Beery Visual-Motor Integration Research Articles

Integrated Life Skills Training and Executive Function Strategies in Children With Autism Spectrum Disorder in Qatar: A Pilot Study of a Randomized Controlled Trial.

Background and aim Executive function (EF) impairment is common in children with autism spectrum disorder (ASD). EF strategies are considered effective in improving the therapeutic outcomes of children with ASD. This study primarily aimed to explore whether integrating EF strategies combined with regular occupational therapy intervention is more effective in improving daily life skills (DLS) and sensory integration/processing (SI/SP) skills than regular occupational therapy alone in children with ASD and secondarily aims to assess treatment outcomes on improving visual motor integration (VMI) skills. Methods A total of 17 participants (13 males, mean age 4.29 years,standard deviation 0.66) completed the study. Following the baseline assessments, the participants were randomly assigned to the treatment group (45-minute once-weekly individual occupational therapy plus EF strategies) or control group (45-minute once-weekly individual therapy sessions alone). All participants received one intervention per week for 14 weeks. All children were systematically evaluated using a pediatric functional independent measure (WeeFIM) and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) to assess DLS, the Short Sensory Profile 2 (SSP2) to assessSP/SI, and the Beery VMI test (Beery VMI) to assess VMI. Assessments were conducted at baseline, seven weeks, and 14 weeks of treatment. Results The analysis of the results between the treatment and control groups revealed that the treatment group had greater gains and significant differences in the mean values of both the WeeFIM and SSP2. In addition, notable distinctions were observed in the VB-MAPP transition subscale; although these differences did not reach statistical significance, they were clinically significant. Minimal differences were noted in the VMI between the two groups. Nevertheless, both groups showed statistically significant improvements across all outcome measures. Conclusions Our study provides preliminary evidence of the efficacy of EF strategies combined with regular occupational therapy for DLS, SP/SI, and VMI in children with ASD. The differences between the groups support further evaluation of the effectiveness of EF strategies for the next stage of a larger randomized clinical trial.

Examining the Association Between the Computer-Aided Scoring and Manual Scoring for the Beery Buktenica Developmental Test of Visual Motor Integration (Beery VMI) and Children’s Handwriting Skills: A Convergent Validity Study

ABSTRACT Introduction Visual motor integration (VMI) is an important underlying mechanism for children’s handwriting. The Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) is commonly used to assess children’s VMI skills, using a manual scoring method which can be prone to individual subjectivity and impact its sensitivity. This study investigated the use of the Computer-Aided Scoring System for scoring the Berry VMI (CASS-Beery VMI) to assess school-aged children’s VMI and handwriting skills. Specifically, the convergent validity between the CASS-Beery VMI and three standardized handwriting assessments was investigated. Methods A quantitative cross-sectional design was used. Thirty-five neurotypical Australian students aged 6–9 years completed the Beery-VMI–6th edition, Minnesota Handwriting Assessment (MHA), Evaluation Tool of Children’s Handwriting – Manuscript (ETCH-M) and the Here’s How I Write Assessment – Child version (HHIW-C). The Berry-VMI was scored using its original scoring method and the CASS-Beery VMI. Thirty parents of the child participants completed the Here’s How I Write Assessment – Parent version (HHIW-P). Descriptive statistics, Spearman rho correlations and regression analyses using bootstrapping were completed. Results The CASS-Beery VMI error scores were significantly correlated with the Beery-VMI score, and subscales of the MHA, ETCH and HHIW-P scores (r = 0.341– −0.555; p = .045–0.001). The CASS-Beery VMI error scores and Beery VMI raw scores were found to be significant predictors of the ETCH-M number legibility scores (adjusted R2 = 0.209; p = 0.017) and MHA form scores (adjusted R2 = 0.220; p = 0.007). Individually, the CASS-Beery VMI score was a significant predictor of the ETCH-M word legibility scores (Adjusted R2 = 0.305; p = 0.001). Conclusion Findings indicate that the CASS-Beery VMI can be used to assess children’s VMI skills. The significant correlations between the CASS-Beery VMI and other standardized handwriting assessments (MHA, ETCH-M and HHIW) adds to the body of convergent validity evidence that the CASS-Beery VMI can be a sensitive scoring method for Beery VMI when assessing children’s handwriting performance.

