4D dynamic system for visual-motor integration analysis

It is very important to evaluate visual-motor integration (VMI), as it is used as an index to evaluate cognitive abilities. However, it is difficult to use the existing paper-based tests to evaluate the dynamic process, including spatial and depth perception abilities. Therefore, this study aims to extract kinematic and dynamic features for dynamic assessment for VMI. We propose a 4D dynamic analysis system that implements a VMI test in a virtual space using Leap motion controller and Unity3D and acquires the time-series data of hand joints and traces. We selected three categories of features: postural control ability, spatial and depth perception ability, and 4D analysis. The degree and patterns of postural maintenance differed between subjects in the VMI and MC tests. In addition, the personal patterns were identified with dynamic features, including their fluency and hesitation in relation to the task figures of the VMI test tool. As such, this system enables dynamic feature extraction and analysis which were previously impossible and presents performance results for healthy adults.

Bender-Gestalt II Test: Psychometric Properties with Global Scoring System on a Turkish Standardization Sample

The present study aims to standardize the Bender-Gestalt II Test by exploring its psychometric properties on a Turkish sample between the ages of 4 and 17 years and to obtain its normative values. The standardization sample consisted of 2691 students aged 4.0-17.11 years/months from low, middle, and high socioeconomic statuses, attending preschool, primary, and high school education. The participants were administered the Bender-Gestalt II Test and other tests, including the Gesell Developmental Schedules test, Colored Progressive Matrices Test, Goodenough Draw-a-Man Test, Test of Nonverbal Intelligence, Raven Standard Progressive Matrices Test, and Visual-Aural Digit Span Test-Revised Form, according to their age groups. The results revealed the absolute agreement values of the Copy items to be between .87 and .98. Thereafter, we calculated the test-retest reliability coefficients of the Copy scores to range from .74 to .67 by age groups, while the split-half reliability coefficients for each age group were between .62 and .87. The results of the exploratory and confirmatory factor analyses suggested its single-factor structure for all age groups. The Copy scores showed significant correlations and predicted the criterion characteristics, which include general cognitive ability, mental development/fine motor skills, short-term memory, and attention. Overall, the present study confirmed that the Bender-Gestalt II Test is a valid, reliable, and standardized measure to evaluate the visual-motor integration ability of those aged 4.0-17.11 years/months.

Gross, Fine and Visual-Motor Skills in Children with Language Disorder, Speech Sound Disorder and Their Combination

Increasing evidence shows that children with Communication Disorders (CDs) may show gross, fine, and visual-motor difficulties compared to children with typical development. Accordingly, the present study aims to characterize gross, fine and visual-motor skills in children with CDs, distinguishing children with CDs into three subgroups, i.e., with Language Disorders (LD), Speech Sound Disorders (SSD), and LD + SSD. In Experiment 1, around 60% of children with CDs (4 to 7 years; 21 with LD, 36 with SSD, and 90 with LD + SSD) showed clinical/borderline scores in balance skills, regardless of the type of communication deficit. However, children with LD, SSD, and LD + SSD did not differ in gross and fine motor skills. In Experiment 2, a higher percentage of children with CDs (4 to 7 years; 34 with LD, 62 with SSD, 148 with LD + SSD) obtained clinical/borderline scores in Visual Perception skills. Moreover, children with LD + SSD performed significantly worsen in Visual Perception and Fine Motor Coordination skills compared to children with SSD only. Our results underlined that CDs are generally associated with gross motor difficulties and that visual-motor difficulties are related to the type of communication deficit. Paying earlier attention to the motor skills of children with CDs could help clinicians design effective interventions.

Comparison of Visual Motor Integration, Participation and Hand Skills in Children with and Without Type 1 Diabetes

Our aim in this study was to compare hand skills, visual-motor integration ability, and participation in daily living activities of children with and without Type 1 diabetes (T1DM). In this prospective cross-sectional study, we included 44 children withT1DM (17 males, 27 females; aged 8-12 years) and a control group of 45 healthy age-matched children without T1DM (22 males, 23 females). We compared group scores on the Jebsen-Taylor Hand Function Test (JTHFT), the Beery-Buktenica Developmental Visual Motor Integration Test (Beery VMI), and on the Participation and Environment Measure - Children and Youth (PEM-CY). The JTHFT and Beery VMI scores of children with T1DM were significantly lower than those of the control group (p ≤ 0.005); on the PEM-CY, children with T1DM were found to have more barriers in the community than controls. Relative deficits in hand skills and visual motor integration of children with T1DM should be managed with greater attention and assistance.

