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Studie: Eshkol–Wachmanova notace pohybu ve screeningu autismu

 

 

Eshkol–Wachman movement notation in diagnosis: The early detection of Asperger's syndrome

Overview

  • Title: Eshkol–Wachman movement notation in diagnosis: The early detection of Asperger's syndrome
  • Authors: Osnat Teitelbaum, Tom Benton, Prithvi K. Shah, Andrea Prince, Joseph L. Kelly, and Philip Teitelbaum
  • Country of origin: USA
  • Year: 2018
  • Number of participants: 16
  • https://pubmed.ncbi.nlm.nih.gov/15282371/ 

Premises

  • The diagnostic criteria of Asperger's syndrome (AS) and autism spectrum disorder (ASD) are still unclear, and a critical marker that distinguishes AS from autism is the presence of language.
  • Abnormal movement patterns can be detected in infants with AS and ASD, suggesting that these disorders can be diagnosed very early, independent of the presence of language.
  • Almost all of the movement disturbances in ASD and AS can be interpreted as infantile reflexes "gone astray"; i.e., some reflexes are not inhibited at the appropriate age in development, whereas others fail to appear when they should.

Highlights

  • The study used Eshkol–Wachman movement notation (EWMN) to analyze videos of infants who later received a diagnosis of AS.
  • EWMN allowed for a detailed analysis of movement patterns, including the type of movement, the angle of movement, and the relationship between limbs.
  • Similar movement patterns of motor disturbances exist in infants who will later be diagnosed as AS and those diagnosed as ASD.

Conclusions

  • The study suggests that the assessment of movement patterns, which are the infant's "first language," can serve as a common identifier of the difficulty already at an early age when comparing and studying different syndromes.
  • The study highlights the potential of EWMN as a tool for early detection of ASD and AS.

Recommendations

  • Further research is needed to investigate the relationship between movement patterns and other aspects of development, such as language or social cognition, in infants with ASD or AS.
  • The use of EWMN in early detection of ASD and AS should be explored in larger studies with a more diverse population.

Methodology

  • The study solicited videos of infants who later received a diagnosis of AS from parents through conversations at professional conferences, over the Internet, or in advertisements in professional publications.
  • A total of 16 videos of children diagnosed with AS were converted to DVDs and analyzed using EWMN.
  • The study analyzed the videos frame-by-frame and used EWMN to classify the movements based on the angle of movement, the type of movement, and the relationship between limbs.

Results

  • The study found that similar movement patterns of motor disturbances exist in infants who will later be diagnosed as AS and those diagnosed as ASD.
  • The study also found that the use of EWMN allowed for a detailed analysis of movement patterns in infants with AS and ASD, which can serve as a common identifier of the difficulty already at an early age when comparing and studying different syndromes.

Discussion

  • The study's findings support the idea that infants at risk for ASD and AS show atypical motor development patterns that seem to predict social and linguistic outcomes.
  • The study's findings suggest that almost all of the movement disturbances in ASD and AS can be interpreted as infantile reflexes "gone astray"; i.e., some reflexes are not inhibited at the appropriate age in development, whereas others fail to appear when they should.
  • The study's findings also support the idea that progress in motor development is related to a reflexive process, in which the infant gradually matures by the inhibition of more primitive motor forms.
  • The study's findings also support the idea that primary (or primitive) reflexes are muscle reactions that occur automatically in response to a specific stimulus; they emerge during fetal development and are critical for the survival of the newborn infant.
  • The study's findings also support the idea that primary reflexes are readily elicited during the first six months after birth, but as the nervous system matures, they are progressively inhibited and gradually superseded by postural reflexes.
  • The study's findings also support the idea that if primary reflexes are retained beyond the normal developmental period, they have the potential to disrupt maturation processes and reduce the brain's ability to process sensory information effectively.

Tilting Test

  • The study proposes a simple test using one such reflex for the early detection of a subgroup of children with AS or autism.
  • The study recommends the "Tilting Test" as an easy tool to spot if primary reflexes are persisting or replaced with higher, postural Head Righting Reflex.
  • The study suggests that the tilting test should be routinely performed on all infants beginning at 6 months, 
  • The study notes that the absence of the head verticalization response (even on one side) can be an early warning sign of neurological damage that may be characteristic of autism or AS and indicates the need for additional testing for aberrant movement patterns.