18 Executive Dysfunction Following Treatment for Pediatric Low Grade Brain Tumors: Increased Risk Associated with Infratentorial Tumor Location

Objective:Treatment for pediatric brain tumors (PBTs) is associated with neurocognitive risk, including declines in IQ, executive function, and visual motor processing. Low grade tumors require less intensive treatment (i.e., focal radiotherapy (RT) or surgical resection alone), and have been associated with more favorable cognitive outcomes. However, these patients remain at risk of cognitive problems, which may present differently depending on tumor location. Executive functioning (EF), in particular, has been broadly associated with both frontal-subcortical networks (supratentorial) and the cerebellum (infratentorial). The current study examined intellectual functioning, executive functioning (set-shifting and inhibition), and visual motor skills in patients who were treated for low-grade tumors located in either the supratentorial or infratentorial region.Participants and Methods:Participants were survivors (age 8-18) previously treated with focal proton RT or surgery alone for infratentorial (n=21) or supratentorial (n=34) low grade glioma (83.6%) or low grade glioneuronal tumors (16.4%). Survivors >2.5 years post-treatment completed cognitive testing (WISC-IV/WAIS-IV; D-KEFS Verbal Fluency (VF), Color-Word Interference (CW), Trail Making Test (TM); Beery Visual-Motor Integration). We compared outcomes between infratentorial and supratentorial groups using analysis of covariance (ANCOVA). Demographic and clinical variables were compared using Welch’s t-tests. ANCOVAs were adjusted for age at evaluation, age at treatment, and history of posterior fossa syndrome due to significant or marginally significant differences between groups.Results:Tumor groups did not significantly differ with respect to sex (49.0% male), length of follow-up (M 4.4 years), or treatment type (74.5% surgery alone, 25.5% proton RT). Marginally significant group differences were found for age at evaluation (infratentorial M = 12.4y, supratentorial M = 14.1y, p = .054) and age at treatment (infratentorial M = 7.9y, supratentorial M = 9.7y, p =.074). Posterior fossa syndrome only occurred with infratentorial tumors (n=5, p = .003). Adjusting for covariates, the supratentorial group exhibited significantly superior performance on a measure of inhibition and set-shifting (CW Switching Time (t(32) = -2.05, p=.048, n2 =.11). There was a marginal group difference in the same direction on CW Inhibition Time (t(32 = -1.77, p = .086, n2 =.08). On the other hand, the supratentorial group showed significantly lower working memory than the infratentorial group (t(50) = 2.45, p = .018, n2 = .11), and trends toward lower verbal reasoning (t(50)=1.96, p = .056, n2 = .07) and full-scale IQ (t(50)=1.73, p = .090, n2 = .055). No other group differences were identified across intellectual, EF, and visualmotor measures.Conclusions:Infratentorial tumor location was associated with weaker switching and inhibition performance, while supratentorial tumor location was associated with lower performance on intellectual measures, particularly working memory. These findings suggest that even with relatively conservative treatment (i.e., focal proton RT or surgery alone), there remains neurocognitive risk in children treated for low-grade brain tumors. Moreover, tumor location may predict distinct patterns of long-term neurocognitive outcomes, depending on which brain networks are involved.

Relationship between longitudinal changes in neuropsychological outcome and disease biomarkers in urea cycle disorders.

