Beery-Buktenica Developmental Test of Visual-Motor Integration

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Purpose[edit | edit source]

The Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) is a gold standard measure designed to identify challenges related to the coordination of visual and motor skills in both children and adults[1][2]. Difficulties in this area can affect the learning ability of children[3][4][5], but can also be an early sign of dementia[6]. It is the most commonly used standardized test for testing the visual-motor integration[7][8] [9]and mainly employed in educational, medical, and research context[10]. The Beery VMI is a norm-referenced test that had been standardized through five extensive large-scale studies conducted in the USA[11].

The key objectives of using the Beery VMI include:

  • Early identification: Detecting visual-motor integration problems at an early age, allowing for timely intervention and support[12].
  • Intervention planning: Assisting in the development of targeted intervention plans for children with visual-motor integration problems.

The Beery VMI is composed of one central task: Visual-Motor Integration (VMI), and two additional tasks: Visual Perception (VP) and Motor Coordination (MC)[13][14]. The Visual Perception and Motor Coordination both gather more information concerning an individual's abilities in the event of a poor performance on the VMI.

The Beery VMI is a useful screening tool for writing[15]. Academic skills necessary for visual motor integration:

  • Gross motor skills
  • Fine motor skills
  • Visual Perception
  • Visuomotor development

Intended population[edit | edit source]

  • Target group: Individuals aged 2-100 years[1][10]
  • Children born preterm[16][17][18][19]
  • Children with Autism spectrum disorder (ASD)[7][20][21][22][23][24][25][26]
  • Children with traumatic brain injury[27]
  • Children with Brachial Plexus injury[26]
  • Children with Cerebral Palsy[26]
  • Children with Attention-Deficit/Hyperactivity Disorder (ADHD)[27]
  • Children with Developmental Coordination Disorder (DCD)[28]
  • Children with special needs[29]
  • Children with mild intellectual disability[30]
  • Children with Fetal Alcohol Spectrum Disorder (FADS)[31]
  • Children with Human Immunodeficiency Virus (HIV)[32]
  • Children with Sickle Cell Disease[33]
  • Children with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)[34]
  • Children with congenital heart disease[35]
  • Children with type 1 Diabetes[36]
  • Children with Cerebral Visual Impairment (CVI)[37]
  • Children with Strabismus with and without amblyopia[38]
  • Children with idiopathic infantile nystagmus[39]
  • Children with severe specific language impairment[40]
  • Children with speech sound problems[41]
  • Children and adults with Williams syndrome[42]
  • Children with Prader-Willi syndrome[43]
  • Children with 22q11 deletion syndrome[44][45][46]
  • Children with 3q29 deletion syndrome[47]
  • Children with obstructive sleep apnea syndrome[48]
  • Adults with obsessive-compulsive disorder[49]
  • Elderly with Alzheimer's disease[6]
  • Elderly with mild cognitive impairment[6]

Target examiner population[edit | edit source]

The Beery VMI can be used by[9][50][51][52][53]:

  • (Pediatric) Occupational therapists
  • (Pediatric) Physiotherapists
  • Educational Psychologists
  • Neuropsychologists
  • Educators

Technique[edit | edit source]

  • Administration time: Visual Motor Integration takes approximately 10-15 min. The supplemental Visual Perception (VP) and Motor Coordination (MC) tasks each take approximately 5 min[10].
  • It is crucial to adhere to the proper testing sequence: start with the Beery VMI, followed by Visual Perception, and finally Motor Coordination. This sequence is essential as the exposure of one test may influence the outcomes of another, and result in significantly affected norms[54].
  • Visual Motor Integration: the individual copies a series of geometric shapes in a developmental sequence using pen and paper. Children under the age of 5 start by mimicking the examiner's drawing tasks. The shapes start with simple line drawings and progress to more complex figures[55].
  • Visual Perception: this task assesses an individual's visual capabilities without involving the coordination of fine motor skills. For children below the age of 5, the initial steps involve pointing to various items, such as body parts and pictures from the manual. This is to gauge their ability to visually distinguish gross differences and objects. Older children and adults start by being presented with a set of visually similar figures, with one designated as the target. They must point to the item in the array that matches the target figure. The examiner records the responses, eliminating the need for fine motor control. The elapsed time is monitored from item 7, and the task ends after 3 minutes.
  • Motor Coordination: this task assesses fine motor skills independently of visual perceptual abilities. The initial three items can be evaluated based on prior observations by the examiner, considering factors whether the individual has grasped the pencil with the thumb and at least one finger. If succesful in these initial tasks, participants are given three practice items to learn how to connect dots and draw within specified borders. They are then directed to proceed with subsequent tasks within a 5-minute time limit. Starting and ending dots are provided, marking where the tracing should initiate and conclude for each line segment forming every geometric shape. This is done to reduce the perceptual demands of the task.

