Test Of Visual-Motor Integration Research Articles

G.T.A.R.A. (Grip/Grasp Training with Active Range of Motion Activities Using Guitar): A Randomized Controlled Trial Using Guitar Lessons for Restoring Hand Function among Patients with Unilateral Hand Impairment

Objective. To determine the effects of guitar lessons (intervention group) in comparison to conventional occupational therapy (OT) sessions (control group) on hand function of chronic stroke patients with unilateral hand impairment. Methods. This randomized controlled trial enrolled 34 chronic stroke patients with unilateral hand impairment. Participants were grouped randomly into intervention (guitar lessons) and control (conventional occupational therapy) groups. Each group participant underwent a total of eight consecutive therapy sessions, twice weekly for an hour each session, at the designated treatment rooms in the Department of Rehabilitation Medicine of the Philippine General Hospital. Pre- and post-treatment evaluations were done to assess range of motion, grip and pinch strength, and hand functions. Satisfaction surveys were answered at the end of the 8-therapy session. Results. Improvements in hand function were assessed through measurement of range of motion (ROM), grip and pinch strength, and with the use of Beery-Buktenica Developmental Test of Visual-Motor Integration, Jebsen-Taylor Hand Function test, and Purdue Pegboard Test of Manual Dexterity. In this study, the comparison of actual change of passive range of motion (ROM) of the impaired hand from pre- to post-treatment between control and intervention groups showed no statistically significant difference. No statistically significant difference between groups were also observed for the active ROM of the impaired hand. Comparison of function of the impaired hand pre- and posttreatment between control and intervention groups showed no statistically significant difference except for an observed greater improvement with the control group in motor coordination (median [IQR] 0 [-1 to 0] vs 1 [1 to 5], p = 0.004), tip (median [IQR] 0.33 [0 to 0.75] vs 1 [0.58 to 1.5], p = 0.006), and 3-jaw (median [IQR] 0.5 [0 to 0.92] vs 1.08 [0.41 to 2], p = 0.043) pinch strength. In evaluating the satisfaction of participants in both groups, higher mean scores were observed in the control group. No statistically significant difference in most of the questions in the satisfaction survey in both groups. All participants in both groups displayed 100% compliance in attending onsite treatments. Despite not showing statistically significant difference between groups (p = 0.721), an 11.8% tendency for better compliance is found in the intervention group. Conclusion. The specific guitar lesson created and performed in this study as used by 17 participants of the intervention group have brought about improvement in hand function that is comparable with those who underwent traditional occupational therapy. This may be most helpful in areas with limited access to rehabilitation facilities and occupational therapy services. This may also be used as a continuing activity of chronic stroke patients at home to help improve hand function.

Tablet computer-based cognitive training for visuomotor integration in children with developmental delay: a pilot study

BackgroundImpaired visuomotor integration (VMI) is commonly observed in children with developmental delay (DD). This pilot study aimed to evaluate the effects of tablet computer-based cognitive training on the VMI in children with DD.MethodsThis study included children aged 4 to under 18 years diagnosed with DD. The children participated in a 12-week tablet computer-based visual-spatial and visuomotor training program. They were administered the Mind Rx Kids Program (Brain Academy, Seoul, South Korea). The participants underwent daily 30-min tablet computer-based training for 12 weeks. The primary visuomotor function was measured using the Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition (VMI-6). For secondary outcomes, measurements were taken before and after 12-week treatment using the Quality of Upper Extremity Skills Test (QUEST), Functional Independence Measure for Children (WeeFIM), Childhood Autism Rating Scale (CARS), Attention deficit hyperactivity disorder Rating Scale (ARS), and Child Smartphone Addiction Observer Scale. The Wilcoxon signed-rank test was used to compare the pre- and post-treatment outcomes.ResultsTen children with DD participated in this study. The results of the 12-week tablet computer-based cognitive training showed significant improvements in the raw score, standard score, percentile score, and equivalent age of the Beery VMI-6. Additionally, there were significant improvements in QUEST and WeeFIM scores. Although there were improvements in the CARS, ARS, and smartphone addiction observer scale, these were not statistically significant.ConclusionThis pilot study confirmed that applying tablet computer-based cognitive training to children with DD not only improves VMI, but also enhances fine motor skills and activities of daily living. Furthermore, the results of this study indicate that tablet computer-based cognitive training does not increase digital media addiction. Therefore, children with DD can engage in tablet computer-based cognitive training at home without concerns about digital media addiction.

