Visual Attention Skills Research Articles

Use of Virtual Reality in School-Aged Children with Developmental Coordination Disorder: A Novel Approach.

Virtual reality (VR) applications in paediatric rehabilitation are recent but promising. This brief report describes a VR rehabilitation program for a small sample of children with Developmental Coordination Disorder (DCD). The program focused explicitly on executive functions, a key area of concern for this population. It was conducted over 11 weeks in the CARE Lab. This lab was designed with appropriate structural characteristics and sophisticated technology to provide a rehabilitative setting with recreational and semi-immersive features. Before and after the VR training, the children were evaluated in terms of visual attention, inhibition, planning abilities, and visual-motor coordination. The rehabilitation programs were customised according to the clinical needs and the functional profile of each patient, proposing different games with variable complexity levels. These preliminary results showed a global and clinically significant change in executive functions, especially visual attention and inhibition skills. These findings suggest interesting implications for clinical practice, providing new information for professionals regarding the application of VR in the field of paediatric rehabilitation.

Early cognitive assessment in premature infants: the discriminatory value of eye-tracking vs. Bayley Scales.

The testing of visuocognitive development in preterm infants shows strong interactions between perinatal characteristics and cognition, learning and overall neurodevelopment evolution. The assessment of anticipatory gaze data of object-location bindings via eye-tracking can predict the neurodevelopment of preterm infants at the age of 3 years; little is known, however, about the early cognitive function and its assessment methods during the first year of life. The current study presents data from a novel assessment tool, a Delayed Match Retrieval (DMR) paradigm via eye-tracking was used to measure visual working memory (VWM) and attention skills. The eye-tracking task that was designed to measure infants' ability to actively localize objects and to make online predictions of object-location bindings. 63 infants participated in the study, 39 preterm infants and 24 healthy full term infants - at a corrected age of 8-9 months for premature infants and similar chronological age for full term infants. Infants were also administered the Bayley Scales of Infant and Toddler Development. The analysis of the Bayley scores showed no significant difference between the two groups while the eye-tracking data showed a significant group effect on all measurements. Moreover, preterm infants' VWM performance was significantly lower than full term's. Birth weight affected the gaze time on all Areas Of Interest (AOIs), overall VWM performance and the scores at the Cognitive Bayley subscale. Furthermore, preterm infants with fetal growth restriction (FGR) showed significant performance effects in the eye-tracking measurements but not on their Bayley scores verifying the high discriminatory value of the eye gaze data. Visual working memory and attention as measured via eye-tracking is a non-intrusive, painless, short duration procedure (approx. 4-min) was found to be a significant tool for identifying prematurity and FGR effects on the development of cognition during the first year of life. Bayley Scales alone may not pick up these deficits. Identifying tools for early neurodevelopmental assessments and cognitive function is important in order to enable earlier support and intervention in the vulnerable group of premature infants, given the associations between foundational executive functional skills and later cognitive and academic ability.

Visual attention and phonological processing in children with developmental language disorder

IntroductionDevelopmental Language Disorder (DLD) is a neurobiological condition characterized by insufficient language and communication development, with no underlying physical, sensory, or cognitive explanations. A prominent feature among children with DLD is their struggle with phonological processing, a pivotal skill for later reading proficiency. Recent research suggests that children with DLD may also exhibit impairments in various non-linguistic cognitive abilities, including memory, attention, and perception. Of particular importance is visual attention, which plays a critical role in integrating visual perceptual information with diverse cognitive and linguistic processes.ObjectiveTo characterize visual attention during phonological processing tasks in Colombian children with DLD.MethodologyThis study employed a cross-sectional descriptive experimental design involving 20 children diagnosed with Developmental Language Disorder (DLD) and 20 children without language difficulties. All participants underwent language, vocabulary, and phonological awareness tests. Additionally, an experimental task utilizing the eye-tracking method was designed and administered to measure phonological processing with phonological and lexical distractors.ResultsChildren with DLD exhibited diminished performance on phonological awareness tasks, as evidenced by their lower scores. This was further supported by the experimental phonological processing task, where an interference effect was observed in the presence of lexical distractors for word recognition, but not with phonological distractors.ConclusionChildren with DLD demonstrated deficiencies in both phonological awareness and visual attention skills during linguistic and phonological processing tasks. They also exhibit reduced sensitivity in identifying phonological relations such as rhyme. The study discusses these findings along with their clinical implications, emphasizing the importance of assessing online processing abilities in children with DLD and considering the influence of other cognitive abilities on their linguistic performance.