Urea cycle disorders (UCDs) cause impaired conversion of waste nitrogen to urea leading to rise in glutamine and ammonia. Elevated ammonia and glutamine have been implicated in brain injury. This study assessed relationships between biomarkers of metabolic control and long-term changes in neuropsychological test scores in participants of the longitudinal study of UCDs. The hypothesis was that elevated ammonia and glutamine are associated with neuropsychological impairment. Data from 146 participants who completed 2 neuropsychological assessments were analyzed. Neuropsychological tests that showed significant changes in scores over time were identified and associations between score change and interim metabolic biomarker levels were investigated. Participants showed a significant decrease in performance on visual motor integration (VMI) and verbal learning immediate-recall. A decrease in scores was associated with experiencing interim hyperammonemic events (HAE) and frequency of HAE. Outside of HAE there was a significant association between median ammonia levels ≥50µmol/L and impaired VMI. VMI and memory encoding are specifically affected in UCDs longitudinally, indicating that patients experience difficulties when required to integrate motor and visual functions and learn new information. Only ammonia biomarkers showed a significant association with impairment. Preventing HAE and controlling ammonia levels is key in UCD management. The Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) and List A Trial 5 of the California Verbal Learning Test (CVLT) may be good longitudinal biomarkers of treatment outcome in urea cycle disorders (UCD). This is the first report of longitudinal biomarkers for treatment outcome in UCD. These two biomarkers of outcome may be useful for clinical trials assessing new treatments for UCD. These results will also inform educators how to design interventions directed at improving learning in individuals with UCDs.

Impact of Retinopathy of Prematurity on Visual Motor Integration

Background: Preterm infants are at risk for neurodevelopmental deficits. An association between retinopathy of prematurity (ROP) and impaired cognitive outcome has already been described. However, less is known about the impact of ROP on visual motor integration (VMI), which is a prerequisite not only for fine motor abilities but also for further school skills. Therefore, the aim of this study was to retrospectively investigate the impact of ROP on VMI at preschool age. Methods: The study was conducted at the Medical University of Vienna, including patients born between January 2009 and December 2014 with a gestational age of less than 30 weeks and/or a birth weight of less than 1,500 g. VMI was determined by Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI) at the age of 5 years. Results: Out of 1,365 patients, 353 met inclusion criteria for this study. Two hundred sixteen of them had no ROP, while 137 had ROP (stage 1: n = 23, stage 2: n = 74, stage 3: n = 40). Mean value of the Beery VMI score was significantly lower in the ROP group compared to the No-ROP group (90 ± 16 vs. 99 ± 14; p < 0.01). By correcting for other important medical conditions, ROP still had a significant impact on Beery VMI score (p < 0.01). Particularly, lower scores were found for stage 2 (p < 0.01) and stage 3 (p < 0.01). Conclusion: Beery VMI scores were significantly lower in preterm infants with ROP stage 2 and 3 than in infants without ROP. This study shows the negative impact of ROP on VMI skills at preschool age, even after adjustment for key demographic and medical characteristics.

Beery VMI Scores of Children with Autism Spectrum Disorder Undergoing Occupational Therapy

Visual motor integration (VMI) is the ability to control hand movements through vision. Children with autism are at risk for VMI deficits although this correlation is well described in previous research not much else is known about the relationship between autism and VMI. This study investigated the potential predictors of VMI performance in children with autism. The impact of occupational therapy attendance, age, gender, and pre-Beery-Buktenica Developmental Test of VMI scores on post-Beery-Buktenica Developmental Test of VMI scores were analyzed. Secondary data from 104 subjects were analyzed using multiple linear regression. It was concluded that the pre-Beery-Buktenica Developmental Test of VMI score was the greatest predictor of the post-Beery-Buktenica Developmental Test of VMI score. Age and gender were not predictive. Occupational therapy attendance was not a significant predictor; however, there was a significant difference between pre and post-assessment scores. The findings of this study illustrate that children with autism who have VMI deficits can benefit from rehabilitation services, that all ages and both genders can expect similar positive outcomes, and that these positive changes were not limited by attendance. Professionals can utilize the predictive model to formulate realistic goals based on current VMI performance for both rehabilitative and school settings.

Visual-motor integration scale for Korean elderly (VMIS-KE) is an effective indicator for cognitive changes in diabetic older adults.

This study aimed to investigate the adequacy of the visual-motor inte-gration (VMI) scale for Korean elderly (VMIS-KE) compared to tradition-al measures, mini-mental state examination of Korean version (MMSE-KC) and Beery VMI for cognitive decline in diabetic older adults. For this explanatory research, data were collected from September 1 to Sep-tember 15, 2013, from 34 diabetic older adults and 31 nondiabetic older adults in Daegu and Gyeongsan of Korea. Mean differences between the two groups were analyzed with SPSS 18.0. The diabetic older adults showed significantly lower scores in the VMIS-KE (t=4.128, P<0.001) and MMSE-KC (t=2.231, P=0.029) compared with the nondiabetic older adults. In all subcategories of VMI-KE, figure cognition (t=5.342, P<0.001), memory (t=3.011, P=0.004) and spatial cognition (t=2.639, P=0.011), there were significant differences whereas no significant difference in the VMI-6th revision (t=0.994, P=0.325). VMIS-KE could be a sensitive indicator to assess cognitive change in older adults with diabetes and health care providers should periodically evaluate vulnerable groups such as them with it.

