The Journal of Genetic Psychology

Research and Theory on Human Development

ISSN: 0022-1325 (Print) 1940-0896 (Online) Journal homepage: https://www.tandfonline.com/loi/vgnt20

Disentangling Fine Motor Skills’ Relations

to Academic Achievement: The Relative
Contributions of Visual-Spatial Integration and
Visual-Motor Coordination

Abby G. Carlson , Ellen Rowe & Timothy W. Curby

To cite this article: Abby G. Carlson , Ellen Rowe & Timothy W. Curby (2013) Disentangling Fine
Motor Skills’ Relations to Academic Achievement: The Relative Contributions of Visual-Spatial
Integration and Visual-Motor Coordination, The Journal of Genetic Psychology, 174:5, 514-533,
DOI: 10.1080/00221325.2012.717122

To link to this article: https://doi.org/10.1080/00221325.2012.717122

Published online: 27 Aug 2013.

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 The Journal of Genetic Psychology, 2013, 174(5), 514–533
Copyright C Taylor & Francis Group, LLC
doi: 10.1080/00221325.2012.717122

Disentangling Fine Motor Skills’

Relations to Academic Achievement: The
Relative Contributions of Visual-Spatial
Integration and Visual-Motor
Coordination
ABBY G. CARLSON
ELLEN ROWE
TIMOTHY W. CURBY
George Mason University

ABSTRACT. Recent research has established a connection between children’s fine motor
skills and their academic performance. Previous research has focused on fine motor skills
measured prior to elementary school, while the present sample included children ages
5–18 years old, making it possible to examine whether this link remains relevant through-
out childhood and adolescence. Furthermore, the majority of research linking fine motor
skills and academic achievement has not determined which specific components of fine
motor skill are driving this relation. The few studies that have looked at associations of sep-
arate fine motor tasks with achievement suggest that copying tasks that tap visual-spatial
integration skills are most closely related to achievement. The present study examined
two separate elements of fine motor skills—visual-motor coordination and visual-spatial
integration—and their associations with various measures of academic achievement. Visual-
motor coordination was measured using tracing tasks, while visual-spatial integration was
measured using copy-a-figure tasks. After controlling for gender, socioeconomic status,
IQ, and visual-motor coordination, and visual-spatial integration explained significant vari-
ance in children’s math and written expression achievement. Knowing that visual-spatial
integration skills are associated with these two achievement domains suggests potential
avenues for targeted math and writing interventions for children of all ages.
Keywords: academic achievement, education, fine motor skills, math, visual-spatial
integration

Address correspondence to Abby G. Carlson, George Mason University, Department of Psy-

chology, 415 Michigan Ave. NE, Washington, DC 20017, USA; [email protected]
(e-mail).

514
 Carlson et al. 515

Recent research has documented a link between children’s fine motor skills and
their academic achievement. This relation is robust, and has been found in multiple
diverse samples (Grissmer, Grimm, Aiyer, Murrah, & Steele, 2010; Son & Meisels,
2006). However, there has not yet been a clear distinction as to the specific
aspects of fine motor skill that are linked to academic performance. Fine motor
skills that involve some level of integration between fine motor and visual-spatial
abilities (often captured with copying and drawing tasks) appear to have stronger
associations with achievement as compared to fine motor skills that do not require
an integration component (Cameron et al., 2012; Grissmer et al., 2010). At the
same time, this relation has yet to be fully explored, and there has yet to be a clear
examination of which specific aspects of fine motor skills have unique influence
on achievement.
The present study differentiates between visual-motor coordination (VMC)
and visual-spatial integration (VSI) as they contribute to young children’s learning
in order to gain a more thorough understanding of the link between fine motor skills
and academic achievement. VMC involves controlling small finger movements,
whereas VSI involves creating a mental representation of an image and replicating
it with controlled small muscle movements. VSI skills are captured with tasks
that involve writing, and copying (i.e., not tracing) words and pictures onto a new
sheet of paper (Davis & Matthews, 2010). By using assessments that focus on
either tracing tasks (VMC) or copy-a-figure tasks (VSI), these two distinct skills
can be separated and their individual contributions to achievement evaluated. Fine
motor performance has recently been recognized as a potential area for targeted
classroom interventions (Mashburn & Cottone, 2011), so a full understanding
of which fine motor characteristics are related to achievement will aid in the
effectiveness of such interventions.

