Comparing fine motor performance among young children with autism spectrum disorder, intellectual disability, attention-deficit/hyperactivity disorder, and specific developmental disorder of motor function.

Objective: The acquisition of fine motor skills is considered to be a crucial developmental milestone throughout early childhood. This study aimed to investigate the fine motor performance of young children with different disability diagnoses. Methods: We enrolled a sample of 1,897 young children under the age of 6 years who were at risk of developmental delays and were identified by a transdisciplinary team. A series of standardized developmental assessments included the Bayley Scales of Infant Development-Third Edition, Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, Peabody Developmental Motor Scale-Second Edition, and Movement Assessment Battery for Children-Second Edition were used. Retrospective chart reviews were conducted on all children to identify specific developmental disorders. The number of autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), comorbidity, motor dysfunction, and unspecified developmental delays (DD) were 363 (19.1%), 223 (11.8%), 234 (12.3%), 285 (15.0%), 128 (6.7%), and 590 (31.1%), respectively. Results: Young children with ID, comorbidity, and motor dysfunction demonstrated significant difficulty in performing manual dexterity and visual motor integration tasks and scored significantly lower in these areas than children with ASD, ADHD, and unspecified DD. In addition, fine motor performance was associated with cognitive ability in children with different disability diagnoses, indicating that young children showed better fine motor performance when they demonstrated better cognitive ability. Conclusion: Our findings support that differences in fine motor performance differ by disability type. Close links between fine motor performance and cognitive ability in children under the age of 6 years were seen in all disability types.

Efficacy of Motor Interventions on Functional Performance Among Preschool Children With Autism Spectrum Disorder: A Pilot Randomized Controlled Trial.

IMPORTANCE: Motor ability plays an important role in overall developmental profiles. Preschool children with autism spectrum disorder (ASD) are at risk of motor skills deficits and delays. However, evidence of the efficacy of different motor interventions for the identification of optimal treatment types is lacking, especially for preschool children with ASD. OBJECTIVE: To examine the efficacy of the Motor Skill Occupational Therapy Intervention ON ASD (MOTION-ASD) and Cognitive Orientation Exercise (CO-EXC) programs to improve motor skills performance, self-care performance, and adaptive behaviors among preschool children with ASD. DESIGN: Randomized controlled trial, two-group, triple-blinded, repeated-measures design Setting: University laboratory. PARTICIPANTS: Thirteen preschool children with ASD (M age = 4.91 yr). OUTCOMES AND MEASURES: The Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Brief Form, Assessment of Motor and Process Skills, and Vineland Adaptive Behavior Scales-Third Edition. RESULTS: Children in the MOTION-ASD group showed significantly greater improvements in manual coordination and overall gross and fine manual skills than those in the CO-EXC group immediately after the intervention. Significant improvements in fine manual control, body coordination, overall motor skills, and self-care performance were made throughout both interventions and were retained at the posttest and the 4-wk follow-up. CONCLUSIONS AND RELEVANCE: These findings provide supporting evidence that motor skills interventions involving fundamental skills and cognitive training may be a viable therapeutic option for treating children with ASD. The results also suggest that practitioners may consider providing structured and strategic motor skills interventions for preschool children with ASD. What This Article Adds: This study's rigorous tests of motor skills interventions support ways to manage motor difficulties in children with autism spectrum disorder (ASD). An intervention based on motor learning theory could benefit preschool children with ASD, especially in terms of manual coordination ability and overall gross and fine motor skills.

WDR4 promotes the progression and lymphatic metastasis of bladder cancer via transcriptional down-regulation of ARRB2.

