Test Of Visual-Motor Integration Research Articles

Effect of osteopathic manipulation using SSDV protocol on improving motor coordination and hand eye coordination in children with developmental coordination disorder: a protocol for randomized controlled trial

Developmental Coordination Disorder (DCD) significantly impacts motor coordination and hand-eye coordination in children, affecting their daily activities and academic performance. This study aims to investigate the efficacy of Physical Rehabilitation utilizing the Sensory Stimulation and Developmental Vestibular (SSDV) protocol in improving motor coordination and hand-eye coordination in children diagnosed with DCD. Children diagnosed with DCD will be recruited and randomly allocated to either the intervention group receiving Physical Rehabilitation using the SSDV protocol or the control group receiving standard care. The intervention will involve a structured program incorporating sensory stimulation and developmental vestibular activities tailored to the individual needs of participants. Motor coordination and hand-eye coordination will be assessed using standardized measures such as the Movement Assessment Battery for Children (MABC) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI). Assessments will be conducted at baseline, post-intervention, and follow-up time points. This randomized controlled trial seeks to evaluate the effectiveness of Physical Rehabilitation using the SSDV protocol in enhancing motor coordination and hand-eye coordination in children with DCD. By employing standardized measures, this study aims to provide objective insights into the impact of the intervention. Findings from this trial may contribute to the development of evidence-based interventions for children with DCD, potentially improving their motor skills and overall functioning in daily life and academic settings. Registration: CTRI/2024/03/064467

Developing drawing skill: Exploring the role of parental support and cultural learning

Learning to draw is an important developmental milestone that most children achieve during their preschool years. Primary caregivers play a significant role in supporting this process, which may affect the pace of acquisition and subsequent unfolding of drawing ability. In this study, we aimed to investigate parental support in the context of children's drawing activity, complemented by quantifying the effects of four individual factor constructs of parental support for drawing. Our sample comprised 68 parent-child dyads with children aged 3.0–6.9 years. Parents completed an online survey about actions related to promoting the drawing abilities of their child, while children's drawing skill was measured with the Beery-Buktenica Test of Visual-Motor Integration. Contrary to our initial prediction, we found that parental support as a construct had no significant effect on children’s drawing skill. However, the component Scaffolding was positively associated with enhanced drawing skill. These results have important theoretical implications for understanding skill development within a cultural learning framework, and open up practical applications for art education and developmental studies.

Visual-motor integration in children with unilateral cerebral palsy: application of the computer-aided measure of visual-motor integration

BackgroundChildren with unilateral cerebral palsy (UCP) are encouraged to participate in the regular school curriculum. However, even when using the less-affected hand for handwriting, children with UCP still experience handwriting difficulties. Visual-motor integration (VMI) is a predictor of handwriting quality. Investigating VMI in children with UCP is important but still lacking. Conventional paper-based VMI assessments is subjective and use all-or-nothing scoring procedures, which may compromise the fidelity of VMI assessments. Moreover, identifying important shapes that are predictive of VMI performance might benefit clinical decision-making because different geometric shapes represent different developmental stepping stones of VMI. Therefore, a new computer-aided measure of VMI (the CAM-VMI) was developed to investigate VMI performance in children with UCP and to identify shapes important for predicting their VMI performance.MethodsTwenty-eight children with UCP and 28 typically-developing (TD) children were recruited. All participants were instructed to complete the CAM-VMI and Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI). The test items of the CAM-VMI consisted of nine simple geometric shapes related to writing readiness. Two scores of the CAM-VMI, namely, Error and Effort, were obtained by image registration technique. The performances on the Beery-VMI and the CAM-VMI of children with UCP and TD children were compared by independent t-test. A series of stepwise regression analyses were used to identify shapes important for predicting VMI performance in children with UCP.ResultsSignificant group differences were found in both the CAM-VMI and the Beery-VMI results. Furthermore, Error was identified as a significant aspect for predicting VMI performance in children with UCP. Specifically, the square item was the only significant predictor of VMI performance in children with UCP.ConclusionsThis study was a large-scale study that provided direct evidence of impaired VMI in school-aged children with UCP. Even when using the less-affected hand, children with UCP could not copy the geometric shapes as well as TD children did. The copied products of children with UCP demonstrated poor constructional accuracy and inappropriate alignment. Furthermore, the predictive model suggested that the constructional accuracy of a copied square is an important predictor of VMI performance in children with UCP.

