Abstract
While social impairment, difficulties with communication, and restricted repetitive behaviors are central features of Autism Spectrum Disorders, physical clumsiness is a commonly co-occuring feature. In a sample of 398 twin pairs (aged 8–17 years) from the Italian Twin Registry we investigated the nature of the co-variation between a psychometric index of Clumsiness and the Child Behavior Checklist (CBCL) Autistic scale. Bivariate twin analyses showed that a genetic etiological overlap, rather than direct causation, is a plausible explanation for the association between clumsiness and autistic-like traits, as measured by indices derived from the parent-rated CBCL scale. Additive genetic influences that impinge upon clumsiness/motor problem and autistic-like traits coincided remarkably, with a genetic correlation of 0.63.
Similar content being viewed by others
References
Achenbach, T. M., Dumenci, L., & Rescorla, L. A. (2003). DSM-oriented and empirically based approaches to constructing scales from the same item pools. Journal of Clinical Child and Adolescent Psychology, 32(3), 328–340.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research: ASEBA.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks: Sage.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn., text revision ed.). Washington, DC, USA: American Psychiatric Association.
Asperger, H. (1944). Die “Autistischen psychopathen” im kindesalter. Archiv Für Psychiatrie and Nervenkrankheiten, Berline, 117, 76–136.
Bohlin, G., & Janols, L. O. (2004). Behavioural problems and psychiatric symptoms in 5–13 year-old swedish children—A comparison of parent ratings on the FTF (five to fifteen) with the ratings on CBCL (child behavior checklist). European Child and Adolescent Psychiatry, 13(Suppl 3), 14–22.
Bölte, S., Poustka, F., & Constantino, J. N. (2008). Assessing autistic traits: Cross-cultural validation of the social responsiveness scale (SRS). Autism Research, 1(6), 354–363.
Bouffard, M., Watkinson, E. J., Thompson, L. P., & Causgrove Dunn, J. (1996). A test of the activity deficit hypothesis with children with movement difficulties. Adapted Physical Activity Quarterly: APAQ, 12, 61–73.
Constantino, J. N., & Todd, R. D. (2000). Genetic structure of reciprocal social behavior. The American Journal of Psychiatry, 157(12), 2043–2045.
Constantino, J. N., & Todd, R. D. (2003). Autistic traits in the general population: A twin study. Archives of General Psychiatry, 60(5), 524–530.
Cox, A., Rutter, M., Yule, B., & Quinton, D. (1977). Bias resulting from missing information: Some epidemiological findings. British Journal of Preventive & Social Medicine, 31(2), 131–136.
De Moor, M. H., Boomsma, D. I., Stubbe, J. H., Willemsen, G., & de Geus, E. J. (2008). Testing causality in the association between regular exercise and symptoms of anxiety and depression. Archives of General Psychiatry, 65(8), 897–905.
Dewey, D., Cantell, M., & Crawford, S. G. (2007). Motor and gestural performance in children with autism spectrum disorders, developmental coordination disorder, and/or attention deficit hyperactivity disorder. Journal of the International Neuropsychological Society: JINS, 13(2), 246–256.
Duarte, C. S., Bordin, I. A., de Oliveira, A., & Bird, H. (2003). The CBCL and the identification of children with autism and related conditions in brazil: Pilot findings. Journal of Autism and Developmental Disorders, 33(6), 703–707.
Duffy, D. L., & Martin, N. G. (1994). Inferring the direction of causation in cross-sectional twin data: Theoretical and empirical considerations. Genetic Epidemiology, 11(6), 483–502.
Dworzynski, K., Happe, F., Bolton, P., & Ronald, A. (2009). Relationship between symptom domains in autism spectrum disorders: A population based twin study. Journal of Autism and Developmental Disorders, 39(8), 1197–1210.
Fliers, E., Vermeulen, S., Rijsdijk, F., Altink, M., Buschgens, C., Rommelse, N., et al. (2009). ADHD and poor motor performance from a family genetic perspective. Journal of the American Academy of Child and Adolescent Psychiatry, 48(1), 25–34.
Fournier, K. A., Hass, C. J., Naik, S. K., Lodha, N., & Cauraugh, J. H. (2010). Motor coordination in autism spectrum disorders: A synthesis and meta-analysis. Journal of Autism and Developmental Disorders, 40(10), 1227–1240.
Ghaziuddin, M., & Butler, F. (1998). Clumsiness in autism and asperger syndrome: A further report. Journal of Intellectual Disabilities Research, 42, 43–48.
Gillberg, C. (1989). Asperger syndrome in 23 swedish children. Developmental Medicine and Child Neurology, 31(4), 520–531.
Goldsmith, H. H. (1991). A zygosity questionnaire for young twins: A research note. Behavior Genetics, 21(3), 257–269.
