Assessment & Research

Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder.

Doney et al. (2016) · Research in developmental disabilities 2016
★ The Verdict

Screen every child with prenatal alcohol exposure for visual-motor and fine-motor deficits—half will need help.

✓ Read this if BCBAs working with remote or Indigenous children with FASD or prenatal alcohol exposure.
✗ Skip if BCBAs serving only adult clients or children with no alcohol exposure history.

01Research in Context

01

What this study did

Researchers tested 108 remote-living Aboriginal children years.

They used three quick tests: Beery VMI for visual-motor skills, Motor Coordination subtest for fine motor, and Visual Perception subtest for seeing details.

Half the kids had confirmed FASD; half had prenatal alcohol exposure but no diagnosis.

02

What they found

Every child scored below average on visual-motor integration, even those without FASD.

Kids with FASD scored even lower on fine-motor coordination.

Nearly half of all children showed moderate to severe impairment on at least one test.

03

How this fits with other research

Bellon-Harn et al. (2020) adds that 73 % of these same kids also have big sensory processing differences.

Weinmann et al. (2023) later showed these motor and sensory problems lead to more foster-care moves.

Lim et al. (2022) systematic review warns that FASD screens miss many cases—our findings show why: motor tests catch kids the screens skip.

04

Why it matters

If you work with any child who had prenatal alcohol exposure, run a quick Beery VMI plus a fine-motor check. These simple tests flag hidden problems that standard FASD screens can miss, letting you start OT referrals and placement support earlier.

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Add the Beery VMI and a five-minute fine-motor task to your intake for any child with prenatal alcohol exposure.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
108
Population
mixed clinical
Finding
negative

03Original abstract

BACKGROUND: Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. METHODS: VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. RESULTS: Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%). CONCLUSIONS: Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments.

Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.05.009