How Do Children and Adolescents with ASD Look at Animals? A Scoping Review.

Autism spectrum disorder (ASD) is characterized by interaction and communication differences, entailing visual attention skill specificities. Interactions with animals, such as in animal-assisted interventions or with service dogs, have been shown to be beneficial for individuals with ASD. While interacting with humans poses challenges for them, engaging with animals appears to be different. One hypothesis suggests that differences between individuals with ASD's visual attention to humans and to animals may contribute to these interaction differences. We propose a scoping review of the research on the visual attention to animals of youths with ASD. The objective is to review the methodologies and tools used to explore such questions, to summarize the main results, to explore which factors may contribute to the differences reported in the studies, and to deduce how youth with ASD observe animals. Utilizing strict inclusion criteria, we examined databases between 1942 and 2023, identifying 21 studies in international peer-reviewed journals. Three main themes were identified: attentional engagement and detection, visual exploration, and behavior. Collectively, our findings suggest that the visual attention of youths with ASD towards animals appears comparable to that of neurotypical peers, at least in 2D pictures (i.e., eye gaze patterns). Future studies should explore whether these results extend to real-life interactions.

Effectiveness of a Program Based on Central Cohesion Tasks to Develop Visual attention in Children with Autism Spectrum Disorder

Previous research indicates that there are deficits in visual attention skills in children with autism spectrum disorder. The current research aims to verify the effectiveness of a program based on some tasks of central coherence (visual sensory perception and non-verbal communication) in developing visual attention skills (visual communication, visual crossing out, visual tracking, flexibility in transferring visual attention, visual joint attention) for children with disabilities with Autism spectrum disorder. The experimental method was used and the design of the experimental and control groups was chosen with pre, post and follow-up measurements. The sample consisted of 10 children at the Fort-T Rehabilitation Centre , aged between 8 and 10 years old, with a level of autism disorder (55-70) on the Gilliam scale-3, divided into two equivalent experimental and control groups. The study tools consisted of the Stanford-Binnet Intelligence Scale to determine the intelligence coefficient, the Gilliam-3 scale for diagnosing autism spectrum disorder, a visual attention scale for children with autism spectrum disorder (prepared by the researcher), and a program based on central coherence tasks (prepared by the researcher).The data were analyzed using appropriate non-parametric statistical methods (Mann-Whitney, Wilcoxon) using the statistical program (SPSS). The results indicated the effectiveness of the central coherence task program in developing visual attention in children with autism spectrum disorder. This study supports the employment of central coherence tasks in improving the response of children with autism spectrum disorder to emotional expressions, and recommends the continuation of efforts in developing visual attention, which is the main entrance to provide these children with all positive behaviors and skills.

Investigating the Relationship Between Visual Attention, Story Comprehension, and Vocabulary Skills in Malaysian Prereaders

Based on the cross-channel connections between auditory and pictorial representations, it has been proposed that the presentation of coherent narration along with the picture and text content may enhance children's story comprehension and vocabulary learning. The authors tested 40 four- to five-year-old Malaysian prereaders (17 Malays, 23 Chinese) for story comprehension while observing their eye movements to determine the degree to which the presence of pictures and/or text aids understanding of the narration and influences looking patterns. Both Malay and Chinese prereaders showed no interest in the printed text that was presented alongside the picture on the same page, which is consistent with earlier findings. This suggests that ethnic origins have little influence on how prereaders direct their visual attention to the relevant information for story comprehension. When there was no narration, they fixated longer on the text and less on the image, indicating that a significant amount of mental effort was required to process the words without verbal information. Regardless of stimulus congruency, storytelling performance affected how much children focused on target objects and keywords. More intriguingly, it was found that in Malay prereaders, there was a correlation between story comprehension and vocabulary skills across tasks. Additionally, Malay prereaders who performed well looked at the displayed stimuli longer than Chinese prereaders who performed well, especially when a narrator was presented alongside the visual stimulus. These novel findings are discussed along with their implications for multimedia learning and future research directions.

Effects of the self-perceived sensorimotor demand and immersion during video gaming on visual-attention skills.

