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Made available in DSpace on 2016-06-02T20:44:10Z (GMT). No. of bitstreams: 1 4234.pdf: 2829356 bytes, checksum: ca8f7a2166c16710523703f4d3e8294b (MD5) Previous issue date: 2012-02-29 / Financiadora de Estudos e Projetos / The influence of preterm birth in visual-motor skills, visual perception and fine and global motor coordination has been being increasingly investigated in the initial stages of schooling. Considering the literature data that shows the relationship between prematurity and Developmental Coordination Disorder (DCD), and relations between the DCD and disorders of visual-motor integration, evaluation and research become essential in the search for possibilities of intervention in children considered at risk. By requiring motor and cognitive repertoires increasingly sophisticated, and of its importance as developmental context, the school becomes a locus for observing the behavior and performance of the child and also a context of prevention and early intervention. This study aimed to describe visual-motor coordination and global development of preterm infants at the beginning of the school and discuss the implications of performance in occupational role envisaged for this stage of its life cycle. It is a study of case-control and descriptive-correlational. The study group was composed by 18 children with a history of preterm birth that were included in the municipal school, attending preschool or first grade of elementary school, that did not have serious neurological damage. To its pairing, participants were selected - Compared Group - by sex, age, and often the same classroom. Parents / tutors provided information on child development and on the moments pre, peri and post-natal, and answered the Developmental Coordination Disorder Questionnaire-DCDQ-Brazil 2. The children were assessed using the Denver Development Screening Test II -DDST-II and the Test of Visual-Motor Integration- VMI. Descriptive analysis and statistical tests were conducted to assess the significance of the results. Such analysis revealed that the performance of preterm infants is lower when compared with the performance of full-term infants, although the difference was not significant for all items and instruments used. In DDST-II premature infants compared with children without a history of prematurity are more likely to delay in several areas of development; in DCDQ-Brazil 2 none of the children presented the classification "probably DCD", but it was possible to observe lower average score for SG; children's performance on the VMI test revealed that the premature children had lower scores in all areas. Statistical tests revealed significant differences between SG and CG for the variables Visual-Motor and Fine Motor of VMI, but significant difference between the performance of groups Adequate Weight and Low Birth Weight was observed in the variables Visual-Motor, Fine Motor and Visual Perception, all belonging to the VMI instrument, showing that weight is a more influential factor than prematurity for visual perception performance. There are significant differences in all parts of the VMI instrument when compared the groups Suspect Denver and Normal Denver and hypothesizes that the worst performance in screening tests for development can be a predictive factor for poorer performance on tests of visual-motor integration. In the groups established by variables belonging only to premature infants there was no significant difference among the groups, demonstrating that the premature child is susceptible to developmental delays independent of birth weight and gestational age. It is observed that premature infants had poorer performance on assessment instruments, and despite coping cases, prematurity represents risks to development. During the initial education, visual-motor skills and global motor coordination become more required and increasingly complex mainly due to the requirements and domains present in the process of writing and reading. Other skills are demanded at the beginning of schooling, which require the integrity of many sensorimotor systems. Difficulties in these areas can influence the performance of children in their occupational role as a student, and other occupational areas present in their life. Considering the school as a protective environment and the work of occupational therapist by collaborative consulting approach, in this context there is the potential to minimize the deficits presented by preterm children and promote