P.26 Motor and cognitive manifestations of young female carriers of Duchenne muscular dystrophy (DMD): a prospective natural history study

Clinical manifestations of Duchenne muscular dystrophy (DMD) have been well documented. However, less is known about the impact of DMD gene mutations for young female carriers. This cross-sectional study seeks to address the gap in understanding of the impact of carrier status on motor skill and cognitive functioning during formative years of development. We examined the motor abilities and neuropsychological functioning of genetically confirmed female DMD carriers in childhood and adolescence. Age appropriate functional and motor outcome assessments were administered including the Neuromuscular Gross Motor Outcome (GRO), 100-meter timed test (100m), Performance of Upper Limb (PUL), and others. Additionally, we assessed intelligence, executive functioning, visual motor integration, behavioral functioning and emotional regulation using standardized testing. To date, 8 subjects have been enrolled, average 11.7 years of age (range: 5–17 years) through the Nationwide Children's Hospital clinics. Gross motor performance was variable across the full cohort ranging between 71–100% of total score on the GRO, 10-95% of average predicted performance on the 100m, and 85-100% of total score on the PUL. Fine motor behavior and visual-motor integration tests indicate this cohort may experience a higher rate of motor coordination deficit and fine motor slowing, as evidenced by performance on norm-referenced assessments including the Grooved Pegboard Test (z-scores range: -0.75 to -5.61; N=7) and Beery Visual Motor Integration Scale (percentiles range: 0.7 – 63; N=7). Individual and group performance on motor outcome assessments and cognitive performance in areas related to attention, organization, working memory, arithmetic/mathematics, and verbal fluency to be presented. Subject enrollment, data collection, and analysis is ongoing.

A-166 The Beery VMI in focal Pediatric Epilepsy: Clinical Correlates and Lateralizing Value

Abstract Objective: The Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) is a commonly used test of visuoconstruction. While many assume this task has lateralizing value in focal epilepsy, this remains untested. The present study investigated the utility of the VMI in children and adolescents with focal, well-lateralized epilepsy. Methods: One hundred and one children and adolescents with focal epilepsy (ages 4–18, 47 males, 54 females) completed the VMI as part of their neuropsychological evaluation. Pearson and Spearman correlations assessed relations between VMI scores and epilepsy severity factors (age of onset, number of antiepileptic drugs [AEDs], seizure frequency, IQ). T-tests assessed VMI differences between left (n=56) and right (n=45) hemisphere cases and Chi-square analyses tested differences in impairment rates across groups (defined as standard scores ≤79). Results: VMI correlated significantly with IQ (r=.673, p&amp;lt;.001), but not age of onset (r=-.080, p=.428), seizure frequency (r=.013, p=.895), or number of AEDs (r=-.181, p=.071). Further, VMI scores did not differ between left (84.43 [16.06]) and right (81.89 [14.31]; t=.839, p=.403) sided seizures, nor did impairment rates differ (left 35.7%, right 46.7%, chi-square=1.24, p=.265). Conclusion: While the VMI is related to IQ, relations with other epilepsy variables were minimal and despite popular belief, VMI does not strongly lateralize left and right hemisphere cases likely due to functional reorganization/crowding effects that may occur in left hemisphere epilepsy.