Lymph node (LN) metastasis is one of the key prognostic factors in bladder cancer, but its underlying mechanisms remain unclear. Here, we found that elevated expression of WD repeat domain 4 (WDR4) in bladder cancer correlated with worse prognosis. WDR4 can promote the LN metastasis and proliferation of bladder cancer cells. Mechanistic studies showed that WDR4 can promote the nuclear localization of DEAD-box helicase 20 (DDX20) and act as an adaptor to bind DDX20 and Early growth response 1 (Egr1), thereby inhibiting Egr1-promoted transcriptional expression of arrestin beta 2 (ARRB2) and ultimately contributing to the progression of bladder cancer. Immunohistochemical analysis confirmed that WDR4 expression is also an independent predictor of LN metastasis in bladder cancer. Our results reveal a novel mechanism of LN metastasis and progression in bladder cancer and identify WDR4 as a potential therapeutic target for metastatic bladder cancer.

The relationship between affiliate stigma, stress, and quality of life for parents of individuals with cerebral palsy in Malaysia.

OBJECTIVE: To examine the relationship between affiliate stigma, stress, and perceived quality of life among parents of children with cerebral palsy (CP). METHOD: Surveys (Study 1) and semi-structured interviews (Study 2) were used to collect data. Thirty-eight respondents completed the Affiliate Stigma Scale (ASS), Caregiver Burden Inventory (CBI), and Care-related Quality of Life (CarerQol) scales (GMFCS). Eleven respondents took part in semi-structured interviews, which were then thematically evaluated. RESULTS: Parents did not feel stigmatized because they had a child with CP. However, parents needed some form of short-term relief from caregiving. After controlling for demographics, high stress respondents experienced high affiliate stigma whereas low stress respondents had better quality of life. Although the respondents with less stigma had a better quality of life, this effect was moderate. Three major themes emerged from the interviews. CONCLUSION: Counseling, support groups, and helper services should be offered to parents. Also, healthcare professionals participating in CP rehabilitation, community-based rehabilitation, and health institutions should be educated on how to better help parents of children with CP.

There is a need in Malaysia to offer counseling, support groups, and assistance programs for parents of children with cerebral palsy.Healthcare professionals, who offer rehabilitation services to children with cerebral palsy, need greater awareness of the needs of families and caregivers and should be educated about how to best support them.There should be greater recognition of the importance of respite and relief from caregiving among Malaysian parents of children with cerebral palsy.

Emotion Dysregulation Mediates the Relationship Between Sensory Processing and Behavior Problems in Young Children with Autism Spectrum Disorder: A Preliminary Study.

Emotion dysregulation is one of the challenges that children with autism spectrum disorder (ASD) and their families face. It is unclear whether emotion dysregulation plays a mediating role in the relationship between sensory processing patterns and problem behaviors among these children. This study examined the relations between emotion dysregulation, behavioral problems, and sensory processing patterns among fifty-seven young children with ASD. Behavioral problems and sensory processing patterns were moderately to strongly correlated with emotion dysregulation. The relationship between sensory processing patterns and behavioral problems was significant with emotion dysregulation as a mediator. These findings help identify the relationship between emotion dysregulation, sensory processing patterns, and behavioral problems to facilitate the planning of intervention strategies for young children with ASD.

Mediating effect of sequential memory on the relationship between visual-motor integration and self-care performance in young children with autism spectrum disorder.

Objective: Visual perception is a skill that contributes to the performance of self-care and important development tasks in early childhood. The relationship between self-care and visual perception is especially significant for young children with autism spectrum disorder (ASD), who have been described as visual learners. However, this relationship is not clearly understood among young children with ASD. We investigated the role of motor-free visual perception on the relationship between self-care and visual-motor integration in young children with ASD. Methods: A sample of 66 children with ASD aged 48 to 83 months were recruited. Measurements included the Assessment of Motor and Process Skills, the Developmental Test of Visual Perception-Third Edition, and Test of Visual-Perceptual Skills-Third Edition. Results: The results indicated that self-care performance had significant positive correlations with visual-motor integration, visual discrimination, visual memory, visual spatial relationships, and visual sequential memory. Of these, visual sequential memory and visual spatial relationships were the main factors related to self-care performance. Sequential memory was a mediator of the relationship between visual-motor integration and self-care performance. Conclusion: This study establishes a deeper understanding of self-care and motor-free visual perception among young children with ASD. Understanding the relationship between visual perception and self-care in young children with ASD may aid professionals in providing self-care interventions for this population.

