How are movements assessed in the physical exam for autism spectrum disorder (ASD)?

Updated: Sep 30, 2019
  • Author: James Robert Brasic, MD, MPH; Chief Editor: Caroly Pataki, MD  more...
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Answer

Patients with autistic disorder merit a careful assessment of movements. The caregiver and clinicians may be asked whether the patient shows any unusual motions in the mouth, face, hands, or feet and, if so, may be asked to describe them and how they bother the patient.

The patient may be asked to sit on the chair with legs slightly apart, feet flat on the floor, and hands hanging supported between the legs or hanging over the knees. The patient may be asked to open his or her mouth and then twice to stick out the tongue.

If the subject does not perform the requested action, the examiner then repeatedly performs the actions in the direct view of the subject to demonstrate the desired actions.

The patient may be asked to sit, stand, and lie on a sheet on the floor for 2 minutes in each position and to remain motionless while in each posture. In each position, the patient is asked, "Do you have a sensation of inner restlessness?" and "Do you have the urge to move?" These questions require an appropriate developmental level for a useful response. Therefore, most children with autism cannot respond appropriately.

In the absence of a clear verbal response, the subjective items are not rated. Nevertheless, the objective behavior of the child can be observed and rated.


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