Quantitative Assessment of Neuromotor Function in Adolescents with High Functioning Autism and Asperger Syndrome

  • Christine M. Freitag
  • Christina Kleser
  • Marc Schneider
  • Alexander von Gontard
Original Paper



Motor impairment in children with Asperger Syndrome (AS) or High functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14–22 year old HFA/AS.


16 HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA).


The HFA/AS group showed strongest impairments of dynamic balance skills and diadochokinesis. Motor abilities were associated with degree of social withdrawal in the full sample and severity of current autistic symptoms in the HFA/AS group.


Similar motor patterns as in younger children were found in the older adolescents. The association of autistic symptoms with motor performance points towards an essential role of motor impairment in autism spectrum disorders.


High functioning autism Asperger syndrome neuromotor function 



We thank the adolescents and the parents who took part in the study. This research was supported by the Saarland University, Germany.


  1. Abell, F., Krams, M., Ashburner, J., Passingham, R., Friston, K., Frackowiak, R., Happé, F., Frith, C., & Frith, U. (1999). The neuroanatomy of autism: a voxel-based whole brain analysis of structural scans. NeuroReport, 10, 1647–1651.PubMedCrossRefGoogle Scholar
  2. Achenbach, T. M. (1991). Manual for the youth self-report and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
  3. Achenbach, T. M. (1997). Manual for the young adult self-report and young adult behaviour checklist. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
  4. Allen, G., Muller, R. A., & Courchesne, E. (2004). Cerebellar function in autism: functional magnetic resonance image activation during a simple motor task. Biological Psychiatry, 56, 269–278.PubMedCrossRefGoogle Scholar
  5. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  6. Arbeitsgruppe Deutsche Child Behavior Checklist (1999). Deutsche Bearbeitung der Child Behavior Checklist (CBCL/4–18)––Einführung und Anleitung zur Handauswertung, 2. Auflage mit deutschen Normen. Koeln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik .Google Scholar
  7. Bauman, M. L., & Kemper, T. L. (2005). Neuroanatomic observations of the brains in autism: a review and future directions. International Journal of Developmental Neuroscience, 23, 183–187.PubMedCrossRefGoogle Scholar
  8. Bölte, S., & Poustka, F. (2004). The German form of the Autism Diagnostic Observation Schedule (ADOS): first results on reliability and validity. Zeitschrift fur Kinder-und Jugendpsychiatrie und Psychotherapie, 32, 45–50.PubMedCrossRefGoogle Scholar
  9. Bruininks R. (1978). Bruininks oseretsky test of motor proficiency. Circle Pines MN: American Guidance Service.Google Scholar
  10. Cody, H., Pelphrey, K., & Piven, J. (2002). Structural and functional magnetic resonance imaging of autism. International Journal of Developmental Neurosciences, 20, 412–438.Google Scholar
  11. Gepner, B., Mestre, D., Masson, G., & de Schonen, S. (1995). Postural effects of motion vision in young autistic children. Neuroreport, 30, 1211–1214.CrossRefGoogle Scholar
  12. Ghaziuddin, M., Butler, E., Tsai, L., & Ghaziuddin, N. (1994). Is clumsiness a marker for Asperger syndrome? Journal of Intellectual Disabilities Research, 38, 519–527.CrossRefGoogle Scholar
  13. Ghaziuddin, M., & Butler, E. (1998). Clumsiness in autism and Asperger syndrome: A further report. Journal of Intellectual Disabilities Research, 42, 43–48.CrossRefGoogle Scholar
  14. Gillberg, C. (1989). Asperger’s syndrome in 23 Swedish children. Developmental Medicine and Child Neurology, 31, 520–531.PubMedCrossRefGoogle Scholar
  15. Green, D., Baird, G., Barnett, A. L., Henderson, K., Huber, J., & Henderson, S. E. (2002). The severity and nature of motor impairment in Asperger’s syndrome: A comparison with Specific Developmental Disorder of Motor Function. Journal of Child Psychology and Psychiatry, 43, 655–668.PubMedCrossRefGoogle Scholar
