Self-perception in Children Aged 3 to 7 Years With Amblyopia and Its Association With Deficits in Vision and Fine Motor Skills

Abstract

IMPORTANCE Deficits in fine motor skills and slow reading speed have been reported in school-aged children and adults with amblyopia. These deficits were correlated with lower self-perception of athletic and cognitive competence. Although perceived competence and social acceptance are key determinants of developing self-perception in young children, the association of amblyopia with self-perception and the association of altered self-perception with fine motor skills to date have not been reported for young children aged 3 to 7 years. OBJECTIVES To investigate whether amblyopia is associated with altered self-perception in young children and to assess whether any differences in self-perception are associated with deficits in vision and fine motor skills. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, conducted at a pediatric vision laboratory from January 10, 2016, to May 4, 2018, healthy children aged 3 to 7 years (preschool to second grade) were enrolled, including 60 children with amblyopia; 30 children who never had amblyopia but had been treated for strabismus, anisometropia, or both; and 20 control children. MAIN OUTCOMES AND MEASURES Self-perception was assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children, which includes the following 4 specific domains: cognitive competence, peer acceptance, physical competence, and maternal acceptance (total score range, 1-4; higher scores indicate higher perceived competence or acceptance). Fine motor skills were evaluated with the Manual Dexterity and Aiming and Catching scales of the Movement Assessment Battery for Children, second edition (score range, 1-19; higher scores indicate better skill performance). Visual acuity and stereoacuity also were assessed. RESULTS Children with amblyopia (28 girls and 32 boys; mean [SD] age, 6.3 [1.3] years) had significantly lower mean (SD) peer acceptance and physical competence scores compared with the control children (peer acceptance, 2.74 [0.66] vs 3.

Factors Associated with Impaired Motor Skills in Strabismic and Anisometropic Children

“…Manual dexterity deficits have been reported previously in children with amblyopia. [20][21][22][23][24][25] We have also reported lower scores for all manual dexterity tasks in amblyopic children; nonamblyopic children scored lower for the drawing trail only. In the MABC-2 manual dexterity scale, the unilateral (e.g., coins in a slot) and bimanual (e.g., threading beads) tasks are scored by time to completion, whereas the drawing trail task is scored by the number of drawing errors.…”

“… 29 Finally, motor impairments may affect self-esteem and self-perception. 24 , 25 , 54 Lower self-perception is evident in amblyopic children, due in part to lower scores for physical competence and peer acceptance related to worse manual dexterity and ball skills. 24 , 25 Successful treatment of the visual acuity deficits and binocular dysfunction that accompany amblyopia and strabismus may lead to improved motor abilities.…”

“…These studies have found that amblyopic children and adults have impaired fine motor skills, such as reaching, grasping, object manipulation, and transferring test answers to a multiple-choice form. [17][18][19][20][21][22][23][24][25] A limited number of studies have also found gross motor impairments in amblyopic adults and children performing tasks designed to assess postural stability and walking, [26][27][28] and such impairments can increase the risk of injury. 29 However, these studies had heterogeneous groups with limited age ranges and small sample sizes, thus making it difficult to ascertain factors associated with motor impairments.…”

Abnormal Monocular and Dichoptic Temporal Synchrony in Adults with Amblyopia

“…Although the best-corrected visual acuity of the amblyopic eye is the main outcome in clinical trials and clinical practice regarding amblyopia, recent studies have suggested that best-corrected visual acuity of the amblyopic eye might not be the main reason for the poor life quality of amblyopes. 44,45 The relationship between temporal synchrony deficits within the eye and between eyes in amblyopia and patients' quality of life will need to be further studied. In addition, accumulating evidence indicates that the poor visual performance of amblyopes in spatial visual processing can be improved by refractive correction, patching, atropine, perceptual learning, and other methods.…”

Two Patterns of Interocular Delay Revealed by Spontaneous Motion-in-Depth Pulfrich Phenomenon in Amblyopes with Stereopsis

“…Further studies are needed to explore the underlying mechanisms and to evaluate how this form of interocular processing delay affects the binocular perception and real-world performance of amblyopes in daily life. 53 – 56 It would be also interesting to see whether we can manipulate this delay precisely in combination with binocular treatments. 57 – 59 …”