Rinehart NJ et al. (2006) Gait function in newly diagnosed children with autism: cerebellar and basal ganglia related motor disorder. Dev Med Child Neurol 48: 819–824

Autism is a lifelong developmental disability affecting social interaction, and often characterized by repetitive behavior and resistance to change. Research has typically focused on the psychiatric symptoms of the disorder, but improved understanding of its neurobiological basis could help diagnosis and treatment. Motor investigations have so far focused on the fronto–striatal basal ganglia region. Rinehart et al. now report a strong association between abnormal gait features and autism, highlighting an additional important role of the cerebellum in this disorder.

Gait and intra-walk measurements were analyzed in 11 children with autism (age range 4 years 4 months to 6 years 9 months) and 11 typically developing children, using an electronic walkway and observation by experienced physiotherapists. Consistent with the clinical features of cerebellar ataxia, the children with autism had greater difficulty walking along a straight line, and concurrent variable stride length and duration. Affected children also had less consistent walking velocity (cm/s), and were less coordinated and less smooth when walking than were the controls. Suggesting an involvement of the fronto–striatal basal ganglia region in the disorder, children with autism also had postural abnormalities in the head and trunk.

These gait variables could, the authors suggest, be used in the clinical definition of autism; similar results were shown in older children up to 14 years of age, demonstrating that these abnormalities are evident over the usual age of presentation and diagnosis of pervasive developmental disorders.