Visual profile of children with handwriting difficulties in Hong Kong Chinese

The purpose of this study was to find out the visual profiles of children with handwriting difficulties (HWD) in Hong Kong Chinese. Forty-nine children with HWD (mean age 8.4 ± 1.1 years) and 27 controls (mean age 7.7 ± 0.7 years) were recruited. All subjects received eye examination and vision assessment included ocular health, refraction, accommodative functions, binocularity, visual perception (by Gardner reversal frequency test: recognition subtest; Test of visual perceptual skills (non-motor)-revised) and motor skills (by The Beery-Buktenica developmental test of visual motor integration; Detroit test of motor speed and precision). Higher percentages of tropia and phoria (of magnitude >6 prism dioptres) were found in children with HWD of 6.1% and 14.3% respectively. After adjusted for the effect of age, children with HWD showed significantly worse accommodative facility, directionality, visual discrimination, visual spatial relation, visual form constancy, visual sequential memory, visual figure ground, visual closure and visual motor integration. Studies reported the visual functions of children with HWD were mostly concerned with alphabetic languages, while studies concerning Chinese HWD were relatively less. This study provided the visual profiles of children with Chinese HWD. Based on the visual profile, further study is indicated to investigate the effect of optometric interventions on the assessment and remediation for children with HWD.