Scoring[edit | edit source]

The manual offers scoring guidelines and examples for all three tasks.

  • In the case of the VMI items, the examiner may apply various measurements and angles to determine a score. However, a general guideline for all tasks is ''if in doubt, score the item as passed''. The examiner manually scores from zero (no shape resemblance) to one (shape resemblance)[55].
  • For Visual Perception, one point is given for each correct item based on the individual's initial response.
  • In Motor Coordination, one point is awarded for each item where pencil marks are present between all dots and within the specified borders. There are specific additional rules for items 27 and 30.
  • Raw scores on the Beery VMI can range from 1 to 27, with a higher score reflecting a better performance[1]. Raw scores can be converted into norm scores, which are adjusted for age.
  • Poor performance on the Beery VMI is associated with difficulties in spatial organization of written text and maths[3]. The cut-off percentile for the Beery VMI, utilized in research concerning Developmental Coordination Disorder (DCD), varies based on the specific study and the studied population. Some studies propose a cut-off below the 25th percentile[1][56][57]to identify below-average motor performance. This treshold is higher than the 15th and 16th percentile cut-offs used in research to indicate severe difficulties with motor coordination affecting daily life[58][59].
  • By using the standard scores of individual sub-tests, individuals can be categorized into five categories: Well above average (scores between 130-145), Above average (scores between 115-130), Average (scores between 85-115), Below average (scores between 70-85) and Well below average (scores below 70).

Norm values[edit | edit source]

Cultural nuances, educational practices, and environmental factors can shape the way children engage with visual and motor tasks. Therefore, having norm values that are specific to a particular country ensures a more accurate and relevant assessment of visual-motor integration skills in the respective population. There is no significant difference in the VMI scores between boys and girls[60]. Practitioners should be careful when applying an evaluation in communities and cultural settings different to the ones on which it was originally standardized[11].

There are norm values for the following countries:

Evidence[edit | edit source]

The psychometric properties of the Beery VMI are:

  • Excellent test-retest reliability (0.84-0.88)[1][13][65]
  • Interrater reliability of (0.90-0.98)[1][13][65]. The Interrater reliability may be significantly affected by the extent of training and experience that the scores possess[10][66][67][68][69].
  • Internal consistency (0.81-0.82)[1][13]
  • The Beery VMI stands out in terms of psychometric properties among other instruments assessing writing readiness[70].
  • The Beery VMI has strong construct validity based on the construction of test items and strong predictive validity regarding academic outcomes[71].
  • The Beery VMI demonstrates moderate concurrent validity when compared to the Copying subtest of the Developmental Test of Visual Perception - 2nd edition[72] and the Wide Range Assessment of Visual-Motor Abilities[73], with correlation coefficients of 0.75 and 0.52 respectively[1].
  • The Beery VMI is considered to be a culture-free assessment tool by some researchers[74][75][76][77], but there is also evidence that it is not a culture- and ethnic-free assessment tool[11].
  • The Beery VMI is not sensitive in detecting change in visual-motor integration[52][78], so it should not be used as an outcome measure for assessing changes after a handwriting intervention[14][21][79][80][81][82][83].
  • The Beery VMI can serve as a valuable tool for evaluating changes over time in pediatric clinical vision studies. Its applicability spans a broad age range, with norms provided for ages 2 years through adulthood. This enables consistent longitudinal assessments using the same instrument from toddlerhood through adulthood[65].

The scoring can be time consuming, and the results can be influenced by the examiner's subjectivity and bias. This can potentially impact the sensitivity of the Beery VMI[13].

