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.

BACKGROUND: In 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. METHOD: Eighty-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. RESULTS: The 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.). CONCLUSIONS: Beery 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.

Cognitive health outcomes of fundamental motor skill applications in children through cooperative learning method.

BACKGROUND: Previous research has suggests that cooperative learning methods and the development of fundamental motor skills support children's cognitive development, and further studies covering various aspects are recommended. In this study, as an alternative to traditional physical education classes including fundamental motor skill activities, we investigated the impact of cooperative learning methods incorporating these skills on children's visual-motor integration and selective attention. METHODS: A total of 60 boy children in the 10-11 age range were included in the study. Groups; classical method (10.95 ± 0.58age), and cooperative learning group (10.91 ± 0.42age). The study spanned a total of 24 physical education class hours. While the classical method group continued to attend physical education lessons with an FMS-based prepared program for 8 weeks, cooperative learning group participated in an FMS-based program prepared according to the cooperative learning method (40min/3days/8weeks).At the beginning and end of the study, children underwent the Bender-Gestalt test and the d2 test of attention. RESULTS: Within-group pre-post test comparisons revealed improvement in visual-motor integration and selective attention for both the classical method and cooperative learning groups. In between-group post-test comparisons, the cooperative learning group demonstrated greater improvement in visual-motor integration and selective attention parameters compared to the classical method. CONCLUSION: The results support increasing the inclusion of fundamental motor skill activities in physical education classes and advocating for the use of cooperative learning methods in these classes. Enhancements in visual-motor integration and selective attention may contribute to children forming quality relationships, enjoying activities, learning stress management, and developing as a group.

Long-term outcomes of visual motor integration and motor development children with retinopathy of prematurity.

Premature infants have a risk of neurodevelopmental deficits. Little is known, however, about how retinopathy of prematurity (ROP) affects visual motor integration (VMI), which is necessary for both fine motor skills and further school abilities. Due to the systemic escape of bevacizumab in the treatment of ROP, concerns regarding the long-term neurodevelopmental effect of the drug have arisen. The aim is to evaluate VMI and motor development long-term outcomes after intravitreal bevacizumab (IVB) injection and laser treatment for ROP. Two groups of premature children were included: Bevacizumab group - 16 premature children who received IVB treatment and laser group - 23 premature children who underwent laser photocoagulation treatment in this single center cross-sectional study. At 2-6 years of age, VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status were assessed. The incidence of abnormal visual function was significantly higher in bevacizumab group than in laser group (p = 0.022). The incidence of abnormal VMI skill was significantly higher in bevacizumab group than in laser group (p = 0.024). Incidences of abnormal gross, fine, and total motor skills were significantly higher in bevacizumab group compared to laser group (p < 0.05). Premature children who received bevacizumab for ROP demonstrated significantly lower VMI and motor development features than those with laser treatment at preschool age. Although our results suggest the relevance of bevacizumab injection in impaired VMI and motor development outcomes, general level of sickness rather than treatment might be the cause of delayed motor development.

Factors associated with mathematical capacity in children with Developmental Coordination Disorder.

BACKGROUND: Developmental Coordination Disorder (DCD) is a condition characterized by difficulties in motor planning and coordination and affects 5 to 6% of all school-aged children. Children with DCD frequently present with difficulties with academic activities such as handwriting. However, no study to date has comprehensively described mathematical capacity and its potential associated factors in this high-risk group. AIMS: We aimed to describe the frequency and nature of mathematical difficulties of school-aged children with DCD and to evaluate potential factors associated with mathematical performance. METHODS: A total of 55 elementary school-aged children with DCD underwent comprehensive standardized assessments of mathematical, visuoperceptual (VP), attentional, visual-motor integration (VMI), and motor skills. The contribution of each factor to mathematical capacity was established using hierarchical multivariate linear regression models. RESULTS: Children with DCD (9.1 ± 1.5 years, 44 males) had lower overall mathematical capacity compared to normative data (-0.59 SD) on the KeyMath 3rd edition, with poorer performance in basic concepts and problem-solving. Thirty-eight percent of the sample performed below the 15th percentile in overall mathematical skills. VP skills were the most important factors associated with most mathematical domains. Thirty-four percent of the variance of overall mathematical capacity was explained by VP skills, inattention, VMI and motor impairments while controlling for household income (F [5,49]=5.029, p < .0001). CONCLUSION: Children with DCD present with mathematical difficulties in basic concepts and problem-solving, which are partially explained by VP skills. Our findings stress the important of systematically assessing mathematical difficulties children with DCD to ensure they receive the necessary support that leads to academic success.

Changes in effective connectivity during the visual-motor integration tasks: a preliminary f-NIRS study.