No evidence of a minimal clinically important difference for the Beery-Buktenica Developmental Test of Visual-Motor Integration in children with autism spectrum disorder

The Beery Visual-Motor Integration (VMI) battery of tests are some of the most commonly used assessments in pediatric occupational therapy, often used to measure change over time. However, the minimal clinically important difference (MCID) has not been estimated for interpreting change scores. We estimated the MCID for the Beery VMI battery of tests in children with autism spectrum disorder (ASD). Four occupational therapists collected data in a public elementary school on 64 children with ASD. The Beery VMI battery was administered to children with ASD twice, approximately 11 months apart. To estimate MCID values, Beery VMI battery scores were anchored to 15-point Likert questions measuring occupational therapists’ ratings of functional change over three domains: fine motor skills, handwriting, and activities of daily living (ADLs). Using this anchor-based method, we were unable to estimate MCID values for the Beery VMI battery. Children’s Beery VMI battery scores did not change significantly over the course of the school year, and there was only one weak correlation between VMI battery change scores and therapists’ ratings of change. The inability to estimate Beery VMI battery MCID values for children with ASD adds further support for research cautioning the use of the Beery VMI as an outcome measure.

THE EFFECT OF CO-OP APPROACH IN IMPROVING VISUAL MOTOR INTEGRATION SKILLS IN CHILDREN WITH LEARNING DISABILITY

The importance of visual perception, motor coordination and visual motor integration (VMI) skills for school achievements has been shown in various studies. Cognitive orientation to daily occupational performance or CO-OP is an evidence-based approach that has been effective in children with developmental coordination disorder and autism spectrum. The present study evaluated the effect of CO-OP approach in improving VMI skills in children with learning disability. Sample of 58 children were included in the study. National Centre for Learning Disabilities (NCLD) Checklist was used as a screen tool and pre and post intervention Beery VMI and Canadian Occupational Performance Measures (COPM) was used as outcome measures.Occupational therapy program using CO-OP approach, based on each childs individualized goals. children were thought global strategy of GO-PLAN-DO-CHECK the sessions were conducted for 12 weeks one hour a day three times a week. After 12 weeks post assessment was done using t test. There significant difference in pre and post CO-OP intervention. p-value was found to be less than 0.0001 for VMI, COPM performance and satisfaction whereas, there was significant difference in motor coordination and visual perception component of Beery VMI. The result shows that CO-OP approach is effective in improving visual motor integration skills of children with learning disability.

Occupational therapy and Beery VMI scores of children with autism spectrum disorder, brachial plexus injury, and cerebral palsy

Data of 107 children (84 males and 23 females) who received occupational therapy services were collected. Data collected included age, gender, prescribed frequency of occupational therapy, number of sessions attended within the six-month timeframe, pre and post Beery Visual Motor Integration scores.

Relationship between academic achievement, visual-motor integration, gender and socio-economic status: North-West Child Health Integrated with Learning and Development study

Background: Inconsistencies are found regarding the relationship between academic achievement and visual-motor integration (VMI), gender and socio-economic status (SES). Aim: The study examined the associations between academic achievement in different compulsory learning areas and VMI skills, and what role gender and SES play. Setting: A total of 863 participants ( n = 538, low SES group; n = 325, high SES group) from 20 schools in four school districts in the North West province of South Africa were randomly selected to participate. Methods: The Beery Visual-Motor Integration Test, 4th edition (VMI-4) was used to evaluate the VMI, visual perception and motor coordination skills; and the June mid-year school assessment (JMSA) and the Annual National Assessment (ANA) marks were used to examine their academic achievements. Spearman rank-order correlations and stepwise regression analyses were used to, examine significant associations and unique contributors, respectively. Results: Small-to-moderate significant correlations were found between all the learning areas assessed during the JMSA and the ANA examinations and the VMI-4. The strongest correlations occurred between visual perception and most of the learning areas. Socio-economic status had the greatest predictive association with most of the academic learning areas. The largest contributions (≥ 10% moderate, ≥ 25% great) of SES were found during the JMSA in English, life orientation, mathematics, natural science, social sciences and in the grade point averages. During the ANA, SES had the highest predictive contribution to English and mathematics. Conclusion: The overall academic achievement of learners could be negatively affected by their SES and visual perception skills, that suggest timeously prevention strategies to counter these effects.

Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity.

