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Persons with Down syndrome are frequently described as ‘clumsy’. The recent progress in the development of quantitative approaches to motor synergies has allowed researchers to move towards an understanding of ‘clumsiness’ at the level of underlying control mechanisms. This progress has also offered an opportunity to quantify changes in motor synergies that accompany improvement in the performance of motor tasks. Previous studies of our group have shown, in particular, that persons both with and without Down syndrome are able to show improvements in indices of their multi-finger synergies in tasks that require accurate production of finger forces. In particular, 3 days of practice has been shown to lead to significant improvements in indices of multi-finger synergies that stabilize the time patterns of the total force produced by the fingers of a hand. Persons with Down syndrome showed a qualitative change in their synergies that failed to stabilize the total force altogether prior to practice and became able to do so after practice. In addition, the studies have also shown that variable practice is more beneficial for the improvement of motor synergies than blocked practice. I would like to draw an optimistic conclusion that persons with Down syndrome are not inherently ‘clumsy’, but have a vast potential for an improvement of their motor performance. The current state of the area of motor control allows researchers and practitioners to tap into these reserves, and to use quantitative indices of changes in motor synergies with practice to optimize motor performance of these individuals. [ABSTRACT FROM AUTHOR]

Clumsiness has been proposed as a diagnostic feature of Asperger syndrome (AS), a type of pervasive developmental disorder recently introduced in the ICD-10 and DSM-IV. However, the extent to which this symptom is specific to AS is not clear. To investigate this issue, we compared a sample of AS children with age- and sex-matched groups of children with autistic disorder and pervasive developmental disorder not otherwise specified (PDDNOS). Twelve subjects with AS (ICD-10/DSM-IV; 11 males; average age 11.4 years; mean full-scale IQ 104.9) were compared with 12 subjects with autistic disorder (DSM-III-R; 11 males; average age 10.3 years; mean full-scale IQ 78.4) and 12 subjects with PDDNOS (DSM-III-R; 10 males; average age 10.1 years; mean full-scale IQ 78.2). The BruininksOseretsky test, a standardized test of motor coordination, was administered blind by the same investigator to all the three groups. While coordination deficits were found in all three groups, children with AS were found to be less impaired than those with autistic disorder and PDDNOS. However, no significant relationship was found between coordination scores and diagnosis after adjusting for the level of intelligence. These findings suggest that some patients with AS may be less clumsy than those with autistic disorder and that this difference may be the result of their higher level of intelligence. Studies based on larger samples using multiple measures of coordination are needed to further clarify the role of clumsiness in the classification of pervasive developmental disorders. [ABSTRACT FROM AUTHOR]

Although Asperger syndrome (AS) has been included in the ICD-10 as a distinct category within the pervasive developmental disorders, it is still unclear to what extent it differs from normal-intelligence autism (high-functioning autism; HFA). Persons with AS are said to be particularly clumsy. To test the hypothesis that clumsiness can reliably distinguish AS from autism, the present authors compared 11 patients with AS (ICD-10; 10 males; mean age, 13-6 years; mean IQ, 98) with nine patients with HFA (ICD-10/DSM-III- R; eight males; mean age, 12-9 years; mean IQ, 84). Clumsiness was assessed by the Bruininks-Oseretsky test. Both groups showed problems with coordination and the distribution of standard scores was virtually identical. This suggests that motor clumsiness, as measured by tests of coordination, may not reliably distinguish AS from HFA. However, qualitative differences may occur between the two groups in the manner in which movements are performed. Further research with larger samples may elicit differences into the pattern of motor deficits that occur in autism and AS. [ABSTRACT FROM AUTHOR]