Intelligence and visual motor integration in 5-year-old children with 22q11-deletion syndrome

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.

Executive functioning in preschoolers with 22q11.2 deletion syndrome and the impact of congenital heart defects

BACKGROUND

Executive functioning (EF) is an umbrella term for various cognitive functions that play a role in monitoring and planning to effectuate goal-directed behavior. The 22q11.2 deletion syndrome (22q11DS), the most common microdeletion syndrome, is associated with a multitude of both somatic and cognitive symptoms, including EF impairments in school-age and adolescence. However, results vary across different EF domains and studies with preschool children are scarce. As EF is critically associated with later psychopathology and adaptive functioning, our first aim was to study EF in preschool children with 22q11DS. Our second aim was to explore the effect of a congenital heart defects (CHD) on EF abilities, as CHD are common in 22q11DS and have been implicated in EF impairment in individuals with CHD without a syndromic origin.

METHODS

All children with 22q11DS (n = 44) and typically developing (TD) children (n = 81) were 3.0 to 6.5 years old and participated in a larger prospective study. We administered tasks measuring visual selective attention, visual working memory, and a task gauging broad EF abilities. The presence of CHD was determined by a pediatric cardiologist based on medical records.

RESULTS

Analyses showed that children with 22q11DS were outperformed by TD peers on the selective attention task and the working memory task. As many children were unable to complete the broad EF task, we did not run statistical analyses, but provide a qualitative description of the results. There were no differences in EF abilities between children with 22q11DS with and without CHDs.

CONCLUSION

To our knowledge, this is the first study measuring EF in a relatively large sample of young children with 22q11DS. Our results show that EF impairments are already present in early childhood in children with 22q11DS. In line with previous studies with older children with 22q11DS, CHDs do not appear to have an effect on EF performance. These findings might have important implications for early intervention and support the improvement of prognostic accuracy.

Systematic Review of Visual Motor Integration in Children with Developmental Disabilities

Original research articles regarding visual motor integration skills in children with developmental disabilities and the impact of occupational therapy were identified, appraised, and synthesized. Twenty-four articles were chosen for this review. Themes were noted during the critique of articles. Three themes emerged: "age," "gender," and "diagnosis." Regarding the impact on visual motor integration, there was strong evidence for age, moderate evidence for gender, and strong evidence for diagnosis. Future research investigating visual motor integration in children should control for age and diagnosis.

The association between under-nutrition, school performance and perceptual motor functioning in first-grade South African learners: The North-West Child Health Integrated with Learning and Development study

BACKGROUND

Early childhood is characterised by an immense spurt of growing and learning where under-nutrition can have adverse effects on the neuro-developmental health and school performance of children. A full understanding of the relationship between school performance and motor functioning skills and malnourishment in school beginners is still lacking.

AIM

To determine the association between indices of under-nutrition and how it relates to school performance and motor functioning skills of first-grade learners.

SETTING

North West province (NWP) of South Africa (SA).

METHOD

The baseline data of the stratified, randomised North-West Child Health Integrated with Learning and Development (NW-CHILD) longitudinal study were used. Grade 1 learners (N = 816, 420 boys, 396 girls, mean age 6.78+ years) from four school districts in the NWP of SA took part in the study. Indices of under-nutrition were determined by Z-scores (-2 standard deviation [s.d.]) for stunting (height-for-age [HAZ]) and wasting and underweight (Z-score for body mass index) using the 2007 World Health Organization reference sample. The Bruininks-Oseretsky Test of Motor Proficiency Short Form and the Visual Motor Integration fourth edition were used to assess different aspects of motor functioning, while school performance in mathematics, reading and writing was assessed by teachers according to the National South African standards of assessments.

RESULTS

Both HAZ and Z-score for weight-for-age correlated significantly with school performance and motor functioning skills (r > 2.0, p < 0.05), while visual perception was moderately associated (r < 0.30) with mathematics in HAZ and Z-score for weight-for-height (WHZ) children. Motor functioning of HAZ and WHZ children was significantly poorer (p < 0.05) compared to typical children, while underweight was not associated with any outcome variables.

CONCLUSION

Moderate forms of stunting and wasting influence school performance and motor functioning of school beginners negatively, while an association between visual perceptual abilities and inferior mathematics, reading and writing suggests a close link with inferior cognitive information processing in stunted and wasted children. These barriers should be addressed as poor scholastic success in Grade 1 may influence future school performance and the subsequent well-being of children.