Agreement Between Caregivers' Concerns of Children's Developmental Problems and Professional Identification in Taiwan.

Objective: Early detection of developmental delays relies on the accuracy of the caregivers' concerns of children's developmental problems. The aim of this study was to investigate the agreement between the caregivers' awareness of children's developmental problems and professional identification. Methods: Caregivers of 1,963 children (age range: 5-71 months; mean: 38.4 months) younger than 6 years old who were at risk of developmental delays and referred to the center for a comprehensive evaluation were enrolled in this study. Children were identified by a transdisciplinary team including a pediatric neurologist, a pediatric psychiatrist, two psychologists, two occupational therapists, two physical therapists, two speech therapists, a social worker, and a special instructor. A series of standardized developmental assessments were used to identify children with developmental delay. Retrospective chart reviews were conducted on all children to confirm specific developmental disorders. Results: The caregivers' initial concerns of cognitive, speech/language, emotional/behavioral, and motor and global development showed low agreement with the results of professional identification. The major disagreement was observed in the cognitive domain. Speech/language developmental concern was an important red-flag indicator of cognitive and emotional/behavioral developmental delays. The presence of intellectual disability, autism spectrum disorder, and attention deficit hyperactivity disorder was high in this study. When having caregivers' concerns about speech/language and emotional/behavioral development, the odds of children with autism spectrum disorder was 2.37 and 2.17 times greater than those without autism spectrum disorder, respectively. The presence of attention deficit hyperactivity disorder was significantly associated with concerns about cognitive and emotional/behavioral developmental delays. Child's age and mothers' level of education were significant indicators for detecting the child's developmental problems. Conclusion: It is recommended that assessing the cognitive developmental status is essential for all children in the identification process. Practitioners should not overlook caregivers' concern about speech/language and emotional/behavioral development. Transdisciplinary practitioners provide educational guidance to caregivers, especially in the domains of cognitive, speech/language, and emotional/behavioral development.

Using the Assessment of Motor and Process Skills and the Pediatric Evaluation of Disability Inventory to Assess Self-Care Performance Among Preschool Children With Autism Spectrum Disorder.

IMPORTANCE: Caregiver rating scales often give an unclear picture of the actual self-care performance of preschool children with autism spectrum disorder (ASD). OBJECTIVE: To assess self-care performance among preschool children with ASD using two standardized instruments. DESIGN: Cross-sectional study. SETTING: Clinics, hospitals, and early intervention centers in Tainan, Taiwan. PARTICIPANTS: Sixty children with ASD (ages 48-71 mo). Outcomes and Measures: The Standard Version of the Childhood Autism Rating Scale-Second Edition, the Assessment of Motor and Process Skills (AMPS), and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C). RESULTS: About 53.3% of children with ASD scored below 1.5 logits for AMPS motor skills and below 1 logit for AMPS process skills, indicating difficulties performing activities of daily living tasks. The average PEDI-C self-care normative standard scores were moderately low (between -1 and -2 SDs), indicating poor self-care performance. The correlations between the two measures were also low (rs = .27-.44). Overall, the results for 36 children were consistent with AMPS and PEDI-C scores; however, those for 24 children (40.0%) were discrepant. CONCLUSIONS AND RELEVANCE: These findings have implications for how preschool children with ASD perform their self-care activities and suggest that more than half of preschool children with ASD have a need for occupational therapy interventions that target self-care skills. Occupational therapy practitioners can work with preschool children with ASD and their families to help them improve their self-care performance. What This Article Adds: Many children with ASD need occupational therapy interventions that target self-care skills. Both the AMPS and the PEDI-C provide valuable information from different perspectives on the self-care performance of preschool children with ASD.

Physical Activity and Motor Performance: A Comparison Between Young Children With and Without Autism Spectrum Disorder.