Green, D., Charman, T., Pickles, A., Chandler, S., Loucas, T., Simonoff, E., et al. (2009). Impairment in movement skills of children with autistic spectrum disorders. Developmental Medicine and Child Neurology, 51(4), 311–316.
Heath, A. C., Kessler, R. C., Neale, M. C., Hewitt, J. K., Eaves, L. J., & Kendler, K. S. (1993). Testing hypotheses about direction of causation using cross-sectional family data. Behavior Genetics, 23(1), 29–50.
Hoekstra, R. A., Bartels, M., Verweij, C. J., & Boomsma, D. I. (2007). Heritability of autistic traits in the general population. Archives of Pediatrics and Adolescent Medicine, 161(4), 372–377.
Hoekstra, R. A., Happé, F., Baron-Cohen, S., & Ronald, A. (2009). Association between extreme autistic traits and intellectual disability: Insights from a general population twin study. British Journal of Psychiatry, 195(6), 531–536.
ISTAT. (2003). Rapporto annuale 2002. Roma: Istituto Nazionale di statistica.
Jansiewicz, E. M., Goldberg, M. C., Newschaffer, C. J., Denckla, M. B., Landa, R., & Mostofsky, S. H. (2006). Motor signs distinguish children with high functioning autism and asperger’s syndrome from controls. Journal of Autism and Developmental Disorders, 36(5), 613–621.
Kenworthy, L., Black, D. O., Harrison, B., della Rosa, A., & Wallace, G. L. (2009). Are executive control functions related to autism symptoms in high-functioning children? Neuropsychology, 15, 425–440.
Leary, M. R., & Hill, D. A. (1996). Moving on: Autism and movement disturbance. Mental Retardation, 34(1), 39–53.
Mandich, A. D., Polatajko, H. J., & Rodger, S. (2003). Rites of passage: Understanding participation of children with developmental coordination disorder. Human Movement Science, 22(4–5), 583–595.
Manjiviona, J., & Prior, M. (1995). Comparison of asperger syndrome and high-functioning autistic children on a test of motor impairment. Journal of Autism and Developmental Disorders, 25(1), 23–39.
Martin, N. C., Piek, J. P., & Hay, D. (2006). DCD and ADHD: A genetic study of their shared aetiology. Human Movement Science, 25(1), 110–124.
Moruzzi, S., Pesenti-Gritti, P., Brescianini, S., Salemi, M., Battaglia, M., & Ogliari, A. (2010). Clumsiness and psychopathology: Causation or shared etiology? A twin study with the CBCL 6–18 questionnaire in a general school-age population sample. Human Movement Science, 29(2), 326–338.
Mostofsky, S. H., Powell, S. K., Simmonds, D. J., Goldberg, M. C., Caffo, B., & Pekar, J. J. (2009). Decreased connectivity and cerebellar activity in autism during motor task performance. Brain, 132, 2413–2425.
Neale, M. C., Boker, S. M., Xie, G., & Maes, H. (2003). Mx: Statistical modeling (6th ed.). Richmond: Department of Psychiatry, Virginia Commonwealth.
Neale, M. C., & Cardon, L. R. (1992). Methodology for genetic studies of twins and families. Dordrecht, The Netherlands: Kluwer.
Nelson, E. C., Hanna, G. L., Hudziak, J. J., Botteron, K. N., Heath, A. C., & Todd, R. D. (2001). Obsessive-compulsive scale of the child behavior checklist: Specificity, sensitivity, and predictive power. Pediatrics, 108(1), E14.
Ogliari, A., Citterio, A., Zanoni, A., Fagnani, C., Patriarca, V., Cirrincione, R., et al. (2006). Genetic and environmental influences on anxiety dimensions in Italian twins evaluated with the SCARED questionnaire. Journal of Anxiety Disorders, 20(6), 760–777.
Ooi, Y. P., Rescorla, L., Ang, R. P., Woo, B., & Fung, D. S. S. (2010). Identification of autism spectrum disorders using the child behavior checklist in Singapore. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-010-1015-x.
Ozonoff, S., Young, G. S., Goldring, S., Greiss-Hess, L., Herrera, A. M., Steele, J., et al. (2008). Gross motor development, movement abnormalities, and early identification of autism. Journal of Autism and Developmental Disorders, 38(4), 644–656.
Piek, J. P., Dyck, M. J., Francis, M., & Conwell, A. (2007). Working memory, processing speed, and set-shifting in children with developmental coordination disorder and attention-deficit-hyperactivity disorder. Developmental Medicine and Child Neurology, 49(9), 678–683.
Piek, J. P., & Skinner, R. A. (1999). Timing and force control during a sequential tapping task in children with and without motor coordination problems. Journal of the International Neuropsychological Society: JINS, 5(4), 320–329.
Reiersen, A. M., Constantino, J. N., & Todd, R. D. (2008). Co-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 47(6), 662–672.