their full development. / A influência do nascimento pré-termo nas habilidades viso motoras, viso perceptivas e de coordenação motora fina e global vem sendo cada vez mais investigadas nas fases de escolarização inicial. Considerando dados da literatura que revelam relações entre a prematuridade e o Transtorno do Desenvolvimento da Coordenação (TDC), e relações entre o TDC e transtornos de integração viso motora, a avaliação e investigação se tornam essenciais na busca de possibilidades de intervenção em crianças consideradas de risco. Através da exigência de repertórios motores e cognitivos cada vez mais sofisticados, e da importância como contexto desenvolvimental, a escola passa a ser um lócus de observação do comportamento e desempenho da criança e também um contexto de prevenção e intervenção precoce. Este estudo teve como objetivo descrever a coordenação viso motora e o desenvolvimento global de crianças pré-termo no início da escolarização e discutir as implicações do seu desempenho no papel ocupacional previsto para esta etapa do seu ciclo de vida. Trata-se de um estudo do tipo caso-controle e descritivo-correlacional. O Grupo de Estudo foi composto por 18 crianças com histórico de prematuridade ao nascimento que estavam inseridas na rede municipal de ensino, frequentando pré-escola ou 1º ano do ensino fundamental, e que não possuíssem sequelas neurológicas graves. Para seu pareamento foram selecionados participantes - Grupo Comparado - de acordo com sexo, idade e frequência a mesma sala de aula. Pais/responsáveis forneceram dados sobre o desenvolvimento da criança e sobre os momentos pré, peri e pós-natais, e responderam o Developmental Coordination Disorder Questionnaire-DCDQ-Brasil 2. As crianças foram avaliadas por meio do Teste de Triagem de Desenvolvimento de Denver II-TTDD-II e pelo Teste de Integração Viso Motora- VMI. Foram realizadas análises descritivas e testes estatísticos para verificar a significância dos resultados. Tais análises revelaram que o desempenho das crianças pré-termo é inferior quando comparado com o desempenho de crianças a termo, apesar da diferença não se mostrar significativa em todos os itens e instrumentos empregados. No TTDD-II as crianças prematuras quando comparadas com crianças sem o referido histórico apresentam maior probabilidade de atraso em diversas áreas do desenvolvimento; no DCDQ-Brasil 2 nenhuma das crianças apresentou a classificação provavelmente TDC , porém foi possível observar média de pontuação inferior para o GE; o desempenho das crianças no teste VMI revelou que as crianças prematuras apresentaram pontuações inferiores em todas as áreas. Os testes estatísticos revelaram diferença significativa entre o GE e GC para as variáveis Viso Motor e Motor Fino do instrumento VMI, porém diferença significativa entre o desempenho dos grupos Baixo Peso e Peso Adequado foi observado nas variáveis Viso Motora, Viso Perceptiva e Motor Fino, todas pertencentes ao instrumento VMI, demonstrando que o peso é um fator mais influente que a prematuridade para o desempenho viso perceptivo. Há diferença significativa em todas as partes do instrumento VMI quando comparado os grupo Denver Suspeito e Denver Normal e observa-se que o pior desempenho em testes de triagem do desenvolvimento pode ser um fator preditivo para o pior desempenho nos testes de integração viso motora. Nos grupos estabelecidos através de variáveis pertencentes apenas às crianças prematuras não foi observada diferença significativa no desempenho dos sujeitos, demonstrando que a criança prematura é suscetível a atrasos no desenvolvimento independente da IG e peso ao nascimento. Observa-se que as crianças prematuras obtiveram pior desempenho nos instrumentos de avaliação e, apesar dos casos de enfrentamento, a prematuridade representa risco ao desenvolvimento. Habilidades mais complexas exigidas na fase escolar para a leitura e escrita, podem ser influenciadas pelas dificuldades viso motoras, viso perceptivas e motoras finas. Outras habilidades são exigidas no início da escolarização, as quais requerem a integridade de inúmeros sistemas sensório motores. Dificuldades nessas áreas podem influenciar o desempenho das crianças no seu papel ocupacional de estudante, além de outras áreas ocupacionais presentes em sua vida. Considerando a escola como um ambiente protetivo e a atuação do terapeuta ocupacional por meio da consultoria colaborativa, neste contexto há perspectiva de minimizar possíveis déficits apresentados por crianças prétermo e promover seu desenvolvimento integral.

