Abstract
BackgroundMany children in the remote Fitzroy Valley region of Western Australia have prenatal alcohol exposure (PAE). Individuals with PAE can have neurodevelopmental impairments and be diagnosed with one of several types of Fetal Alcohol Spectrum Disorder (FASD). Fine motor skills can be impaired by PAE, but no studies have developed a comprehensive profile of fine motor skills in a population-based cohort of children with FASD. We aimed to develop a comprehensive profile of fine motor skills in a cohort of Western Australian children; determine whether these differed in children with PAE or FASD; and establish the prevalence of impairment.MethodsChildren (n = 108, 7 to 9 years) were participants in a population-prevalence study of FASD in Western Australia. Fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, which provided a Fine Motor Composite score, and evaluated Fine Manual Control (Fine Motor Precision; Fine Motor Integration) and Manual Coordination (Manual Dexterity; Upper-Limb Coordination). Descriptive statistics were reported for the overall cohort; and comparisons made between children with and without PAE and/or FASD. The prevalence of severe (≤ 2nd percentile) and moderate (≤16th percentile) impairments was determined.ResultsOverall, Fine Motor Composite scores were ‘average’ (M = 48.6 ± 7.4), as were Manual Coordination (M = 55.7 ± 7.9) and Fine Manual Control scores (M = 42.5 ± 6.2). Children with FASD had significantly lower Fine Motor Composite (M = 45.2 ± 7.7 p = 0.046) and Manual Coordination scores (M = 51.8 ± 7.3, p = 0.027) than children without PAE (Fine Motor Composite M = 49.8 ± 7.2; Manual Coordination M = 57.0 ± 7.7). Few children had severe impairment, but rates of moderate impairment were very high.ConclusionsDifferent types of fine motor skills should be evaluated in children with PAE or FASD. The high prevalence of fine motor impairment in our cohort, even in children without PAE, highlights the need for therapeutic intervention for many children in remote communities.
Highlights
Many children in the remote Fitzroy Valley region of Western Australia have prenatal alcohol exposure (PAE)
We reviewed fine motor skills in primary school aged children with PAE or Fetal Alcohol Spectrum Disorder (FASD) [27], and found that complex fine motor skills, such as visual-motor integration, were more likely to be impaired than basic skills, such as grip strength
We identified a range of assessment tools used to assess fine motor skills in children with PAE or FASD, but few that comprehensively assessed a range of different skills
Summary
Many children in the remote Fitzroy Valley region of Western Australia have prenatal alcohol exposure (PAE). Local Aboriginal leaders in the remote Fitzroy Valley region of Western Australia introduced alcohol restrictions in 2007 because they were concerned about the social and health effects of chronic alcohol misuse These concerns included the potential harm caused by alcohol consumption during pregnancy, which can cause Fetal Alcohol Spectrum Disorder (FASD). PAE can affect the development and function of the corpus callosum [4], cerebellum [5], basal ganglia [6], and motor cortex [7], and children with FASD may have skeletal malformations [8], abnormal muscle development [9], tremor [10], and impaired nerve conductivity [11] All these factors may impair fine motor performance. Many Australian Aboriginal students perform below-average on the National Assessment Program – Literacy and Numeracy (NAPLAN), which is conducted annually with students in Years 3, 5, 7, and 9 [15]
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