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Beery KE, Beery NA. The Beery-Buktenica developmental test of visual-motor integration: Administration, scoring, and teaching manual (6th ed.). 2010; Minneapolis, MN: NSC Pearson
  2. ↑ Crotty K, Baron IS. Beery developmental test of visual-motor integration (VMI). In: Kreutzer JS, DeLuca J, Caplan B Encyclopedia of clinical neuropsychology. Springer, Berlin. 2011; 364-365
  3. ↑ 3.0 3.1 Barnhardt C, Borsting E, Deland P, Pham N, Vu T. Relationship between visual-motor integration and spatial organization of written language and math. Optometry and Vision Science. 2005; 82: 138-143
  4. ↑ Abou-El-Saad T. Afsah O, Baz H, Shaaban W. The relationship between visual-motor integration and handwriting skills in Arabic-speaking Egyptian children at the age of 4-6 years. Egyptian Journal of Otolaryngology. 2017; 33(4): 663-669
  5. ↑ Khatib L, Li Y, Geary DC, Popov V. Meta-analysis on the relation between visuomotor integration and academic achievement Role of educational stage and disability Educational Research Review. 2021; 35(2): 100412
  6. ↑ 6.0 6.1 6.2 Malloy P, Belanger HG, Hall S, Aloia M, Salloway S. Assessing Visuoconstructtional Performance in AD, MCI and Normal Elderly Using the Beery Visual-Motor Integration Test. The Clinical Neuropsychologist. 2003; 17(4): 544-50
  7. ↑ 7.0 7.1 Green RR, Bigler ED, Froehlich A, Prigge MBD, Travers BG, Cariello AN, Lainhart JE. Beery VMI performance in autism spectrum disorder. Child Neuropsychology. 2015;22(7),795-817
  8. ↑ Brown GT, Rodger S, Brown A, Roever C. A profile of Canadian pediatric occupational therapy practice. Occupational Therapy in Health Care. 2007; 21(4), 39-69
  9. ↑ 9.0 9.1 Bagatell N, Hartmann K, Meriano C. The evaluation process and assessment choice of pediatric practitioners in the Northeast United States. Journal of Occupational Therapy, Schools, & Early Intervention. 2013; 6(2): 143-157
  10. ↑ 10.0 10.1 10.2 10.3 McCrimmon AW, Altomare AA, Matchullis RL, Jitlina K. Test Review: The Beery Developmental Test of Visual-Motor Integration. Journal of Psychoeducational Assessment. 2012; 30(6): 588-592
  11. ↑ 11.0 11.1 11.2 Lim C, Tan P, Koh C, Koh E, Guo H, Yusoff N, See C, Tan T. Beery-buktenica developmental test of visual-motor integration (Beery-VMI): Lessons from exploration of cultural variations in visual-motor integration performance of pre-schoolers. Child: Care, Health and Development. 2015; 41(2): 213-221
  12. ↑ Oberer N, Gashaj V, Roebers CM. Executive functions, visual-motor integration, physical fitness and academic achievement: Longitudinal relations in typically developing children. Human Movement Science. 2018; 58: 69-79
  13. ↑ 13.0 13.1 13.2 13.3 13.4 Axford C, Joosten A, Harris C. iPad applications that required a range of motor skills promoted motor coordination in children commencing primary school. Australian Occupational Therapy Journal. 2018; 65(1): 146-155
  14. ↑ 14.0 14.1 Hunter E, Potvin M. Effectiveness of a handwriting curriculum in kindergarten classrooms. Journal of Occupational Therapy, Schools, & Early Intervention. 2020; 13(1): 55-68
  15. ↑ Daly CJ, Kelley GT, Krauss A. Relationship between visual-motor integration and hand writing skills of children in kindergarten: A modified replication study. American Journal of Occupational Therapy. 2003; 57(4): 459-462
  16. ↑ Ibrahimi D, Mendiola Santibanez JD, Rodriguez-Reséndiz J. Visual Performance and Perceptual-Motor Skills of Late Preterm Children and Healthy Controls Using the TVPS-3rd and VMI-6th Editions. Technologies. 2023; 11(2): 53
  17. ↑ Zimmerman DL, Schned H, Unterasinger L, Kirchner L, Fuiko R, Olischar M, Klebermass-Schrehof K, Berger A, Weninger M, Giordano V. Impact of Retinopathy of Prematurity on Visual Motor Integration. Neonatology. 2023; 120: 317-324