The visual system and good ocular motor control play an important role in the effective development of gross motor, sport, fine motor and academic skills (Erhardt et al., 1988:84; Desrocher, 1999:36; Orfield, 2001:114). Various researchers report a link between ocular motor problems and attention–deficit hyperactivity disorder (ADHD) (Cheatum & Hammond, 2000:263; Farrar et al., 2001:441; Gould et al., 2001:633; Armstrong & Munoz, 2003:451; Munoz et al., 2003:510; Borsting et al., 2005:588; Hanisch et al., 2005:671; Mason et al., 2005:1345; Loe et al., 2009:432). A few studies were carried out to analyse the links between ADHD and ocular motor control with regard to matters like visual attention, visual perception and ocular motor control like eye movement outside the normal fixation point, but no studies have been reported on the status of the ocular motor control of South African populations, and the effect of visual–motor intervention on the ocular motor control or visual–motor integration of learners with ADHD. The aim of the study was twofold, namely firstly to determine the ocular motor control functions and status of visual–motor integration of a selected group of 6– tot 8–year–old learners with ADHD in Brakpan, South Africa, while the second aim was to determine whether a visualmotor– based intervention programme can improve the ocular motor control and status of the visual–motor integration of a selected group of 6– to 8–year–old learners with ADHD in Brakpan, South Africa. Statistica for Windows 2010 was used to analyse the data. The Sensory Input Screening measuring instrument and the Quick Neurological Screening Test II (QNST–II) were used to assess the ocular motor control functions (fixation, ocular alignment, visual tracking and convergence–divergence), while the Beery Developmental Test of Visual–Motor Integration (VMI–4de weergawe) was used to determine the status of the learners’ visual–motor integration (VMI), visual perception (VP) and motor coordination (MC). The Disruptive Behaviour Scale, a checklist for ADHD (Bester, 2006), was used as measuring instrument to identify the learners with ADHD. Fifty–six learners (31 boys, 25 girls, with an average age of 7,03 years +0,65) participated in the pre–test and were divided into an ADHD (n=39) and a non–ADHD (n=16) group for aim one. Two–way tables were used to determine the percentage of ocular motor control deficits in the learners with and without ADHD, and an independent t–test was used to analyse the visual–motor integration of these learners. The Pearson Chi–squared test was used to determine the practical significance of differences in VMI and VP (d>0,05). The results of the study reveal that the majority of learners displayed ocular motor control deficits, regardless of whether they were classified with ADHD or not. The biggest percentage of learners fell into Class 2 (moderate deficits), particularly with regard to horizontal (68,57%; 52,63%; w=0,16) and vertical tracking (65,71%; 73,68%), as well as convergence–divergence (80%; 78,95%; w=0,11). However, it appears that ADHD learners experience more serious problems (Class 3) with visual tracking than learners without ADHD (both eyes: 22,86%; compared to 10,53% (w=0,22); right eye: 11,43% compared to 0% (p=0,05; w=0,34); left eye: 14,29% compared to 0% (p=0,02; w=0,38)). Learners with and without ADHD displayed a practically significant difference with respect to visual perception (d=0,37) and motor coordination (d=0,5) compared to learners without ADHD (who achieved better results). For aim 2 the subjects were divided into three groups. A pre–test–post–test design compiled from an availability sample of three groups (intervention group with ADHD (n=20); control group with ADHD (n=10) and control group without ADHD (n=17)) was used for this part of the study. The intervention group participated in a nine–week (3x/week and for 45 minutes) visualmotor– based intervention programme in which the ocular motor control functions section was applied for about 5 minutes per learner. Forty–seven learners (25 boys and 22 girls) with an average age of 6,95 years (+0,69) constituted the experimental group, while a control group with ADHD with an average age of 7,2 years (+0,79) and a control group without ADHD with an average age of 7,12 years (+0,60) did not receive any intervention and just participated in the pre– and post–test opportunity. A two–way cross–tabulation table was used to determine the changes in ocular motor control functions. These results mainly revealed that practically significant changes occurred in all three groups, be it improvement or deterioration in the various classes of ocular motor control. It appears that as far as horizontal and vertical visual tracking is concerned, and with convergence–divergence, more subjects were moved back from Class 3 (serious cases) to Class 1 (no deficits) and 2 (moderate deficits) in particular than in the other two groups that had received no intervention. Independent t–testing was used to analyse intragroup differences in the visual–motor integration subdivisions, while a covariance analysis (ANCOVA) (corrected for pre–test differences) was used to determine adjusted average post–test difference values. These results revealed that the motor coordination of the intervention group improved more than that of the control group with ADHD (p=0,18). This can lead to the conclusion that the intervention programme did have an effect on this specific skill. Abstract The overall indications of the results are that learners with ADHD have a general tendency to achieve poorer results in ocular motor control tests and with skills involving visual–motor integration, visual perception and motor coordination than learners without ADHD. Although only a minor improvement was identified in the experimental group after participation in the intervention programme, it is recommended with regard to motor coordination in particular that a similar programme be compiled for ADHD learners that focuses more specifically on the ocular motor control needs of each learner, and that it be presented on a more individual basis in order to accomplish greater improvement. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2012.

