Autism Journal Club

All change for the DSM-5: motor deficits in Autism Spectrum Disorder and Developmental Coordination Disorder

The DSM-5 brought a lot of change to autism. The biggest change was the adoption of the umbrella term 'ASD' at the expense of more specific diagnoses like Asperger Syndrome. A lesser known change concerns motor deficits in ASD. Motor impaired children with ASD can now have their motor difficulties formally recognised. Under DSM-IV criteria, motor impaired children with ASD did not receive a formal diagnosis of a motor disorder such as Developmental Coordination Disorder (DCD). A dual diagnosis of ASD and DCD was not possible. This suggested that children with ASD have autism-specific motor difficulties. However, the literature did not seem to point to any such autism-specific difficulty. I will discuss a series of studies which tested motor skills and underlying visual-proprioceptive cue processing in children with ASD and DCD. In all tests, children with ASD with motor difficulties resembled children with DCD. This was true for high-level motor tasks, such as model building and ball skills; and basic visual-proprioceptive cue weighting tasks. These results support the change to DSM criteria. It is unclear what evidence this major change was based on, as ASD/DCD comparisons are few and far between, however this series of studies supports this important new diagnostic relationship.