Establishing Normative Data for the Number Cancelation Test Among Children in Kindergartens and Primary Schools in China

This study aimed to suggest an attention assessment tool using a Digital Pen for measuring the temporal-spatial parameters during the Number Cancelation Test (NCT), and then to establish the normative data for the NCT among children in kindergartens and primary schools in China by recruiting a total of 989 children (496 males). Four measures, i.e., selective attention (SA), speed of cognitive processing (SpC), averaged time of circlings (ATC), and averaged circumference of circled curves (ACCC), were proposed to evaluate the NCT performance. They basically have a development trend with fast speed in the beginning before Grade 1 or 2 of primary schools, and then enter an extremely slow development period (with ceiling or floor effect). SA and SpC have gender and grade main effects, while ATC and ACCC have the grade main effect, only. In particular, females have higher SA scores than males in middle class of kindergarten, and Grade 2-Grade 5 of primary school, but no gender differences in other grades; females have higher SpC scores than males in middle class of kindergarten, and Grade 3-4 of primary school, but no gender differences in other grades. More importantly, in clinical practice, if SA or SpC measure of a child is below than the 5th centile (i.e., p5 level) of his/her grade-specific normative data, then this child may be predicted to have a high-risk of learning disabilities. Findings suggest that the proposed method can be used for early screening of learning disabilities by setting appropriate cut-off values.

Is there a relation between visual motor integration and academic achievement in school-aged children with and without ADHD?

Visual-motor integration, motor coordination, and visual perception are associated with academic achievement in early school-aged children; however, our understanding of these associations in older school-aged children and children with neurodevelopmental disorders is limited. A well-characterized, clinically evaluated sample of 39 children with and without ADHD ages 8-13 (M = 10.07, SD = 1.56; 14 girls; 67.5% White/non-Hispanic) were administered standardized academic and visual-motor integration tests. Results: Backward entry regression analyses that initially included age, sex, socioeconomic status, ADHD symptoms, comorbidities, and IQ revealed that better visual perception uniquely predicted better-developed reading (β = .38) and math skills (β = .21; both p < .03), whereas better motor coordination was associated with better reading (β = .25), writing (β = .50), and math skills (β = .21 all p < .05). The integration of visual perception and motor coordination processes was uniquely associated only with math skills (β = .28; p = .007). Children with ADHD exhibited significantly lower visual-motor integration (d = 1.16) and potentially motor coordination (d = 0.51), but did not differ from Non-ADHD children in terms of visual perception (d = 0.03). These findings extend prior evidence from younger, neurotypical samples, and indicate that underdeveloped visual-motor integration and/or its subcomponents (visual perception and motor coordination) reflect unique risk factors for academic underachievement in school-aged children's math, reading, and written language skills.

Efficacy of Visual Training Program for Students with Visual Impairment

This pilot study investigated the effects of a visual training program for students with low vision. A pre and post design was used. The Beery-Buktenica Developmental Test of Visual-Motor Integration and the Test of Visual-Perceptual Skills were used to assess the perceptual and visual motor skills of fifteen students with low vision. Their mean age was (8.47 ± 1.12); and the mean of their visual acuity of was (0.12 ± 0.11). The three-part intervention program (physical worksheets, a computer-based intervention program, activities of visual perceptual skills) was implemented over four weeks (three sessions/week). Kruskal Wallis tests were used to examine the effect of visual acuity on the progress achieved, and the Wilcoxon-Signed Ranks test was used to identify differences in the scores pre-post intervention. Results showed statistically significant improvement in the visual perceptual and visual-motor integration skills. There was not any statistically significant effect of visual acuity on the progress achieved.

Bilingualism May Be Protective Against Executive Function and Visual Processing Deficits Among Children With Attention Problems

Objective: The current study examined how the opposing effects of bilingualism and attention problems operate on executive functioning, visual processing, and verbal fluency in children with clinically significant levels of attention problems. Method: We tested whether bilingualism moderated associations between attention problems and visual processing, executive functioning, and verbal fluency. Results: Bilingual children (n = 331) showed visual processing advantages relative to their monolingual peers (n = 165), but only at higher, and not lower, levels of attention problems. Bilingualism did not moderate the association between attention problems and interference control; however, across all children, those with higher levels of attention problems had more difficulty with interference control. Monolingual children demonstrated advantages in verbal fluency relative to bilingual children, but this did not vary with attention problems. Conclusion: Visual processing advantages in bilinguals are detected among children with heightened attention problems, but advantages in interference control are not; findings may have implications for classroom interventions.