Motor Skills and Cognitive Development

Neuroimaging has provided evidence of a link between overall motor skills

and cognition. The prefrontal cortex, basal ganglia, and cerebellum are activated
for both motor and cognitive tasks (Diamond, 2000; Willingham, 1999). The
prefrontal cortex (PFC) has long been associated with cognitive ability, and the
cerebellum with motor ability; however, case studies of patients with localized
brain damage, as well neuroimaging studies of typically functioning individuals,
offer evidence of an overlap between the two brain structures and the two types of
abilities. Brain damage to either of these areas often results in impaired functioning
for both cognitive and motor activities (Diamond, 2000).
Additionally, cognitive and motor tasks that have not yet been automated
and require attention and focus are more reliant on cerebellum and PFC activa-
tion (Diamond, 2000). Such patterns of activation also occur when conditions
of a well-learned task change. Once a cognitive or motor task is learned to the
516 The Journal of Genetic Psychology

point of automaticity, activation in the PFC decreases (Willingham, 1999). Dia-

mond pointed to these overlaps in activation, as well as the similar developmental
timetable followed by cognitive and motor skills, as evidence of the interrelated
nature of these two constructs.
Further examination of these brain regions offers more insight into the rela-
tionship between motor development and cognitive development. The dorsolat-
eral prefrontal cortex (DPFC) is activated while selecting the appropriate motor
movement for a given scenario (e.g., picking up a pencil to draw; Willingham,
1999). The DPFC is also associated with novel, difficult, or un-automated motor
and cognitive tasks (Diamond, 2000). Activation increases in this brain region
when tasks require conscious attention and planning (Doya, 2000), and this is
applicable for both motor tasks and more demanding cognitive tasks (Diamond,
2000).
The cerebellum is associated with integration of visual information and motor
movements. More specifically, the premotor cortex and posterior parietal cortex
are activated when relations are formed between objects in the environment and
the associated motor responses necessary to carry out actions on those objects
(Willingham, 1999). In other words, the DPFC determines which motor action
to perform, and the cerebellum actually coordinates this action. This requires the
cerebellum to appropriately guide movements as they are happening, as well as
create an internal representation of the objects that are going to be manipulated or
reproduced (Doya, 2000). Neuroimaging has established an association between
this structure and general motor movements (Diamond, 2000), as well as some
elements of fine motor movement. The cerebellum has been linked to more spe-
cific fine motor tasks, including finger tapping (Rivkin et al., 2003) and sequential
finger movement tasks (Gabbard, Cacola, & Bobbio, 2011). The cerebellum co-
ordinates motor activities, and in these cases it is coordinating the fine motor
activities associated with fine motor coordination. The cerebellum has also been
associated more broadly with performance on novel cognitive tasks that require
increased attention (Diamond, 2000), as well as consolidation of various indepen-
dent cognitive functions into a coordinated approach to solving familiar problems
(Thach, 1998).
Finally, the basal ganglia has been tied to memory-guided movement (Doya,
2000), meaning more automated types of motor performance. This is in contrast
to the cerebellum, which is tied to visually guided movement. In addition, this
structure works to suppress superfluous actions while promoting appropriate motor
choices (Doya, 2000).
Although each of these structures plays its own role, they are all intertwined
and relevant to both motor and cognitive learning and performance. The PFC
builds the initial internal representations of our environments and our bodies that
the cerebellum and basal ganglia use to operate on the world. Most fine motor and
cognitive problems involve multiple components, and it is rare that one type of task
 Carlson et al. 517