BACKGROUND: Visual-motor integration (VMI) is an essential skill in daily life. The present study aimed to use functional near-infrared spectroscopy (fNIRS) technology to explore the effective connectivity (EC) changes among brain regions during VMI activities of varying difficulty levels. METHODS: A total of 17 healthy participants were recruited for the study. Continuous Performance Test (CPT), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), and Beery VMI test were used to evaluate attention performance, executive function, and VMI performance. Granger causality analysis was performed for the VMI task data to obtain the EC matrix for all participants. One-way ANOVA analysis was used to identify VMI load-dependent EC values among different task difficulty levels from brain network and channel perspectives, and partial correlation analysis was used to explore the relationship between VMI load-dependent EC values and behavioral performance. RESULTS: We found that the EC values of dorsal attention network (DAN) → default mode network (DMN), DAN → ventral attention network (VAN), DAN → frontoparietal network (FPN), and DAN → somatomotor network (SMN) in the complex condition were higher than those in the simple and moderate conditions. Further channel analyses indicated that the EC values of the right superior parietal lobule (SPL) → right superior frontal gyrus (SFG), right middle occipital gyrus (MOG) → left SFG, and right MOG → right postcentral gyrus (PCG) in the complex condition were higher than those in the simple and moderate conditions. Subsequent partial correlation analysis revealed that the EC values from DAN to DMN, VAN, and SMN were positively correlated with executive function and VMI performance. Furthermore, the EC values of right MOG → left SFG and right MOG → right PCG were positively correlated with attention performance. CONCLUSIONS: The DAN is actively involved during the VMI task and thus may play a critical role in VMI processes, in which two key brain regions (right SPL, right MOG) may contribute to the EC changes in response to increasing VMI load. Meanwhile, bilateral SFG and right PCG may also be closely related to the VMI performance.

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

BACKGROUND: Children 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. METHODS: Twenty-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. RESULTS: Significant 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. CONCLUSIONS: This 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 assess SP/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.

Visual Function and Neuropsychological Profiling of Idiopathic Infantile Nystagmus.

Though considered a benign condition, idiopathic infantile nystagmus (IIN) may be associated with decreased visual acuity and oculo-motor abnormalities, resulting in developmental delays and poor academic performance. Nevertheless, the specific visual function profile of IIN and its possible impact on neuropsychological development have been poorly investigated. To fill this gap, we retrospectively collected the clinical data of 60 children presenting with IIN over a 10-year period (43 male; mean age of 7 years, range of 2 months-17 years, 9 months). The majority of the subjects in our cohort presented with reduced visual acuity for far distances and normal visual acuity for near distances, associated with oculo-motor abnormalities. The overall scores of cognitive and visual-cognitive tests were in the normal range, but revealed peculiar cognitive and visual-cognitive profiles, defined by specific frailties in processing speed and visual-motor integration. The same neuropsychological profiles characterize many neurodevelopmental disorders and may express a transnosographic vulnerability of the dorsal stream. As the first study to explore the neuropsychologic competencies in children with IIN, our study unveils the presence of subclinical frailties that need to be addressed to sustain academic and social inclusion.

The Impact of School Closures during COVID-19 Lockdown on Visual-Motor Integration and Block Design Performance: A Comparison of Two Cohorts of Preschool Children.

The COVID-19 outbreak has led to the closure of educational institutions, which may prevent children from attaining skills essential for learning, such as visual-motor integration (VMI) and visuospatial constructional ability (often reflected with the Block Design Test, BDT). This study compares VMI and BDT performance between a pre-pandemic cohort (children who attended preschool in late 2019) and a post-pandemic cohort (those physically attending preschool for the first time at the end of 2021). Participants were children attending government preschools with similar syllabi catered for low-income families. The pre-pandemic cohort was part of an earlier study (n = 202 for VMI and n = 220 for BDT) before lockdowns commenced in March 2020. The post-pandemic cohort comprised 197 children who completed the Beery-VMI and 93 children who completed the BDT. Compared to the pre-pandemic cohort, the post-pandemic cohort had significantly lower mean Beery-VMI scores (t(397) = 3.054, p = 0.002) and was 3.162-times more likely to have a below average Beery-VMI score (OR = 3.162 (95% CI 1.349, 7.411)). The post-pandemic cohort also had significantly lower BDT scores than the pre-pandemic cohort (t(311) = -5.866, p < 0.001). In conclusion, children with disrupted conventional preschool education due to the COVID-19 lockdowns were more likely to have below-average VMI and lower BDT scores.

Associations Between Autism Spectrum Quotient and Integration of Visual Stimuli in 9-year-old Children: Preliminary Evidence of Sex Differences.

PURPOSE: The dorsal stream vulnerability hypothesis posits that the dorsal stream, responsible for visual motion and visuo-motor processing, may be particularly vulnerable during neurodevelopment. Consistent with this, autism spectrum disorder (ASD) has been associated with deficits in global motion integration, though deficits in ventral stream tasks, such as form identification, have also been reported. In the current study, we examined whether a similar pattern of results is found in a cohort of 381 children born with neurodevelopmental risk factors and exhibiting a wide spectrum of caregiver-reported autistic traits. METHODS: We examined the associations between global motion perception, global form perception, fine motor function, visual-motor integration, and autistic traits (autism spectrum quotient, AQ) using linear regression, accounting for possible interactions with sex and other factors relevant to neurodevelopment. RESULTS: All assessments of dorsal stream function were significantly associated with AQ such that worse performance predicted higher AQ scores. We also observed a significant sex interaction, with worse global form perception associated with higher AQ in boys (n = 202) but not girls (n = 179). CONCLUSION: We found widespread associations between dorsal stream functions and autistic traits. These associations were observed in a large group of children with a range of AQ scores, demonstrating a range of visual function across the full spectrum of autistic traits. In addition, ventral function was associated with AQ in boys but not girls. Sex differences in the associations between visual processing and neurodevelopment should be considered in the designs of future studies.

