Evaluation of Visual Function, Eye-Hand Coordination and Motor Ability in Typically Developing Children

Abstract

Many aspects of a child’s development contribute to thriving in everyday activities. For example, motor ability and visual function play a crucial role impacting social, physical and emotional development. While it is expected that better visual function would be associated with better motor performance, this association has not been directly assessed in school-aged, typically developing children. Thus, this study aims to characterize the visual function, motor ability, and hand-eye coordination in a typically developing cohort of children and to determine if there is any association between measures of visual function and motor performance. A cohort of 35 children aged 7-14 years (9.7 SD 2.1 years, 19 males) were tested during a one-time visit which included three standardized clinical tests, an assessment of vision and binocular function, and an experimental hand-eye coordination task. The clinical tests consisted of the Movement Assessment Battery for Children (MABC-2) to assess overall motor development with subtests including fine and gross motor skills, the Beery Butkenica Developmental Test of Visual-Motor Integration (Beery-VMI) to assess visuomotor integration, and the Test of Word Reading Efficiency – 2nd Edition (TOWRE-2) to assess reading and pronunciation ability. The optometric assessment included visual acuity, stereoacuity, fixation disparity, phoria, fusional vergence, vergence facility, accommodative facility, and amplitude of accommodation. Eye-hand coordination was assessed using eye tracking and hand motion tracking while children performed a bead threading task. Results from the optometric tests fell within expected ranges with the exception of vergence facility (13.5 SD 3.9) and binocular accommodative facility (9.2 SD 3.1). Performance on the TOWRE-2 subtests and the Beery-VMI aligned with the expected norms as well. The overall score for the MABC-2 was within the expected range (8.9 SD 2.1), however the manual dexterity subtest fell below the expected range (7.8 SD 2.8). A correlation analysis was performed revealing a relationship between the total MABC-2 score and vergence facility (ρ = -0.38, p = 0.04, 95% CI -0.65, -0.02) as well as accommodative facility (r = -0.48, p = 0.007, 95% CI -0.71, -0.05). The MABC-2 manual dexterity subtest score was associated with accommodative facility (r = -0.38 p = 0.037, 95% CI -0.71, -0.05). In addition, the amplitude of accommodation was associated with three kinematic measures from the bead threading task: the grasping interval (ρ = 0.63, p = <.001, 95% CI 0.35, 0.81), bead threading interval (ρ = 0.38, p = 0.041, 95% CI 0.02, 0.65), and total movement time (ρ = 0.42, p = 0.021, 95% CI 0.07, 0.67). The findings from this study provide preliminary information about visual and motor function measures obtained from the same cohort of typically developing children. In contrast to the hypothesis, a negative moderate association was found between the MABC scores and accommodative and vergence facility. Similarly, the association between accommodation amplitude and bead threading task measures was in the opposite direction to the hypothesis. A larger study is necessary to determine whether the associations found in this small cohort are reliable. An important contribution of this study is the creation of a normative database that includes both the visual and motor scores. These normative values will be used when comparing the performance of children with a coordination disorder in a subsequent study.