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.

Kindergarten Visual-Perceptual and Motor Skills and Behavioral Traits Predict First-Grade Chinese Handwriting Legibility and Speed.

Clarifying the relationship between kindergarteners' characteristics and their future handwriting performance is beneficial for the early detection of children at risk of handwriting difficulties. To determine which visual-perceptual and motor skills and behavioral traits significantly predict kindergartners' Chinese handwriting legibility and speed in the first grade. One-year longitudinal, observational design. Kindergarten and elementary schools. One hundred six kindergarten children (53 boys and 53 girls; ages 5 or 6 yr) were recruited. The participants completed two subtests of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Test of Visual Perceptual Skills-Third Edition, Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™ VMI), and the Attention-Deficit/Hyperactivity Disorder Test-Chinese Version in kindergarten. Their handwriting legibility (character accuracy and construction) and speed were assessed by investigator-developed Chinese handwriting tests in the first grade. Multivariate regression analyses indicated the independent predictive power of spatial relationships (p = .042) and inattention (p = .004) for character accuracy. Visual-motor integration (VMI; p = .008) and inattention (p = .002) were the key predictors of character construction. Manual dexterity (p = .001) was the only significant predictor of writing speed. Kindergarteners who perform poorly in spatial relationships, VMI, manual dexterity, and attention are likely to have less legible Chinese handwriting and slow writing speed in first grade. Plain-Language Summary: Children's visual-perceptual and motor skills and behavioral traits in kindergarten can predict their Chinese handwriting legibility and speed in first grade. This study found that kindergarteners who performed poorly in spatial relationships, VMI, manual dexterity, and attention were likely to have less legible Chinese handwriting and slow writing speed in the first grade.

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.

Enhancing visual-motor integration and visual perception of 6-year-old children

Background: Perceptual motor development is crucial during early childhood and not properly addressing it in physical education (PE) can be detrimental.Aim: To determine the effect of a South African curriculum-aligned PE intervention on the visual-motor integration (VMI), visual perception (VP) and motor coordination (MC) of 6-year-old children.Setting: Quintile 3 schools in Mangaung, Free State Province, South Africa.Methods: Grade 1 children from two quintile 3 schools in Mangaung were recruited. Complete data sets were obtained for 44 participants. A quantitative randomised control trial design was followed. The Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (Beery VMI-6), determined participants’ VMI, VP and MC during the pre- and post-tests. The KaziKidz toolkit was used as intervention during 10 sessions of 40 min each for the experimental group, while the control group continued with the South African PE curriculum. The Fisher’s exact and Kruskal–Wallis tests were used for pre- and post-test comparisons, with p 0.05 indicating statistical significance.Results: The median age of the control (n = 18) and intervention (n = 26) groups was 6.7 and 6.5 years, respectively. Post intervention, the intervention group displayed significantly improved VMI (p = 0.042) and VP (p 0.001), compared to the control group. No significant differences between the groups were observed for MC.Conclusion: Exposure to PE including perceptual motor aspects significantly improved the VMI and VP of 6-year-old children.Contribution: Results deemed the KaziKidz toolkit to be a successful mode of PE delivery to improve the perceptual skills of Grade 1 learners in South Africa.

