Visual Perception and Fine Motor Skills Mediate Effects of Very Preterm Birth on Visual‐Motor Integration

AIM: The developmental profile underlying visual-motor difficulties in very preterm children (< 32 weeks gestation) remains unclear. The aim is to test whether visual perception and fine motor skills mediate effects of very preterm birth on visual-motor integration before school entry. METHODS: 60 very preterm and 60 term children were assessed at age 5-6 years with the Movement Assessment Battery for Children and the Developmental Test of Visual Perception. Direct and indirect effects of very preterm birth, visual perception and fine motor performance on visual-motor integration were tested using mediation analysis with SPSS. RESULTS: Mediation hypothesis was confirmed, specifically: (I) very preterm birth was associated with low visual-motor integration, fine motor skills and visual perception (β = -0.46, β = -0.44, β = -0.25, p < 0.01, respectively). (II) Fine motor skills and visual perception were positively associated with visual motor skills (β = 0.62, β = 0.43, p < 0.001). (III) In the full mediation model, the direct association of very preterm birth with visual motor integration was partially mediated by fine motor skills (β = -0.39, p < 0.001) and visual perception (β = -0.12, p < 0.001). CONCLUSION: Effects of very preterm birth on visual-motor integration are partially mediated by fine motor skills and visual perception. This developmental profile should be considered in screening and follow-up assessments. TRIAL REGISTRATION: German clinical trial register number: DRKS00011503.