  18. ↑ Pétursdóttir D, Holmström G, Larsson E, Böhm B. Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity. Acta Paediatrica. 2020; 110(1) : 127-133
  19. ↑ Geldof CJA, van Wassenaer AG, de Kieviet JF, Kok JH, Oosterlaan J. Visual perception and visual-motor integration in very preterm and/or very low birth weight children: A meta-analysis. Research in Developmental Disabilities. 2012; 33(2): 726-736
  20. ↑ Carsone B, Green K, Torrence W, Henry B. Beery Visual Motor Integration Scores of Children with Autism Spectrum Disorder: Undergoing Occupational Therapy. International Journal of Special Education. 2023; 38(1): 43-46
  21. ↑ 21.0 21.1 Ohl AM, Schelly D. No evidence of a minimal clinically important difference for the Beery-Buktenica Developmental Test of Visual-Motor Integration in children with autism spectrum disorder. Britisch Journal of Occupational Therapy. 2021; 85(2)
  22. ↑ Faber L, van den Bos N, Houwen S, Schoemaker MM, Rosenblum S. Motor skills, visual perception, and visual-motor integration in children and youth with Autism Spectrum Disorder. Research in Autism Spectrum Disorders. 2022; 96
  23. ↑ Green RR, Bigler ED, Froehlich A. Beery VMI and brain volumetric relations in autism spectrum disorder. Journal of Pediatric Neuropsychology. 2019; 5(3): 77-84
  24. ↑ Rosenblum S, Ben-Simhon HA, Meyer S. Predictors of handwriting performance among children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2019; 60: 16-24
  25. ↑ Zhang M, Jiao J, Hu X, Yang P, Huang Y, Situ M, Guo K, Cai J, Huang Y. Exploring the spatial working memory and visual perception in children with autism spectrum disorder and general population with high autism-like traits. Plos One. 2020; 15(7): e023552
  26. ↑ 26.0 26.1 26.2 Carsone B, Green K, Torrence W. Occupational therapy and Beery VMI scores of children with autism spectrum disorder, brachial plexus injury, and cerebral palsy. F1000 Research. 2021; 10: 515
  27. ↑ 27.0 27.1 Sutton GP, Barchard KA, Bello DT, Thaler NS, Ringdahl E, Mayfield J, Allen DN. Beery-buktenica developmental test of visual-motor integration performance in children with traumatic brain injury and attention-deficit/hyperactivity disorder. Psychological Assessment. 2011; 23(2): 805-809
  28. ↑ Valverde A, Araújo RS, Magalhaes L, Cardoso A. Relationship between visual-motor integration and manual dexterity in children with developmental coordination disorder. Cadernos Brasileiros De Terapia Ocupacional. 2020; 28(3)
  29. ↑ Papadopoulos A, Vasileiad I. Detection of difficulties and intervention programme for the improvement of visual-motor integration in preschoolers with special educational needs. Research Square. 2024
  30. ↑ Memisevic H, Djordjevic M. Visual-Motor Integration in Children with Mild Intellectual Disability: A Meta-Analysis. Perceptual and Motor Skills. 2018; 125(4): 696-717
  31. ↑ Doney R, Lucas BR. Watkins RE, Tsang TW, Sauer K, Howat P, Latimer J, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder. Research in Developmental Disabilities. 2016; 55: 346-357
  32. ↑ Odejayi R, Franzsen D, De Witt P. Visual motor integration delay in preschool children infected with HIV. South African Journal of Occupational Therapy. 2019; 49(3)
  33. ↑ Newby RF, Epping A, Geiger JA, Miller MS, Scott JP. Visual Motor Integration in Children With Sickle Cell Disease. Journal of Pediatric Hematology/Oncology. 2018; 40(7): 495-498
  34. ↑ Thorsson M, Galazka MA, Hajjari P. Fernell E, Delafield-Butt J, Gillberg C, Johnson M, Asberg Johnels J, Hadjikhani N. A novel tablet-based motor coordination test performs on par with the Beery VMI subtest and offer superior temporal metrics: findings from children with pediatric acute-onset neuropsychiatric syndrome. Experimental Brain Research. 2023; 241: 1421-1436