Rescorla, L. (1988). Cluster analytic identification of autistic preschoolers. Journal of Autism and Developmental Disorders, 18(4), 475–492.
Ronald, A., Edelson, L. R., Asherson, P., & Saudino, K. J. (2010). Exploring the relationship between autistic-like traits and ADHD behaviors in early childhood: Findings from a community twin study of 2-year-olds. Journal of Abnormal Child Psychology, 38, 185–196.
Ronald, A., Happe, F., Bolton, P., Butcher, L. M., Price, T. S., Wheelwright, S., et al. (2006a). Genetic heterogeneity between the three components of the autism spectrum: A twin study. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 691–699.
Ronald, A., Happe, F., & Plomin, R. (2005). The genetic relationship between individual differences in social and nonsocial behaviours characteristic of autism. Developmental Science, 8(5), 444–458.
Ronald, A., Happe, F., Price, T. S., Baron-Cohen, S., & Plomin, R. (2006b). Phenotypic and genetic overlap between autistic traits at the extremes of the general population. Journal of the American Academy of Child and Adolescent Psychiatry, 45(10), 1206–1214.
Saudino, K. J., & Plomin, R. (2007). Why are hyperactivity and academic achievement related? Child Development, 78(3), 972–986.
Sikora, D. M., Hall, T. A., Hartley, S. L., Gerrard-Morris, A. E., & Cagle, S. (2008). Does parent report of behavior differ across ADOS-G classifications: Analysis of scores from the CBCL and GARS. Journal of Autism and Developmental Disorders, 38(3), 440–448.
Spatola, C. A., Rende, R., & Battaglia, M. (2010). Genetic and environmental influences upon the CBCL/6–18 DSM-oriented scales: Similarities and differences across three different computational approaches and two age ranges. European Child and Adolescent Psychiatry, 19(8), 647–658.
Stazi, M. A., Cotichini, R., Patriarca, V., Brescianini, S., Fagnani, C., D’Ippolito, C., et al. (2002). The Italian twin project: From the personal identification number to a national twin registry. Twin Research: The Official Journal of the International Society for Twin Studies, 5(5), 382–386.
Summers, J., Larkin, D., & Dewey, D. (2008). Activities of daily living in children with developmental coordination disorder: Dressing, personal hygiene, and eating skills. Human Movement Science, 27(2), 215–229.
Tantam, D. (1988). Asperger’s syndrome. Journal of Child Psychology and Psychiatry, 29, 245–255.
Teitelbaum, P., Teitelbaum, O., Nye, J., Fryman, J., & Maurer, R. G. (1998). Movement analysis in infancy may be useful for early diagnosis of autism. Proceedings of the National Academy of Sciences of the United States of America, 95(23), 13982–13987.
Van Beijsterveldt, C. E. M., Verhulst, F. C., Molenaar, P. C. M., & Boomsma, D. I. (2004). The genetic basis of problem behavior in 5 years old Dutch twin pairs. Behavior Genetics, 34, 229–242.
Van den Oord, E. J., Pickles, A., & Waldman, I. D. (2003). Normal variation and abnormality: An empirical study of the liability distributions underlying depression and delinquency. Journal of Child Psychology and Psychiatry, 44, 180–192.
Viding, E., & Blakemore, S. J. (2007). Endophenotype approach to developmental psychopathology: Implications for autism research. Behavioural Genetics, 37, 51–60.
Wilson, B. N., Kaplan, B. J., Crawford, S. G., Campbell, A., & Dewey, D. (2000). Reliability and validity of a parent questionnaire on childhood motor skills. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 54(5), 484–493.
Wing, L. (1981). Asperger’s syndrome: A clinical account. Psychological Medicine, 11(1), 115–129.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva, Switzerland: World Health Organization.
Acknowledgments
We thank all children and parents for their participation to this study. The database for this paper was collected with the collaboration of the Italian Twin Registry, under the direction of Dr. M. A. Stazi. We thank Leslie Rescorla, PhD, for support and suggestions on the CBCL Autistic scale, and three anonymous reviewers for their thoughtful comments on the first draft of this article. This study was supported in part by COFIN 2001 and PRIN 2006061953 grants, and Italian Ministry of Health 2002 and 2009 Strategic Research grants to M. Battaglia. The first author of this paper is in the San Raffaele University Developmental Psychopathology Ph D Program, supported in part by the CARIPLO Foundation ‘Human Talents’ Grant for Academic Centres of Excellence in Post-Graduate Teaching (Dr. Battaglia recipient).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moruzzi, S., Ogliari, A., Ronald, A. et al. The Nature of Covariation Between Autistic Traits and Clumsiness: A Twin Study in a General Population Sample. J Autism Dev Disord 41, 1665–1674 (2011). https://doi.org/10.1007/s10803-011-1199-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-011-1199-8