Autism spectrum disorder assessment in cerebral palsy and other early-onset motor conditions: A scoping review.

AIM: To map diagnostic procedures and standardized instruments reportedly used to identify autism spectrum disorder (ASD) in people with cerebral palsy or other early-onset motor conditions (EOMC) including Rett syndrome and muscular dystrophy.

METHOD: This review followed the scoping review methodology of the JBI and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The Web of Science, PubMed, PsycINFO, CINAHL Complete, and ERIC databases were searched in December 2022 and updated in February 2025. Studies specifying ASD diagnostic criteria and/or instruments used to assess ASD in people with EOMC were eligible. Titles, abstracts, and full texts were screened and data extracted by two reviewers per publication.

RESULTS

Eighty-eight selected studies included 97 544 people with EOMC. Assessment currently seems feasible only in a subset of people with motor issues. Participants presenting severe motor impairments were underrepresented. Many authors reported challenges when performing ASD assessments. Some adaptations were reported for screening-questionnaires, but their validities were untested. A few standardized instruments showed promising psychometric properties in small samples with EOMC, but their diagnostic validity is not established.

INTERPRETATION: There is a critical need for consensus guidelines on ASD assessment practices for people with cerebral palsy and other EOMC, as well as for validated screening and diagnostic tools.