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

AIM

To assess visual-motor integration in young adults previously included in a prospective study on the incidence of retinopathy of prematurity (ROP).

METHODS

The study encompassed 59 preterm individuals, born 1988-1990, with a birth weight ≤1500 g, and 44 full-term controls, aged 25-29 years. Ophthalmological examination, including visual acuity and contrast sensitivity, and the Beery Visual-Motor Integration (VMI) with supplemental tests of visual perception and motor coordination, were performed. A short questionnaire was filled in.

RESULTS

The preterm individuals had significantly lower scores than the controls in all VMI tests, median values and interquartile ranges: Beery VMI 87 (21) vs 103 (11), visual perception 97 (15) vs 101 (8) and motor coordination 97 (21) vs 102 (15), respectively. Within the preterm group, no correlations were found between the VMI tests and ROP, gestational age, birth weight or visual acuity. Contrast sensitivity was correlated to visual perception. Neurological complication at 2.5 years was a risk factor for lower scores on Beery VMI. The preterm subjects reported six times as many health problems as compared to the controls.

CONCLUSION

Being born preterm seemed to have life-long effects. This study shows that visual-motor integration was affected in young adults born preterm.

Handwriting Readiness among Digital Native Kindergarten Students

Aims: Handwriting is an essential life skill, impacted by proficiency in visual-motor integration and fine motor control. The increase in the use of digital technology has changed the way children interact with their environments, and potentially, the development of the important requisite skills for handwriting. This study examined the "handwriting readiness" skills of children born in the digital age.Methods: 219 children in their first year of formal schooling (mean age = 5 years, 10 months), completed the Beery Buktenica Developmental Test of Visual Motor Integration (Beery-VMI) and the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) Short Form to assess visual motor integration, overall motor proficiency, and fine motor proficiency. Pencil grasp was also observed. Data analysis consisted of descriptive statistics and comparison to established normative data using summary t-tests.Results: Participants met the expected performance level on the Beery-VMI and the manual dexterity subtest of the BOT-2. However, overall motor proficiency on the BOT-2 for our sample was lower than published normative data. Further, 60.3% of participants used static pencil grasps.Conclusions: The findings prompt us to question the potential contribution of digital technology to changes in motor performance among children in the digital age.

Relationship Between the Performance of Self-Care and Visual Perception Among Young Children With Autism Spectrum Disorder and Typical Developing Children

Studies investigating the performance of self-care and visual perception in young children with autism spectrum disorder (ASD) are limited. The relationship between self-care performance and visual perception ability in young children with ASD is not yet clearly understood. Here, self-care performance was evaluated by the caregivers and therapists of children with ASD. The differences in self-care performance and visual perception ability were investigated in 66 children with ASD and 66 typically developing (TD) children between the ages of 48-83 months. The relationships between self-care and visual perception were tested in both two groups. The Assessment of Motor and Process Skills (AMPS) and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C) were used to assess the children's self-care performance. The Test of Visual Perceptual Skills-Third Edition (TVPS-3) and the Developmental Test of Visual Perception-Third Edition (DTVP-3) were used to evaluate visual perception ability. Young children with ASD obtained significantly lower scores for self-care performance (AMPS and PEDI-C) and visual perception ability (TVPS-3 and DTVP) compared with TD children. Additionally, positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD. The findings of this research highlight the need for pediatric practitioners to include self-care and visual-motor integration evaluations for young children with ASD. LAY SUMMARY: Young children with ASD obtained significantly lower scores for self-care performance and visual perception ability compared with TD children. Positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD.

Who Benefits from An Intervention Program on Foundational Skills for Handwriting Addressed to Kindergarten Children and First Graders?

