The neurological examination in adults with autism spectrum conditions: a pilot study

Autism is a neurodevelopmental condition. However, the way neurological aspects of autism persist into adulthood and old age is not well understood. Neurological disorders are the second highest cause of mortality in adults with autism, the highest being suicide. A primary care clinician uses the neurological examination (neuroexam) as the first port of call to assess neurological function. The neurodevelopmental nature of autism begs the question of how useful the standard physical examination is in assessing neurological health or pathology in adults with autism. The study had two objectives: to assess the feasibility of the neuroexam protocol and the tolerability of the neuroexam to participants with autism, and to assess the results of the neuroexam for between group differences. The present study recruited 17 participants, aged 18 – 30 years, to attend a neuroexam. Seven participants had a diagnosis of autism, whilst the other ten were typically developed participants as controls. The neuroexam was well tolerated by all participants. The protocol revealed some problems in the application of the graphaesthesia and timed motor coordination tests but otherwise ran smoothly. The neuroexam results displayed significant differences between groups in cranial nerves, and motor coordination and balance. Individual tests which were significant included: saccades, muscles of facial expression, finger-to-nose, and pronation/supination.