Risk factors for visual-motor integration and intelligence in children with craniofacial anomalies.

The purpose of this study was to investigate the relation between condition variables and child variables in children with craniofacial anomalies (CFA). Condition variables were brain anomalies, obliterated sutures, syndromic diagnosis, hypertelorism, phenotypical expression, age at craniotomy, and hospitalizations. Child variables were visual-motor integration (VMI), intelligence, and sex of subject. Setting was two university hospitals for children. Patients were 217 children with CFA, 125 boys and 92 girls, aged 5 to 16 years. Main outcome measure was the Developmental Test of VMI. Data on intelligence were obtained using different instruments, depending on the age and developmental level of the child. All IQ tests were standardized with mean 100 and standard deviation 15 or 16. Mean VMI score was 97.9 (SD = 17.1). Only 5.2% of the children scored below 70. For computing the mean IQ score, IQ scores below 50 were fixed at 0 as well as at 50. This procedure yielded a minimum mean IQ score of 94.0 (SD = 27.0) and a maximum mean IQ score of 95.8 (SD = 21.7). An IQ score below 70 was found in 14.1% of the children. A significant correlation was found between VMI and IQ score and the variables brain anomalies, syndromic diagnosis, hypertelorism, phenotypical expression, hospitalizations, and sex of subject. The majority of children with CFA (+/- 85%) score within the normal or borderline range for VMI or intelligence. Approximately 15% of the children with CFA have poor VMI skills or mental retardation. Risk factors for VMI and intelligence are the presence of brain anomalies, a syndromic diagnosis, hypertelorism, a severe phenotypical expression, a high frequency of hospitalizations, and the female sex.