This study examined the effectiveness of a 10-wk intervention program based on occupational therapy principles on visual-motor integration skills and fine motor abilities in kindergartners and first graders. We recruited 55 students tested three times with the Visual-Motor Integration Test (VMI) and Movement Assessment Battery for Children-2 (MABC-2): before the intervention (T1), post-intervention (T2) and one month later (T3). Research findings: Significant improvements were found on VMI between T1 and T2, particularly for kindergartners. Neither group of children demonstrated changes on manual dexterity scores. The present study showed that the intervention program led to different changes in the at-risk of motor impairment group than in the not at-risk children. Results indicated that games and stimulation activities helped children below the 16th percentile over time in the manual dexterity domain. A gender effect was observed, with female children increasing their abilities over time more than male peers. Future research should concentrate on stimulating fine motor skills in hand manipulation and test how these abilities influence graphomotor skills and handwriting over time. Finally, more research is needed to determine the impact of activities and games carried out in educational settings.

Relationship between screen-time and hand function, play and sensory processing in children without disabilities aged 4-7 years: A exploratory study

INTRODUCTION

Screen-time has become a regular occupation for young children at home and school, with little evidence of its impact on children's developmental skills. This study explored the association between children's screen-time, fine motor, in-hand manipulation (IHM), visual-motor integration (VMI), sensory processing (SP) and parent-reported play skills.

METHOD

The fine motor, IHM, VMI, SP and play skills of a sample of 25 Australian children without disabilities (M age = 6.2 years, SD = 1.03; 64% girls) were assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Test of In-Hand Manipulation-Revised, Berry Buktenica Developmental Test of Visual-Motor Integration Sixth Edition, Sensory Processing Measure-Home Form and Pretend Play Enjoyment Developmental Checklist (PPEDC). Parents completed a week-long log of their child's screen-time. Spearman's rho correlations and linear regressions with bootstrapping were used for data analysis.

RESULTS

Statistically significant moderate level negative correlations were found between Total Screen-Time (TST) and VMI skills (r = -.67, p < .01); Interactive Screen-Time and IHM abilities (r = -.46, p < .05) and TST and bilateral coordination skills (r = -.42, p < .05). There were significant negative correlations between SP ability and both TST (r = -.53, p < .01) and Watching Screen-Time (r = -.66, p < .01). When the PPEDC Object Substitution variable was entered into a regression model as a co-variate of hand function, it appeared to lessen the impact of TST as an independent predictor variable of children's VMI and bilateral coordination skills (p < .23 and p < .61).

CONCLUSION

Playing with toys and using object substitution in play (e.g. a child uses an object for something else other than its intended use when playing with it) potentially appear to be a moderating factor of the impact of children's screen-time on their bilateral coordination and VMI skills. Clinicians can encourage children's active and dynamic involvement in games and play pursuits to counteract the potential impact of increased use of devices that involve screen-time.

Augmented Biofeedback Training with Physical Therapy Improves Visual-Motor Integration, Visual Perception, and Motor Coordination in Children with Spastic Hemiplegic Cerebral Palsy: A Randomised Control Trial

Aim: The aim of this study is to investigate the efficacy of combining augmented biofeedback training and standard therapy for improving visual-motor integration (VMI), visual perception (VP), and motor coordination (MC) in children with spastic cerebral palsy (CP).Methods: Participants were 45 children, 5-8 years of age, with spastic hemiplegic CP. They were randomized into three groups: group A followed a 3-month specially designed program physical therapy intervention to facilitate VMI and VP. Group B received augmented biofeedback training. Group C received augmented biofeedback training and the physical therapy program provided to group A. The treatment sessions lasted 60 min, three times a week for three months. The Beery-Buktenica Developmental Test of VMI and its supplemental tests were used to evaluate the children before and after the program.Results: After a 3-month treatment, standard scores and age equivalent scores for VMI, VP, and MC were significantly higher in group C compared with group A.Conclusion: The combination of augmented biofeedback and physical therapy could be used to improve VMI, VP, and MC in children with spastic hemiplegic CP.

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.