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.

Impact of Retinopathy of Prematurity on Visual Motor Integration.

BACKGROUND: Preterm infants are at risk for neurodevelopmental deficits. An association between retinopathy of prematurity (ROP) and impaired cognitive outcome has already been described. However, less is known about the impact of ROP on visual motor integration (VMI), which is a prerequisite not only for fine motor abilities but also for further school skills. Therefore, the aim of this study was to retrospectively investigate the impact of ROP on VMI at preschool age. METHODS: The study was conducted at the Medical University of Vienna, including patients born between January 2009 and December 2014 with a gestational age of less than 30 weeks and/or a birth weight of less than 1,500 g. VMI was determined by Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI) at the age of 5 years. RESULTS: Out of 1,365 patients, 353 met inclusion criteria for this study. Two hundred sixteen of them had no ROP, while 137 had ROP (stage 1: n = 23, stage 2: n = 74, stage 3: n = 40). Mean value of the Beery VMI score was significantly lower in the ROP group compared to the No-ROP group (90 ± 16 vs. 99 ± 14; p < 0.01). By correcting for other important medical conditions, ROP still had a significant impact on Beery VMI score (p < 0.01). Particularly, lower scores were found for stage 2 (p < 0.01) and stage 3 (p < 0.01). CONCLUSION: Beery VMI scores were significantly lower in preterm infants with ROP stage 2 and 3 than in infants without ROP. This study shows the negative impact of ROP on VMI skills at preschool age, even after adjustment for key demographic and medical characteristics.

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.

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.

Mediating effect of sequential memory on the relationship between visual-motor integration and self-care performance in young children with autism spectrum disorder.

Objective: Visual perception is a skill that contributes to the performance of self-care and important development tasks in early childhood. The relationship between self-care and visual perception is especially significant for young children with autism spectrum disorder (ASD), who have been described as visual learners. However, this relationship is not clearly understood among young children with ASD. We investigated the role of motor-free visual perception on the relationship between self-care and visual-motor integration in young children with ASD. Methods: A sample of 66 children with ASD aged 48 to 83 months were recruited. Measurements included the Assessment of Motor and Process Skills, the Developmental Test of Visual Perception-Third Edition, and Test of Visual-Perceptual Skills-Third Edition. Results: The results indicated that self-care performance had significant positive correlations with visual-motor integration, visual discrimination, visual memory, visual spatial relationships, and visual sequential memory. Of these, visual sequential memory and visual spatial relationships were the main factors related to self-care performance. Sequential memory was a mediator of the relationship between visual-motor integration and self-care performance. Conclusion: This study establishes a deeper understanding of self-care and motor-free visual perception among young children with ASD. Understanding the relationship between visual perception and self-care in young children with ASD may aid professionals in providing self-care interventions for this population.

Comparisons of Children with and without Type I Diabetes on Hand and Visual Motor Integration Skills and on Participation in Daily Activities.

Our aim in this study was to compare hand skills, visual-motor integration skills, 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 with T1DM (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 the Participation and Environment Measure - Children and Youth (PEM-CY). 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 participation 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.

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.

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.

Antenatal steroids and neurodevelopment in 12-year-old children born extremely preterm.

AIM: To investigate neurodevelopmental outcome in 12-year-old children born very preterm in relation to perinatal, neonatal and socioeconomic variables. To examine whether previously described positive effects of antenatal steroids on cognition persist at 12 years. METHODS: Prospective cohort, 78 children with gestational ages 22.7-31.9 weeks, born in 2004-2007 and examined at 12 years of age with cognitive, motor and visual motor integration tasks and compared to an age-matched control group (n = 50). Two preterm subgroups were studied: very preterm children (28-31 gestational weeks, n = 53) and extremely preterm children (22-27 gestational weeks, n = 25). RESULTS: The preterm children had significantly lower scores on all cognitive, motor and visual motor integration tasks than the controls. Gestational age and maternal education influenced associations differently in the two preterm subgroups. Also, severe retinopathy of prematurity demonstrated strong associations to outcome. In the extremely preterm group, administration of antenatal steroids was associated with better cognition, basic attention, word generation and motor skills. CONCLUSION: At 12 years of age, very preterm children born in the 2000s still have deficits across several neurodevelopmental domains compared to term-born peers. Administration of antenatal steroids has long-lasting associations to cognition and motor skills in extremely preterm-born children.