Impact of Cerebral Visual Impairments on Motor Skills: Implications for Developmental Coordination Disorders

Abstract

Cerebral visual impairment (CVI) has become the primary cause of visual impairment and blindness in children in industrialized countries. Its prevalence has increased sharply, due to increased survival rates of children who sustain severe neurological conditions during the perinatal period. Improved diagnosis has probably contributed to this increase. As in adults, the nature and severity of CVI in children relate to the cause, location and extent of damage to the brain. In the present paper, we define CVI and how this impacts on visual function. We then define developmental coordination disorder (DCD) and discuss the link between CVI and DCD. The neuroanatomical correlates and aetiologies of DCD are also presented in relationship with CVI as well as the consequences of perinatal asphyxia (PA) and preterm birth on the occurrence and nature of DCD and CVI. This paper underlines why there are both clinical and theoretical reasons to disentangle CVI and DCD, and to categorize the features with more precision. In order to offer the most appropriate rehabilitation, we propose a systematic and rapid evaluation of visual function in at-risk children who have survived preterm birth or PA whether or not they have been diagnosed with cerebral palsy or DCD.

Keywords: cerebral palsy (CP); cerebral visual impairment (CVI); children; developmental coordination disorder (DCD); learning disorders; occipital lobe.

FIGURE 1

Stylised diagram resembling a tree denoting the visual pathways and the visual capacities they serve.

FIGURE 2

Stylised diagram illustrating homonymous visual field disorders, and the approximate location of affected brain structures. (The sinuous arrows denote the distinct pathways of the superior and inferior optic radiations around the lateral ventricles of the brain).

FIGURE 3

Coronal CT scan of bilateral posterior parietal lobe scarring in a 10 years old boy with features of Balint syndrome. (Reproduced by the author GN Dutton, from Gillen and Dutton, 2003.)

FIGURE 4

Diagram illustrating the difference between hemianopia and visual neglect. (A) Illustrates left hemianopia due to right occipital lobe damage that moves with rotation of the head and eyes (B), but not rotation of the body (C). (D) Illustrates left visual neglect due to damage of the right inferior posterior parietal lobe, that does not move with rotation of the head and eyes (E), but does move with rotation of the body (F).

FIGURE 5

Possible hypothetical links between CVI and motor coordination disorders.