Visual-motor Integration Flashcards
Visual-motor integration
- Visual and proprioceptive information are integrated in the brain
- Integration of information allows for motor judgments to be made
- Tracing something, driving
Visual motor functions:
- Expressive function: output / production of a movement
o includes non-verbal communication - Receptive function: intake of information
o Receiving environmental cues
§ Visual information: spatial relationships, closure, tracking
o Combining sensory and proprioceptive cues
Observing visual-motor integration
Provides information about the child’s:
- Fine and gross motor skills
- Intactness of sensory and motor modalities
- Possible neurological deficits / impairments
o Cerebral palsy (CP)
o ADHD
o Traumatic brain injury (TBI) - ⅓ of children will show deficits in visual motor integration and skills
o Learning disabilities (SLD)
How the child carries out the test can be critical
Child’s style of responding:
* Dealing with frustration
* Correcting of errors
* Concentration and attention
* Planning and organization
* Motivation
* Encouragement
* Time to complete… perfectionism?
Fine motor skill:
* How the child holds the pencil
* Handedness
* Signs of tremor / holding pencil tightly
* Shifting posture / arm position
Visual integration:
* Traces designs with finger before drawing them
* Reorients paper or card so design is on a tilt
* Difficulty with the parts of designs
* What part of the design does the child draw first?
* Are parts integrated into the whole?
* Does the child spot differences between his drawing and the example?
How does the brain
integrate information?
4 NETWORKS FOR EVERYDAY FUNCTION
Brain networks share information with one another constantly
Several brain networks are involved in everyday function
- Default mode network (DMN)
o Maintenance of the self
–Most active when you are not engaged in task- task-negative network
–Autobiographical, integrate sensory to add to self awareness - Sensory-motor network
o Processing of sensations and movements
—Sensory info and motor responses - make interpretations about sensations in our environment
—Develops much earlier than higher-order networks - Salience network
o Monitors the environment for important information
–Alarm system of the brain
–When info is detected - help redirect our attention - Central Executive Network
o Involved in decision-making and planning
–Higher order executive functioning skills
—Near the end develops
Disruptions (due to injury, psychological distress, illness) can cause
poor information integration within a network and between networks
- Can result in deficits in information integration à visuomotor
dysfunctions can ensue
Visual-perceptual / Visual-motor Tasks
- Visual perception with motor response
- Visual perception without motor response
How does the brain integrate information?
White matter
Axon bundles - highways that connect one brain region to another
Visual-perceptual / Visual-motor Tasks
1. Visual perception with motor response
Visual perception with motor response:
1. The Bender-Gestalt Test
2. Beery Visual-Motor Integration
* Pencil and paper copying tests
* Untimed
3. NEPSY II > NEuroPSYchological test for children
o Route finding subtest
Visual Perceptual Tests
without motor response
Visual perception without motor response
1. NEPSY II (Arrows subtest – which arrow will hit the bullseye?)
* Identification of poor visuospatial skills: judging line orientation, direction,
angularity, and estimating distance
–Test whether a child can judge line orientation visually - which arrow points directly to the target
- Kaufman Assessment Battery for Children
* Gestalt Closure subtest - what shape is this?
Tests of Motor Skills
Motor skills impaired due to:
* Motor planning
* Physical dexterity
* … Or combination of both
TBI:
* Ability to perform motor tasks quickly decreases corresponding to the severity of closed head injury
* Common effect = reduced fine motor skills – particularly timed motor tasks
To assess:
* Use tests that do not have a visual-perceptual component so that poor visualperceptual skills do not confound the findings (e.g. Halstead-Reitan Finger Oscillation
Test)
Interpreting performance
Visual-motor tests require fine motor skills, perceptual discrimination
ability, and ability to integrate perceptual and motor processes
Poor performance may reflect:
* Misperception
* Poor fine motor control
* Integrative processing difficulties
* Impulsivity / poor planning
(executive function)
Poor performance can be associated with:
* Maturational delay
* Limited intellectual stimulation
* Unfamiliarity with testing situations
* Neurological impairment
The Bender Visual-Motor Gestalt Test
- Most widely used neuropsychological test
- Popular test of the visual-motor function
- Developed in 1938 by Lauretta Bender for use as a visual-motor test with adult clinical populations and as a developmental test with children
- Individually administered, paper-and-pencil test
- 9 geometric figures
- Serves as a good icebreaker with which to begin the test session
o Task is innocuous, non-threatening, interesting, and appealing to children
Bender-Gestalt outcomes and interpretations:
* Child must copy pencil drawings
* Scored based on errors
* Koppitz (1975) generated a scoring method
Koppitz Method
Four category system used to classify errors
1. Distortion of shape
2. Rotation
3. Integration difficulties
4. Preservation
Scoring:
* 1 point per error
* Points are summed to obtain a total error score which is compared to aged normative data. Percentile norms are available for children aged 5 through
11-11 years.
Koppitz Method
Four category system used to classify errors
- Distortion of Shape
* Destruction of the Gestalt
* Misshapen figures
* Disproportions between sizes of the component parts
* Substituted shapes (e.g. circles or dashes for dots, substitution of angles,
curves, or total lack of curves where they should exist)
* Extra angles or missing angles - Rotation
* Rotation of figure or any part by 45 degrees or more
* Rotation of the card (even if the child’s drawing is copied correctly) - Integration
* Failure to connect parts of figure
o (> 1/8 inch between parts or overlap)
* Failure to cross lines or crossing incorrectly
* Omission or addition - Preservation
* Increase, continuation, or prolongation of the number of units in the design
Compensatory mechanisms
Even in the absence of errors, clinicians can observe deficits by noticing a number of compensatory mechanisms
- More time needed for completion
- “Anchoring” designs by placing finger on them while drawing
- Constant checking of original
- Child rotates page
- Drawing rushed, then painstakingly corrected