PURPOSE: This study aims to examine the differences in physical activity and motor performance between young children with autism spectrum disorder (ASD) and children with typical development (TD) and to investigate the relationships between the levels of physical activity and motor performance. PATIENTS AND METHODS: Twenty-five children with ASD (mean age = 59.3 ± 8.1 months) and 28 children with TD (mean age = 63.1 ± 8.6 months) were recruited. The Actigraph accelerometer, Movement Assessment Battery for Children-second edition, and Assessment of Preschool Children's Participation were used. RESULTS: Young children with ASD spent significantly less time in moderate and light physical activity and exhibited more sedentary behavior than did children with TD. Those children with ASD also had greater motor difficulties and engaged less frequently in physical recreation activities compared to their TD peers. Motor performance was significantly correlated with physical activity in all children. CONCLUSION: This study highlighted the specificity of the levels of physical activity, motor difficulties, and participation diversity in children with ASD comparing performances on children with TD. Additional research is needed to provide valuable information for early interventions.

Relationship Between the Performance of Self-Care and Visual Perception Among Young Children With Autism Spectrum Disorder and Typical Developing Children.

Studies investigating the performance of self-care and visual perception in young children with autism spectrum disorder (ASD) are limited. The relationship between self-care performance and visual perception ability in young children with ASD is not yet clearly understood. Here, self-care performance was evaluated by the caregivers and therapists of children with ASD. The differences in self-care performance and visual perception ability were investigated in 66 children with ASD and 66 typically developing (TD) children between the ages of 48-83 months. The relationships between self-care and visual perception were tested in both two groups. The Assessment of Motor and Process Skills (AMPS) and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C) were used to assess the children's self-care performance. The Test of Visual Perceptual Skills-Third Edition (TVPS-3) and the Developmental Test of Visual Perception-Third Edition (DTVP-3) were used to evaluate visual perception ability. Young children with ASD obtained significantly lower scores for self-care performance (AMPS and PEDI-C) and visual perception ability (TVPS-3 and DTVP) compared with TD children. Additionally, positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD. The findings of this research highlight the need for pediatric practitioners to include self-care and visual-motor integration evaluations for young children with ASD. LAY SUMMARY: Young children with ASD obtained significantly lower scores for self-care performance and visual perception ability compared with TD children. Positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD.

Activity Participation and Sensory Processing Patterns of Preschool-Age Children With Autism Spectrum Disorder.

IMPORTANCE: A dearth of information is available on the relationship between activity participation and sensory processing patterns in preschool-age children with autism spectrum disorder (ASD). OBJECTIVE: To investigate differences in activity participation and sensory processing patterns between preschool-age children with ASD and typically developing (TD) children. DESIGN: Cross-sectional. SETTING: Clinics, hospitals, early intervention centers, and preschools in Tainan, Taiwan. PARTICIPANTS: Forty children with ASD and 40 TD children (ages 36-71 mo). OUTCOMES AND MEASURES: The Childhood Autism Rating Scale (2nd ed., Standard Version), Assessment of Preschool Children's Participation, and Short Sensory Profile 2 (SSP-2). RESULTS: Compared with TD children, children with ASD had significantly lower scores on participation diversity in activities across areas of play, physical recreation, and social activities and higher scores in each of the four sensory quadrants. For children with ASD, participation in social activities was significantly negatively correlated with SSP-2 quadrant scores. CONCLUSIONS AND RELEVANCE: These findings have implications for how preschool-age children with ASD typically engage in daily activities and suggest that some sensory processing patterns may be associated with participation in social activities. WHAT THIS ARTICLE ADDS: Occupational therapy practitioners can facilitate activity participation for preschool-age children with ASD by using their strengths and the activities that they find interesting; practitioners should consider the role of sensory systems to promote activity participation in natural settings.

Relationship Among Sensory Over-Responsivity, Problem Behaviors, and Anxiety in Emerging Adults with Autism Spectrum Disorder.

