1. 1) Autism Research Unit, “Villa S. Maria” Institute, Tavernerio, Italy
Valentina Gariboldi2, Giulio Valagussa1,2, Erica Terragni2, Luca Trentin1, Davide Mauri1, Cecilia Perin2, Cesare Cerri2, Enzo Grossi1
1) Autism Research Unit, “Villa S. Maria” Institute, Tavernerio, Italy
2) School of Medicine and Surgery – University of Milano Bicocca, Milan, Italy
POSTURAL CONTROL ASSESSMENT IN ASD CHILDREN USING THE PEDIATRIC BALANCE SCALE AND THE FALL SCREEN ASSESSMENT SYSTEM: RESULTS FROM A PILOT STUDY
Background
ASD in children is associated with impairments in fine and gross motor skills, planning and coordination of movement, and praxis. ASD affects in particular the basic sensorimotor control process of upright standing. Little evidence is available on this topic in the literature, mostly neglecting the assessment of different balance’s constituents in favor of simpler and functional approaches.
The aim of this study is balance’s assessment in a group of ASD subjects: 1) using the Pediatric Balance Scale (PBS); 2) using the Fall Screen Assessment System (FSAS), matching the results with a control group of normally developing subjects.
Methods
The study sample included 9 ASD subjects and 16 healthy subjects matched by age. ASD subjects were diagnosed according to the DSM V criteria. Tests used were: 1) PBS; 2) FSAS, a multi-item mean which explores sensorimotor performances, validated for adult subjects.
Results
The two groups were comparable as regards age distribution. Five ASD subjects (56%) showed a balance deficit at the PBS and were also positive for the FSAS. Two more subjects appear to be at risk of falling only by the FSAS. FSAS application resulted to be easily feasible both for children and adolescents. A statistically significant difference (p<0.05) between the two groups was found for: visual contrast sensitivity, touch sensitivity, ankle and knee forces, reaction time for hand and sway tests, evidencing an overall postural control impairment in ASD.
FSAS
Control group
Mean (95%C.I.)
ASD group (CI)
T-test
independent means
Visual acuity high contrast (MAR) (C.I.)
0,94 (0,15)
1,31 (0,26)
p-value 0,862
Visual acuity low contrast (MAR) (C.I.)
1,79 (0,45)
2,21 (0,36)
p-value 0,485
Contrast sensitivity (dB) (C.I.)
21,63 (0,58)
20,44 (1,02)
p-value 0,025
Depth perception (cm) (C.I.)
1,07 (0,41)
1,69 (0,66)
p-value 0,673
Proprioception (degrees) (C.I.)
2,05 (0,51)
1,80 (0,83)
p-value 0,503
Touch sensitivity (Log 0,1 mg) (C.I.)
3,93 (0,27)
4,42 (0,95)
p-value 0,036
Ankle DF (kg) (C.I.)
13,13 (1,85)
9,89 (3,01)
p-value 0,044
Kneeext (kg) (C.I.)
39,25 (9,22)
22,22 (8,36)
p-value 0,014
Kneeflex (kg) (C.I.)
19,38 (3,89)
11,22 (3,3)
p-value 0,006
Reaction time hand (ms) (C.I.)
235,91 (26,34)
385,17 (105,21)
p-value: 0,036
Reaction time foot (ms) (C.I.)
318,34 (36,27)
456,49 (89,76)
p-value 0,081
Sway floor EO (mm) (C.I.)
68,19 (18,73)
195,93 (69,9)
p-value 0,003
Sway floor EC (mm) (C.I.)
98,29 (14,76)
211,01 (81,99)
p-value 0,042
Sway foam EO (mm) (CI)
137,08 (36,17)
598,39 (338,01)
Sway foam EC (mm) (C.I.)
278,12 (101,43)
851,77 (434,75)
p-value 0,009
Co-ordinated stability track (n) (C.I.)
3,45 (3,93)
15,67 (9,98)
p-value 0,077
Maximal balance range (mm) (C.I.)
215,00 (17,86)
172,19 (48,01)
p-value 0,244
TOTAL SCORE (C.I.)
0,28 (0,54)
3,30 (1,17)
p-value 0,381
Conclusion
This study confirms that ASD subjects are at major risk of fall in everyday life, probably due to a deficit in processing of sensory and motor inputs. We suggest FSAS as a complementary tool in ASD’s management since it directly assesses the individual’s physiological abilities as regards balance. In this way intervention strategies can be improved towards areas of deficit. Further studies are necessary to confirm the results of this pilot study.