Visual-Motor Integration in Children With Mild Intellectual Disability: A Meta-Analysis

Exercise-Based Interventions Aimed at Improving Balance in Children with Autism Spectrum Disorder: A Meta-Analysis

Children with Autism Spectrum Disorder (ASD) often have deficits in motor skills, especially balance. This article presents a meta-analytic review of 15 intervention studies that aimed to improve balance in children and adolescents with ASD. Across these studies, there were 195 participants with ASD for whom pre-intervention and post-intervention balance scores were available. We measured the standardized mean difference (Hedges' g) between their pre-intervention and post-intervention balance scores and found a large, positive effect from these balance interventions (standardized mean difference-1.82 (95% CI [1.34, 2.29])). Various balance intervention procedures were shown to be very efficacious for children and adolescents with ASD. Clearly, balance is a motor skill that is very susceptible to intervention efforts. We also provided recommendations to researchers regarding what information to include when conducting intervention studies.

Systematic Review of Visual Motor Integration in Children with Developmental Disabilities

Original research articles regarding visual motor integration skills in children with developmental disabilities and the impact of occupational therapy were identified, appraised, and synthesized. Twenty-four articles were chosen for this review. Themes were noted during the critique of articles. Three themes emerged: "age," "gender," and "diagnosis." Regarding the impact on visual motor integration, there was strong evidence for age, moderate evidence for gender, and strong evidence for diagnosis. Future research investigating visual motor integration in children should control for age and diagnosis.

Fine motor skills and attention level of individuals with mild intellectual disability getting education in inclusive classrooms and special education schools

In this study, the difference between fine motor skills and attention levels of children with mild intellectual disabilities (MID) who get education in inclusive classrooms and special education schools and the relationship between fine motor skills and attention levels were analysed. A total of 176 children with MID between the ages of 9-14, who get education in inclusive classrooms (n = 96) and special education schools (N = 80), participated in the study. Bruininks-Oseretsky Test of Motor Proficiency-Second Version (BOT-2) and Bourdon Attention Tests were applied as data tools. Fine Motor Precision (FMP), Fine Motor Integration (FMI) and Attention levels of the children in inclusive classrooms were higher than those who get education at special education schools (p < .05). In all parameters of the children of inclusive classrooms and special education schools (except the parameters of FMP-6: Folding Paper and FMI-8: Copying Overlapping Pencils), there was a positive correlation between attention and fine motor skill values (p < .05). The fact that children with MID get inclusive education with typically developing peers contributes more to these individuals in terms of fine motor skills and attention parameters. However, more extensive work is needed in this field.

Combined Effects of Virtual Reality and Computer Game-Based Cognitive Therapy on the Development of Visual-Motor Integration in Children with Intellectual Disabilities: A Pilot Study

PURPOSE

Visual-motor integration is a good indicator of a child's overall developmental and functional level. This study investigated the combined effects of virtual reality (VR) and computer game-based cognitive therapy on the development of visual-motor integration in children with intellectual disabilities.

METHODS

The study used a single-group pre-post study design and 13 children with intellectual disabilities who were recruited from a community rehabilitation center participated in the study. We used the Wii VR video game and the CoTras computer game to deliver cognitive therapy over 12 sessions. The Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) was used to evaluate motor function related to visual-motor integration to identify changes in function, and the Developmental Test of Visual Perception-2 (DTVP-2) was used to assess changes in visual perception function associated with visual-motor integration.

RESULTS

The VR and computer game-based cognitive therapy has shown significant difference in total standard score of BOT-2 associated with visual-motor integration representing improved motor function (p < 0.01). Comparison of the DTVP-2 scores showed the significant difference in visual-motor integration of spatial relation and visual-motor speed (p < 0.05), motor-reduced visual perception (p < 0.01), and general visual perception (p < 0.01).

CONCLUSIONS

Results of this study provide useful evidence supporting the possibility of combined VR and computer game-based cognitive therapy for children with intellectual disabilities.

Central neurogenetic signatures of the visuomotor integration system

Visuomotor impairments characterize numerous neurological disorders and neurogenetic syndromes, such as autism spectrum disorder (ASD) and Dravet, Fragile X, Prader-Willi, Turner, and Williams syndromes. Despite recent advances in systems neuroscience, the biological basis underlying visuomotor functional impairments associated with these clinical conditions is poorly understood. In this study, we used neuroimaging connectomic approaches to map the visuomotor integration (VMI) system in the human brain and investigated the topology approximation of the VMI network to the Allen Human Brain Atlas, a whole-brain transcriptome-wide atlas of cortical genetic expression. We found the genetic expression of four genes-TBR1, SCN1A, MAGEL2, and CACNB4-to be prominently associated with visuomotor integrators in the human cortex. TBR1 gene transcripts, an ASD gene whose expression is related to neural development of the cortex and the hippocampus, showed a central spatial allocation within the VMI system. Our findings delineate gene expression traits underlying the VMI system in the human cortex, where specific genes, such as TBR1, are likely to play a central role in its neuronal organization, as well as on specific phenotypes of neurogenetic syndromes.

Latent subgroups of cognitive performance in lead- and manganese-exposed Uruguayan children: Examining behavioral signatures

OBJECTIVES

Lead (Pb) and manganese (Mn) are confirmed neurotoxins but it is unclear to what extent low-level exposure produces a unique behavioral signature. The objective of this study was to investigate latent cognitive profiles among children (6-8 years) from Montevideo, Uruguay co-exposed to these metals.

METHOD

Among 345 children, blood Pb and hair Mn were measured using atomic absorption spectroscopy and ICP-MS, respectively. Sixteen measures, reflecting multiple domains of cognitive functioning were gathered: (1) three tests from Cambridge Neuropsychological Test Automated Battery (CANTAB): Intra-Extra Dimensional Shift (IED), Spatial Span (SSP) and Stockings of Cambridge (SOC), (2) ten tasks from Woodcock-Muñoz Achievement Battery, Revised (WM): Visual-Motor Integration, Verbal Comprehension (Vocabulary, Synonyms, Antonyms, Analogies), Visual-Auditory Comprehension, Concept Formation, Visual Spatial Thinking, Number Inversion and Spatial Relations, (3) Bender Gestalt task, and (4) Weschler block design task. Scores were modeled using latent profile analysis (LPA). Association between blood Pb and hair Mn on performance profiles was assessed using ordinal regression, controlling for confounders. An interaction between Pb and Mn was tested.

RESULTS

Mean ± SD of blood Pb was 4.1 ± 2.1 μg/dL and 35% of children had blood Pb ≥ 5 μg/dL. Median [5%, 95%] hair Mn level was 0.8 [0.3, 4.1] ppb. Three latent cognitive performance profiles were identified: high (n = 46, 13%), average (n = 209, 61%) and low (n = 90, 26%). Each one-unit increase in blood Pb was associated with a 28% greater likelihood of belonging to a poorer-performing profile. The association was non-linear, with the effect of Pb on profile membership strongest at lower levels of exposure. There was no meaningful interaction between Pb and Mn.

CONCLUSIONS

A behavioral signature for low-level Pb & Mn exposure was not identified, but the likelihood of membership in low-performing profile was higher at lowest levels of blood Pb. There was no effect measure modification between Pb and Mn. Future research should address how complex environments created by chemical exposures and the social context relate to cognitive performance in young children.