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Eye-movement disorders and visual-perceptual impairment in diplegic children born preterm: a clinical evaluation
E Fedrizzi1, A Anderloni, R Bono
1Department of Child Neuropsychiatry Developmental Neurology, Istituto Nazionale Neurologico Carlo Besta, Milan, Italy.
Insights
Preterm diplegic children exhibit visual-perceptual difficulties beyond sensory loss, impacting eye movements and information processing. Their performance on visual-motor tasks is poorer and not age-dependent compared to controls.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Ophthalmology
Background:
- Preterm birth is associated with various neurodevelopmental challenges.
- Visual-perceptual and visual-motor deficits are common in children with cerebral palsy, particularly diplegia.
- Previous research often attributes these deficits solely to sensory visual impairment or motor difficulties.
Purpose of the Study:
- To investigate the visual-motor behavior of preterm diplegic children compared to typically developing controls.
- To identify specific deficits in visual-perceptual processing and eye movement control in this population.
- To determine if visual-perceptual impairments are solely due to sensory loss and fine motor issues.
Main Methods:
- Video recording of 15 preterm diplegic children and 50 control children (4-7 years) performing a visual-perceptual task.
- Analysis of parameters including task completion time, omissions, figure-color association, sequence direction, scanning order, target fitting accuracy, and anticipatory saccadic movements.
- Statistical comparison of performance between the diplegic and control groups, and correlation with age.
Main Results:
- Control children showed significant age-related improvement in task performance.
- Diplegic children performed significantly poorer overall and their scores were not age-related.
- Diplegic children made more errors in sequence direction and scanning order, and fewer anticipatory saccadic movements than controls.
Conclusions:
- Visual-perceptual impairment in preterm diplegic children extends beyond sensory visual loss and fine motor deficits.
- Difficulties in eye movement control and anticipatory information processing contribute significantly to these deficits.
- Findings highlight the need for interventions addressing oculomotor control and predictive processing in diplegic children.
Abstract:
The visual-motor behaviour of 15 preterm diplegic children and 50 control children (age range 4 to 7 years) was recorded on video as they performed a visual-perceptual task (an adaptation of the Animal House subtest of the Wechsler Preschool Primary Scale of Intelligence). The following parameters were analysed and scored: time to perform task; omissions; figure-colour association; sequence direction; sequential scanning order; accuracy of fitting target; and number of anticipatory saccadic movements to next target. The ability of the control children to perform the task improved significantly with age, as measured by performance time, mistakes in sequence direction and scanning order, accuracy of target fitting, and number of anticipatory saccadic movements. The scores of children with diplegia were not related to age and were poorer overall than those of the control group. Children with diplegia made significantly more mistakes of sequence direction and scanning order, and significantly fewer anticipatory saccadic movements than the control group. These results indicate that visual-perceptual impairment in diplegic children born preterm is not attributable only to sensory visual loss and to fine manipulation difficulties but is also related to difficulties in eye movements and in using anticipatory control to process information.