DEVELOPMENT OF FINE MOTOR COORDINATION AND VISUAL-MOTOR INTEGRATION IN PRESCHOOL CHILDREN

Abstract

Fine motor skills are prerequisite for many everyday activities and they are a good predictor of a child's later academic outcome. The goal of the present study was to assess the effects of age on the development of fine motor coordination and visual-motor integration in preschool children. The sample for this study consisted of 276 preschool children from Canton Sarajevo, Bosnia and Herzegovina. We assessed children's motor skills with Beery Visual Motor Integration Test and Lafayette Pegboard Test. Data were analyzed with one-way ANOVA, followed by planned comparisons between the age groups. We also performed a regression analysis to assess the influence of age and motor coordination on visual-motor integration. The results showed that age has a great effect on the development of fine motor skills. Furthermore, the results indicated that there are possible sensitive periods at preschool age in which the development of fine motor skills is accelerated. Early intervention specialists should make a thorough evaluations of fine motor skills in preschool children and make motor (re)habilitation programs for children at risk of fine motor delays. [PUBLICATION ABSTRACT]

Headnote

Abstract

Fine motor skills are prerequisite for many everyday activities and they are a good predictor of a child's later academic outcome. The goal of the present study was to assess the effects of age on the development of fine motor coordination and visual-motor integration in preschool children. The sample for this study consisted of 276 preschool children from Canton Sarajevo, Bosnia and Herzegovina. We assessed children's motor skills with Beery Visual Motor Integration Test and Lafayette Pegboard Test. Data were analyzed with one-way ANOVA, followed by planned comparisons between the age groups. We also performed a regression analysis to assess the influence of age and motor coordination on visual-motor integration. The results showed that age has a great effect on the development of fine motor skills.

Furthermore, the results indicated that there are possible sensitive periods at preschool age in which the development of fine motor skills is accelerated. Early intervention specialists should make a thorough evaluations of fine motor skills in preschool children and make motor (re)habilitation programs for children at risk of fine motor delays.

Key words: fine motor development, visual motor integration, preschool children

(ProQuest: ... denotes non-US-ASCII text omitted.)

...

Introduction

Fine motor coordination and visual motor integration are a good indicator of a child's overall level of functioning. They are also a good predictor of the child's later academic achievement (1). Visual motor integration is very important for social and emotional adjustment to school (2). Besides academic achievement, social and emotional adjustment, fine motor skills are also necessary for numerous everyday activities such as dressing, eating, holding and manipulating objects etc. Proper fine motor development depends on several factors including: Central Nervous System (CNS) maturation, muscle tone and strength. In the same line, visual-motor integration skills depend on intact visualmotor abilities, fine motor coordination, motor inhibition and sustained attention (3). Fine motor skills deficits and Visual-motor integration deficits are present in a number of acquired and developmental disabilities such as intellectual disability, traumatic brain injury, preterm children, children with Tourette syndrome etc. (4, 5).

One of the major tasks of special educators/occupational therapists and rehabilitators (also known as defectologists) in the work with preschool children is assessment of the fine motor skills and their subsequent rehabilitation. The (re)habilitation consists of improvement of the fine motor skills with special attention given to eye-hand coordination and manipulation (6). The benefits of a timely intervention on the development of fine motor skills are well documented, with the general principle being the earlier we start the intervention the better are the outcomes for the children (7, 8).

The current study is a part of a larger research conducted in Canton Sarajevo to estimate the number of preschool children with deficits in motor and speech development. The results on the prevalence and effects of sex on speech and language disorders and visual motor integration are to be published in Journal of Occupational Therapy, Schools and Early Intervention (9).

In this study we present the effects of age on the development of fine motor coordination and visual-motor integration and the relationship between age, fine motor coordination and visual-motor integration in preschool children in Canton Sarajevo, Bosnia and Herzegovina (BiH). This is the first study to examine the developmental trends of fine motor skills in preschool children in BiH using psychometrically sound and valid instruments.

Method

Participants

The sample comprised 276 children aged 3 to 6 mean age 4.58, SD=0.93), both sexes (150 boys, 126 girls), attending regular kindergardens in Canton Sarajevo. Children were categorized into four age groups: 1. children between 2.8-3.6 years N=44), 2. children between 3.7-4.5 years (N=90), 3. children between 4.6-5.5 years (N=86) and 4. children between 5.6-6.5 years (N=56). Children's educational records contained information on medical and psycho-educational status of the children. According to these records, the children in the sample did not have any known sensory hearing or visual) impairment or neurological impairment and the children in the sample did not have intellectual disability as measured by an IQ score of less than 70.

