Relationship between Vision and Visual Perception in Hong Kong Preschoolers

Abstract

Although superior performance in visual motor and visual perceptual skills of preschool children has been documented in the Chinese population, a normative database is only available for the US population. This study aimed to determine the normative values for these visuomotor and visual perceptual tests for preschool children in the Hong Kong Chinese population and to investigate the effect of fundamental visual functions on visuomotor and visual perceptual skills. One hundred seventy-four children from six different kindergartens in Hong Kong were recruited. Distance visual acuity, near visual acuity, and stereopsis were tested, along with two measures of visual perception (VP): Visual-Motor Integration (VMI) and Test of Visual-Perceptual Skills (TVPS). Raw VMI and TVPS scores were converted into standard/scaled scores. The impact of basic visual functions on VP (VMI and TVPS) was examined using multiple regression. Visual functions were generally good: only 9.2 and 4.6% of subjects had unilateral and bilateral reduced habitual vision, respectively (distance visual acuity in the better eye >0.3 logMAR [logarithm of the minimum angle of resolution]). Performance in the VMI and in the visual memory and spatial relationships subtests of the TVPS exceeded that reported for age-matched children from the United States. Multiple regression analysis provided evidence that age had the strongest predictive value for the VMI and VP skills. In addition, near visual acuity was weakly associated with performance in the VMI and the visual discrimination and spatial relationships subtests of the TVPS, accounting for a limited proportion of the intersubject variability (R < 3%; p < 0.001). Hong Kong preschoolers outperformed their US peers in the VMI and visual memory/spatial relationships of TVPS subtests, perhaps attributed to greater exposure to such material during their preschool home education. This study provided normality data for VMI and four subtests of the TVPS for Hong Kong Chinese preschool children as a reference for future studies.