Fine Motor Skill Mediates Visual Memory Ability with Microstructural Neuro-correlates in Cerebellar Peduncles in Prematurely Born Adolescents

Adolescents born preterm (PT) with no evidence of neonatal brain injury are at risk of deficits in visual memory and fine motor skills that diminish academic performance. The association between these deficits and white matter microstructure is relatively unexplored. We studied 190 PTs with no brain injury and 92 term controls at age 16 years. The Rey-Osterrieth Complex Figure Test (ROCF), the Beery visual-motor integration (VMI), and the Grooved Pegboard Test (GPT) were collected for all participants, while a subset (40 PTs and 40 terms) underwent diffusion-weighted magnetic resonance imaging. PTs performed more poorly than terms on ROCF, VMI, and GPT (all P < 0.01). Mediation analysis showed fine motor skill (GPT score) significantly mediates group difference in ROCF and VMI (all P < 0.001). PTs showed a negative correlation (P < 0.05, corrected) between fractional anisotropy (FA) in the bilateral middle cerebellar peduncles and GPT score, with higher FA correlating to lower (faster task completion) GPT scores, and between FA in the right superior cerebellar peduncle and ROCF scores. PTs also had a positive correlation (P < 0.05, corrected) between VMI and left middle cerebellar peduncle FA. Novel strategies to target fine motor skills and the cerebellum may help PTs reach their full academic potential.

Visual-motor integration, visual perception and motor coordination in a population with Williams syndrome and in typically developing children

BACKGROUND

Williams syndrome (WS) is characterised by severe deficits in visual-spatial abilities in contrast to relatively well-developed language abilities. There is very limited knowledge about visual-motor integration (VMI) in people with WS.

METHOD

Twenty-six participants with WS aged 6 to 41 years were assessed with all three tests of the Beery-VMI test, namely the VMI test, the visual perception test (VP) and the motor coordination test (MC). Their results were compared with those of 154 typically developing children (TD) aged 4 to 12.

RESULTS

No influence of age on the three tested abilities was found amongst the participants with WS in comparison with the TD children. The participants with WS scored similarly to the 5-year-old TD children in all three tasks; their scores on the VMI correlated with the results on the VP and MC tests, which were similar to those of the TD children. Finally, the scores on the non-verbal intelligence test (Raven Coloured Progressive Matrices) were highly predictive of the scores in the VMI and VP tests and partially explain the variance in the MC scores.

CONCLUSIONS

The present study is the first to use all three tasks of the Beery-VMI test. For the TD children, the performances on the three subtests did not show the same developmental trajectory. In contrast, the participants with WS did not show the same developmental trajectory. The participants with WS exhibited poor performances on all tasks with scores comparable with the 5-year-old TD children. As high correlations between these abilities were observed, improving VP and MC could help the development of VMI, which in turn could improve visual-spatial abilities in individuals with WS.

Visual-motor integration performance in children with severe specific language impairment

BACKGROUND

This study investigated (1) the visual-motor integration (VMI) performance of children with severe specific language impairment (SLI), and any effect of age, gender, socio-economic status and concomitant speech impairment; and (2) the relationship between language and VMI performance. It is hypothesized that children with severe SLI would present with VMI problems irrespective of gender and socio-economic status; however, VMI deficits will be more pronounced in younger children and those with concomitant speech impairment. Furthermore, it is hypothesized that there will be a relationship between VMI and language performance, particularly in receptive scores.

METHODS

Children enrolled between 2000 and 2008 in a school dedicated to children with severe speech-language impairments were included, if they met the criteria for severe SLI with or without concomitant speech impairment which was verified by a government organization. Results from all initial standardized language and VMI assessments found during a retrospective review of chart files were included.

RESULTS

The final study group included 100 children (males = 76), from 4 to 14 years of age with mean language scores at least 2SD below the mean. For VMI performance, 52% of the children scored below -1SD, with 25% of the total group scoring more than 1.5SD below the mean. Age, gender and the addition of a speech impairment did not impact on VMI performance; however, children living in disadvantaged suburbs scored significantly better than children residing in advantaged suburbs. Receptive language scores of the Clinical Evaluation of Language Fundamentals was the only score associated with and able to predict VMI performance.

CONCLUSIONS

A small subgroup of children with severe SLI will also have poor VMI skills. The best predictor of poor VMI is receptive language scores on the Clinical Evaluation of Language Fundamentals. Children with poor receptive language performance may benefit from VMI assessment and multidisciplinary management.

Oxidative Stress, Motor Abilities, and Behavioral Adjustment in Children Treated for Acute Lymphoblastic Leukemia

PURPOSE/OBJECTIVES

To examine associations among oxidative stress, fine and visual-motor abilities, and behavioral adjustment in children receiving chemotherapy for acute lymphoblastic leukemia (ALL)
.

DESIGN

A prospective, repeated-measures design
.