60 Associations Between Motor Task Deficits and Uneven Scores Across WISC-V Coding and Symbol Search Subtests

Objective:Deficits in visual-motor coordination and/or fine motor dexterity are often present in pediatric neurological and neurodevelopmental conditions and may adversely affect performance on tests with motor demands. This consideration is relevant when interpreting discrepant scores across Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) Processing Speed Index (PSI) subtests, specifically Symbol Search and the more motorically demanding Coding. Although test developers maintain that motor ability is unlikely to significantly impact Coding performances, clinicians often consider whether uneven WISC-V PSI subtest scores (Coding<Symbol Search) may in part be attributed to motor-related difficulties, when indicated. This has important clinical implications, as WISC-V Coding may then be omitted or substituted when calculating FSIQ. Thus, the present study aims to evaluate the role of motor task deficits in uneven PSI subtest scores in a sample of clinic-referred youth.Participants and Methods:Participants were 238 children and adolescents (MAge=10.62 years; 65.5% male; 60.5% white) referred for neuropsychological assessment. All participants completed the Coding and Symbol Search subtests of the WISC-V and at least one of two motor tasks: the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) and the Grooved Pegboard (GP). To evaluate patterns of functioning, we determined the frequencies of patients who demonstrated uneven PSI subtest performances (defined in this study as a Coding scaled score [ss] at least 3-points lower than that of Symbol Search) and/or normative weaknesses (i.e., Standard Score [SS] below 80, per recommendations from the American Academy of Clinical Neuropsychology) on motor tasks. A chi-square test of independence was used to evaluate associations between uneven PSI performance and the presence/absence of motor weaknesses. Among those with uneven PSI performance, a one-way ANOVA was used to examine whether PSI subtest difference scores varied as a function of motor performance group (No Weakness=0, VMI Weakness Only=1, GP Weakness Only=2, Weaknesses on Both=3).Results:Of the 238 participants, 28 (11.0%) displayed normative weaknesses on the VMI only, 43 (16.9%) displayed weaknesses on the dominant-GP only, and 18 (7.1%) displayed weaknesses on both tasks. On the WISC-V, 56 participants (23.5%) exhibited uneven PSI subtest performance (Coding<Symbol Search), with 21 (37.5%) of those participants displaying at least one normative motor weakness. Chi-square analyses indicated no significant association between the presence/absence of motor skill weakness and uneven PSI subtest performance, (X2 (3) = 5.79, p = .122). Among those with uneven PSI performance, Coding/Symbol Search difference scores were not significantly associated with motor performance group (F(3,55) = 1.26, p = .297).Conclusions:These findings suggest that while patients with uneven WISC-V Coding and Symbol Search scores may also display motor task deficits, these deficits are not significantly associated with uneven performances overall. Additionally, of the participants with uneven PSI subtest scores, the majority did not exhibit normative weaknesses on motor tasks. Therefore, clinicians may be overcorrecting for a motoric cause of uneven performance and underappreciating the potential unevenness a child demonstrates in processing speed. Future studies should evaluate the role of other neurocognitive factors, such as working memory, in this score discrepancy pattern.

2 Cognitive Sparing in Proton Versus Photon Radiotherapy for Pediatric Brain Tumor Associated with White Matter Integrity

Objective:Radiotherapy for pediatric brain tumor is associated with reduced white matter structural integrity and neurocognitive decline. Superior cognitive outcomes have been reported following proton radiotherapy (PRT) compared to conventional photon radiotherapy (XRT), presumably due to sparing of healthy brain tissue. This study examined long-term white matter change and neuropsychological performance in pediatric brain tumor survivors treated with XRT vs. PRT.Participants and Methods:Pediatric brain tumor survivors treated with either XRT (n = 10) or PRT (n = 12) underwent neuropsychological testing and diffusion weighted imaging > 7 years following radiotherapy. A healthy control group (n = 23) was also recruited. Groups had similar demographic characteristics, except for handedness (p = .01), mean years of age at testing (XRT = 21.7, PRT = 16.9, Control = 15.5; p = .01), and mean years since radiation (XRT =14.7, PRT = 8.9, p < .001). Age and handedness were selected as covariates; analyses were not adjusted for time since radiation due to redundancy with treatment group (i.e., standard of care transitioned from XRT to PRT in 2007). Participants completed age-appropriate versions of the Weschler Intelligence Scales (WAISIV/WISC-IV/WISC-V) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI and Motor Coordination subtests). Tractography was conducted using automated fiber quantification (AFQ), and fractional anisotropy (FA) was extracted from 12 tracts of interest. Linear mixed models were used to summarize group differences in FA, with tracts nested within subjects. Neuropsychological performance and tract-level FA were compared between groups using analysis of covariance (ANCOVA). Pearson correlation was used to examine associations between cognitive functioning and tract-level FA.Results:Across all tracts, FA was significantly lower in the XRT group than the PRT group (t(514) = -2.58, p = .01), but did not differ between PRT and Control groups (t(514) = .65, p = .51). For individual tracts, FA differed significantly between treatment groups (XRT < PRT) in the left inferior fronto-occipital fasciculus (IFOF), right IFOF, left inferior longitudinal fasciculus (ILF) and right uncinate (all t < -2.05, all p < .05). No significant differences in FA were found between PRT and Control participants for any tract. All neuropsychological scores were significantly lower for XRT than PRT patients (all p < .03), while PRT and Control groups performed similarly on these measures (all p >.19). Cognitive functioning was most consistently associated with FA of the corpus callosum major forceps (4/7 domains; all r > .33, all p < .04) and the left ILF (4/7 domains; all r > .37, all p <.02).Conclusions:Both white matter integrity and neuropsychological performance were generally reduced in patients with a history of XRT, but not in those who received PRT. The PRT group was similar to healthy control participants with respect to both FA and cognitive scores, suggesting improved long-term outcomes compared to patients receiving XRT. This exploratory study is the first to provide direct support for white matter integrity as a mechanism of cognitive sparing in PRT. Future work with larger samples is necessary to replicate these findings.

