Sensorimotor Development Flashcards by Alex Lord

Importance of sensorimotor skills adapted from

Piaget developmental stages

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Sensorimotor

0-2 years
The infant explores the world through direct sensory and motor contact
Object permanence and separation anxiety develop during this stage

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Preoperational

2-6 years
The child uses symbols (words and images) to represent objects but does not reason logically.
This child also has the ability to pretend
During this stage, the child is egocentric

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Concrete operational

6-12 years
The child can think logically about concrete objects and can thus age and subtract
The child also understands conversation

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Formal operational

12 years - adult

The adolescent can reason abstractly and thinks in hypothetical terms

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What are some sensorimotor skills

Walking
‘Clumsiness’
Hand/eye coordination
Reading
Writing
Coordinating eye contact with speech and gesture during a conversation

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The range of skills need

Intact sensorimotor processing

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Gowen and Hamilton 2013

How does it work?

Vision and Proprioception = 1) Sensory systems = 2) State estimation = (current state) 3) Inverse Model (planning / control) - desired state of the world (motor control) = 4) Forward model (predictor) this links to 2) state estimation. 3 also leads to 5) Motor execution (muscle activity) - body interacting with the world

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Gowen and Hamilton 2013

What can go wrong

Number 1 and Number 3 can go wrong

1) Sensory systems
3) Inverse Model (planning/control) (desired state of the world)

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Disorders of sensorimotor development

Autism spectrum disorder
Developmental co-ordination disorder (DCD) / Dyspraxia
Both conditions encompass sensory and motor difficulties

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Sensorimotor skills associated with

Autism and autistic skills

Help with communication and empathy

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Autism spectrum disorder

Pronounced difficulties in

–Communication
–Socialisation
–Narrow Circumscribed interests
–Repetitive Behaviours
–Sensory hypersensitivity

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Developmental Co-ordination Disorder (DCD) / Dyspraxia

Pronounced difficulties in:

–Selection, timing and spatial organization of purposeful movement and coordination
–Social anxiety, social and communication skills

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Cassidy, S., Hannant, P., Tavassoli, T., Allison, C., Smith, P., & Baron-Cohen, S. (2016).

DCD/Dyspraxia, autism and autistic traits
Subscale
Social skill
Attention to switching
Attention to detail
Communication
Imagination
•Adults with autism significantly more likely to have DCD/dyspraxia (6.9%) than the gen pop (0.8%)
•Adults with DCD/dyspraxia have significantly higher autistic traits and lower empathy than controls

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People with autism

Have an over load of sensations

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Piek and Dyck 2004

DCD/Dyspraxia + autism

Much overlap between these conditions

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Cummins et al. 2005

DCD/Dyspraxia + autism

Both associated with difficulties in social and communication skills, and empathy into adulthood

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People with autism have difficulty in

Raising own head 
Unusual gait 
Sitting up 
Unusual way of formal words 
Unusual motor things then later on social things

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Hannant et al. 2016

DCD/Dyspraxia + autism

Autism must be assessed in those with DCD and vice versa

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Understanding sensorimotor difficulties

Start with looking at sensory and motor difficulties separately
Then bring them together – intrinsically related
Explore their impact on development
Can these difficulties explain the development and maintenance of autism?

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Motor difficulties in autism

Kanner and Asperger

First clinical reports of general “clumsiness”

Unusual gait included in autism diagnostic assessment (ADI-R)

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Green et al. 2009

Motor difficulties in autism

80% of people with autism have definite motor difficulties, and an additional 10% are borderline

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Flanagan et al. 2012

Motor difficulties in autism

Motor differences are present from early infancy

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Impact of motor difficulties
Motor difficulties associated with difficulties in:
Mostofsky et al. 2006

Imitation

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Impact of motor difficulties Motor difficulties associated with difficulties in: Page and Boucher, 1998

Speech sound production

Impact of motor difficulties Motor difficulties associated with difficulties in: Cummins et al. 2005

Emotion recognition

Impact of motor difficulties Motor difficulties associated with difficulties in: Batt et al. 2011

Anxiety in response to social interaction

Many of the studies are not with

Autistic people but with the general population

Motor skills are important for

Social development

Sensory difficulties in autism are now a part of

* Now part of current diagnostic criteria for autism in DSM-V * Early clinical reports described “sensory intrusions” (Kanner and Asperger)

Caminha and Lampreia, 2012; Tomcheck and Dunn, 2007 | Sensory difficulties in autism

High prevalence in autism (65% - 95%)

Blanche et al. 2012 | Sensory difficulties in autism

Proprioceptive impairment (determining where body is in space)

Contradictory evidence because

Intact lots of sensation processing but difficulty with movement processing Appears contradictory – intact form but deficits in motion

Baron-Cohen et al. | Sensory difficulties in autism

Increased rates of synaesthesia (where one sensory modality triggers another)