will operate in a vacuum without relying on the other brain structures for successful
completion. Understanding the roles of these different brain structures provides
greater insight into the various ways that fine motor skills relate to cognition and
achievement.
Various theories relating to early motor and cognitive development offer a
further potential causal explanation for the association between children’s motor
skills and cognitive functioning. One of the first ways that children learn in-
volves mastering intentional control and coordination of their early involuntary
muscle movements (Adolph, 2005; Campos et al., 2000; Piaget, 1953). Early
in development, children’s movements are primarily reflexive responses to their
environments. Over time these reflexive movements become more cognitively
controlled as children attempt to master various motor skills (Piaget, 1953). More
specifically, when children learn new motor skills they are developing the abil-
ity to combine all of the steps involved in each motor action into an organized
framework, and such organization is likely to lead to higher-order cognitive pro-
cesses. This developmental sequence suggests that movement drives cognition
by placing an increasingly complex set of demands on children’s developing
brains (Campos et al., 2000). With each new motor skill they learn, children
continue to integrate necessary motor information, thus continuing development
of their higher-order cognitive abilities. It is through this problem-solving pro-
cess that cognition develops in response to the demands of these tasks (Adolph,
2005).
On a more basic level, Bushnell and Boudreau (1993) proposed that mo-
tor development early in life sets the stage for cognitive development because
it is through movement that children are able to have the types of interactions
with the world that lead to cognitive advances. They point to motor develop-
ment as the key event, a prerequisite without which other areas of development
will not occur as they should. This view has been reinforced in studies link-
ing children’s early motor performance with their later cognitive ability (Burns,
O’Callaghan, McDonell, & Rogers, 2004; Piek, Dawson, Smith, & Gasson, 2008).
All of these studies found that children’s motor abilities in infancy were predic-
tive of their later cognitive abilities. Of note, Piek et al. did not find a signif-
icant association between children’s fine motor and cognitive skills, although
there was an association between gross motor skills and cognition. This may
be because motor skills were assessed via a parent questionnaire, as opposed to
a direct assessment. As demonstrated previously, many authors focus on gen-
eral motor development, and those that do focus on the association between
fine motor skills and cognitive ability often do not highlight the different as-
pects of the fine motor skill set (e.g., Diamond, 2000; Thach, 1998). In reality,
fine motor performance relies on the two distinct abilities of visual perception
and motor coordination, as well as the integration of the two (Sorter & Kulp,
2003).
518 The Journal of Genetic Psychology

Fine Motor Skills and Academic Achievement

There is little research aimed at differentiating the associations from VMC

and VSI to achievement. Grissmer et al. (2010) found associations between kinder-
garten VSI skills and math and reading outcomes at age ten, but only in one of
three longitudinal datasets. Cameron et al. (2012) found associations between
preschool VSI skills and kindergarten reading skills. In both studies, VMC were
not found to be significantly associated with achievement. These studies are some
of the few that have examined separate contributions of individual facets of fine
motor skills to achievement, and both samples include only kindergarten measures
of fine motor skills. Within the general literature linking the fine motor construct
to academic achievement, much research has failed to fully explore what elements
of fine motor skills matter for achievement. A number of papers either use a com-
bined fine motor measure, or they fail to describe how the fine motor construct was
operationalized (e.g., Diamond, 2000; Gabbard et al., 2011; Thach, 1998). Those
that have examined individual components of fine motor skills (Cameron et al.,
2012; Grissmer et al., 2010) have yet to determine if one component remains as
powerful when another is held constant.

VMC. VMC can be conceptualized as fine motor coordination with a visual com-
ponent. This skill set includes such abilities as finger dexterity, motor sequencing,
and fine motor speed and accuracy. These skills are captured by various sensori-
motor tasks such as tracing, finger tapping, and imitative hand movements (Davis
& Matthews, 2010; Korkman, Kirk, & Kemp, 2007).

VSI. VSI can be conceptualized as skills that involve the organization of small
muscle movements in the hand and fingers with the processing of visual stimuli.
Visual information from the environment must be processed and integrated with
fine motor movements (Sorter & Kulp, 2003); including incorporating visual
judgments of object position and directionality with fine motor output (Korkman
et al., 2007). VSI relies more on synchronized hand-eye movements than VMC.
VSI skills are often captured with tasks that involve writing, and copying (Davis
& Matthews, 2010).
A general association has been established between fine motor skills and
academic achievement for math and reading outcomes using both concurrent
(Sortor & Kulp, 2003) and longitudinal analyses (Grissmer et al., 2010). The
strength of these associations has been found even after controlling for various
child-level predictors of achievement, and has been replicated among multiple
large-scale data sets (Grissmer et al., 2010). These findings indicate that the
relations are likely to be relevant for the majority of young children.
Part of this association is likely due to the link between motor skills and
cognitive skills established above. Children with better early cognitive abilities
enter school better prepared for academic learning in multiple domains (Duncan
 Carlson et al. 519