The visual system and good ocular motor control play an important role in the effective development of gross motor, sport, fine motor and academic skills (Erhardt et al., 1988:84; Desrocher, 1999:36; Orfield, 2001:114). Various researchers report a link between ocular motor problems and attention–deficit hyperactivity disorder (ADHD) (Cheatum & Hammond, 2000:263; Farrar et al., 2001:441; Gould et al., 2001:633; Armstrong & Munoz, 2003:451; Munoz et al., 2003:510; Borsting et al., 2005:588; Hanisch et al., 2005:671; Mason et al., 2005:1345; Loe et al., 2009:432). A few studies were carried out to analyse the links between ADHD and ocular motor control with regard to matters like visual attention, visual perception and ocular motor control like eye movement outside the normal fixation point, but no studies have been reported on the status of the ocular motor control of South African populations, and the effect of visual–motor intervention on the ocular motor control or visual–motor integration of learners with ADHD. The aim of the study was twofold, namely firstly to determine the ocular motor control functions and status of visual–motor integration of a selected group of 6– tot 8–year–old learners with ADHD in Brakpan, South Africa, while the second aim was to determine whether a visualmotor– based intervention programme can improve the ocular motor control and status of the visual–motor integration of a selected group of 6– to 8–year–old learners with ADHD in Brakpan, South Africa. Statistica for Windows 2010 was used to analyse the data. The Sensory Input Screening measuring instrument and the Quick Neurological Screening Test II (QNST–II) were used to assess the ocular motor control functions (fixation, ocular alignment, visual tracking and convergence–divergence), while the Beery Developmental Test of Visual–Motor Integration (VMI–4de weergawe) was used to determine the status of the learners’ visual–motor integration (VMI), visual perception (VP) and motor coordination (MC). The Disruptive Behaviour Scale, a checklist for ADHD (Bester, 2006), was used as measuring instrument to identify the learners with ADHD. Fifty–six learners (31 boys, 25 girls, with an average age of 7,03 years +0,65) participated in the pre–test and were divided into an ADHD (n=39) and a non–ADHD (n=16) group for aim one. Two–way tables were used to determine the percentage of ocular motor control deficits in the learners with and without ADHD, and an independent t–test was used to analyse the visual–motor integration of these learners. The Pearson Chi–squared test was used to determine the practical significance of differences in VMI and VP (d>0,05). The results of the study reveal that the majority of learners displayed ocular motor control deficits, regardless of whether they were classified with ADHD or not. The biggest percentage of learners fell into Class 2 (moderate deficits), particularly with regard to horizontal (68,57%; 52,63%; w=0,16) and vertical tracking (65,71%; 73,68%), as well as convergence–divergence (80%; 78,95%; w=0,11). However, it appears that ADHD learners experience more serious problems (Class 3) with visual tracking than learners without ADHD (both eyes: 22,86%; compared to 10,53% (w=0,22); right eye: 11,43% compared to 0% (p=0,05; w=0,34); left eye: 14,29% compared to 0% (p=0,02; w=0,38)). Learners with and without ADHD displayed a practically significant difference with respect to visual perception (d=0,37) and motor coordination (d=0,5) compared to learners without ADHD (who achieved better results). For aim 2 the subjects were divided into three groups. A pre–test–post–test design compiled from an availability sample of three groups (intervention group with ADHD (n=20); control group with ADHD (n=10) and control group without ADHD (n=17)) was used for this part of the study. The intervention group participated in a nine–week (3x/week and for 45 minutes) visualmotor– based intervention programme in which the ocular motor control functions section was applied for about 5 minutes per learner. Forty–seven learners (25 boys and 22 girls) with an average age of 6,95 years (+0,69) constituted the experimental group, while a control group with ADHD with an average age of 7,2 years (+0,79) and a control group without ADHD with an average age of 7,12 years (+0,60) did not receive any intervention and just participated in the pre– and post–test opportunity. A two–way cross–tabulation table was used to determine the changes in ocular motor control functions. These results mainly revealed that practically significant changes occurred in all three groups, be it improvement or deterioration in the various classes of ocular motor control. It appears that as far as horizontal and vertical visual tracking is concerned, and with convergence–divergence, more subjects were moved back from Class 3 (serious cases) to Class 1 (no deficits) and 2 (moderate deficits) in particular than in the other two groups that had received no intervention. Independent t–testing was used to analyse intragroup differences in the visual–motor integration subdivisions, while a covariance analysis (ANCOVA) (corrected for pre–test differences) was used to determine adjusted average post–test difference values. These results revealed that the motor coordination of the intervention group improved more than that of the control group with ADHD (p=0,18). This can lead to the conclusion that the intervention programme did have an effect on this specific skill. Abstract The overall indications of the results are that learners with ADHD have a general tendency to achieve poorer results in ocular motor control tests and with skills involving visual–motor integration, visual perception and motor coordination than learners without ADHD. Although only a minor improvement was identified in the experimental group after participation in the intervention programme, it is recommended with regard to motor coordination in particular that a similar programme be compiled for ADHD learners that focuses more specifically on the ocular motor control needs of each learner, and that it be presented on a more individual basis in order to accomplish greater improvement. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2012.