they did not report having interaction, empathy and social anxiety. a child or other family members with autism, to avoid in- There are however very few studies on dyspraxia in cluding those with the ‘broader autism phenotype’ [38]. adults with and without ASC—all of the aforementioned Individuals with a diagnosis of bipolar disorder, epilepsy, studies involved children. However, the limited number of schizophrenia, attention deficit/hyperactivity disorder available studies suggests that in those with and without (ADHD), obsessive-compulsive disorder (OCD), learning ASC, motor difficulties continue into adulthood [32, 33]. disability (LD), intersex/transsexual condition or psychosis There is also preliminary evidence from a small number were excluded from the control group. of studies that general population young adults (aged 16– After exclusions, 2871 participants reported having a 25 years) with dyspraxia may have many of the same diffi- formal clinical diagnosis of ASC (70% male). A majority culties as in childhood [34, 35]. There is also high risk of (n = 2056) had Asperger syndrome; the remaining partici- these individuals experiencing mental health problems, pants reported having high-functioning
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