et al., 2007). Cognitive skills enhanced through superior early motor development
may better prepare children to learn and perform in an academic setting.
Comparisons of fine motor skills to other typical child- and family-level pre-
dictors of achievement reveal an interesting overlap. Children with lower levels
of fine motor skills also tend to have multiple additional risk factors for poor
achievement. Children with poor fine motor abilities are more often male, of
low socioeconomic status, and have parents with low levels of education (Pot-
ter, 2011). These at-risk groups often perform below average in the classroom
and on academic achievement tests, and while the aforementioned academic risk
factors are relatively stable, early deficits in fine motor skills can be drastically
improved through targeted physical and occupational therapy interventions (e.g.,
Case-Smith, 1996). This offers a potential avenue for academic interventions tar-
geting children’s fine motor skills. The possibility for intervention necessitates an
even greater need for a more clear understanding of what elements of fine motor
skill are associated with achievement.
The studies that compare different elements of fine motor skills in predict-
ing achievement have found that copy-a-figure tasks, which tap into VSI, have
stronger relations with achievement (Cameron et al., 2012; Grissmer et al., 2010).
Grissmer et al. found stronger longitudinal effects on achievement for copy-a-
design tasks as compared to drawing tasks that did not involve copying (measured
in kindergarten). This effect was present for both math and reading outcomes.
Cameron et al. assessed children’s achievement gains in kindergarten using pre-
kindergarten figure copying, person drawing, and block building tasks. Similar to
Grissmer et al.’s findings, copy-a-figure tasks were more predictive of kindergarten
language and literacy skills than the other two fine motor skill measures. Although
these findings suggest that it is likely the VSI component of fine motor skills that
relates to achievement, much of the other literature in this area does not delineate
the distinctions of the fine motor construct. It has also not yet been determined if
this relation remains robust after parsing out the effects of VMC skills.

The Present Study

Initial examinations of the link between fine motor skills and achievement used
measurements and analyses that did not always clearly differentiate between these
two integrative skills. The present study attempts to further separate the different
aspects of fine motor skills in order to determine the differing associations of
VMC and VSI with academic achievement. Specifically, this study differs from
previous work as it is the first to assess the strength of VSI skills (copy-a-figure
tasks) after first controlling for children’s basic VMC skills. Cameron et al. (2012)
determined that a VSI task was a better predictor of multiple prereading skills than
fine motor tasks that did not require children to recreate an image (i.e., building
with blocks and drawing their own pictures). In the present study we expanded on
these findings by controlling for another facet of fine motor skills.
520 The Journal of Genetic Psychology

Additionally, the available research that examines these two elements of fine
motor skill has focused on fine motor measures collected prior to Grade 1 entry
(Cameron et al., 2012; Grissmer et al., 2010). In the present study we used a broad
age range, thus addressing the question of whether the association between fine
motor skills and achievement continues after children begin formal schooling.
Here we assessed the association between these two types of fine motor
skills and concurrently measured academic achievement after controlling for IQ,
gender, and socioeconomic status (SES). We hypothesized that VSI has a stronger
association with achievement than VMC, so analyses were used to determine the
predictive power of VSI above and beyond that of VMC. The research aims of the
present study were addressed with the following research questions:

Research Question 1: Are VMC skills associated with math, reading, written
expression, and oral language achievement scores after controlling for IQ,
gender, and SES?
Research Question 2: Are VSI skills associated with math, reading, written
expression, and oral language achievement scores above and beyond VMC
skills (and other covariates)?

Method

Participants

Participants were drawn from archival data at a university Center for Psycho-
logical Services. The center serves the dual functions of being a training clinic for
graduate students in clinical and school psychology as well as being a provider of
psychological services to the community at reduced rates. Participants were in-
cluded in the study if they received a comprehensive assessment that included both
the Beery-Buktenica Developmental Test of Visual-Motor Integration (DTVMI;
Beery & Beery, 2006) and a comprehensive test of achievement. All participants
were referred by their parents for concerns including problems with attention,
social or emotional functioning, or learning problems. A total of 97 participants
had information to qualify them for the present study. Participants ranged in age
from 5 to 18 years old (M age = 10.59 years, SD = 3.39 years), and 57 were boys
or young men.

Procedures

All participants were referred to the center by their parents for a compre-
hensive psychoeducational evaluation. Comprehensive assessments conducted at
the center routinely include a measure of cognitive functioning, a broad-band
measure of academic achievement, as well as a test of visual-motor integration.
The Wechsler Intelligence Scale for Children (WISC-IV; Wechsler, 2003) and the
 Carlson et al. 521

Woodcock-Johnson Tests of Achievement (WJ-III; McGrew & Woodcock, 2001)

are the most commonly administered measures at the Center. However, because
training in child assessment is a goal, graduate students are often encouraged to
use other equivalent measures in order to broaden their assessment experience.
There was no systematic pattern for which children received which tests, but rather
this was based on the preference of the examiner or his or her supervisor.

