Assessment of Gross Motor Skills Performance in Italian Children with and Without Visual Impairment

Vision plays a key role in acquiring and automating fundamental movement skills. Evidence from Italy is scarce. This study compared Test of Gross Motor Development-2 (TGMD-2) performance between Italian children with visual impairment (VI) and sighted peers and explored differences by degree of VI (severe VI vs. blindness).

This was a cross-sectional study including 38 children (VI: n = 19, 5-12 y; sighted: n = 19, 5-11 y). VI was classified per the WHO criteria. TGMD-2 was administered with adaptations suitable for VI (e.g., high-contrast cones, auditory balls, verbal cueing). Group differences (VI vs. sighted; blindness vs. severe VI; severe VI vs. sighted) were analyzed with Mann-Whitney U (α = 0.05). For participants > 10 y, raw scores were analyzed and age-equivalent scores were summarized to calculate developmental gaps.

Children with VI scored lower than sighted peers on locomotor, object control, and total TGMD-2 scores (all p < 0.001). Within VI, blindness was associated with lower locomotor, object control, and total scores than severe VI (p = 0.013; p = 0.043; p = 0.013). Children with severe VI also scored lower than sighted peers across outcomes (all p < 0.001). Based on age-equivalent estimates, average gross motor performance in VI was ~4-5 years below chronological age; values < 3 years were set to 3 years for calculation (the floor effect).

Italian children with VI show reduced gross motor competence compared with sighted peers, with a substantial developmental lag. Findings support early adapted physical education and structured movement opportunities to promote participation and inclusion. Future studies should examine long-term outcomes and contextual factors shaping motor competence in youth with VI.