Using kinematic analyses to explore sensorimotor control impairments in children with 22q11.2 deletion syndrome

BACKGROUND

The 22q11.2 deletion is associated with psychiatric and behavioural disorders, intellectual disability and multiple physical abnormalities. Recent research also indicates impaired coordination skills may be part of the clinical phenotype. This study aimed to characterise sensorimotor control abilities in children with 22q11.2 deletion syndrome (22q11.2DS) and investigate their relationships with co-occurring IQ impairments and psychopathology.

METHODS

Fifty-four children with 22q11.2DS and 24 unaffected sibling controls, comparable in age and gender, underwent kinematic analysis of their hand movements, whilst performing a battery of three visuo-manual coordination tasks that measured their tracking, aiming and steering abilities. Additionally, standardised assessments of full-scale IQ (FSIQ), attention deficit hyperactivity disorder, indicative autism spectrum disorder (ASD) and anxiety disorder symptomatology were conducted.

RESULTS

Children with 22q11.2DS showed deficits on seven of eight kinematic descriptors of movement quality across the three coordination tasks, compared to controls. Within 22q11.2DS cases, the extent of impairment on only three kinematic descriptors was significantly related to FSIQ after correction for multiple testing. Moreover, only error whilst visuo-manually tracking was nominally associated with ADHD symptom counts.

CONCLUSIONS

Impairments in sensorimotor control are seen on a range of visuo-manual tasks in children with 22q11.2DS but the extent of these impairments are largely unrelated to the severity of other psychopathological and intellectual impairments commonly found in children with 22q11.2DS.

Effect of interactive cognitive-motor training on eye-hand coordination and cognitive function in older adults

Background

Poor eye–hand coordination is associated with the symptoms of the early stage of cognitive decline. However, previous research on the eye–hand coordination of older adults without cognitive impairment is scant. Therefore, this study examined the effects of interactive cognitive-motor training on the visual-motor integration, visual perception, and motor coordination sub-abilities of the eye–hand coordination and cognitive function in older adults.

Methods

A double-blind randomized controlled trial was conducted with older adults. Sixty-two older adults were randomly assigned to the experimental (interactive cognitive-motor training) or active control (passive information activity) group, and both groups received 30 min of training each week, three times a week for 8 weeks. The primary outcome was eye–hand coordination, which was further divided into the sub-abilities of visual–motor integration, visual perception, and motor coordination. The secondary outcome was cognitive function. The generalized estimating equation was used to examine differences in immediate posttest, 3-month posttest, and 6-month posttest results between the two groups. Additionally, the baseline effect sizes were compared with the effect sizes of the immediate posttest, 3-month posttest, and 6-month posttests for the experimental group.

Results

There were no statistically significant differences between the intervention and control groups. The only statistically significant difference between the groups was in the attention dimension of cognitive function (p = 0.04). The visual–motor integration results showed a small to moderate effect size for pre post comparisons.

Conclusions

The 24 sessions of interactive cognitive-motor training showed no difference to an active control intervention. In the future, this intervention could be further investigated to establish whether it can be superior to an active control group in other populations.

Trial registration

The study protocol has been published on Chinese Clinical Trial Registry (ChiCTR) (registry no.: ChiCTR-IOR-14005490).

Electronic supplementary material

The online version of this article (10.1186/s12877-019-1029-y) contains supplementary material, which is available to authorized users.

Influence of Different Visual Perceptual Constructs on Academic Achievement Among Learners in the NW-CHILD Study

Visual perception plays an important and integrating role in the development of cognitive abilities and perceptual-motor skills. Visual perception comprises different independent constructs that may function in an integrative manner. This study aimed to determine whether (and the extent to which) various visual-perceptual constructs influence the academic achievement of 12-year-old school children. In a cross-sectional analysis, we extracted only 2016 data from 581 learners (mean age = 12.92 years, SD = 0.42) who were participants in the North-West Child Health, Integrated with Learning and Development longitudinal study (2010-2016). We used the Test of Visual Perceptual Skills, Third Edition, the North-West Provincial Assessment and mid-year school examination reports to determine visual perceptual abilities and academic achievement of this participant group. We calculated correlations between visual perceptual constructs and academic performance using Spearman rank order correlations and separately analyzed the influence of gender and socioeconomic status with independent T tests. Different visual perceptual constructs did have significant influences on specific areas of academic learning and on academic achievement generally ( r = .26 to r = .41). Spatial relationships showed slightly greater correlations with academic achievement ( r = .15 to r = .33) than did other basic visual perceptual constructs, possibly because spatial relationships are not completely developed at age 12. Complex and basic visual perceptual skills had medium significant retrospective correlations with grade point average ( r = .40 and r = .41) and first additional language ( r = .30 and r = .33). We concluded that basic and complex visual perceptual constructs remain important for academic achievement in this age-group, while gender and socioeconomic status influence both visual perceptual abilities and academic achievement.

