Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder

Robyn Doney; Barbara R Lucas; Rochelle E Watkins; Tracey W Tsang; Kay Sauer; Peter Howat; Jane Latimer; James P Fitzpatrick; June Oscar; Maureen Carter; Elizabeth J Elliott

doi:10.1016/j.ridd.2016.05.009

Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder

Res Dev Disabil. 2016 Aug:55:346-57. doi: 10.1016/j.ridd.2016.05.009. Epub 2016 May 23.

Authors

Affiliations

¹ School of Public Health, Curtin University, Perth, Australia. Electronic address: robyndoney@gmail.com.
² Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; Poche Center for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia; Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia. Electronic address: blucas@georgeinstitute.org.au.
³ Telethon Kids Institute, University of Western Australia, Perth, Australia. Electronic address: rochelle.watkins@telethonkids.org.au.
⁴ Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia. Electronic address: tracey.tsang@sydney.edu.au.
⁵ School of Public Health, Curtin University, Perth, Australia; Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Australia. Electronic address: k.sauer@curtin.edu.au.
⁶ School of Public Health, Curtin University, Perth, Australia; Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Australia. Electronic address: p.howat@curtin.edu.au.
⁷ The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia. Electronic address: jlatimer@georgeinstitute.org.au.
⁸ Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; Telethon Kids Institute, University of Western Australia, Perth, Australia. Electronic address: james.fitzpatrick@telethonkids.org.au.
⁹ Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia. Electronic address: ceo@mwrc.com.au.
¹⁰ Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia. Electronic address: maureen.carter@nindilingarri.org.au.
¹¹ Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; The Sydney Children's Hospitals Network (Westmead), Sydney, Australia. Electronic address: elizabeth.elliott@health.nsw.gov.au.

PMID: 27228005
DOI: 10.1016/j.ridd.2016.05.009

Abstract

Background: Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits.

Methods: VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established.

Results: Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%).

Conclusions: Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments.

Keywords: Fetal alcohol spectrum disorders; Indigenous population; Motor skills; Psychomotor performance; Visual motor.

MeSH terms

Alcohol Drinking / epidemiology
Central Nervous System Depressants
Child
Cohort Studies
Ethanol
Female
Fetal Alcohol Spectrum Disorders / epidemiology
Fetal Alcohol Spectrum Disorders / physiopathology*
Humans
Maternal Exposure / statistics & numerical data
Motor Skills Disorders / epidemiology
Motor Skills Disorders / physiopathology*
Motor Skills*
Native Hawaiian or Other Pacific Islander / statistics & numerical data
Pregnancy
Prenatal Exposure Delayed Effects / epidemiology
Prenatal Exposure Delayed Effects / physiopathology*
Prevalence
Psychomotor Performance*
Visual Perception*
Western Australia / epidemiology

Substances

Central Nervous System Depressants
Ethanol