To assess visual-motor integration in young adults previously included in a prospective study on the incidence of retinopathy of prematurity (ROP). The study encompassed 59 preterm individuals, born 1988-1990, with a birth weight ≤1500g, and 44 full-term controls, aged 25-29years. Ophthalmological examination, including visual acuity and contrast sensitivity, and the Beery Visual-Motor Integration (VMI) with supplemental tests of visual perception and motor coordination, were performed. A short questionnaire was filled in. The preterm individuals had significantly lower scores than the controls in all VMI tests, median values and interquartile ranges: Beery VMI 87 (21) vs 103 (11), visual perception 97 (15) vs 101 (8) and motor coordination 97 (21) vs 102 (15), respectively. Within the preterm group, no correlations were found between the VMI tests and ROP, gestational age, birth weight or visual acuity. Contrast sensitivity was correlated to visual perception. Neurological complication at 2.5years was a risk factor for lower scores on Beery VMI. The preterm subjects reported six times as many health problems as compared to the controls. Being born preterm seemed to have life-long effects. This study shows that visual-motor integration was affected in young adults born preterm.

Longitudinal influences of socio-economic status on visual-motor integration: The North-West Child Health, Integrated with Learning and Development study

Background: Visual motor integration plays an important role in academic skills of learners in the early school years and can have an impact on their overall academic performance.Aim: This study aimed to determine the influence of socio-economic status (SES) on changes in visual-motor integration, visual perception and motor coordination over a period of three years.Setting: Four school districts in the North West province of South Africa were used.Methods: Five hundred and seventy-three learners (282 boys, 291 girls) were randomly selected (representing different SES schools) and evaluated at baseline during 2010 when they were in Grade 1 (6.9 years ±0.38) and again three years later in 2013 (9.9 years ±0.42) as part of a longitudinal research study. The Beery Visual-Motor Integration Test 4th edition was used to evaluate the visual-motor integration, visual perception and motor coordination skills at baseline and three years later.Results: Baseline measurements were higher among high SES learners in all three skills. Although learners from high SES still outperformed the learners from low SES three years later, low SES learners showed statistically significant improvements over the three years in visual-motor integration (88.24 to 89.85, p=0.041) and visual perception (89.69 to 90.04, p≤0.001).Conclusion: Age-related development and improvement of the visual-motor integration skills were reported over the three year period. However, more learners from the low SES still showed delays in these skills. Delays in the development of these skills could contribute to poorer academic and learning-related achievements.

Beery VMI and Brain Volumetric Relations in Autism Spectrum Disorder.

Although diminished proficiency on tasks that require visual-motor integration (VMI) has been reported in individuals with autism spectrum disorder (ASD), very few studies have examined the association between VMI performance and neuroanatomical regions of interest (ROI) involved in motor and perceptual functioning. To address these issues, the current study included an all-male sample of 41 ASD (ages 3-23 years) and 27 typically developing (TD) participants (ages 5-26 years) who completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) as part of a comprehensive neuropsychological battery. All participants underwent 3.0 T magnetic resonance imaging (MRI) with image quantification (FreeSurfer software v5.3). The groups were statistically matched on age, handedness, and intracranial volume (ICV). ASD participants performed significantly lower on VMI and IQ measures compared with the TD group. VMI performance was significantly correlated with FSIQ and PIQ in the TD group only. No pre-defined neuroanatomical ROIs were significantly different between groups. Significant correlations were observed in the TD group between VMI and total precentral gyrus gray matter volume (r = .51, p = .006) and total frontal lobe gray matter volume (r = .46, p = .017). There were no significant ROI correlations with Beery VMI performance in ASD participants. At the group level, despite ASD participants exhibiting reduced visuomotor abilities, no systematic relation with motor or sensory-perceptual ROIs was observed. In the TD group, results were consistent with the putative role of the precentral gyrus in motor control along with frontal involvement in planning, organization, and execution monitoring, all essential for VMI performance. Given that similar associations between VMI and ROIs were not observed in those with ASD, neurodevelopment in ASD group participants may not follow homogenous patterns making correlations in these brain regions unlikely to be observed.