Playing specific genres of video games (e.g., action video games) has been linked to improvements in cognitive skills mostly related to attentional phenomena. Nonetheless, do video games have features or dimensions in common that impact cognitive improvements beyond the game genre? Here, we argue that the sensorimotor demand-the amount of demand for precise coordination between movement and perception-is a key element in the improvements associated with playing video games. We conducted a two-part study to test this hypothesis: a self-report online gaming instrument development and validation and an in-lab behavioural and electrophysiological study. In the first study, data from 209 participants were used to devise the sensorimotor demand instrument (SMDI). The SMDI was split into three dimensions of video game playing: sensorimotor contingency, immersion and unfocused gaming. Criterion validity related to video gamers' characteristics supported that the SMDI is sensitive to the input device (e.g., keyboard or touchscreens), and the most recent experience gained during gaming sessions while not being sensitive to the game genre. In the second study, data from 20 participants who performed four visual-attentional tasks previously reported in the literature showed that the SMDI's dimensions were associated with behavioural performance measures and the latency and amplitude of event-related potentials (N1, P2 and P3). Despite the challenge of studying the video gamer population, our study remarks on the relevance of sensorimotor demands in the performance of attentional tasks and its potential use as a dimension to characterize the experience of playing video games beyond the game genre.

Visual Perception and Attentional Skills in School-age Children: A Cross-Sectional Study of Reading Proficiency in the Hearing Impaired.

Auditory impairment is one of the common sensory deficits that occur in humans. Hearing loss affects students' ability to communicate and read, which eventually causes social and scholastic stigma. Reading relies heavily on phonics as well as visual attention. Students with normal hearing read by transforming phonic sounds into words. Hearing impaired has little to no phonic ability, making them visual readers who rely on visual cues while reading. Present study sought to investigate factors that affect reading skills in hearing-impaired children. A cross-sectional study was conducted in hearing- and hearing-impaired schools of Ludhiana, Punjab, India. After vision screening among all students, sixty students were enrolled via convenient sampling. Higher order of visual perception, attention, and reading ability was investigated. A total of 60 students were evaluated (30 hearing impaired and 30 age-matched hearing). The hearing group was statistically better than the hearing impaired (p = 0.001), Hearing impaired were better in visual attention (p = 0.001), whereas a correlation was found between reading ability and visual perception, attention skill of hearing- and hearing-impaired students (r = 0.80, P = 0.001). Present study concludes that hearing-impaired students exhibit issues with visual-motor integration, visual-spatial relationships, and visual sequential memory. Higher visual attention was demonstrated by hearing-impaired students. The results of the current investigation revealed a correlation between visual perception and attention skills and reading competency. Thus, the present study demands that the newly enrolled hearing-impaired students must undergo a thorough ocular evaluation.

A multi-method approach to addressing the toddler data desert in attention research

Visual attention skills undergo robust development change during infancy and continue to co-develop with other cognitive processes in early childhood. Despite this, this is a general disconnect between measures of the earliest foundations of attention during infancy and later development of attention in relation to executive functioning during the toddler years. To examine associations between these different measures of attention, the current study administered an oculomotor task (infant orienting with attention, IOWA) and a manual response (Flanker) task with a group of toddlers. We collected simultaneous neural recordings (using functional near-infrared spectroscopy), eye-tracking, and behavioral responses in 2.5- and 3.5-year-olds to examine the neural and behavioral associations between these skills. Results revealed that oculomotor facilitation in the IOWA task was negatively associated with accuracy on neutral trials in the Flanker task. Second, conflict scores between the two tasks were positively associated. At the neural level, however, the tasks showed distinct patterns of activation. Left frontal cortex was engaged during the Flanker task whereas right frontal and parietal cortex was engaged during the IOWA task. Activation during the IOWA task differed based on how well children could control oculomotor behavior during the task. Children with high levels of stimulus reactivity activated parietal cortex more strongly, but children with more controlled oculomotor behavior activated frontal cortex more strongly.

