Sensorimotor and visual perceptual functioning in school-aged children with Williams syndrome.

BACKGROUND: The purpose of the study was to describe sensorimotor profile and visual perceptual performance in school-aged (6-12 years) children with Williams syndrome (WS). The impacts of sensorimotor and visual perception on participation in WS were examined as well to guide research and evidence-based practices. METHODS: A total of 38 children with WS aged 6 to 12 years were evaluated with measures of motor performance (Bruininks-Oseretsky of Motor Proficiency-Second Edition), sensory processing (Sensory Profile), visual perceptual abilities (Test of Visual Perception Skills-Third Edition) and activity participation (Vineland Adaptive Behavior Scale, School Function Assessment). RESULTS: Children with WS performed significantly less well on all sensorimotor and visual perceptual measures, and 71% of children scored in the impaired range on six or more (one third of ) out of 18 measures. They had weaker fine motor skills than gross motor skills. Sensory modulation was the most impaired among the sensory processing functions. Visual perceptions were all moderately impaired. All the sensorimotor measures and visual perceptual functions correlated to the cognitive functions (IQ) and linked to activity participation measures in WS. CONCLUSIONS: Our findings characterised the profiles of body functions (sensorimotor functions and visual organisation) of children with DS, and revealed their correlations with activity participation. Interventions focused on improving body functions are needed while stressing the acquisition of functional skills that increase participation in age-appropriate activities.

Psychometric comparisons of three measures for assessing motor functions in preschoolers with intellectual disabilities.

BACKGROUND: Deficit in motor performance is common in children with intellectual disabilities (ID). A motor function measure with sound psychometric properties is indispensable for clinical and research use. The purpose of this study was to compare the psychometric properties of three commonly used clinical measures for assessing motor function in preschoolers with ID: the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, the Movement Assessment Battery for Children-Second Edition and the Peabody Developmental Motor Scale-Second Edition (PDMS-2). METHOD: One hundred and ninety-one children aged 3-6 years with ID were evaluated with the three measures at three time points: two baseline measurements with a 1-week interval before the intervention, and a follow-up measurement after 6 months of paediatric rehabilitation programme. One hundred and forty-one participants completed all of the assessments. The distribution (ceiling and floor effects) and reliability (internal consistency and test-retest reliability) of each measure were examined. Concurrent validity, predictive validity, and responsiveness were examined as well. RESULTS: All measures, except for the PDMS-2, had significant floor effects or ceiling effects at one or more time points. The three measures had good internal consistency (Cronbach α ≥ 0.86) and test-retest reliability (intraclass correlation coefficient ≥ 0.96). The Spearman ρ correlation coefficient for each pair of the three measures was ≥ 0.80, indicating high concurrent validity. The predictive validity of the three measures was satisfactory (Spearman ρ ≥ 0.52). The responsiveness of the three measures was moderate (0.47 ≤ effect size ≤ 0.74). The minimal detectable changes of the three measures were satisfactory. CONCLUSIONS: All three measures showed sufficient reliability, validity and responsiveness in preschoolers with ID, but the PDMS-2 is recommended for its superior psychometric properties.

Profiles and cognitive predictors of motor functions among early school-age children with mild intellectual disabilities.

BACKGROUND: The purpose of the study was to describe sensorimotor profile in children with mild intellectual disability (ID), and to examine the association between cognitive and motor function. METHODS: A total of 233 children with mild ID aged 7 to 8 years were evaluated with measures of cognitive, motor and sensory integrative functioning. RESULTS: Children with mild ID performed significantly less well on all test measures. 44.2% of children scored in the impaired range on seven out of 22 sensorimotor measures. They had weaker fine motor skills than gross motor skills. Sensory integrative functions were only mildly impaired. Total IQ substantially predicted overall performance on each motor test. Specifically, verbal comprehension and processing speed indexes were significant predictors of gross and fine motor function. CONCLUSIONS: Sensorimotor dysfunctions were found to be very frequent in children with mild ID. Early identification of sensorimotor impairments is essential to prompt early intervention and facilitate better integration into regular school settings.

Neuropsychological predictors of everyday functioning in adults with intellectual disabilities.

BACKGROUND: Very little is known about the neuropsychological correlates of adaptive functioning in people with intellectual disabilities (ID). This study examined whether specific cognitive deficits and demographic variables predicted everyday functioning in adults with ID. METHOD: People with ID (n = 101; ages 19-41 years; mean education = 11 years; 34% women; 54% competitively employed; 41% with mild ID) completed a comprehensive neuropsychological battery grouped into four cognitive domains: processing speed, verbal memory and comprehension, visual perception/constructive function, and executive function. In addition, parents completed an 89-item rating scale developed to assess a wide range of independent living skills. RESULTS: Confirmatory factor analysis results confirmed a correlated four-factor model of cognitive function and a unidimensional model of everyday functioning. Furthermore, structural equation modelling results supported the predictive relationship of verbal memory/comprehension and employment status (standardized regression coefficients 0.45, 0.22, P < or = 0.01 for each) to measures of everyday functioning. The two variables together explained 35% of the variance in everyday functioning. CONCLUSIONS: Both general cognitive dysfunction and specific verbal memory and comprehension deficit impair daily functions in people with ID. These findings have implications for predictive models of adaptive functioning, and for cognitive rehabilitation and deficit compensation strategies for this group.