Visual perceptive skills account for very preterm children's mathematical difficulties in preschool

BackgroundAlready in preschool, very preterm (VP) children perform worse than term born-children on preschool mathematical skills tests. Strong associations have been found between preschool mathematical skills, cognition and visual-motor integration. AimsTo compare VP children and their term-born peers on preschool mathematical achievement at the corrected age of five years, and determine whether cognitive, visual-perceptive, visual-motor, and motor-coordination skills, account for any significant differences observed. Study designSingle-center, consecutive cohort study with a term-born comparison group. Subjects54 five-year-old VP children and 28 term-born comparison children. Outcome measuresStandardized test for preschool mathematical skills (Dutch pupil monitoring system), cognitive skills (Wechsler Preschool and Primary Scale for Intelligence - third edition), visual-perception, visual-motor integration, and motor-coordination (Beery Visual-Motor Integration test - sixth edition). Group differences were analyzed with ANCOVAs, adjusting for maternal education, preschool grade, and time of assessment. Sobel's mediation analyses tested for possible mediation effects. ResultsPreschool mathematical skills and visual perceptive skills were significantly lower in VP children than in term-born children (Cohen's d = 0.63, p = 0.01; Cohen's d = 0.84, p < 0.01, respectively). Sobel's test indicated a significant mediating effect of visual perceptive skills on the association between VP birth and preschool mathematical skills. ConclusionsAt preschool age, VP children have poorer preschool mathematical skills compared to term-born peers; deficits that were fully accounted for by poor visual perceptive skills. Our findings indicate the relevance of screening visual perceptive skills at preschool age, enabling timely identification of children at risk for mathematical difficulties.

Impact of the Dexteria™ application use on visual–motor integration in elementary-age children

ABSTRACTUse of iPad technology in the classroom may facilitate learning, engagement, motivation, and interest (Crescenzi, Jewitt, & Price, 2014). The Dexteria™ iPad application was implemented into first grade curriculum using a nonequivalent control group design to explore impact on visual–motor integration (VMI) skills using the Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery VMI) as an assessment tool. The experimental group (n = 23) participated in traditional curriculum combined with the Dexteria™ app whereas the control group (n = 20) received only the traditional curriculum for 4 weeks. Pretest and posttest Beery VMI administration yielded raw scores which were compared for significance. The results of the comparison between groups were deemed inconclusive due to the minute difference in mean scores of the experimental group (M = .087) and control group (M = 0). Although the study did not yield statistically significant results, findings of the study may have clinical relevance and contribute to the broad literature supporting the addition of interactive technological interventions in the classroom.

Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention.

Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5years was explored. Fifty 4-year-old children (born <28weeks gestation or birth weight <1,000g) with minimal/mild motor impairment were randomly allocated to intervention (n=24) or standard care (n=26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p=.004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p=.026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains.

Interrater and Test-Retest Reliability of the Beery Visual-Motor Integration in Schoolchildren.

To assess interrater and test-retest reliability of the 6th Edition Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) and test-retest reliability of the VMI Visual Perception Supplemental Test (VMIp) in school-age children. Subjects were 163 Native American third- to eighth-grade students with no significant refractive error (astigmatism <1.00 D, myopia <0.75 D, hyperopia <2.50 D, anisometropia <1.50 D) or ocular abnormalities. The VMI and VMIp were administered twice, on separate days. All VMI tests were scored by two trained scorers, and a subset of 50 tests was also scored by an experienced scorer. Scorers strictly applied objective scoring criteria. Analyses included interrater and test-retest assessments of bias, 95% limits of agreement, and intraclass correlation analysis. Trained scorers had no significant scoring bias compared with the experienced scorer. One of the two trained scorers tended to provide higher scores than the other (mean difference in standardized scores = 1.54). Interrater correlations were strong (0.75 to 0.88). VMI and VMIp test-retest comparisons indicated no significant bias (subjects did not tend to score better on retest). Test-retest correlations were moderate (0.54 to 0.58). The 95% limits of agreement for the VMI were -24.14 to 24.67 (scorer 1) and -26.06 to 26.58 (scorer 2), and the 95% limits of agreement for the VMIp were -27.11 to 27.34. The 95% limit of agreement for test-retest differences will be useful for determining if the VMI and VMIp have sufficient sensitivity for detecting change with treatment in both clinical and research settings. Further research on test-retest reliability reporting 95% limits of agreement for children across different age ranges is recommended, particularly if the test is to be used to detect changes due to intervention or treatment.