Procedure

Out of 27 public kindergardens in Canton Sarajevo, 11 were randomly selected and 500 consent forms were distributed to parents of children attending these kindergardens. Total of 320 signed consent forms were returned and these children were assessed. Occupational therapists/special education teachers with advanced degrees in psychology, and occupational therapy assessed the children's motor skills. Incomplete data were not included in the analysis, leaving us with the total sample of 276 children. First, children were given Beery VMI test and the raw scores were used in subsequent analysis in order to assess the effects of age. Fine motor coordination was assessed with Lafayette Purdue test and the time to complete the test was used as a dependant variable.

Instruments

Visual-motor integration was assessed using the Beery VMI- Test of Visual Motor Integration 6th Edition- Short Form (10). It is a widely used test with very good psychometric properties (split-half correlation for these age groups varies between 0.86-0.93 and alpha coefficient of internal consistency varies between 0.81-0.89). The Beery VMI is designed to assess the extent to which individuals can integrate their visual and motor abilities. Research indicates that Beery VMI is almost culture free test and as such was convenient for the purposes of this study. Raw scores of Beery VMI were used for the analysis. Higher scores indicate better performance.

Lafayette Pegboard test is used for assessment of fine motor skills, motor coordination and dexterity. It consists of 25 holes in which children need to place the pegs. Time to complete the task was used as a dependant variable. Lower scores indicate better performance.

Statistical analysis

Descriptive and inferential statistics were used for the purposes of the study. We compared the results of Beery VMI and fine motor coordination in relation to the age category with ANOVA. Planned comparisons were performed afterwards to see the trend for the differences. In order to gain a better understanding of the development of visual-motor integration, we performed a regression analysis with age and Lafayette Pegboard scores being in the one block (enter method). Finally the relationships between Beery VMI, Lafayette Pegboard and age were calculated by using the Pearson correlation coefficient. An alpha level of 0.05 was used for all tests. Data were analyzed with the computer program SPSS v.13 for Windows.

Results

The mean results on the Beery Visual Motor Integration Test and Lafayette Pegboard Test are shown in table 1.

For the Beery VMI Test, the results of ANOVA revealed a statistically significant differences between the age categories F (3,272) = 167.5, p<0.001. Three planned comparisons were performed and each showed statistically significant differences between the age groups (youngest group vs. three others, t (272) = 16.7, p<0.001; second youngest vs. two oldest groups t (272) = 15.8, p<0.001; and finally the comparison between the two oldest groups revealed significant differences t (272)=4.1, p<0.001). We can see that increasing age significantly contributes to better results on VMI Test.

For the Lafayette Pegboard Test, the result of ANOVA also revealed a statistically significant difference between the age groups, F(3,272) = 99.6, p<0.001. We used the same planned comparisons as for the VMI and the results revealed the same trend that better performance on the tests comes with the increasing age the (first comparison t(272)=14.8, p< 0.001; second comparison t(272)=9.6, p<0.001; and the third comparison t(262)=2.6, p<0.001).

Next, we performed a regression analysis in order to see the influence of age and motor coordination (Lafayette Pegboard scores) on visual motor integration. The results are shown in table 2.

As it can be seen from the table, the model was statistically significant and age and motor coordination explained 71% of the variance in the Visual-motor integration.

The correlations of VMI Test results, Lafayette Pegboard results and age are shown in Table 3.

As it can be seen from the table, all correlations were statistically significant. Further on, we examined the correlation between visual motor integration and age, controlling the influence of motor coordination. Again, the correlation was statistically significant with r=0.64 (p<0.001).

Discussion

In this study we evaluated the effects of age on the development of fine motor coordination and visual motor integration. Furthermore, we examined the correlations between age, motor coordination and visual motor integration. The existing studies have shown the developmental course of visualmotor abilities which develop rapidly in childhood, continue to develop into adolescence, plateau in adulthood and decline in late adulthood (11).

