Instruments assessing mobility of children and adolescents with autism spectrum disorder: A systematic review and decision map

Abstract

Aim: To identify the standardized instruments used to assess mobility aspects in children and adolescents with autism spectrum disorder (ASD), analyse the quality of their psychometric properties and their level of evidence, and develop a clinical decision map for these instruments. Method: Articles were screened and study characteristics were extracted. The methodological quality of the selected studies was analysed using the COSMIN Risk of Bias checklist. The quality of evidence for each measurement property was defined using a modified version of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Eleven instruments were analysed in 11 studies. Of these instruments, three are directed towards performance assessment and eight towards capacity assessment. The selected studies evaluated the psychometric properties of Vineland Adaptive Behavior Scales, Gross Motor Assessment of Children and Adolescents with Autism Spectrum Disorder, Ignite Challenge, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, Miller Function and Participation Scales, Peabody Developmental Motor Scales, Second Edition, Test of Gross Motor Development, Second and Third Editions, Timed Up and Go, Developmental Coordination Disorder Questionnaire, and Movement Assessment Battery for Children, Second Edition. Of these instruments, nine were developed for the evaluation of typically developing children and children with disabilities, and have been validated for the population with ASD (81.8%). The other two instruments (18.2%) were specifically developed for the evaluation of the population with ASD. Interpretation: Most (56.51%) of the measurement properties of the instruments demonstrated low or very low evidence because of risk of bias and imprecision, reinforcing the importance of further studies to strengthen the validity and applicability of these assessments.