Visual-motor skill is fundamental to human development and is an important component of psychological evaluations. The goal of the present study was to determine whether there is a correlation between visual-motor development, as measured by the Bender Visual-Motor Gestalt Test (Bender test), and sexual maturity in adolescents, based on the Tanner Stages in Adolescents. 134 adolescents from 10 to 15 years of age participated in the study. The Bender test and the Raven's Progressive Matrices Test were employed. The measures were administered individually and information on sexual maturity and the presence of developmental disorders was collected from medical charts. The results of the Bender test were not affected by gender, age, schooling, or changes stemming from puberty, but were significantly affected by having repeated a school year and by developmental disorders. An association was found with Raven's scores. The Bender test proved sensitive to developmental disorders in adolescence. No association was found between visual-motor development and sexual maturity in adolescents.

BackgroundAdherence to treatment for chronic diseases is lower in children than in adults, less extensively studied in children and is associated with multiple related factors. The aim of this study is to perform a descriptive analysis of psycho-cognitive aspects of primary caregivers of pediatric patients with chronic rheumatic diseases, as well as socioeconomic and clinical factors, family functioning and treatment satisfaction.MethodsPrimary caregivers of 90 patients were included. Pairs (caregiver plus patient) were grouped as presenting good adherence (n = 50) or poor adherence (n = 40) according to the Morisky Adherence Test. Psycho-cognitive aspects were evaluated by Adult Self-Report and Wechsler Adult Intelligence Scale tests. For statistical comparisons, quantitative variables with normal distribution were analyzed by Student’s t test, and those with non-Gaussian distribution with the Mann Whitney test. Categorical variables were analyzed by Chi square test. A multivariate logistic regression analysis was performed to estimate the contribution of the independent variables to adherence.ResultsCompared to caregivers in the good adherence group, caregivers in the poor adherence group were more likely to be classified as clinical on the scales for attention problems and externalizing problems, which include impulsiveness and aggressiveness. They also scored higher on the depressive problem scale. In addition, the average number of children per caregiver and the mean age of caregivers and patients were significantly higher in the poor adherence group, while the proportion of caregivers with higher education was lower. The poor adherence group also included a higher incidence of pediatric patients assuming sole responsibility for managing medications. Economic status, clinical factors, treatment satisfaction, family functioning and caregiver cognitive profile were not related to adherence, except for working memory index.ConclusionOlder patients, patients as the one solely responsible for medication management, and caregivers with externalizing problems, were observed to be the most strongly associated to poor adherence. Interventions aimed at adolescent patients are needed. Also, psychological programs and interventional studies to better determine caregivers’ behavioral/emotional status, and parent-child relationships are recommended.

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Visual-motor skill forms an important psycho diagnostic component and is associated with psycho-neurological aspects. The Bender Visual-Motor Gestalt Test, widely used for the evaluation of this area, is meant for children up to 11 years. In adolescence, the changes associated with puberty generate nonlinear anthropometric development resulting in mild and temporary incoordination. This study investigated the relation between visual-motor development measured by the Bender test and pubertal changes according to the Tanner scale. In all 134 adolescents of both sexes, aged from 10 to 15, who kept routine medical appointments, participated. We used the Bender Visual-Motor Gestalt Test, Raven's Progressive Matrices Test, and medical chart data. The techniques were applied individually. Pubertal changes were associated with the Bender test results showing higher scores at the G3 stage, the period corresponding to a growth spurt, compared to the G5 stage (p = .007, ES = .187), the post-growth spurt period in boys. Age and gender did not influence the Bender test scores. According to the Raven test, the g intelligence factor, interfered significantly in the visual-motor performance (r = -57%, p < .001). Schooling, repetition of a school year, and developmental problems (p = .002, ES = .156; p = .002, ES = .623; p < .001, ES = .880, respectively) obtained similar results. The Bender Test was sensitive to schooling and maturational problems during adolescence. There was an association between visual-motor development and sexual maturity in male adolescents. Our results indicate the usefulness of the Bender Test at older ages than those used in the test standardization.

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Influence of the cognitive aspects of caregivers in the adhesion of treatment in children and adolescents with chronic rheumatic diseases-preliminary data.