Relationship of Visual Motor Integration and School Performance in Children with a History of Low Birth Weight

Tuesday, 14 July 2009

Jun Zhang, PhD, RN
College of Nursing, Seton Hall University, South Orange, NJ

Learning Objective 1: identify factors, namely LBW and impaired VMI, that are related to poor school performance in children.

Learning Objective 2: identify the relationship between VMI and different types of achievement (reading, mathematics, knowledge) in school performance.

Purpose: Low birth weight (LBW) is a public health problem which may place children at risk for poor school performance. Research indicates children with LBW history may experience learning difficulties, need remedial education, and drop out of school.  Poor school performance can have long-lasting psychological, social and economical effects on children, families and society. Visual motor integration (VMI) affects coordination ability and cognitive processing. Impaired VMI may be why LBW children perform poorly in school. The purpose of this study was to investigate the relationship of VMI and school performance of children with LBW history.
Methods: Data was retrieved from a prospective cohort study, the Neonatal Brain Hemorrhage Project, and a secondary data analyses was conducted on a regional birth cohort (n=777) from New Jersey. Developmental outcomes of LBW survivors were assessed longitudinally. Instruments: VMI was measured by Beery-Buktenica Developmental Test of VMI and evaluated by pediatricians/psychologists. School performance was measured by Woodcock-Johnson Tests of Achievement and guardians/teacher interviews. Birth weights were retrieved.
Results: MANOVA indicated VMI is a significant factor influencing poor school performance (Hotelling's trace value is .028, F=3.414, p=.018). VMI was significantly related to reading (ANOVA:F=4.639, p=.01) and mathematics (ANOVA:F=11.549, p<.001), but not knowledge performance. Both reading and mathematics scores were highest for children with higher LBW (1000-2000g) than lower LBW (<1000 g). The hypothesis that school performance will be lower for children with impaired VMI, compared to children with intact VMI was supported.
Conclusion: VMI and LBW are significant factors influencing school performance of children.  Children with intact VMI and higher birth weights performed better on reading and mathematics than children with lower birth weights and impaired VMI. Implications for nurses include monitoring children with a LBW history and collaborating with teachers and parents to provide early detection and intervention for children having school performance problems.