Reliance on visual feedback from ocular accommodation on motor skills in children with developmental coordination disorder and typically developing controls.

Children with developmental coordination disorder (DCD) present with marked impairments in motor skills, including visual-motor integration. Oculomotor anomalies are more prevalent in children with DCD than typically developing children. Children with DCD further demonstrate altered use of visual feedback compared to typically developing controls. We investigated whether the accommodation system, a key component of the oculomotor system, contributes to visual feedback during fine and gross motor skills performance; and whether children with DCD demonstrate differences in reliance on visual feedback from accommodation. Minus dioptre lenses were used to maximally induce accommodation and impede accommodation dynamics. Children with DCD and typically developing controls performed motor skills tests assessing balance, upper limb coordination, visual-motor performance, gross and fine dexterity. Motor skills performance in controls was significantly affected by impeded accommodation in all tasks. Children with DCD demonstrated reliance on accommodation feedback in upper limb and visual-motor tasks only. Children with DCD may be less reliant on visual feedback obtained from accommodation due to adaptive mechanisms to overcome faulty information in the presence of oculomotor anomalies. These results strengthen our previous findings that accommodation anomalies contribute to motor skills impairment, and suggest that performance on these motor tasks is heavily reliant on visual feedback from accommodation.

Relationship of ocular accommodation and motor skills performance in developmental coordination disorder.

Ocular accommodation provides a well-focussed image, feedback for accurate eye movement control, and cues for depth perception. To accurately perform visually guided motor tasks, integration of ocular motor systems is essential. Children with motor coordination impairment are established to be at higher risk of accommodation anomalies. The aim of the present study was to examine the relationship between ocular accommodation and motor tasks, which are often overlooked, in order to better understand the problems experienced by children with motor coordination impairment. Visual function, gross and fine motor skills were assessed in children with developmental coordination disorder (DCD) and typically developing control children. Children with DCD had significantly poorer accommodation facility and amplitude dynamics compared to controls. Results indicate a relationship between impaired accommodation and motor skills. Specifically, accommodation anomalies correlated with visual motor, upper limb and fine dexterity task performance. Consequently, we argue accommodation anomalies influence the ineffective coordination of action and perception in DCD. Furthermore, reading disabilities were related to poorer motor performance. We postulate the role of the fastigial nucleus as a common pathway for accommodation and motor deficits. Implications of the findings and recommended visual screening protocols are discussed.

Predicting the continued use of overlays in school children--a comparison of the Developmental Eye Movement test and the Rate of Reading test.

Coloured overlays have been advocated to enhance reading speed and ability in children with reading difficulty or dyslexia. Assessing the efficacy of overlays has to date been largely subjective. Objective assessment is presently carried out with the Rate of Reading test (RRT), where an increase in reading speed of more than 5% is considered to indicate a positive prognosis for continued use of the overlay. The Developmental Eye Movement (DEM) test is used to assess horizontal scanning behaviour in a number naming task. In this study both tests were utilised to determine whether coloured overlays could enhance reading performance or scanning. This article shows that for some children rate of reading is not improved with coloured overlays although performance on the DEM test does improve. Improvements to the DEM scores occurred in 88% of children who continued to use overlays for more than 3 months. This compared with 60% sensitivity in the RRT. The possible reasons for this phenomenon and the clinical implications are discussed.