Engaging cognitive domains of people with dementia during tablet game play

AbstractBackgroundKeeping cognitively active is important for people living with dementia or MCI but finding engaging activities can be challenging. Playing digital games has been shown to engage cognitive processes such as visual attention, working memory, and visuomotor skills, in children and adults. This study explored whether these cognitive domains are engaged when people living with dementia or MCI play digital games.MethodParticipants (n = 32) with dementia or MCI, mean MoCA 13.9, were recruited from adult day programs to play four mainstream games on touchscreen tablets. Each session was recorded and a video coding scheme was developed using behavioral analysis software to map observable behaviors, including eye gaze, hand movements, and game strategy, to five DSM cognitive domains : complex attention, executive function, learning and memory, language, and perceptual motor (DSM‐V, 2013). Five minutes from each initial gameplay session were analyzed to explore the engagement of cognitive domains.ResultsAll five cognitive domains were engaged but varied across the games. For example, a word search games engaged language much more than a jigsaw puzzle game which was higher on perceptual‐motor skills. The most engaged cognitive domain was ‘complex attention’ and the least engaged cognitive domain was ‘language’. All participants demonstrated cognitive engagement whilst playing the games.ConclusionPlaying digital games can provide cognitive engagement for people living with dementia or MCI. Using mainstream games increases accessibility of opportunities for cognitive engagement, in a way which is also immersing and rewarding. Future research incorporating eye tracking will increase understanding of how people living with dementia learn to play digital games and respond to prompts. This study presents huge potential for low cost cognitive activity for people with dementia or MCI.

Spatial processing rather than logical reasoning was found to be critical for mathematical problem-solving

Students' ability to solve mathematical problems is a standard mathematical skill; however, its cognitive correlates are unclear. Thus, this study aimed to examine whether spatial processing (mental rotation, paper folding, and the Corsi blocks test) and logical reasoning (abstract and concrete syllogisms) were correlated with mathematical problem-solving (word problems and geometric proofing) for college students. The regression results showed that after controlling for gender, age, general IQ, language processing, cognitive processing (visual perception, attention, and memory skills), and number sense and arithmetic computation skills, spatial processing skills still predicted mathematical problem-solving and geometry skills in Chinese college students. Contrastingly, logical reasoning measures related to syllogisms did not predict after controlling for these variables. Further, notably, it did not correlate significantly with geometry performance when no control variables were included. Our results suggest that spatial processing is a significant component of math skills involving word and geometry problems (even after controlling for multiple key cognitive factors).

Team ball sport experience minimizes sex difference in visual attention.

Simultaneous tracking of the position of the ball and player locations and activities places high demands on visual attention in team ball sport athletes. Owing to their extensive sports training, these athletes may be expected to exhibit visual attention skills superior to non-athletes; however, the results of studies examining this are inconsistent. Thus, the first aim of this study was to assess the impact of participating in a team ball sport on visual attention. There is limited empirical evidence indicating a sex difference in visual attention, and few studies have reported on visual attention in male and female athletes. Thus, the second aim of this study was to determine whether team ball sport experience affected any sex differences in visual attention. In total, 44 highly skilled basketball players—22 men (mean age: 21.86 ± 2.15 years) with a mean (SD) of 8.46 (2.92) years training experience and 22 women (mean age: 21.32 ± 1.58 years) with a mean (SD) of 8.22 (2.44) years of training experience—and 44 non-athletic undergraduate college students—22 men (mean age: 21.62 ± 1.88 years) and 22 women (mean age: 21.55 ± 1.72 years)—were recruited and completed this study. Visual attention was measured by using the multiple object tracking (MOT) task. Skilled basketball players showed superior tracking accuracy to non-athletic college students on the MOT task. A significant sex difference was found only among the non-athletic college students, with better tracking accuracy for men than for women on the MOT task. By contrast, no significant sex difference was observed among the skilled basketball players for tracking accuracy on the MOT task. These findings indicated that team ball sport training may enhance visual attention as assessed by tracking accuracy. Given that the male and female basketball players in this study had similar training experience and game performance demands, long-term team ball sport experience appeared to minimize the sex difference in visual attention found among non-athletic students.

How visual attention span and phonological skills contribute to N170 print tuning: An EEG study in French dyslexic students

Developmental dyslexia is a disorder characterized by a sustainable learning deficit in reading. Based on ERP-driven approaches focusing on the visual word form area, electrophysiological studies have pointed a lack of visual expertise for written word recognition in dyslexic readers by contrasting the left-lateralized N170 amplitudes elicited by alphabetic versus non-alphabetic stimuli. Here, we investigated in 22 dyslexic participants and 22 age-matched control subjects how two behavioural abilities potentially affected in dyslexic readers (phonological and visual attention skills) contributed to the N170 expertise during a word detection task. Consistent with literature, dyslexic participants exhibited poorer performance in these both abilities as compared to healthy subjects. At the brain level, we observed (1) an unexpected preservation of the N170 expertise in the dyslexic group suggesting a possible compensatory mechanism and (2) a modulation of this expertise only by phonological skills, providing evidence for the phonological mapping deficit hypothesis.

