Autism spectrum disorder assessment in cerebral palsy and other early-onset motor conditions: A scoping review.
TL;DR
There is a critical need for consensus guidelines on ASD assessment practices for people with cerebral palsy and other EOMC, as well as for validated screening and diagnostic tools.
Abstract
Aim
To map diagnostic procedures and standardized instruments reportedly used to identify autism spectrum disorder (ASD) in people with cerebral palsy or other early-onset motor conditions (EOMC) including Rett syndrome and muscular dystrophy.
Method
This review followed the scoping review methodology of the JBI and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The Web of Science, PubMed, PsycINFO, CINAHL Complete, and ERIC databases were searched in December 2022 and updated in February 2025. Studies specifying ASD diagnostic criteria and/or instruments used to assess ASD in people with EOMC were eligible. Titles, abstracts, and full texts were screened and data extracted by two reviewers per publication.
Results
Eighty-eight selected studies included 97 544 people with EOMC. Assessment currently seems feasible only in a subset of people with motor issues. Participants presenting severe motor impairments were underrepresented. Many authors reported challenges when performing ASD assessments. Some adaptations were reported for screening-questionnaires, but their validities were untested. A few standardized instruments showed promising psychometric properties in small samples with EOMC, but their diagnostic validity is not established.
Interpretation
There is a critical need for consensus guidelines on ASD assessment practices for people with cerebral palsy and other EOMC, as well as for validated screening and diagnostic tools.