Using Artificial Intelligence to Identify the Associations of Children's Performance of Coloring, Origami, and Copying Activities With Visual-Motor Integration.

Performance of coloring, origami, and copying activities reflects children's visual-motor integration (VMI), but the levels of association remain unclear. To use artificial intelligence (AI) to investigate associations of performance of coloring, origami, and copying activities with VMI. Cross-sectional study. Kindergartens. A sample of 370 children (182 boys and 188 girls) in the second and third years of kindergarten. Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition (VMI-6). Data for preschool children from an ongoing project were retrieved. AI models were trained to use photographs of activity products to predict total score on the VMI-6. R2 values were used to identify the variance in VMI-6 standardized scores explained by predicted scores from the activities. That is, R2 values reflected associations between activity performance and VMI. The R2 values for the combination of origami and copying were the largest (.390-.577). These R2 values were larger than those for each individual activity (.340-.473) and similar to those for the combination of all three activities (.400-.550). Because moderate R2 values were found between performance of the three activity products and VMI, the three activities have high potential for use in identifying children's level of VMI or as teaching materials to facilitate the development of children's VMI. Furthermore, combining origami and copying activities is recommended for teachers and clinicians who need to address VMI. What This Article Adds: A combination of origami and copying activities had the strongest associations with children's VMI. Teachers and clinicians can use these two activities when addressing VMI development among preschool children.

Profile of Assessments in Pediatric Occupational Therapy Practice.

Occupational therapy practice is intended to reflect the core construct of occupation throughout all aspects of service delivery. In pediatric occupational therapy, the evidence examining regularly selected assessment tools and the occupational constructs of those assessment tools is insufficient. To examine the assessment tools regularly selected by practicing pediatric occupational therapists and the therapists' classification of assessment tools as occupation-based. A cross-sectional quantitative design through the dissemination of an anonymous, close-ended assessment tool inventory with completion of descriptive statistics. Pediatric occupational therapist practice specific to the assessments used. There were 337 pediatric occupational therapists recruited through targeted sampling via social media. The participants were included if they had provided direct client care to individuals ages of 0 to 21 yr during their career. The assessment tools most commonly used by pediatric occupational therapists are the Sensory Profile (86.4%) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (85.2%). The primary assessment tools selected by pediatric occupational therapists were skill-based regardless of years of practice or practice setting. Therapists were unable to correctly classify assessment tools as occupation-based. The limited use of occupation-based assessments in conjunction with decreased recognition of the occupational nature of assessment tools hinders the integration of occupation-based assessment tools across pediatric clinical practice. Pediatric occupational therapists' integration of occupation-based assessment tools is needed to promote the occupational constructs of the profession. What This Article Adds: This article identifies the common assessment tools utilized by pediatric occupational therapists. Additionally, this article brings awareness to the inconsistent identification and integration of occupation-based assessment tools within pediatric clinical practice.

Norman A. Buktenica (1930-2022).

This article memorializes Norman A. Buktenica (1930-2022). An outstanding athlete, consummate psychologist, academic, and juried sculptor, he displayed exceptional capability in a wide range of endeavors. Norm designed the Developmental Test of Visual-Motor Integration (1967). Coauthored with Keith Berry, this instrument continues in widespread use. Norm joined George Peabody College (Nashville) in 1967 as associate professor and director of the doctoral program in School Psychology. In 1976, Norm joined Minnesota State University Moorhead as professor in the Department of Education and director of Special Education programs. In 1992, he retired as professor emeritus of education. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Effect of a Short-Term Occupational Therapy Intervention on the Participation and Personal Factors of Preschoolers with Developmental Disabilities.