Methodology and preliminary data on feasibility of a neurofeedback protocol to improve visual attention to letters in mild Alzheimer's disease

BackgroundBrain-computer interface (BCI) systems are controlled by users through neurophysiological input for a variety of applications, including communication, environmental control, and motor rehabilitation. Although individuals with severe speech and physical impairment are the primary users of this technology, BCIs have emerged as a potential tool for broader populations, including delivering cognitive training/interventions with neurofeedback (NFB). MethodsThis paper describes the development and preliminary testing of a protocol for use of a BCI system with NFB as an intervention for people with mild Alzheimer's disease (AD). The intervention focused on training visual attention and language skills, as AD is often associated with functional impairments in both. This funded pilot study called for enrolling five participants with mild AD in a six-week BCI EEG-based NFB intervention that followed a four-to-seven-week baseline phase. While two participants completed the study, the remaining three participants could not complete the intervention phase because of COVID-19 restrictions. ResultsPreliminary pilot results suggested: (1) participants with mild AD were able to participate in a study with multiple assessments per week and complete all outcome measures, (2) most outcome measures were reliable during the baseline phase, and (3) all participants with mild AD learned to operate a BCI spelling system with training. ConclusionsAlthough preliminary results demonstrate practical feasibility to deliver NFB intervention using a BCI to adults with AD, completion of the protocol in its entirety with more participants is needed to further assess whether implementing NFB-based cognitive intervention is justified by functional treatment outcomes. Trial registrationThis study was registered with ClinicalTrials.gov (NCT03790774).

Innovations in Primary Education: Neuropsychological Aspect

The article is devoted to the influence of neuropsychology on the modern student. The concepts of "neuropsychology" and "neuropsychological research", research and publications of domestic and foreign scientists on the development of neuropsychology and the use of methods that improve the work of the right and left hemispheres of the brain are considered in the article. The scientific potential of neuropsychology is indicated. Attention is drawn to the views of scientists who studied the neuropsychology of childhood. It has been found that there are many more books and periodicals in foreign literature that contain information on neuropsychology. A foreign project aimed at studying the brain is covered. It is emphasized that in modern educational institutions in Spain, teachers pay special attention to the neuropsychological characteristics of each child. Emphasis is placed on the difficulties of primary school children who need neuropsychological care. The focus is on the features of functional blocks of the brain and their mutual development. Emphasis is placed on the need to use health-preserving and play technologies in the organization of the educational process for teachers working on the Concept of the "New Ukrainian School". The effectiveness of kinesiological exercises for brain function, which contribute to the harmonious development of personality, has been proven. The significance of moving activities for the body of a child of primary school age is revealed. The powerful influence of means of musical and fine arts which help to develop visual perception, difficult spatial abilities, visual attention, memory, verbal and visual-motor skills on overcoming of neuropsychological frustration is proved. A block of neuropsychological exercises to activate the brain is presented. Samples of corrective exercises are highlighted: breathing exercises, massage, oculomotor exercises.

Tablet vs. Book learning: association with memory, attention, and learning abilities among lebanese children

ABSTRACT In Lebanon, the methods of teaching employed are mostly conventional. Teachers spend a lot of time giving lessons and homework to students, as well as reading assignments and correcting exercises completed in class. Students usually play a passive role in the education process; they listen calmly, occasionally question what is presented, and copy texts and information dictated by the teacher. Textbooks are the major source of instruction, yet many Lebanese schools have partially introduced electronic devices, and have discreetly started to rely on them. Given the reported discrepancies between textbooks and tablets learning, it was essential to conduct a Lebanese study that compares both entities. To assess the influence of textbooks and tablets on cognition and attention, it was also necessary to consider the schooling age that is critical for understanding the human brain and cognition. Therefore, the objective of this study was to assess the association between of tablet vs. book learning on memory, attention, and learning abilities among Lebanese children. This cross-sectional study, conducted between January-May 2019, enrolled 566 students aged of 11–13 years. Two schools were chosen conveniently for this study, one of them uses the Tablet and text books for students’ learning whereas the second one uses text books exclusively. Students were randomly chosen from the list given by the school administration. Textbook learning was significantly associated with better episodic and visual memory, better attention, processing speed and mathematic skills compared to tablets and textbook learning. Learning is evolving to another level and forever changing. Many studies should be conducted in order to understand the importance of merging new and old techniques to ensure that the next generations are receiving what can positively affect their cognitive skills and their performance.

Does the combination of physical activity and attention training affect the motor skills and cognitive activities of individuals with mild intellectual disability?