  35. ↑ Teixeria J, Caflisch J, Chaouch A, Beck I, Feldmann M, Polentarutti S, Balmer C, Latal B. Motor and visuomotor function in 10-year-old children with congenital heart disease: Association with behaviour. Cardiology in the Young. 2021; 32(8): 1-6
  36. ↑ Kılıçöz M, Kutlutürk Yikilmaz S, Yüksel A, Kaya Kara Ö. Comparisons of Children with and without Type 1 Diabetes on Hand and Visual Motor Integration Skills and on Participation in Daily Activities. Perceptual and Motor Skills. 2022; 129(4): 1226-1244
  37. ↑ Vancleef K, Janssens E, Petré Y, Wagemans J, Ortibus E. Assessment tool for visual perception deficits in cerebral visual impairment: reliability and validity. Developmental Medicine & Child Neurology. 2019; 62(1): 118-124
  38. ↑ Ibrahimi D, Mendiola-Santibanez JD, Gkaros AP. Analysis of the potential impact of strabismus with and without amblyopia on visual-perceptual and visual-motor skills evaluated using TVPS-3 and VMI-6 tests. Journal of Optometry. 2021; 14(2): 166-175
  39. ↑ Morelli F, Catalano G, Scognamillo I, Balzarotti N, Luparia A, Olivier L, Bertone C, Gori M, Signorini S. Visual Function and Neuropsychological Profiling of Idiopathic Infantile Nystagmus. Brain Sciences. 2023; 13(9): 1348
  40. ↑ Nicola K, Watter P. Visual-motor integration performance in children with severe specific language impairment. Child: Care, Health and Development. 2016; 42(5): 742-749
  41. ↑ Ercan AG, Yilmaz S, Tas M, Aral N. Investigation of Visual Motor Integration Skills in Children With Speech Sound Problems. Perceptual and Motor Skills. 2016; 123(3): 624-636
  42. ↑ Barisnikov K. Visual-motor integration, visual perception and motor coordination in a population with Williams syndrome and in typically developing children. Journal of Intellectual Disability Research. 2016; 60(10): 945-955
  43. ↑ Lo ST, Collin PJL, Hokken-Koelega ACS. Visual-motor integration in children with Prader-Willi syndrome. Journal of Intellectual Disability Research. 2015; 59(9): 827-834
  44. ↑ Duijff S, Klaassen P, Beemer F, Swanenburg de Veye H, Vorstman J, Sinnema G. Intelligence and visual-motor integration in 5-year-old children with 22q11-deletion syndrome. Research in Developmental Disabilities. 2012; 33: 334-340
  45. ↑ Niklasson L, Gillberg C. The neuropsychology of 22q11 deletion syndrome. A neuropsychiatric study of 100 individuals. Research in Developmental Disabilities. 2009; 31: 185-194
  46. ↑ Roizen NJ, Higgins AM, Antshel KM, Fremont W, Shprintzen R, Kates WR. 22q11.2 deletion syndrome: Are motor deficits more than expected for IQ level? Journal of Pediatrics. 2010; 157: 658-661
  47. ↑ Pollak RM, Burrel TL, Cubbels JF, Klaiman C, Murphy MM, Saulnier CA, Walker EF, White SP, Mulle JG. Visual-Motor Integration Deficits in 3q29 Deletion Syndrome. Journal of Autism and Developmental Disorders. 2023
  48. ↑ Ruberto M, Precenzano F, Parisi L, Salerno M, Maltese A, Messina G, Roccella M. Visuomotor integration skills in children affected by obstructive sleep apnea syndrome: a case-control study. Acta Medica Mediterranea. 2016; 32: 1659
  49. ↑ Block MH, Sukhodolsky DG, Dombrowski PA, Panza KE, Craiglow BG, Landeros-Weisenberger A, Schultz RT. Poor fine-motor and visuospatial skills predict persistence of pediatric-onset obsessive-compulsive disorder into adulthood. Journal of Child Psychology and Psychiatry. 2011; 52(9): 974-983
  50. ↑ Rabin LA, Barr WB, Burton LA. Assessment practices of clinical neuropsychologists in the United States and Canada: A survey of INS, NAN, and APA Division 40 members. Archives of Clinical Neuropsychology. 2005; 20: 33-65