Preschoolers with developmental disabilities are referred to occupational therapy due to their decreased participation in daily life occupations. The purpose of this study was to evaluate the improvement in preschoolers' participation and sensory-motor abilities following an occupational therapy intervention. A prospective cohort study of 38 preschoolers and their parents was conducted using an interrupted time-series design, including assessments at three time points: base line (upon referral to an occupational therapy assessment), pre-intervention, and post-intervention after 9-12 sessions of occupational therapy interventions. Children were evaluated with the Developmental Test of Visual-Motor Integration, as well as the balance and fine motor precision sub tests of the Bruininks-Oseretsky Test of Motor Proficiency. Parents completed the Children's Participation Questionnaire and the Child Performance Skills Questionnaire. Each intervention session was documented by the therapists using the Documentation of Occupational Therapy Session Intervention form. Significant improvement in children's sensory-motor abilities were found in balance, visual integration, and fine motor precision post-intervention. There were also improvements in the measures of diversity, children's independence, and parental satisfaction. A short-term occupational therapy intervention applied to preschoolers with developmental disabilities is effective in improving their sensory-motor abilities, as well as in promoting their participation in daily activities.

Comparing the impact of two occupational therapy interventions on academic learning outcomes for children with Human Immunodeficiency Virus

INTRODUCTION: The strong association between perinatal HIV infection and poor performance in academic learning is further challenged by various barriers to learning in the South African context of basic education. This study investigated the efficacy of a novel play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving academic learning in HIV-positive children METHODOLOGY: A single-blinded, randomised comparison group design was selected to compare PICHIBI with conventional one-on-one occupational therapy interventions. Children with HIV aged 5 to 8 years old on ART and their primary caregiver (N=23) were randomly allocated to an intervention group. The primary outcome of academic learning was measured using the Griffiths Mental Developmental Scales-Extended Revised and the short form Beery-Buktenica Visual Motor Integration test, 5th edition at baseline, mid (5 months) and post-intervention (after 10 months RESULTS: At baseline, the total sample (n=23) presented with below-average performance in all assessed academic learning outcomes. Between-group differences for all academic learning outcomes were not significant at mid or post-test assessment points. A statistically significant within-group change in visual motor integration was noted in the PICIHBI from baseline to mid-test (p=.019). In the conventional group, there were statistically significant changes in visual perception from baseline to mid (p=.001) and baseline to post-test (p=.009). The sub scale Performance in the conventional group improved significantly from baseline to mid-test (p=.027 CONCLUSION: While improvements were noted, children in both groups continued to present with academic learning concerns at post-test. These concerns motivate the need for continued monitoring and further investigation into the feasibility and effectiveness of occupational therapy interventions targeting the academic learning challenges of this population Implications for practice This paper adds to an emerging body of evidence aiming to demonstrate the effect of occupational therapy interventions on occupational outcomes for children with perinatal HIV infection. The paper presents a detailed overview of the conceptualisation of learning as an occupational outcome. The paper further presents consideration of the practical challenges linked to the implementation of, adherence to and sustainability of rehabilitation interventions in low to middle-income countries.

Pattern of Visual-Motor Integration, Visual Perception, and Fine Motor Coordination Abilities in Children Being Assessed for Fetal Alcohol Spectrum Disorder.

Motor skill assessment is part of the fetal alcohol spectrum disorder (FASD) multidisciplinary assessment. Some clinicians opt to exclude assessment of the subcomponents of visual-motor integration (visual perception and motor coordination), on the assumption that challenges will be revealed based on the assessment of visual-motor integration. The objective is to describe the visual-motor integration, visual perception, and fine motor coordination pattern of abilities in children with confirmed prenatal alcohol exposure being assessed for fetal alcohol spectrum disorder. This cross-sectional study included 91 children (65 males; mean age: 10 years, 6 months SD = 2 years, 10 months) undergoing assessment for FASD. Friedman and Wilcoxon statistics were used to compare mean visual-motor integration, visual perception, and fine motor coordination percentiles from the Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (Beery-6). Children being assessed for FASD (n = 91) had the highest normative scores in visual perception, followed by visual-motor integration and fine motor coordination (mean percentiles (SD): 35.9 (24.9), 20.6 (18.3), and 13.8 (15.5), respectively) (χ 2 distribution = 46.909, p ≤ 0.001). Children being assessed for FASD experience more challenges with fine motor coordination compared with visual-motor integration and visual perception tasks. This pattern differs from the pattern established for the general population in which tasks that require visual-motor integration are more challenging than tasks that isolate visual perception and fine motor coordination. These results suggest that fine motor coordination should be included in FASD diagnostic assessments and considered as an area for intervention.