SETTING

Two pediatric oncology settings in the southwestern United States.

SAMPLE

89 children with ALL were followed from diagnosis to the end of chemotherapy.

METHODS

Serial cerebrospinal fluid samples were collected during scheduled lumbar punctures and analyzed for oxidative stress biomarkers. Children completed fine motor dexterity, visual processing speed, and visual-motor integration measures at three time points. Parents completed child behavior ratings at the same times.

MAIN RESEARCH VARIABLES

Oxidative stress, fine motor dexterity, visual processing, visual-motor integration, and behavioral adjustment
.

FINDINGS

Children with ALL had below-average fine motor dexterity, visual processing speed, and visual-motor integration following the induction phase of ALL therapy. By end of therapy, visual processing speed normalized, and fine motor dexterity and visual-motor integration remained below average. Oxidative stress measures correlated with fine motor dexterity and visual-motor integration. Decreased motor functioning was associated with increased hyperactivity and anxiety
.

CONCLUSIONS

Oxidative stress occurs following chemo-therapy for childhood ALL and is related to impaired fine motor skills and visual symptoms
.

IMPLICATIONS FOR NURSING

Early intervention should be considered to prevent fine motor and visual-spatial deficits, as well as behavioral problems.

Validity and Reliability of the Developmental Test of Visual Perception - Third Edition (DTVP-3)

The Developmental Test of Visual Perception - Third Edition (DTVP-3) is a recently published revision of a visual perceptual test from the United States, frequently used by occupational therapists. It is important that tests have adequate documented reliability and validity and are evaluated in cross-cultural contexts. The purpose of the study was to assess the reliability and validity of the DTVP-3 when completed by a group of Australian participants. Thirty-nine typically developing children 6-8 years of age completed the DTVP-3 and the Developmental Test of Visual-Motor Integration - 6th edition (VMI-6). The internal consistency of the DVTP-3 was assessed using Cronbach alpha coefficients and the DTVP-3's convergent validity was examined by correlating it with the VMI-6 and its two supplementary tests. The five DTVP-3 subscales' Cronbach alpha coefficients ranged from.60 to.80 while its three composite indexes had coefficients all at the.80 level. The VMI-6 was significantly correlated with the DTVP-3 Figure Ground and Visual Closure subscales and the Motor-Reduced Visual Perception Index (MRVPI). The VMI-6 Visual Perception Supplementary Test was significantly correlated with the DTVP-3 Figure Ground, Visual Closure, Form Constancy, MRVPI, and General Visual Perception Index. The DTVP-3 exhibited acceptable levels of internal consistency and moderate levels of convergent validity with the VMI-6 when completed by a group of Australian children.

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.

Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI): lessons from exploration of cultural variations in visual-motor integration performance of preschoolers

BACKGROUND

Visual-motor integration (VMI) is important in children's development because it is associated with the performance of many functional skills. Deficits in VMI have been linked to difficulties in academic performance and functional tasks. Clinical assessment experience of occupational therapists in Singapore suggested that there is a potential difference between the VMI performance of Singaporean and American children. Cross-cultural studies also implied that culture has an influence on a child's VMI performance, as it shapes the activities that a child participates in. The purpose of this study was to (1) explore if there was a difference between the VMI performance of Singaporean and American preschoolers, and (2) determine if there were ethnic differences in the VMI performance of Singaporean preschoolers.

METHODS

The Beery-VMI, which was standardized in America, is commonly used by occupational therapists in Singapore to assess the VMI ability of children. We administered the Beery-VMI (fifth edition) full form test (excluding the supplemental tests) to 385 preschoolers (mean age = 63.3 months) from randomly selected schools in Singapore. We compared the scores of Singaporean preschoolers with those of the American standardization norms using the one-sample t-test. Scores of different ethnic groups among the Singapore population were also compared using a one-way anova, followed by the Bonferroni post-hoc test.

RESULTS

Singaporean preschoolers and the standardization sample of American children performed significantly differently in all age groups (P < 0.05). Among the Singapore population, the scores were also significantly different (P < 0.05) between the (i) Chinese and Malay and (ii) Chinese and Indians ethnic groups.

CONCLUSION

Preschoolers from different cultural and ethnic groups had different VMI performance. Certain cultural beliefs and practices may affect VMI performance. Clinicians should exercise caution when using an assessment in communities and cultures outside the ones on which it was standardized.