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Attention and Visual Motor Integration in Young Children with Uncorrected Hyperopia
Marjean Taylor Kulp1, Elise Ciner, Maureen Maguire
11The Ohio State University, College of Optometry, Columbus, Ohio 2Salus University, Pennsylvania College of Optometry Elkins Park, Pennsylvania 3Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania 4Indiana University School of Optometry, Bloomington, Indiana 5Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 6Northeastern State University College of Optometry, Tahlequah, Oklahoma 7New England College of Optometry, Boston, Massachusetts *Kulp.6@osu.edu.
Insights
Children with moderate hyperopia (3 to 6 diopters) often show attention deficits. Reduced near vision in these children is linked to lower visual-motor integration and visual perception skills.
Area of Science:
- Ophthalmology
- Developmental Psychology
- Pediatric Optometry
Background:
- Moderate, uncorrected hyperopia in young children is associated with deficits in attention, visual-motor integration (VMI), and visual perception (VP).
- Understanding these associations is crucial for early identification and intervention strategies.
Purpose of the Study:
- To compare attention, visual-motor, and visual perceptual skills between uncorrected hyperopic and emmetropic preschool/kindergarten children.
- To evaluate the relationship between these skills and visual function in children with hyperopia.
Main Methods:
- A cohort of 4- and 5-year-old children with either moderate hyperopia (3-6 D) or emmetropia were recruited.
- Participants underwent standardized testing for attention, VMI, and VP, along with assessments of near visual acuity, stereoacuity, and accommodative accuracy.
- Analyses accounted for demographic factors including age, sex, race/ethnicity, and parental education.
Main Results:
- Hyperopic children demonstrated significantly worse scores in sustained attention and receptive attention compared to emmetropic children.
- Hyperopes with reduced near visual acuity or stereoacuity exhibited lower performance in attention, VMI, and VP.
- Conversely, hyperopic children with better near visual function generally performed similarly to their emmetropic peers.
Conclusions:
- Moderate hyperopia in children is linked to deficits in attentional abilities.
- Reduced near visual function in hyperopic children correlates with poorer visual-motor integration and visual perception skills.
- Early detection and management of hyperopia may be essential for optimizing cognitive and visual-perceptual development.
Significance:
Among 4- and 5-year-old children, deficits in measures of attention, visual-motor integration (VMI) and visual perception (VP) are associated with moderate, uncorrected hyperopia (3 to 6 diopters [D]) accompanied by reduced near visual function (near visual acuity worse than 20/40 or stereoacuity worse than 240 seconds of arc).
Purpose:
To compare attention, visual motor, and visual perceptual skills in uncorrected hyperopes and emmetropes attending preschool or kindergarten and evaluate their associations with visual function.
Methods:
Participants were 4 and 5 years of age with either hyperopia (≥3 to ≤6 D, astigmatism ≤1.5 D, anisometropia ≤1 D) or emmetropia (hyperopia ≤1 D; astigmatism, anisometropia, and myopia each <1 D), without amblyopia or strabismus. Examiners masked to refractive status administered tests of attention (sustained, receptive, and expressive), VMI, and VP. Binocular visual acuity, stereoacuity, and accommodative accuracy were also assessed at near. Analyses were adjusted for age, sex, race/ethnicity, and parent's/caregiver's education.
Results:
Two hundred forty-four hyperopes (mean, +3.8 ± [SD] 0.8 D) and 248 emmetropes (+0.5 ± 0.5 D) completed testing. Mean sustained attention score was worse in hyperopes compared with emmetropes (mean difference, -4.1; P < .001 for 3 to 6 D). Mean Receptive Attention score was worse in 4 to 6 D hyperopes compared with emmetropes (by -2.6, P = .01). Hyperopes with reduced near visual acuity (20/40 or worse) had worse scores than emmetropes (-6.4, P < .001 for sustained attention; -3.0, P = .004 for Receptive Attention; -0.7, P = .006 for VMI; -1.3, P = .008 for VP). Hyperopes with stereoacuity of 240 seconds of arc or worse scored significantly worse than emmetropes (-6.7, P < .001 for sustained attention; -3.4, P = .03 for Expressive Attention; -2.2, P = .03 for Receptive Attention; -0.7, P = .01 for VMI; -1.7, P < .001 for VP). Overall, hyperopes with better near visual function generally performed similarly to emmetropes.
Conclusions:
Moderately hyperopic children were found to have deficits in measures of attention. Hyperopic children with reduced near visual function also had lower scores on VMI and VP than emmetropic children.
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