INTRODUCTION: Despite the highly prevailing rate of sensory over-responsivity, problem behaviors, and anxiety among emerging adults with autism spectrum disorder (ASD), little is known about the nature of their experiences. While previous studies have indicated potential relationships among these conditions, their connections still need to be clarified. This study aimed to examine the relationships between sensory over-responsivity, problem behaviors, and anxiety. METHODS: Fifty-seven emerging adults with ASD (Mage = 21.4, SD = 2.5; males = 80.7%) were recruited. The Adult Sensory Profile - Chinese version, Problem Behavior Scale of Scales of Independent Behavior - Revised, and Generalized Anxiety Disorder-7 - Chinese version (GAD-7) were used. RESULTS: The percentage of emerging adults with ASD who scored more than most people in the two quadrants were sensation sensitivity = 33.3% and sensation avoiding = 26.3%. Approximately 66.7%, 27.5%, and 50.9% of participants had internalizing behaviors, externalizing behaviors, and asocial behaviors, respectively. Approximately, 64.9% of the participants scored on or above the cut-off score of 6 on the GAD-7. Sensation sensitivity and sensation avoiding were significantly correlated to problem behaviors; and anxiety was a mediating variable that accounts for the relationships between sensory over-responsivity and problem behaviors. CONCLUSION: These results indicated that emerging adults with ASD showing problem behaviors might also report more exaggerated responses toward sensory inputs and experience more anxiety symptoms. The results indicate that sensory over-responsivity, problem behaviors, and anxiety may have common underlying mechanisms. Findings can be useful to understand the impacts of such difficulties for emerging adults with ASD.

Understanding the characteristics of friendship quality, activity participation, and emotional well-being in Taiwanese adolescents with autism spectrum disorder.

BACKGROUND: Autism spectrum disorder (ASD) is a lifelong developmental disability characterized by deficits in social communication and social interaction across multiple contexts. Existing literature on social relationships and well-being among adolescents with ASD in Asian countries is scant. AIMS: This study compared the perceptions of adolescents with ASD with those of their neurotypical peers toward their friendship quality, activity participation, and emotional well-being, and examined the relationships between friendship quality, activity participation, and emotional well-being. METHODS: The study participants-101 adolescents with ASD and 101 neurotypical peers, aged 10-19 years-completed the following self-administered questionnaires: the Friendship Quality Questionnaire, the Child and Adolescent Scale of Participation, the Beck Anxiety Inventory, and the short-form UCLA loneliness scale. RESULTS: Adolescents with ASD reported lower friendship quality, lower school participation, and higher levels of anxiety and loneliness compared to their neurotypical peers. Loneliness correlated negatively with friendship quality and school participation and positively with anxiety. Adolescents with ASD experienced increased levels of anxiety when low friendship quality was accompanied by greater loneliness. CONCLUSIONS AND SIGNIFICANCE: These findings reveal that friendship quality, school participation, and loneliness have a considerable effect on the emotional well-being of adolescents with ASD, thus indicating the need for therapeutic interventions that address interpersonal relationships and emotional well-being.

Quality of life and its related factors for adults with autism spectrum disorder.

PURPOSE: Improved quality of life is an important outcome for adults with autism spectrum disorder. However, little research has examined factors associated with quality of life among adults with autism spectrum disorder. METHOD: This study comparing 66 adults with autism spectrum disorder (intelligence quotient > 70) aged 20-38 years with neuro-typical adults investigated their quality of life and related factors. All the participants were interviewed with questionnaires by a registered occupational therapist. RESULTS: Participants with autism spectrum disorder scored significantly lower in all domains of quality of life than did the controls. Adults with autism spectrum disorder reported higher anxiety level, more loneliness, and higher scores on four sensory quadrants than neuro-typical adults. The predictors of the physical health domain were anxiety and sensation-sensitivity behaviors. Loneliness and sensation-sensitivity behaviors were predictive of the psychological health domain. Comorbid psychiatric disorders and loneliness were predictive of the social relationship domain. CONCLUSIONS: Adults with autism spectrum disorder need more supportive social contexts and interventions to improve their quality of life. Social relationships, psychological health, and sensory processing difficulty must be considered when designing treatment programs for adults with autism spectrum disorder. Implications for Rehabilitation Adults with autism spectrum disorder scored significantly lower in all domains of quality of life than did the neuro-typical adults. Occupational therapy can provide more supportive social contexts and interventions on social relationship and sensory processing difficulty to improve their quality of life. Understanding factors associated with quality of life among adults with autism spectrum disorder can contribute to address their needs. Occupational therapy can facilitate health promotion through working with adults with autism spectrum disorder. Social relationships, psychological health, and sensory processing difficulty must be considered when designing treatment programs for adults with autism spectrum disorder.