  51. ↑ Rodger S, Brown GT, Brown A. Profile of paediatric occupational therapy practice in Australia. Australian Occupational Therapy Journal. 2005; 52(4): 311-25
  52. ↑ 52.0 52.1 Bazyk S, Michaud P, Goodman G, Papp P, Hawkins E, Welch MA. Integrating occupational therapy services in a kindergarten curriculum: A look at the outcomes. American Journal of Occupational Therapy. 2009; 63: 160-171
  53. ↑ Ohl AM, Graze H, Weber K. Effectiveness of a 10-week Tier-1 response to Intervention program in improving fine motor and visual-motor skills in general education kindergarten students. American Journal of Occupational Therapy. 2013; 67(5): 507-514
  54. ↑ Hofmeyr de Villiers N. Effects of a gross motor skills intervention on visual-motor integration of neuro-typical 5-to 6-year-old children. Faculty of Education at Stellenbosch University. 2019
  55. ↑ 55.0 55.1 Duiser I, van der Kamp J, Ledebt A, Savelsbergh G. Relationship between the quality of children's handwriting and the Beery Buktenica Developmental Test of Visual-Motor Integration after one year of writing tuition. Australian Occupational Therapy Journal. 2014; 61(1): 76-82
  56. ↑ Lahav O, Apter A, Ratzon NZ. Psychological adjustment and levels of self esteem in children with visual-motor integration difficulties influences the results of a randomized intervention trial. Research in Developmental Disabilities. 2013; 34(1): 56-64
  57. ↑ Valverde A, Araújo RS, Magalhaes L, Cardoso A. Relationship between visual-motor integration and manual dexterity in children with developmental coordination disorder. Cadernos Brasileiros De Terapia Ocupacional. 2020; 28(3)
  58. ↑ Ghayour NM, Saghaei B, Shariat A, Ingle L, Babazadeh-Zavieh SS, Shojaei M, Daneshfar A. Validity and reliability of the movement assessment battery second edition test in children with and without motor impairment: a prospective cohort study. Annals of Medicine & Surgery. 2022; 77: 103672
  59. ↑ Smits-Engelsman B, Schoemaker M, Delabastita T, Hoskens J, Geuze R. Diagnostic criteria for DCD: past and future. Human Movement Science. 2015; 42: 293-306
  60. ↑ 60.0 60.1 Ng M, Chui M, Lin L, Fong A, Chan D. Performance of the Visual-Motor Integration of Preschool Children in Hong Kong. Hong Kong Journal of Occupational Therapy. 2015; 25: 7-14
  61. ↑ Coallier M, Rouleou N. Visual-Motor skills Performance on the Beery VMI: A Study of Canadian Kindergarten Children. The Open Journal of Occupational Therapy. 2014; 2(2): 1-10
  62. ↑ Tse LF, Siu AM, Li-Tsang CW. Performance on the Developmental Test of Visual-Motor Integration and its supplementary tests: Comparing Chinese and US kindergarten children. Journal of Occupational Therapy, Schools, and Early Intervention. 2017; 10(4): 408-19
  63. ↑ Hairol MI, Nordin N, P'ng J, Sharanjeet-Klaur S, Narayanasamy S, Mohd-Ali M. Association between reduced visual-motor integration performance and socioeconomic factors among pre-school children in Malaysia: A cross-sectional study. PLOS ONE. 2021; 16(3): e0246846
  64. ↑ Harris M, Franzsen D, De Witt PA. Relevance of Norms and Psychometric Properties of Three Standardised Visual Perceptual Test for Children Attending Mainstream Schools in Gauteng. South African Journal of Occupational Therapy. 2021; 51(3): 4-13
  65. ↑ 65.0 65.1 65.2 Harvey EM, Leonard-Green TK, Mohan KM, Kulp MT, Davis AL, Miller JM, Twelker JD, Campus I, Leslie K. Interrater and test-retest reliability of the beery visual-motor integration in schoolchildren. Optometry and Vision Science. 2017; 94(5): 598-605
  66. ↑ Sortor JM, Kulp MT. Are the results of the Beery-Buktenica Developmental Test of Visual-Motor Integration and its subtests related to achievement test scores? Optometry and Vision Science. 2003; 80(11): 758-763
