The crucial role of the predictability of motor response in visuomotor deficits in very preterm children at school age

Aim We aimed to clarify the underpinnings of widespread visuomotor deficits in very preterm children. Method Fifty-eight very preterm children (26 males, 32 females; mean [SD] age 7y 6mo [5mo], gestational age 29.2wks [1.6]; birthweight 1237g [336]), recruited from a tertiary level neonatal intensive care unit, and 64 age-matched, comparison children born at term (28 males, 36 females; mean age [SD] 7y 8mo [7mo]) participated. IQ was measured using a short form of the Wechsler Intelligence Scale for Children (3rd edition). A research diagnosis of developmental coordination disorder (DCD) was defined as a score below the 15th centile on the Movement Assessment Battery for Children. Visuomotor performance was assessed using a computerized task, in which children followed a predictable (structured condition) or an unpredictable (non-structured condition) trail on a touch screen using their index finger. Results Forty-six per cent of the very preterm children had a research diagnosis of DCD, compared with 16% of children born at term (p<0.001, odds ratio 4.69 [95% CI 2.01-10.99]). No group difference in visuomotor performance was present for the structured condition. In the non-structured condition, children born very preterm with and without a research diagnosis of DCD had poorer visuomotor performance than those born at term. Interpretation The predictability of the required motor response plays a crucial role in visuomotor deficits in very preterm children, regardless of DCD status.