الفهرس 
Normal Developmental MilestonesOnly 14 pages are availabe for public view
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Abstract
Autism is not a rare disorder anymore, it’s characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old, 60%–80% of autistic people have early motor signs that goes un recognized.
Autistic brains have many changes in Purkinje cell morphology and other cerebellar abnormalities which may in turn underlie and explain motor learning dysfunction and motor impairment in autism.
Up-to-date, no specific proved evidence based researches about the exact neurotransmitters involved in the pathology of autism generally and its motor domain specifically. All the available researches are just on the hypothetical level and either contradictory or not yet replicated.
Motor impairment in autism appear to be very evident. So, there is no doubt about the presence of motor deficits in autistics as ”main core symptoms”. These deficits are ”evidence based”. Just put them in your consideration and search for them, you will find them very clearly.
Motor deficits in autistics are considered one of the first signs which probably precede social or linguistic abnormalities and could be used as an early indicator of potential autism since the first months of life.
In our study :The studied group and the control group were well matched regarding the age and sex distribution and showed that there was no statistical significance between the two studied groups regarding gender and age of the studied patients.
The comparison between the two studied groups the cases and the controls showed a highly statistical significant difference between them in all the studied parameters of the Brigance test.
Also it showed that there were high statistical significant inverse relation between (CARS) score and the Brigance scale in gross motor skill while showed no statistical significance but inverse between the (CARS) score and the Brigance scale in fine motor skill whereas showed statistical inverse significant relation between the (CARS) score and the Brigance scale in self help skill and total of Brigance scale total of Brigance score in the patients group.
So it was proven that motor incoordination is a core symptom in autistic children and the more severe the autistic symptoms are the more motor impairment evident with it.
Early identification of children with autism is recognized as a critical aspect of their medical management and treatment.
Adopting the concept that autism is only social and communication deficit disorder (and discarding motor deficits as a core symptom) will delay and complicate the process of early diagnostic assessment.
Dealing with motor deficits as a core symptom and inclusion of these deficits in the diagnostic criteria in the future ”Classification Systems”, will enable health professionals to screen for; detect; and diagnose autism much easier and earlier.
There are number of approaches to the early detection of developmental problems in autism.
There are eight motor assessment tools that are specific for motor abilities in children aged 0 – 3 years. They have applicability to young autistic children as ”screening tool” or ”diagnostic tool”. These tools are very helpful in very early screening and assessment of the prodromal (motor) signs of autism.
Proper ”Early Identification” will abolish the current ”Diagnostic Gap” and current non-evidence based ”Alternative Therapies”, which in turn will decrease the enormous ”Costs” of autism and will re-allocate the resources of autism towards the ”Early Intervention Programs” for motor deficits specifically and autism as a whole which is the essential current trend in management of autism.
Early identification programs imply teaching the parents about the early warning motor signs of autism which sometimes begin from the first month of life as parents of young children with autism are the first people to recognize a developmental problem. They usually detect the motor deficits in their children very early (at an average age of 12 – 15 months).
”Early Intervention” is critical for preventing a cascade of effects that result from early deficits and interfere with later functioning.
Unfortunately, we are left with no clear evidence based documented early intervention for all core symptoms of autism (as a whole, and not specifically directed to motor deficits) neither on the pharmacological nor non-pharmacological levels. Effectiveness of these programs is ”subjective” and some of those programs are ”commercial”.
The role of rehabilitation becomes more evident and important with autistic children. It acts as the sole and the soul of early intervention in autism.
Although, until now there is no structured motor rehabilitative programs for autistic children with motor difficulties, autism researchers who specialize in early intervention have the ability to recognize clues to the syndrome in high-risk babies as young as 3 or 4 months. By initiating intensive physical therapy with infants and their parents, therapists hope to prevent a diagnosis of actual autism at 2 or 3 years.
Several studies have reported positive outcomes for children enrolled in motor intervention programs between the ages of 2 - 4 years.
Neural plasticity is the sole of early intervention in autism.