Individuals with mild intellectual disability (MID) were worse than their peers who typically develop in motor skills and attention-demanding assignments. In this study, effect of a 14-week physical activity and attention training practise on the motor skills, visual retention, perception and attention levels of students with MID were analysed. Twenty-two individuals between 7 and 14 ages participated voluntarily. Activities based on developing attention skills and physical activities enhancing fine-gross motor skills (40 + 60 min./2 days/14 weeks) were given to the experimental group. d2 Test of Attention, Benton Visual Retention and Bruininks-Oseretsky Test of Motor Proficiency-2nd version tests were used as data collection tools. There was significant difference in terms of total number of items processed, commissions, raw score of errors, total number of items minus error scores, concentration performance, Benton visual retention test and perception, fine motor skill precision, fine motor skill integration, manual dexterity and upper-limb coordination values regarding group and time dependant (p< .05). However, there was no significant difference in omissions and fluctuation rate values (p> .05). As a result; it is determined that the combination of physical activity and attention training practises features a positive effect on visual retention, perception, attention and motor skill levels of students with MID.

Eye Movements during Dynamic Scene Viewing are Affected by Visual Attention Skills and Events of the Scene: Evidence from First-Person Shooter Gameplay Videos.

The role of individual differences during dynamic scene viewing was explored. Participants (N=38) watched a gameplay video of a first-person shooter (FPS) videogame while their eye movements were recorded. In addition, the participants’ skills in three visual attention tasks (attentional blink, visual search, and multiple object tracking) were assessed. The results showed that individual differences in visual attention tasks were associated with eye movement patterns observed during viewing of the gameplay video. The differences were noted in four eye movement measures: number of fixations, fixation durations, saccade amplitudes and fixation distances from the center of the screen. The individual differences showed during specific events of the video as well as during the video as a whole. The results highlight that an unedited, fast-paced and cluttered dynamic scene can bring about individual differences in dynamic scene viewing.

An iPad-based intervention to improve visual-motor, visual-attention, and visual-perceptual skills in children with surgically treated hydrocephalus: A pilot study.

Develop and pilot an iPad-based intervention for improving visual-motor coordination, visual-spatial processing/reasoning, and visual attention in children with surgically treated hydrocephalus (HCP). We developed an intervention protocol targeting visual-motor coordination, visual-spatial processing/reasoning, and visual attention. Fourteen participants with HCP completed 30h of training over 6weeks. The primary outcome measure was the Perceptual Reasoning Index from the Wechsler Abbreviated Scale of Intelligence, Second Edition. Secondary measures included subtests from the Wechsler Intelligence Scale for Children, Fourth Edition, Developmental NEuroPSYchological Assessment, Second Edition (NEPSY-II), and Purdue Pegboard. Children with HCP demonstrated gains with statistical significance on the Perceptual Reasoning Index. We also observed significant improvement on a timed test of visuo-motor coordination (Wechsler Intelligence Scale for Children, Fourth Edition, Coding). Our iPad-application-based intervention may promote visual-motor coordination, visual-spatial processing/reasoning, and visual attention skills in children with HCP, offering an engaging and economical supplement to more conventional therapies.

Manganese body burden in children is associated with reduced visual motor and attention skills

Manganese (Mn) is an essential element, however, children with moderate to high Mn exposure can exhibit neurobehavioral impairments. One way Mn appears to affect brain function is through altering dopaminergic systems involved with motor and cognitive control including frontal – striatal brain systems. Based on the risk for motor and attention problems, we evaluated neurobehavioral function in 255 children at risk for Mn exposure due to living in proximity to coal ash storage sites. Proton Induced X-ray Emissions (PIXE) analysis was conducted on finger and toenails samples. Multiple neuropsychological tests were completed with the children. Fifty-five children had Mn concentrations above the limit of detection (LOD) (median concentration = 3.95 ppm). Children with detectable Mn concentrations had reduced visual motor skills (β = −5.62, CI: −9.11, −2.12, p = 0.008) and more problems with sustained attention, based on incorrect responses on a computerized attention test, (β = 0.40, CI: 0.21, 0.59, p < 0.001) compared with children who had Mn concentrations below the LOD. Findings suggest that Mn exposure impacts attention and motor control possibly due to neurotoxicity involving basal ganglia and forebrain regions. Visual-motor and attention tests may provide a sensitive measure of Mn neurotoxicity, useful for evaluating the effects of exposure in children and leading to better treatment options.