title: Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI): lessons from exploration of cultural variations in visual-motor integration performance of preschoolers.
abstract: BACKGROUND
  Visual-motor integration (VMI) is important in children's development because it is associated with the performance of many functional skills. Deficits in VMI have been linked to difficulties in academic performance and functional tasks. Clinical assessment experience of occupational therapists in Singapore suggested that there is a potential difference between the VMI performance of Singaporean and American children. Cross-cultural studies also implied that culture has an influence on a child's VMI performance, as it shapes the activities that a child participates in. The purpose of this study was to (1) explore if there was a difference between the VMI performance of Singaporean and American preschoolers, and (2) determine if there were ethnic differences in the VMI performance of Singaporean preschoolers.
  
  
  METHODS
  The Beery-VMI, which was standardized in America, is commonly used by occupational therapists in Singapore to assess the VMI ability of children. We administered the Beery-VMI (fifth edition) full form test (excluding the supplemental tests) to 385 preschoolers (mean age = 63.3 months) from randomly selected schools in Singapore. We compared the scores of Singaporean preschoolers with those of the American standardization norms using the one-sample t-test. Scores of different ethnic groups among the Singapore population were also compared using a one-way anova, followed by the Bonferroni post-hoc test.
  
  
  RESULTS
  Singaporean preschoolers and the standardization sample of American children performed significantly differently in all age groups (P < 0.05). Among the Singapore population, the scores were also significantly different (P < 0.05) between the (i) Chinese and Malay and (ii) Chinese and Indians ethnic groups.
  
  
  CONCLUSIONS
  Preschoolers from different cultural and ethnic groups had different VMI performance. Certain cultural beliefs and practices may affect VMI performance. Clinicians should exercise caution when using an assessment in communities and cultures outside the ones on which it was standardized.
authors.affiliation: School of Rehabilitation Science, McMaster University, Ontario, Canada; Department of Child Development, KK Women's and Children's Hospital, Singapore.
authors.forename: C Y
authors.initials: CY
authors.lastname: Lim
authors.forename: P C
authors.initials: PC
authors.lastname: Tan
authors.forename: C
authors.initials: C
authors.lastname: Koh
authors.forename: E
authors.initials: E
authors.lastname: Koh
authors.forename: H
authors.initials: H
authors.lastname: Guo
authors.forename: N D
authors.initials: ND
authors.lastname: Yusoff
authors.forename: C Q
authors.initials: CQ
authors.lastname: See
authors.forename: T
authors.initials: T
authors.lastname: Tan
mesh_terms: D044466:Asian People / Q000523:psychology; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology*; D012846:Singapore; D014481:United States; D014796:Visual Perception / Q000502:physiology*; D044465:White People / Q000523:psychology
keywords: Beery; assessment; children; socio-cultural; visual-motor integration