Efficacy of an Animal-Assisted Therapy Program in the Development of Children With Down Syndrome

ABSTRACT This study aimed to evaluate the efficacy of a dog-assisted intervention program in occupational therapy (OT) sessions in the treatment of children with Down syndrome (DS). A randomized clinical trial was conducted with 14 children with DS (9–12 years old) randomly distributed into two groups: control and experimental. Both received 12 OT sessions, one per week. The experimental group also received dog-assisted therapy. To evaluate the effects of the program, the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI), the Test of Playfulness (ToP), an ethogram of positive and negative social behaviors, and comparisons of vasopressin levels in the urine of children upon awakening and after sessions were used. The results showed that after the conventional intervention, the control group had a significant increase in visual perception and attention scores. The experimental group showed a significantly higher frequency of satisfaction and interactivity behaviors. We found that the presence of the dog maximizes the social skills of children with DS and increases their engagement in positive social interactions; however, conventional OT sessions were more effective with visual-motor performance. No physiological changes were observed in either group after the intervention.

Precision in Progress: Unraveling the Clinimetric Properties of Beery-Buktenica Developmental Test of Visual-Motor Integration in Children With Cerebral Palsy Across Diverse Motor Severities

BackgroundIn the realm of pediatric cerebral palsy (CP), visual motor challenges often overshadow a child's developmental journey. This study delves into the responsiveness and crucial benchmarks, specifically the minimal clinically important difference (MCID), of the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) among children with varying motor severities. MethodEighty-eight children with CP (50 males, 38 females; aged three to 12 years) with Gross Motor Function Classification System (GMFCS) levels I to III were recruited from the rehabilitation department of Chang Gung Memorial Hospital in Taiwan. Each participant received the Beery VMI tests at baseline and at one-year follow-up. The standardized response mean (SRM) was calculated to determine the responsiveness of Beery VMI, and a distribution-based approach was used to estimate MCID. ResultsThe Beery VMI exhibited remarkable responsiveness across GMFCS levels I to III (SRM = 0.98-2.36). MCIDs for Beery VMI varied across severities, with ranges of 2.93 to 4.41 (0.2 S.D.), 7.31 to 11.49 (0.5 S.D.), and 11.70 to 18.38 (0.8 S.D.). Notably, in the visual perception subset, MCIDs were 3.93 to 4.03 (0.2 S.D.), 9.83 to 10.07 (0.5 S.D.), and 15.73 to 16.11 (0.8 S.D.). In the supplemental motor coordination subtest, MCIDs spanned 1.67 to 4.87 (0.2 S.D.), 4.18 to 12.17 (0.5 S.D.), and 6.68 to 19.47 (0.8 S.D.). ConclusionsBeery VMI demonstrates robust responsiveness in children with CP. Motor-severity-tailored MCIDs offer a guide for clinicians and researchers, hinting at treatment efficacy. Particularly, lower change scores in VMI and motor coordination subtests may signal effective interventions for moderate motor disability over mild cases.

Visual-Motor Integration (VMI) Is Also Relevant for Computer, Smartphone, and Tablet Use by Adults: Introducing the Brief Box Clicking Test.

Visual-motor integration (VMI) is typically examined in children to promote handwriting, but it may also be relevant for adults' capacity for technology use. To examine the reliability and validity of speed of completion of the box clicking test, a web-based test of VMI. Participants in the Understanding America Study completed online surveys on a regular basis, including a very brief (less than 30 s) self-administered box clicking test. For validity testing, we examined whether box clicking speed was associated with constructs relevant to visual-perceptual skills and motor coordination, the skills underlying VMI. Test-retest reliability was examined by computation of intraclass correlation coefficients. A total of 11,114 adults. Measures included the completion time for the box clicking task and measures relevant to visual perception (e.g., perceptual speed) and motor coordination (e.g., self-reported functional limitation). Results suggested that the box clicking test was a VMI task. Slower test performance was associated with lower visual-perceptual speed and a greater likelihood of reporting difficulties with dressing, a motor coordination relevant task. Box clicking tests taken within at least 2 yr of one another had moderate test-retest stability, but future studies are needed to examine test-retest reliabilities over brief (e.g., 2-wk) time intervals. The box clicking test may serve both as a tool for research and to clinically observe whether clients have VMI difficulties that interfere with computer, smartphone, or tablet use. Plain-Language Summary: Use of devices such as smartphones and computers is increasingly becoming integral for daily functioning. Visual-motor integration (VMI) has often been addressed by occupational therapists to support handwriting of children, but it may also be important for technology use by adults. Prior literature supports the relevance of VMI to technology use, and adults with various chronic conditions have been found to have decrements in VMI. We tested the psychometric properties of a brief box clicking test of VMI that could be used to examine VMI underlying technology use among adults. Overall, results suggested that the box clicking test was a VMI task. Just as speed of gait has been used as an index of functional mobility, speed on the box clicking task seemed serviceable as an index of VMI ability. The box clicking test may also be used for clinical observation of whether VMI interferes with technology use.