  16. Hallett, M., Lebiedowska, M. K., Thomas, S. L., Stanhope, S. J., Denckla, M. B., & Rumsey, J. (1993). Locomotion of autistic adults. Archives of Neurology, 50, 1304–1308.PubMedGoogle Scholar
  17. Hardan, A. Y., Kilpatrick, M., Keshavan, M. S., & Minshew, N. J. (2003). Motor performance and anatomic magnetic resonance imaging (MRI) of the basal ganglia in autism. Journal of Child Neurology, 18, 317–324.PubMedGoogle Scholar
  18. Henderson, S. E., & Sugden, D. (1992). The movement assessment battery for children. London: The Psychological Corporation.Google Scholar
  19. Hill, E. L., & Frith, U. (2003). Understanding of autism: insights from mind and brain. Philosophical Transactions of the Royal Society London B, 358, 281–289.CrossRefGoogle Scholar
  20. Hughes, C. (1996). Brief report: Planning problems in autism at the level of motor control. Journal of Autism and Developmental Disorders, 26, 99–107.PubMedCrossRefGoogle Scholar
  21. Jones, V., & Prior, P. (1985). Motor imitation abilities and neurological signs in autistic children. Journal of Autism and Developmental Disorders, 15, 31–45.CrossRefGoogle Scholar
  22. Kohen-Raz, R., Volkmar, F. R., & Cohen, D.J. (1992). Postural control in children with autism. Journal of Autism and Developmental Disorders, 22, 419–432.PubMedCrossRefGoogle Scholar
  23. Largo, R. H., Fischer, J., & Caflish, J. (2002). Zürcher neuromotorik. Zürich: AWE-Verlag.Google Scholar
  24. Largo, R. H., Caflisch, J. A., Hug, F., Muggli, K., Molnar, K., Molinari, L., Sheehy, A., & Gasser, T. (2001a). Neuromotor development from 5 to 18 years. Part 1: Timed performance. Developmental Medicine and Child Neurology, 42, 436–443.CrossRefGoogle Scholar
  25. Largo, R. H., Caflisch, J. A., Hug, F., Muggli, K., Molnar, K., & Molinari, L. (2001b). Neuromotor development from 5 to 18 years. Part 2: Associated movements. Developmental Medicine and Child Neurology, 42, 444–453.CrossRefGoogle Scholar
  26. Leary, M. R., & Hill, D. A. (1996). Moving on: autism and movement disturbance. Mental Retardation, 34, 39–53.PubMedGoogle Scholar
  27. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  28. Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism Diagnostic Interview—Revised : A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.PubMedCrossRefGoogle Scholar
  29. McAlonan, G., Cheung, V., Cheung, C., Suckling, J., Lam, G. Y., Tai, K. S., Yip, L., Murphy, D. C. M., & Chua, S. E. (2005). Mapping the brain in autism. A voxel-based MRI study of volumetric differences and intercorrelations in autism. Brain, 128, 268–276.PubMedCrossRefGoogle Scholar
  30. 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, 23–39.PubMedCrossRefGoogle Scholar
  31. Mari, M., Castello, U., Marks, D., Marraffa, C., & Prior, M. (2003). The reach-to-grasp movement in children with autism spectrum disorder. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 358, 393–403.PubMedCrossRefGoogle Scholar
  32. Minshew, N. J., Goldstein, G., & Siegel, D. (1997). Neuropsychologic functioning in autism: Profile of a complex information processing disorder. Journal of the International Neuropsychological Society, 3, 303–316.PubMedGoogle Scholar
  33. Minshew, N. J., Sung, K., Jones, B. L., & Furman, J. M. (2004). Underdevelopment of the postural control system in autism. Neurology, 63, 2056–2061.PubMedGoogle Scholar
  34. Miyahara, M., Tsujji, M., Hori, M., Nakanishi, K., Kageyama, H., & Sugiyama T. (1997). Brief report: Motor incoordination in children with Asperger’s syndrome and learning disabilities. Journal of Autism and Developmental Disorders, 27, 597–604.CrossRefGoogle Scholar
  35. Molloy, C. A., Dietrich, K. N., & Bhattacharya, A. (2003). Postural stability in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 33, 643–652.PubMedCrossRefGoogle Scholar