  67. ↑ White E, Armstrong BK, Saracci R. Principles of Exposure Measurement in Epidemiology: Collecting, Evaluating, and Improving Measures of Disease Risk Factors, 2nd ed. Oxford: Oxford University Press. 2008
  68. ↑ Chinner A, Brown T, Stagnitti K. The reliability of two visual motor integration tests used with healthy adults. Occupational Therapy and Health Care. 2011; 24(4): 308-319
  69. ↑ Volker MA, Lopata C, Vujnovic RK, Smerbeck A, Toomey J, Rodgers JD, Schiavo A, Thomeer ML. Comparison of the Bender Gestalt-II and VMI-V in Samples of Typical Children and Children with High-Functioning Autism Spectrum Disorders. Journal of Psychoeducational Assessment. 2010; 28(3): 187-200
  70. ↑ van Hartingsveldt MJ, de Groot IJM, Aarts PBM, Nijhuis-van der Sanden MWG. Standardized tests of handwriting readiness: A systematic review of the literature. Developmental Medicine and Child Neurology. 2011; 53(6): 506-515
  71. ↑ Pavlos K, McKenzie M, Knightbridge E, Bourke-Taylor H. Initial psychometric evaluation of the Hartley knows writing shapes assessment version 2 with typically developing children between the ages of 4 and 8. Australian Occupational Therapy Journal. 2020; 68(1): 32-42
  72. ↑ Hammil DD, Pearson NA, Voress JK, Frostig M. Developmental test of visual perception: DTVP-2. Austin, Tex: Pro-Ed. 1993
  73. ↑ Adams W, Sheslow D, Wide Range I. WRAVMA: Wide range assessment of visual motor abilities. Wide Range, Inc. Wilmington, del. 1995
  74. ↑ Goyen TA, Duff S. Discriminant validity of the developmental test of visual-motor integration in relation to children with handwriting dysfunction. Australian Occupational Therapy Journal. 2005; 52(2): 109-115
  75. ↑ Overvelde A, Hulstijn W. Handwriting development in grade 2 and grade 3 primary school children with normal, at risk, or dysgraphic characteristics. Research in Developmental Disabilities. 2011; 32(2): 540-548
  76. ↑ Parush S, Lifshitz N, Yochman A, Weintraub N. Relationships between handwriting components and underlying perceptual-motor functions among students during copying and dictation tasks. OTJR: Occupation, Participation & Health. 2010; 30(1): 39-48
  77. ↑ van Hoorn JF, Maathuis CGB, Peters LHJ, Hadders-Algra M. Handwriting, visuomotor integration, and neurological condition at school age. Developmental Medicine and Child Neurology. 2010; 52(10): 941-947
  78. ↑ McGarrigle J, Nelson A. Evaluating a school skills programme for Australian indigenous children: A pilot study. Occupational Therapy International. 2006; 13: 1-20
  79. ↑ Howe TH, Roston KL, Sheu CF, Hinojosa J. Assessing handwriting intervention effectiveness in elementary school students: A two-group controlled study. American Journal of Occupational Therapy. 2013; 67: 19-26
  80. ↑ Poon KW, Li-Tsang CWP, Weiss TPL, Rosenblum S. The effect of a computerized visual perception and visual-motor integration training program on improving Chinese handwriting of children with handwriting difficulties. Research in Developmental Disabilities. 2010; 31: 1552-1560
  81. ↑ Pfeiffer B, Moskowits B, Paoletti A, Brusilovskiy E, Zylstra S, Murray T. Developmental test of visual-motor integration (VMI): An effective outcome measure for handwriting interventions for kindergarten, first-grade, and second-grade students? American Journal of Occupational Therapy. 2015; 69(4): 1-7
  82. ↑ Prunty M, Barnett AL, Wilmut K, Plumb M. Visual perceptual and handwriting skills in children with Developmental Coordination Disorder. Human Movement Science. 2016; 49: 54-65
  83. ↑ Coutinho F, Bosisio ME, Brown E. Effectiveness of iPad apps on visual-motor skills among children with special needs between 4y0m-7y11m. Disability and Rehabilitation: Assistive Technology. 2017; 12(4): 402-410
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