The association between motor coordination impairment and restricted/repetitive behaviors in autistic children: The partial mediating effect of executive function

Abstract

BackgroundIt has been strongly argued that impaired motor function contributes to the restricted/repetitive behaviors (RRBs) of autistic children, but the mechanism exploration of these claims has been limited by the absence of potential confounders such as executive function. MethodWe investigated the role that executive function (EF) plays in the relationship between motor coordination, EF, and RRBs in a school-aged autism population (n = 188, age = 7.42 ± 1.46 years, 86.7% males) via a structural equation model in a statistically robust way. The Developmental Coordination Disorder Questionnaire, Behavior Rating Inventory of Executive Function, and Restrictive Behavior Scale-Revised were collected to measure motor coordination, EF, and RRBs, respectively. ResultsAmong the participants, 33.5% (n = 63) were classified as intellectual disability, 46.8% (n = 88) had EF dysfunction and 35.1% (n = 66) had motor coordination impairment. We found a direct effect of motor coordination impairment on RRBs among children with ASD and without intellectual disability (β = -0.334, p<0.001), as well as an indirect effect through EF, which was a partial mediator of the relationship (β = −0.140, p = 0.001). ConclusionsMotor coordination impairment should be included in the routine evaluation of autism surveillance and rehabilitation procedure, to address the ASD children who need additional support. It is important to add motor skills and motor coordination training in the daily intervention of autism, which could also improve EF and decrease RRBs in these children.