This study confirmed that the effect of age on fine motor development was significant in preschool age. Other studies have found the effects of age to be significant in children with intellectual disability as well (12). The sample of children in this study was divided into four age categories. On the Beery VMI the scores raised by 4 points in each age group except for the last group in which the scores increased only 2 points. This "slowing down" of fine motor development in preschool children indicates that there might be periods of rapid development followed by periods of slower increase in fine motor skills. The same trend was seen in the Lafayette Pegboard test of Dexterity and Motor Coordination. The results of this study indicate that the fine motor coordination and visual motor integration have the same developmental trends at the preschool age. We were also interested in the mutual relationship between age, motor coordination and visual motor integration. Therefore, we performed a regression analysis to see how age and motor coordination influence the visual motor integration. The results of this study revealed strong influence of both variables on VMI with the age being the much stronger predictor.

Also, the findings in this study indicate that the relationship between fine motor development and age is not linear, not even in the preschool years. A caution should be noted here as the data for this study were cross-sectional. This findings need to be replicated in a different sample of children and it would be beneficial to conduct a longitudinal study of motor abilities in children to see the exact nature of the relationship between age and motor skills. It would also be usefull to have the same size and same age bands group as it would strenghten the statistical analysis performed and subsequent conclusions. It would also be interesting to replicate this study on the sample of children from the first four grades of elementary school to see the trends in fine motor development in that age group. Finally, it would be useful to use another measure of Visual-motor abilities, such as Bender-Gestalt test in order to get an additional validation of the scores and qualitative analysis of the type of errors children make.

The implications of these findings are very important for the practice of occupational therapy, education, special education and rehabilitation. The focus of this study was to show the developmental course of visual motor abilities at preschool age. The findings presented here indicate the possibility of sensitive periods in the visual motor development of the child. Motor coordination and visual motor integration, as part of visual motor abilities, have a great impact on child's overall level of functioning both academic and social. Knowing the sensitive periods of fine motor development, we can design enriched rehabilitation programs to help children at risk eliminate or at least alleviate some of the fine motor delay they might have. This will, in turn, help children to be better prepared for the academic and everyday challanges ahead them.

Conclusion

Fine motor skills are of extreme importance in child's development. This study has indicated a possible sensitive periods in the development of fine motor skills. Professionals working with children need to be aware of these periods and to provide Individualized (Re)habilitation Programs for alleviation of fine motor delays in children at risk for such delays.

References

.../References

1. Decker SL, England JA, Carboni, JA, Brooks JH. Cognitive and developmental influences in Visual-Motor Integration skills in young children. Psychological Assessment 2011; 23(4):1010-1016.

2. Bart O, Hajami D, Bar-Haim Y. Predicting school adjustment from motor abilities in kindergarten. Infant and Child Development 2007; 16(6):597-615.

3. Schultz RT, Carter AS, Gladstone M, Scahill L, Leckman JF, Peterson BP, Zhang H, Cohen DJ, Pauls D. Visual-Motor integration functioning in children with Tourette syndrome. Neuropsychology 1998; 12(1):134-145.

4. Bohm B, Lundequist A, Smedler AC. Visualmotor and executive functions in children born preterm: The Bender visual motor gestalt test revisited. Scandinavian Journal of Psychology 2010; 51(5):376-384.

5. Sutton GP, Barchard KA, Bello DT, Thaler NS, Ringdahl E, Allen DM, Mayfield J. Beery- Buktenica developmental test of Visual-motor integration performance in children with traumatic brain injury and attention deficit/hyperactivity disorder. Psychological assessment 2011; 23(3):805-809.

6. Case-Smith J. Fine motor outcomes in preschool children who receive occupational therapy services. The American Journal of Occupational Therapy 1996; 50(1):52-61.

7. Ljutic T, Jokovic Oreb I, Nikolic B. The effect of early intervention program on motor development in a child with neurodevelopmental risk. Hrvatska revija za rehabilitacijska istrazivanja 2012; 48(2):55-65.

8. Dankert HL, Davies PL, Gavin WJ. Occupational therapy effects on visualmotor skills in preschool children. American Journal of Occupational Therapy 2003; 57(5):542-549.

9. Memisevic H, Hadzic S. The relationship between visual-motor integration and articulation disorders in preschool children. Journal of Occupational Therapy, School & Early Intervention 2013; (in press).

10. Beery KE, Beery NA. Beery VMIAdministration, Scoring and Teaching Manual. Bloomington: Pearson, 2010.

11. Decker SL. Measuring growth and decline in visual-motor processes with the Bender-Gestalt second edition. Journal of Psychoeducational Assessment 2008; 26(1):3-15.

12. Memisevic H, Sinanovic O. Predictors of visual-motor integration in children with intellectual disability. International Journal of Rehabilitation Research 2012; 35(4):372-374.