The Effect of Amblyopia on Fine Motor Skills in Children

School of Optometry and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Investigative Ophthalmology &amp Visual Science (Impact Factor: 3.4). 03/2008; 49(2):594-603. DOI: 10.1167/iovs.07-0869
Source: PubMed


In an investigation of the functional impact of amblyopia in children, the fine motor skills of amblyopes and age-matched control subjects were compared. The influence of visual factors that might predict any decrement in fine motor skills was also explored.
Vision and fine motor skills were tested in a group of children (n = 82; mean age, 8.2 +/- 1.7 [SD] years) with amblyopia of different causes (infantile esotropia, n = 17; acquired strabismus, n = 28; anisometropia, n = 15; mixed, n = 13; and deprivation n = 9), and age-matched control children (n = 37; age 8.3 +/- 1.3 years). Visual motor control (VMC) and upper limb speed and dexterity (ULSD) items of the Bruininks-Oseretsky Test of Motor Proficiency were assessed, and logMAR visual acuity (VA) and Randot stereopsis were measured. Multiple regression models were used to identify the visual determinants of fine motor skills performance.
Amblyopes performed significantly poorer than control subjects on 9 of 16 fine motor skills subitems and for the overall age-standardized scores for both VMC and ULSD items (P < 0.05). The effects were most evident on timed tasks. The etiology of amblyopia and level of binocular function significantly affected fine motor skill performance on both items; however, when examined in a multiple regression model that took into account the intercorrelation between visual characteristics, poorer fine motor skills performance was associated with strabismus (F(1,75) = 5.428; P = 0.022), but not with the level of binocular function, refractive error, or visual acuity in either eye.
Fine motor skills were reduced in children with amblyopia, particularly those with strabismus, compared with control subjects. The deficits in motor performance were greatest on manual dexterity tasks requiring speed and accuracy.