Sensory difficulties in autism | Mottron et al. 2006

Evidence of superior visual processing of details

``` Sensory difficulties(?) in autism Koldewyn et al. 2011 ```

Difficulties processing motion

People with autism have a fondness of

Routine

Impact of sensory difficulties | Matsushima and Kato, 2013; Reynolds et al. 2011

Sensory reactivity associated with difficulties in social and communication skills

Impact of sensory difficulties | Tavissoli et al. 2013; 2014

Autistic traits associated with sensory reactivity

Sensory processing important for

Social development

Sensory difficulties a core feature of autism and

associated with RRBs and anxiety

Repetitive behaviours (RRBs) also a core feature =

insistence on sameness and repetitive motor movements

What time is it?”

anecdotally, these behaviours associated with anxiety in autism –“Intolerance of uncertainty”

Wigham, S., Rodgers, J., South, M., McConachie, H., & Freeston, M. (2015). The interplay between sensory processing abnormalities, intolerance of uncertainty, anxiety and restricted and repetitive behaviours in autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(4), 943-952.

Autism

Sensory and motor difficulties prevalent in autism, and associated with social and

communication skills

Landa and Garrett-Mayer, 2006

Associated with increased likelihood of autism diagnosis at 3 years

Sensory and motor difficulties in autism appear to be related, and impact on

anxiety and intolerance of uncertainty

Sensory and motor abilities are

* intrinsically connected | * Should explore how they work together in autism

•Children with autism have marked sensory and motor difficulties compared to those ...

Without autism

•Sensorimotor skills, such as catching a | ball, most strongly associated with a

number of autism symptoms across measures in both groups

Sensorimotor skills (as opposed to sensory or motor alone) more strongly predict

social and communication skills in those with and without autism

Sensorimotor integration in autism Eye movements: Schmitt et al. 2013

–less accurate when moving eyes to a | new target

Sensorimotor integration in autism Eye movements: Wilkes et al. 2015)

–Slower to initiate an eye movement

Sensorimotor integration in autism | Glazebrook et al. 2009

Difficulties coordinating hand and eye movements

Sensorimotor integration in autism | Hannant et al. 2016; Klin

Could explain delay in looking to pertinent social cues with downstream effects on social and communication ability

Eye movements | Smooth pursuit

Smooth eye movement to track a moving target | Involuntary - can't be produced without a moving object

Sensorimotor integration in autism | Cascio, C. J., Foss-Feig, J. H., Burnette, C. P., Heacock, J. L., & Cosby, A. A. (2012).

•Rubber hand illusion –Children with autism less susceptible than typically developing controls –Delayed susceptibility to the illusion (6 minutes) –Those children with less empathy less susceptible •Reduced ability to integrate visual and tactile information The rubber hand illusion in children with autism spectrum disorders: delayed influence of combined tactile and visual input on proprioception

Paton, B., Hohwy, J., & Enticott, P. G. (2012). | Rubber hand illusion in autism

•Adults with autism did experience the rubber hand illusion, but were less sensitive to visual-tactile discrepancies •Less proprioceptive drift to the rubber hand than controls rubber hand illusion reveals proprioceptive and sensorimotor differences in autism spectrum disorders

Sensorimotor integration in autism Difficulties in incorporating visual information into motor learning in autism: Dowd et al. 2012

presence of a visual distractor did not impact performance of children with autism like with typical controls

Sensorimotor integration in autism Difficulties in incorporating visual information into motor learning in autism: Gepner and Mestre, 2002

significantly less able to correct movements from visual compared to proprioceptive feedback

People with autism have too much

Excitation

Sensorimotor integration in autism | Gowen et al. 2008)

specific difficulties with motor movements which require integrating visual cues or other sensory signals

Salowitz, N. M., Eccarius, P., Karst, J., Carson, A., Schohl, K., Stevens, S., ... & Scheidt, R. A. (2013)

Brief report: visuo-spatial guidance of movement during gesture imitation and mirror drawing in children with autism spectrum disorders. Direct drawing Mirror drawing

those with autism do not tend to incorporate

other sensory inputs, particularly visual feedback, into motor learning have difficulty coordinating visual and motor movements

Model summary

* Suggests difficulty incorporating sensory feedback into model * Results in impaired forward model, lacking accuracy and flexibility

Modifying the forward model | Cascio et al. 2012; Vandenbroucke et al. 2009; Glazebrook et al. 2009)

People with autism can learn new motor skills, and modify the forward model, but it takes longer Number 4 Also appears to improve with age (e.g. adults more susceptible to rubber hand illusion)

Biological basis Cerebellum could play a key role: Schmitt et al. 2014

Saccadic accuracy has been connected to error-reducing function of the cerebellum

Biological basis Cerebellum could play a key role: Marko et al. 2015

Cerebellum volume associated with difficulties incorporating visual cues in motor learning

Biological basis | Glickstein, 1998

Cerebellum contains pathways that link sensory and motor pathways in the brain

Where Sensorimotor Integration Occurs

Purkinje Cells in Cerebellum (Sensorimotor Neurons) GABA Glutamate

What is GABA

Gamma aminobutyric acid

Neurotypical

Sufficient receptors for GABA | Efficient synthesis of GABA

Autism biology

Inefficient synthesis of GABA | Limited receptors for GABA

Impact of sensorimotor difficulties in autism | Difficulties with:

–accuracy, speed, and initiation of eye movements; –coordination of eye and body movements; –integrating visual and tactile information –integrating visual information into motor learning, with increased reliance on proprioception