Movement smoothness during dynamic postural control to a static target differs between autistic and neurotypical children

BACKGROUND: Autistic children and adults have known differences in motor performance, including postural instability and atypical gross motor control. Few studies have specifically tested dynamic postural control. This is the first study to quantify movement smoothness and its relationship to task performance during lateral dynamic postural control tasks in autism. RESEARCH QUESTION: We sought to test the hypothesis that autistic children would have less smooth movements to lateral static targets compared to neurotypical children, and that this difference would relate to specific movement strategies. METHODS: We used camera-based motion-capture to measure spatiotemporal characteristics of lateral movement of a marker placed on the C7 vertebrae, and of markers comprising trunk and pelvis segments during a dynamic postural movements to near and far targets administered in an immersive virtual environment. We tested a sample of 15 autistic children and 11 age-matched neurotypical children. We quantified movement smoothness using log dimensionless jerk. RESULTS: Autistic children exhibited more medial-lateral pelvic position range of motion compared to neurotypical children, and used a stepping strategy more often compared to neurotypical children. Autistic children also had higher log dimensionless jerk than neurotypical children for motion of the C7 marker. All participants had higher log dimensionless jerk for far targets than for near targets. Autistic children had longer trial durations than neurotypical children, and younger children had longer trial durations than older children across diagnostic groups. SIGNIFICANCE: The stepping strategy observed more often in the autistic group likely contributed to log dimensionless jerk and reduced movement smoothness. This strategy is indicative of either an attempt to prevent an impending loss of balance, or an attempt to compensate for and recover from a loss of balance once it is detected.