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    • "Impoverished visual access to play materials and, often, little intrinsic motivation to explore small objects in children with VI may also limit their ability to train fine-motor skills (Cox et al. 2009; Lewis et al. 2000). Deficits in the motor performance of children with amblyopia but normal sight were greatest in manual dexterity tasks requiring both speed and accuracy, which was particularly seen in children with strabismus (Webber et al. 2008). Caputo and colleagues (2007) used the MABC-I in a study with 4–6 year old children with congenital strabismus and normal visual acuity before surgery and found that they needed significantly more time, especially in uni-and bi-manual dexterity tasks, compared to children without strabismus (Caputo et al. 2007). "
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    ABSTRACT: Insight into the typical motor development of children with visual impairment (VI) is necessary in order to recognise whether children with VI are at risk of motor developmental problems, and to evaluate the effectiveness of exercise interventions. In 2003 the ManuVis was published with reference values for children with VI of ages from 6 to 11 years. This paper reports on a follow-up study of the ManuVis focused on: a) comparison of fine motor skills between children with VI and normal sighted (NS) children; b) sampling norm-references for children with VI in the 4-11 years age range to increase validity; and c) test-retest and inter-rater reliability. In total 256 children with VI and 162 NS children were included in the study. The results demonstrated that children with VI needed significantly more time than NS children to perform all test items, especially at younger ages. Performance time decreased in both children with VI and NS children from the younger to the older age groups, but NS children reached their minimum at a younger age. Test-retest reliability on the items varied from moderate to excellent and inter-rater reliability was excellent. The results suggest that children with VI have slower and more prolonged motor learning than NS children. The ManuVis differentiates between typical and atypical fine-motor performance of children with VI between 4 and 9 years of age, and is useful for monitoring fine-motor skills in children with VI from 4 years to (at least) 11 years.
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    • "However, far more defects have been found in patients with amblyopia. In addition to deficits in primary visual detection or discrimination (Eggers and Blakemore, 1978; Greenwood et al., 2012; McKee et al., 2003) or mid-level visual tasks involving local feature and contour integration (Chandna et al., 2001; Hess et al., 2001) and motion perception (Knox et al., 2013; Simmers et al., 2003, 2005), individuals with amblyopia also show higher-level impairments in visuomotor and visually guided movements (Niechwiej-Szwedo et al., 2010, 2011, 2012a, 2012b; Secen et al., 2011; Suttle et al., 2011; Webber et al., 2008), visual decision-marking (Farzin and Norcia, 2011), visual attention (Popple and Levi, 2008; Thiel and Sireteanu, 2009) and number processing (Mohr et al., 2010). As such, the underlying neural mechanism of amblyopia may be more comprehensive than what has previously been reported, and these mechanisms most likely involve additional neural connections and functional systems across the brain. "
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    ABSTRACT: Amblyopia is a developmental disorder resulting from anomalous binocular visual input in early life. Task-based neuroimaging studies have widely investigated cortical functional impairments in amblyopia, but changes in spontaneous neuronal functional activities in amblyopia remain largely unknown. In the present study, functional connectivity density (FCD) mapping, an ultrafast data-driven method based on fMRI, was applied for the first time to investigate changes in cortical functional connectivities in amblyopia during the resting-state. We quantified and compared both short- and long-range FCD in both the brains of children with anisometropic amblyopia (AAC) and normal sighted children (NSC). In contrast to the NSC, the AAC showed significantly decreased short-range FCD in the inferior temporal/fusiform gyri, parieto-occipital and rostrolateral prefrontal cortices, as well as decreased long-range FCD in the premotor cortex, dorsal inferior parietal lobule, frontal-insular and dorsal prefrontal cortices. Furthermore, most regions with reduced long-range FCD in the AAC showed decreased functional connectivity with occipital and posterior parietal cortices in the AAC. The results suggest that chronically poor visual input in amblyopia not only impairs the brain's short-range functional connections in visual pathways and in the frontal cortex, which is important for cognitive control, but also affects long-range functional connections among the visual areas, posterior parietal and frontal cortices that subserve visuomotor and visual-guided actions, visuospatial attention modulation and the integration of salient information. This study provides evidence for abnormal spontaneous brain activities in amblyopia.
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    • "In their comprehensive review, Houwen, Visscher, Lemmink, and Hartman (2009) identified a total of 17 studies focusing on the comparison of motor skill performances between children with and without visual impairments. Twelve studies show broad agreement that children with visual impairments perform worse on static and/or dynamic balance (Bouchard & Tetreault, 2000; Gipsman, 1981; Hä kkinen, Holopainen, Kautiainen, Sillanpä a ¨ , & Hä kkinen, 2006; Johnson- Kramer, Sherwood, French, & Canabal, 1992; Leonard, 1969; Pereira, 1990; Ribadi, Rider, & Toole, 1987; Wyver & Livesey, 2003) as well as on fine motor skill/manual dexterity tasks (Caputo et al., 2007; Ittyerah, 2000; Reimer, Smits- Engelsman, & Siemonsma-Boom, 1999; Webber, Wood, Gole, & Brown, 2008). However, only one study (Houwen, Visscher, Lemmink, & Hartman, 2008) was regarded as having high methodological standard and thus, will be described in detail below. "
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    ABSTRACT: The aim of this study was to provide an empirical basis for teaching gross motor skills in children with visual impairments. For this purpose, gross motor skill performance of 23, 6-12 year old, boys and girls who are blind (ICD-10 H54.0) and 28 sighted controls with comparable age and gender characteristics was compared on six locomotor and six object control tasks using the Test of Gross Motor Development-Second Edition. Results indicate that children who are blind perform significantly (p<.05) worse in all assessed locomotor and object control skills, whereby running, leaping, kicking and catching are the most affected skills, and corresponding differences are related to most running, leaping, kicking and catching component. Practical implications are provided.
    Research in developmental disabilities 07/2013; 34(10):3246-3252. DOI:10.1016/j.ridd.2013.06.030 · 4.41 Impact Factor
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