The Beneficial Effects of Massage on Motor Development and Sensory Processing in Young Children with Developmental Delay: A Randomized Control Trial Study.

Purpose: We investigated the effects of massage on young children with developmental delay but no clear diagnosis (e.g., cerebral palsy, genetic diseases, or autism). Methods: Thirty-six children with DD, at 1-3 years of age, were randomly assigned to the massage (n = 18) or control group (n = 18) after being stratified by age and motor developmental quotient. The two groups continued to receive routine rehabilitation intervention, whereas the massage group additionally received 20 min of massage twice a week for 12 weeks. The Comprehensive Development Inventory for Infants and Toddlers - Diagnostic Test, the Infant/Toddler Sensory Profile - Chinese version, anthropometric measures, and a sleep questionnaire were administrated before and after the massage intervention. Results: The results of analysis of covariance revealed that the massage group exhibited a greater improvement in the total motor score (p = 0.023), gross motor score (p = 0.047), and sensory sensitivity behavior (p = 0.042). Conclusion: These findings suggest that massage can effectively enhance motor and sensory processing in children with DD.

Differences between preschool children using tablets and non-tablets in visual perception and fine motor skills.

BACKGROUND: Numerous touch-screen applications designed to support visual perceptual skills and fine motor development for young children are available. OBJECTIVES: This study aimed to investigate whether or not there were differences between children using tablets and non-tablets in visual perception and fine motor skills and to examine the association between visual perception and fine motor skills in two groups. METHODS: This study had tablet and non-tablet groups, each with 36 typically developing preschool children. RESULTS: Children in the non-tablet group yielded significantly higher scores in the subtests of visual discrimination, visual memory, spatial relationships, form constancy, visual figure ground, fine motor precision, fine motor integration, and manual dexterity than those in the tablet group. The association between visual perception and fine motor skills demonstrated different patterns in the two groups. CONCLUSION: There are differences in visual perception and fine motor skills between children using tablets and non-using tablets. Different patterns of association relationship support the need for occupational therapists to consider the underlying mechanism.

Sensory Overresponsivity, Loneliness, and Anxiety in Taiwanese Adults with Autism Spectrum Disorder.

PURPOSE: Sensory overresponsiveness is highly prevalent in individuals with autism spectrum disorders (ASD) and typically persist into adulthood. However, the role of sensory processing difficulties in influencing emotional well-being among adults with ASD remains unclear. Additionally, the associations between sensory overresponsiveness, anxiety, and loneliness are yet to be examined among adults with ASD. Therefore, to address these critical gaps in the literature, we aimed to investigate the relationships among sensory avoiding, anxiety, and loneliness in a sample of adults with ASD. PARTICIPANTS: Seventy adults (age, 20-39 years) completed three self-reported measures. All participants had a documented diagnosis of ASD and had normal IQ. METHODS: Sensory processing, loneliness, and anxiety were assessed with the Adult Sensory Profile, short-form UCLA loneliness scale, and Beck Anxiety Inventory, respectively. RESULTS: Autism spectrum traits and sensory avoiding were associated with anxiety and loneliness. Participants who experienced sensory avoiding more frequently reported higher anxiety and feelings of loneliness, with loneliness mediating the relationship between sensory avoiding and anxiety. More anxiety symptoms in participants with greater sensory avoiding were associated with their higher level of loneliness. CONCLUSION: This study demonstrates that the relationships existed between sensory processing difficulties, loneliness, and anxiety among adults with ASD. Interventions regarding sensory processing difficulties and emotional well-being are substantial need for adults with ASD, and our results highlight the importance of sensory overresponsiveness and anxiety in evaluating and improving the psychological well-being of adults with ASD.