Visual-Motor Integration in Children With Mild Intellectual Disability: A Meta-Analysis

Visual-motor integration (VMI) skills, defined as the coordination of fine motor and visual perceptual abilities, are a very good indicator of a child's overall level of functioning. Research has clearly established that children with intellectual disability (ID) have deficits in VMI skills. This article presents a meta-analytic review of 10 research studies involving 652 children with mild ID for which a VMI skills assessment was also available. We measured the standardized mean difference (Hedges' g) between scores on VMI tests of these children with mild ID and either typically developing children's VMI test scores in these studies or normative mean values on VMI tests used by the studies. While mild ID is defined in part by intelligence scores that are two to three standard deviations below those of typically developing children, the standardized mean difference of VMI differences between typically developing children and children with mild ID in this meta-analysis was 1.75 (95% CI [1.11, 2.38]). Thus, the intellectual and adaptive skill deficits of children with mild ID may be greater (perhaps especially due to their abstract and conceptual reasoning deficits) than their relative VMI deficits. We discuss the possible meaning of this relative VMI strength among children with mild ID and suggest that their stronger VMI skills may be a target for intensive academic interventions as a means of attenuating problems in adaptive functioning.

Visual perception and processing in children with 22q11.2 deletion syndrome: associations with social cognition measures of face identity and emotion recognition

BACKGROUND

People with 22q11.2 deletion syndrome (22q11DS) have difficulty processing social information including facial identity and emotion processing. However, difficulties with visual and attentional processes may play a role in difficulties observed with these social cognitive skills.

METHODS

A cross-sectional study investigated visual perception and processing as well as facial processing abilities in a group of 49 children and adolescents with 22q11DS and 30 age and socio-economic status-matched healthy sibling controls using the Birmingham Object Recognition Battery and face processing sub-tests from the MRC face processing skills battery.

RESULTS

The 22q11DS group demonstrated poorer performance on all measures of visual perception and processing, with greatest impairment on perceptual processes relating to form perception as well as object recognition and memory. In addition, form perception was found to make a significant and unique contribution to higher order social-perceptual processing (face identity) in the 22q11DS group.

CONCLUSIONS

The findings indicate evidence for impaired visual perception and processing capabilities in 22q11DS. In turn, these were found to influence cognitive skills needed for social processes such as facial identity recognition in the children with 22q11DS.

Visual-motor integration in children with Prader-Willi syndrome

BACKGROUND

Prader-Willi syndrome (PWS) is characterised by hypotonia, hypogonadism, short stature, obesity, behavioural problems, intellectual disability, and delay in language, social and motor development. There is very limited knowledge about visual-motor integration in children with PWS.

METHOD

Seventy-three children with PWS aged 7-17 years were included. Visual-motor integration was assessed using the Beery Visual-motor Integration test at the start of the study and after 2 years. The association between visual-motor integration and age, gender, genetic subtype and intelligence was assessed.

RESULTS

Children with PWS scored 'very low' (-3 standard deviations) in visual-motor integration and 'below average' (-1 standard deviation) in visual perception and motor coordination compared with typically developing children. Visual-motor integration was higher in children with a deletion (β = -0.170, P = 0.037), in older children (β = 0.222, P = 0.009) and in those with a higher total IQ (β = 0.784, P < 0.001). Visual perception was higher with a deletion (β = -0.193, P = 0.044) and higher IQ (β = -0.618, P < 0.001), but motor coordination was only higher with a higher total IQ (β = 0.429, P = 0.001). Visual perception and motor coordination were not associated with age or gender. There was a trend for visual-motor integration decline over the 2 year follow-up period (P = 0.099). Visual perception and motor coordination did not change over the follow-up period.

CONCLUSIONS

Visual-motor integration is very poor in children with PWS. Children scored higher on the time-limited subtests for visual perception and motor coordination than the combined test for visual-motor integration. Separation of visual-motor integration tasks into pure visual or motor tasks and allowing sufficient time to perform the tasks might improve daily activities, both at home and at school.