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.

Visual-Motor Integration Deficits in 3q29 Deletion Syndrome.

3q29 deletion syndrome (3q29del) is associated with neuropsychiatric and neurodevelopmental phenotypes. We previously reported that graphomotor weakness is present in up to 78% of individuals with 3q29del. We have now explored nuances of the graphomotor phenotype and its association with other comorbidities in this population. Participants were recruited from the online 3q29 registry (3q29deletion.org) for two days of deep phenotyping. 32 individuals with 3q29del (62.5% male) were evaluated with the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) to assess visual-motor integration. Participants were also evaluated with measures of cognitive ability, executive function, adaptive behavior, and school function. Males with 3q29del performed significantly worse than females on the VMI and Motor Coordination subtest. VMI performance was significantly associated with ADHD diagnosis and cognitive ability. Compared to published data from individuals with 22q11.2 deletion syndrome, individuals with 3q29del showed significantly more impairment. The 3q29 deletion is associated with substantial deficits in visual-motor integration, Visual Perception, and Motor Coordination. Our data suggests that 3q29del may qualify as a nonverbal learning disability. Future studies should assess whether individuals with 3q29del would benefit from early interventions, including occupational therapy.

A novel tablet-based motor coordination test performs on par with the Beery VMI subtest and offers superior temporal metrics: findings from children with pediatric acute-onset neuropsychiatric syndrome

Neuropsychiatric and neurodevelopmental disorders are often associated with coordination problems. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) constitutes a specific example of acute and complex symptomatology that includes difficulties with motor control. The present proof-of-concept study aimed at testing a new, bespoke tablet-based motor coordination test named SpaceSwipe, providing fine-grained measures that could be used to follow-up on symptoms evolution in PANS. This test enables computationally precise and objective metrics of motor coordination, taking into account both directional and spatial features continuously. We used SpaceSwipe to assess motor coordination in a group of children with PANS (n = 12, assessed on in total of 40 occasions) and compared it against the motor coordination subtest from the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) 6th edition, traditionally used to follow-up symptomatology. Using a bivariate linear regression, we found that 33 s of the directional offset from tracking a moving target in SpaceSwipe could predict the Beery VMI motor coordination (VMI MC) raw scores (mean absolute error: 1.75 points). Positive correlations between the predicted scores and the VMI MC scores were found for initial testing (radj = 0.87) and for repeated testing (radj = 0.79). With its short administration time and its close prediction to Beery VMI scores, this proof-of-concept study demonstrates the potential for SpaceSwipe as a patient-friendly tool for precise, objective assessment of motor coordination in children with neurodevelopmental or neuropsychiatric disorders.

Visual Performance and Perceptual–Motor Skills of Late Preterm Children and Healthy Controls Using the TVPS-3rd and VMI-6th Editions

Background: The visual system is key to the learning process, preterm births are commonly followed by visual dysfunctions and other neurological conditions. Objective: to measure, analyze and compare the visual efficacy, visual–perceptual, and visual–motor skills of 20 late preterm children (34–36 weeks) born by caesarean section and appropriate weight for gestational age with 20 healthy controls born at full term by natural birth, age 5 to 12 years, from Querétaro, México. Methods: This was an observational, transverse, and prospective study. Parametric and non-parametric tests were performed using the SPSS 25.0. The visual acuity at distance and near, the phoria state, and the degree of stereopsis were analyzed. The Test of Visual-Perceptual Skills, Third Edition, was used to assess the overall performance, basic, sequencing, and complex processes. Fine motor skills were evaluated using the Visual–Motor Integration Test of Beery, Sixth Edition. Results: Visual acuity at distance and near (p<0.001), stereopsis (p<0.001), and the amount of exophoria at distance (p=0.01) showed statistically significant differences between the groups. The overall performance (p=0.006), basic processes (p=0.001), sequencing processes (p=0.02), and General and Motor VMI (p<0.001 and 0.002, respectively) presented lower values in children born preterm. Conclusion: This research showed that even late preterm children present visual deficiencies and are at risk of delays on perceptual–motor skills. Early evaluation of their visual and motor abilities should be considered in order to help improve their cognitive functioning.

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.