  36. Nayate, A., Bradshaw, J. L., & Rinehart, N. J. (2005). Autism and Asperger’s disorder: Are they movement disorders involving the cerebellum and/or basal ganglia? Brain Research Bulletin, 67, 327–334.PubMedCrossRefGoogle Scholar
  37. Noterdaeme, M., Mildenberger, K., Minow, F., & Amorosa, H. (2002). Evaluation of neuromotor deficits in children with autism and children with a specific speech and language disorder. European Child and Adolescent Psychiatry, 11, 219–225.PubMedCrossRefGoogle Scholar
  38. Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia, 9, 97–113.PubMedCrossRefGoogle Scholar
  39. Ozonoff, S., Cook, I., Coon, H., Dawson, G., Joseph, R. M., Klin, A., McMahon, W. M., Minshew, N., Munson, J. A., Pennington, B. F., Rogers, S. J., Spence, M. A., Tager-Flusberg, H., Volkmar, F. R., & Wrathall, D. (2004). Performance on the Cambridge Neuropsychological Test Automated Battery subtests sensitive to frontal lobe function in people with autistic disorder: Evidence from the Collaborative Programs of Excellence in Autism network. Journal of Autism and Developmental Disorders, 34, 139–150.PubMedCrossRefGoogle Scholar
  40. Poustka, F., Lisch, S., Ruhl, D., Sacher, A., Schmotzer, G., & Werner, K. (1996). The standardized diagnosis of autism, Autism Diagnostic Interview-Revised: interrater reliability of the German form of the interview. Psychopathology, 29, 145–153.PubMedCrossRefGoogle Scholar
  41. Rinehart, N. J., Bradshaw, J. L., Brereton, A. V., & Tonge, B. J. (2001). Movement preparation in High-Functioning Autism and Asperger Disorder: A serial choice reaction time task involving motor reprogramming. Journal of Autism and Developmental Disorders, 31, 79–88.PubMedCrossRefGoogle Scholar
  42. Szatmari, P., Tuff, L., Finlayson, M. A., & Bartolucci, G. (1990). Asperger’s syndrome and autism: neurocognitive aspects. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 130–136.PubMedCrossRefGoogle Scholar
  43. Teitelbaum, O., Benton, T., Shah, P. K., Prince, A., Kelly, J. L., Teitelbaum, P. (2004). Eshkol-Wachman movement notation in diagnosis: the early detection of Asperger’s syndrome. Proceedings of the National Academy of Sciences of the United States of America, 101, 11909–11914.PubMedCrossRefGoogle Scholar
  44. Touwen, B. (1982). Die Untersuchung von Kindern mit geringen neurologischen Funktionsstörungen. Stuttgart: Thieme.Google Scholar
  45. Tsatsanis, K. D., Rourke, B. P., Klin, A., Volkmar, F. R., Cicchetti, D., & Schultz, R. T. (2003). Reduced thalamic volume in high-functioning individuals with autism. Biological Psychiatry, 53, 121–129.PubMedCrossRefGoogle Scholar
  46. Vernazza-Martin, S., Martin, N., Vernazza, A., Lepellec-Muller, A., Rufo, M., Massion, J., & Assaiante, C. (2005). Goal directed locomotion and balance control in autistic children. Journal of Autism and Developmental Disorders, 35, 91–102.PubMedCrossRefGoogle Scholar
  47. Vilensky, J. A., Damasio, A. R., & Maurer, R. G. (1981). Gait disturbances in patients with autistic behavior. Archives of Neurology, 38, 646–649.PubMedGoogle Scholar
  48. World Health Organization (1992). The ICD-10 classification of mental and behavioural disorders. Clinical description and diagnostic guidelines. Geneva: WHO.Google Scholar
  49. Young, R. L., Brewer, N., & Pattison, C. (2004). Parental identification of early behavioural abnormalities in children with autistic disorder. Autism, 7, 125–143.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Christine M. Freitag
    • 1
  • Christina Kleser
    • 1
  • Marc Schneider
    • 2
  • Alexander von Gontard
    • 1
  1. 1.Department of Child and Adolescent PsychiatrySaarland University HospitalHomburg(Saar)Germany
  2. 2.Institute of Forensic PsychiatrySaarland University HospitalHomburg (Saar)Germany

Personalised recommendations