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Interestingly, in the general population, dyspraxia was associated with significantly higher autistic traits and lower empathy. These results suggest that motor coordination skills are important for effective social skills and empathy.
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Read More »This study aimed to explore for the first time whether dyspraxia was significantly more prevalent in adults with ASC compared to controls without ASC and associations between dyspraxia and autistic traits in adults with and without ASC. Results showed that adults with ASC self-reported a significantly higher rate of dyspraxia (6.9%) than adults without ASC (0.8%); the relative odds of having a diagnosis of dyspraxia were 8 times higher in adults with ASC compared to controls without ASC. These results show for the first time that the prevalence of dyspraxia is significantly higher in adults with ASC compared to controls without ASC. These findings reflect previous research, showing that motor coordination difficulties are highly prevalent in ASC [6, 7]. Furthermore, these findings add to the small body of currently available evidence showing that the difficulties associated with dyspraxia in childhood persist into adulthood [33, 35]. Results also showed that the association between dyspraxia and levels of autistic traits and empathy differed according to the presence of co-morbid ASC. Specifically, diagnosis of dyspraxia was only significantly associated with self-reported autistic traits and empathy if participants did not have co-morbid ASC. Controls without ASC, with a diagnosis of dyspraxia, self-reported a significantly higher number of autistic traits and significantly lower levels of empathy than controls without ASC or dyspraxia, whereas those with ASC and co-morbid dyspraxia did not self-report significantly different levels of autistic traits or empathy compared to those with ASC without co-morbid dyspraxia. These results suggest that motor coordination difficulties are significantly associated with social skills and empathy in adults without ASC, whereas co-morbid dyspraxia in adults with ASC is not significantly associated with increased difficulties in social communication skills and empathy. One possible explanation for this finding is that dyspraxia and ASC symptoms may overlap, particularly as both conditions are seemingly associated with atypical development of neurons within the cerebral cortex [2, 7, 39]. For example, previous research has shown that the difficulties individuals with dyspraxia experience are somewhat similar to the difficulties people with ASC experience. Empathy, for example, is significantly reduced in children (without ASC) who exhibit motor difficulties [8]. Hence, the association between dyspraxia with social skills and empathy in those without diagnosis of ASC would be greater than in those with co-morbid ASC. Another possibility is that dyspraxia may be under-diagnosed in those with ASC. Motor difficulties are highly prevalent in people with ASC [6, 7], and these difficulties may be viewed as part of their ASC, as opposed to requiring another co-morbid diagnosis. However, given the small but growing body of evidence showing the importance of motor coordination in social skills in both the general population (without ASC) and those with ASC, recognition and diagnosis of these difficulties is key to access appropriate support and treatment. A small body of evidence suggests high risk of adults with dyspraxia, without co-morbid ASC, experiencing mental health problems, low self-esteem and emotional difficulties, exacerbated by low occupational attainment [9]. Results from the current study add to this literature, suggesting that these individuals also experience difficulties in social skills and empathy, characteristic of ASC. Future research will need to explore whether improving motor coordination early in childhood, or in adulthood, improves these poor outcomes.
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Read More »The current study has a number of strengths as well as limitations. It contributes to an under-explored area of research—dyspraxia in adulthood and the prevalence and impact of dyspraxia on autistic traits in adults with and without ASC. It also utilized measures of self-reported autistic traits (AQ) and empathy (EQ), which both have undergone substantial reliability tests and have excellent psychometric properties [40, 41]. The current study also analysed data from a very large population sample—over 2800 adults with ASC and 10,000 control adults without ASC. These large numbers were necessary in order to explore differences in autistic traits between the groups, considering that only 0.8% of control adults had a diagnosis of dyspraxia. One limitation is that in order to achieve this large sample, self-report measures of dyspraxia and ASC diagnoses were necessary. However, previous research has shown significantly high concordance rates between self-reported and clinically confirmed diagnoses [42, 43]. Additionally, participants provide details on when and where they received their ASC diagnosis when they register in the research database, to ensure that these self-reported diagnoses are valid. Hence, it is unlikely that the self-report methods utilized in the study significantly invalidated the results. Another potential limitation is the use of the term ‘dyspraxia’ in the current study. This could have led to an under-reporting of this diagnosis in the control group, due to lack of familiarity with this term. It may also be the case that the likelihood of receiving a dyspraxia diagnosis maybe unevenly distributed across subsets of those with ASC. As discussed above, it is possible that dyspraxia is under-diagnosed in those with ASC, and this may differ by subtype. This could have meant that the rate of dyspraxia in both the control and ASC groups could have been under-estimated in the current study. However, if anything, this means that the rate of dyspraxia diagnosis is a conservative estimate in the current study. If an alternative label, or in person measures, were used, the rates could potentially have been higher in both groups. Future research studies will need to explore whether these rates of dyspraxia are replicable in a large representative sample of those with and without ASC using in person assessments, across the autism spectrum. However, taken together, this is the only and the largest study to date that has explored the prevalence of dyspraxia and associations between dyspraxia and autistic traits in those with and without ASC.
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