APPLICATION OF EDUCATIONAL-REHABILITATION TREATMENT FOR IMPROVING VISUAL PERCEPTION IN STUDENTS WITH VISUAL IMPAIRMENT

Visual impairment can occur in different periods of life, and each person reacts differently in a way that corresponds to their personality, abilities, goals, as well as the life situation in which they find themselves. The aim of this research paper was to show, according to the available literature, the impact of individual educational-rehabilitation treatment on visual perception in students with visual impairment. The sample of respondents included a student, male, aged 9 years, diagnosed with nystagmus, amblyopia, and astigmatism. The student was included in an educational-rehabilitation program in order to improve his visual functioning. For the purpose of assessment and evaluation, the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) fifth edition was used, which is intended for the assessment of visual-motor integration, visual perception, and motor coordination. An initial and final assessment was conducted with the student, and the Visual Perception subtest, consisting of 30 tasks, was used for the same. After the initial assessment, an individual educational-rehabilitation treatment was carried out for 2 months. The research data were processed by frequency analysis. On the basis of statistical processing and data analysis, the results showed an improvement in the area of visual perception, thereby confirming the need to implement an educational-rehabilitation program for a student with visual impairment.Keywords: visual perception,visual impairment, individual educational-rehabilitation program.

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

Postnatal Brain Trajectories and Maternal Intelligence Predict Childhood Outcomes in Complex CHD.

Objective: To determine whether early structural brain trajectories predict early childhood neurodevelopmental deficits in complex CHD patients and to assess relative cumulative risk profiles of clinical, genetic, and demographic risk factors across early development. Study Design: Term neonates with complex CHDs were recruited at Texas Children's Hospital from 2005-2011. Ninety-five participants underwent three structural MRI scans and three neurodevelopmental assessments. Brain region volumes and white matter tract fractional anisotropy and radial diffusivity were used to calculate trajectories: perioperative, postsurgical, and overall. Gross cognitive, language, and visuo-motor outcomes were assessed with the Bayley Scales of Infant and Toddler Development and with the Wechsler Preschool and Primary Scale of Intelligence and Beery-Buktenica Developmental Test of Visual-Motor Integration. Multi-variable models incorporated risk factors. Results: Reduced overall period volumetric trajectories predicted poor language outcomes: brainstem ((β, 95% CI) 0.0977, 0.0382-0.1571; p = 0.0022) and white matter (0.0023, 0.0001-0.0046; p = 0.0397) at 5 years; brainstem (0.0711, 0.0157-0.1265; p = 0.0134) and deep grey matter (0.0085, 0.0011-0.0160; p = 0.0258) at 3 years. Maternal IQ was the strongest contributor to language variance, increasing from 37% at 1 year, 62% at 3 years, and 81% at 5 years. Genetic abnormality's contribution to variance decreased from 41% at 1 year to 25% at 3 years and was insignificant at 5 years. Conclusion: Reduced postnatal subcortical-cerebral white matter trajectories predicted poor early childhood neurodevelopmental outcomes, despite high contribution of maternal IQ. Maternal IQ was cumulative over time, exceeding the influence of known cardiac and genetic factors in complex CHD, underscoring the importance of heritable and parent-based environmental factors.

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.

Effect of Kinesthetic-based Perceptual Integrative Games on Visual Perception and Academic Performance in Children with Autism Spectrum Disorder: A Quasi-Experimental Study

Abstract Background: Children learn everything through play and games. Visual perceptual skills are prerequisites for other areas of functioning, such as academic skills, activities of daily living, play, and leisure activities. Hence, visual perception can be improved using kinesthetic movement-based perceptual integrative games, as the children will be more interested in games rather than doing activities. Objective: The study aimed to identify the effect of kinesthetic-based perceptual integrative games on visual perception and academic performance in children with autism spectrum disorder (ASD). Study Design: Quasi-experimental study design was used. Methods: Fifty children diagnosed with mild and moderate ASD were selected based on convenient sampling. The experimental group (n = 25) received the kinesthetic-based perceptual integrative games for 36 sessions, 45 min per session, while the control group (n = 25) received conventional occupational therapy for the same period. Beery–Buktenica Developmental Test of Visual-Motor Integration (Berry VMI) scale and Academic Performance Rating Scale (APRS) were used. Results: The result revealed that the kinesthetic-based perceptual integrative games significantly improved visual perception (P = 0.042, 95% confidence level (CL) range 13.326–0.846) and academic performance (P = 0.001, 95% CL range of − 8.3718–−2.1882) compared to conventional occupational therapy but there was no correlation between the APRS and Berry VMI (P = 0.114). Conclusion: The kinesthetic-based perceptual integrative games intervention improved the visual perceptual skills and academic performance of children with ASD in this study. Hence, it can be used as a new therapeutic modality in treating children with ASD and other forms of disorders who have deficits in visual perception and academic skills.

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).