Effect of Touch Screen Tablet Use on Fine Motor Development of Young Children.

AIM: To investigate the effects of touch-screen tablet use on the fine motor development of preschool children without developmental delay. METHODS: 40 children who used a touch-screen tablet more 60 minutes per week for at least 1 month received a 24-week home fine motor activity program using a touch-screen-tablet. 40 children matched for age (mean = 61.0 months) and sex who did not meet the criteria for previous tablet use received a 24-week program consisting of manual play activities. Motor performance was measured using the Bruininks-Oseretsky Test of Motor Proficiency. The two-factor mixed design ANOVA was used to compare performance of the touch-screen tablet and non-touch-screen tablet groups. RESULTS: Pretest analysis showed no group differences in motor performance and pinch strength. At posttest, children in the nontouch-screen-tablet group made significantly greater changes in fine motor precision (p < 0.001), fine motor integration (p = 0.008), and manual dexterity (p = 0.003). CONCLUSION: Using a touch screen tablet extensively might be disadvantageous for the fine motor development of preschool children.

Relationship between time use in physical activity and gross motor performance of preschool children.

BACKGROUND/AIM: Participation in physical activity is an important health concern for children in most Western communities, but little is known about Asian children's participation. The purpose of this study was to extend the current knowledge on how much time preschool children in Taiwan spend on physical activity, to examine its relationship with gross motor performance and to provide information on the establishment of physical activity guidelines for preschool children in Taiwan. METHODS: Two hundred and sixty-four children between 36 and 71 months old were recruited from a university medical centre and from preschools in Taiwan. The primary outcomes were measured using the Movement Assessment Battery for Children-Second Edition and the modified Preschool-aged Children's Physical Activity Questionnaire. RESULTS: 89.8% of our participants did not meet the recommendations from the National Association for Sport and Physical Education for time spent in physical activities. Participants spent an average of 155 minutes/week in low intensity physical activity. Children with motor difficulties tended to spend less time on physical activity than did typically developing children. The mother's level of education and whether the child was overweight or obese correlated with how much time the children spent on physical activity. CONCLUSIONS: We conclude that paediatric occupational therapists should explain to parents the relationship between physical activity and motor development and advocate for developmentally positive physical activities for preschool children. Physical activity guidelines for Taiwanese preschoolers should be established immediately.

Applied Cliplets-based half-dynamic videos as intervention learning materials to attract the attention of adolescents with autism spectrum disorder to improve their perceptions and judgments of the facial expressions and emotions of others.

BACKGROUND: Autism spectrum disorders (ASD) are characterized by a reduced ability to understand the emotional expressions on other people's faces. Increasing evidence indicates that children with ASD might not recognize or understand crucial nonverbal behaviors, which likely causes them to ignore nonverbal gestures and social cues, like facial expressions, that usually aid social interaction. OBJECTIVE: In this study, we used software technology to create half-static and dynamic video materials to teach adolescents with ASD how to become aware of six basic facial expressions observed in real situations. METHODS: This intervention system provides a half-way point via a dynamic video of a specific element within a static-surrounding frame to strengthen the ability of the six adolescents with ASD to attract their attention on the relevant dynamic facial expressions and ignore irrelevant ones. RESULTS: Using a multiple baseline design across participants, we found that the intervention learning system provided a simple yet effective way for adolescents with ASD to attract their attention on the nonverbal facial cues; the intervention helped them better understand and judge others' facial emotions. CONCLUSION: We conclude that the limited amount of information with structured and specific close-up visual social cues helped the participants improve judgments of the emotional meaning of the facial expressions of others.