Measures

Fine motor skills. Children’s VMC and VSI skills were measured using the
DTVMI (Beery & Beery, 2006). The DTVMI contains an overall VSI test, as
well as two supplemental tests—visual perception and motor coordination. The
present study utilized the VSI test as well as the supplemental VMC test in order
to determine if VSI skills account for a greater degree of variance in achievement
than VMC skills. The supplemental visual perception test was not the focus of the
present study and was not used in analyses.
The VSI measure requires children to copy various geometric figures, ranging
from single lines and two-dimensional shapes to three-dimensional figures and
combined shapes. All tasks involved replication of an image, which captures VSI
skills (Korkman et al., 2007). The motor coordination supplemental test requires
children to trace various geometric figures. These tasks required fine muscle
control only, and did not involve replicating an image on a separate sheet of paper.
The entire instrument can be administered to individuals preschool-aged through
adulthood.

Control variables. Children’s gender, SES, and full-scale IQ (FSIQ) were included
in analyses as control variables. Gender was recorded in each participant’s com-
prehensive assessment. SES was measured using amount paid for services, which
operated on a sliding scale based on family income, as verified by documentation
such as recent tax records.
FSIQ scores were obtained from a standardized intelligence test administered
as part of the assessment. During comprehensive assessments, children may be
tested using different cognitive measures based on the age of the examinee or the
experience or preference of the examiner. Intelligence tests included the WISC-
IV (Wechsler, 2003; n = 57), the Wechsler Adult Intelligence Scale (WAIS-IV;
Wechsler, 2008a; n = 7), the Wechsler Preschool and Primary Scale of Intelligence
(WPPSI-III; Wechsler, 2002a; n = 4), the WJ-III (McGrew & Woodcock, 2001;
n = 5), the Differential Ability Scale (DAS-II; Elliott, 2007; n = 11), the Stanford-
Binet Intelligence Scales (SB5; Roid, 2003; n = 8), and the Cognitive Assessment
System (CAS; Naglieri & Das, 1997; n = 3). All assessments were administered
and scored in accordance with their respective administration and scoring manuals.
The correlations among full-scale composite scores on intelligence tests tend to
be high. For example, the correlation between the DAS-II and the WISC-IV was
522 The Journal of Genetic Psychology

.84 (Elliott, 2007), and the correlation between the SB5 and the WJ-III was .78
(Roid, 2003).
The WISC-IV is an individually administered instrument for the assessment
of children’s cognitive abilities for children and adolescents 6–16 years old (Wech-
sler, 2003). The internal consistency for the FSIQ score is .97, and the internal
consistency for the subscales ranges from .88 to .94.
The WAIS-IV is a comprehensive measure of intelligence for examinees
age 16 years through 90 years and 11 months old (Wechsler, 2008a) with well-
established reliability and validity (Wechsler, 2008b). Internal consistency for
FSIQ is high, with a Cronbach’s alpha of .98 for the normative sample.
The WPPSI-III is designed for assessing intelligence in children age 2 years
and 6 months through 7 years and 3 months old (Wechsler, 2002a), with good
reliability and validity (Wechsler, 2002b). Internal consistency for the FSIQ is
high, with a Cronbach’s alpha of .96 (Wechsler, 2002b).
The WJ-III tests of cognitive abilities measure general intellectual ability
and specific cognitive abilities for individuals age 2–90 years old (McGrew &
Woodcock, 2001). The overall intelligence score, the General Intellectual Ability,
has a median split-half reliability of .97 (McGrew & Woodcock, 2001).
The DAS-II is an individually administered measure of cognitive abilities for
children and adolescents age 2 years 6 months through 17 years 11 months old
(Elliot, 2007). Six subtests combine to yield an overall General Conceptual Ability
score, similar to a FSIQ score. Average internal consistency is .96, and index score
reliabilities range from .89 to .95. The DAS-II is highly correlated with other tests
of cognitive ability (Elliot, 2007).
The SB5 is an individual-administered intelligence test for examinees age
2–85 years old (Roid, 2003). The 10 subtests on the SB5 combine to yield a FSIQ
score. Average reliability for FSIQ is high (.98), and the SB5 is highly correlated
with other cognitive assessments (Roid, 2003).
The CAS yields a FSIQ score and is designed for the assessment of children
age 5–17 years old. The Basic Battery is normed for children age 5–7 years
old, with reliability ranging from .84 to .90. The Standard Battery is normed for
children age 8–17 years old, with reliability ranging from .88 to .93 (Naglieri &
Das, 1997).

Academic achievement. Academic achievement was measured using subscales of

various standardized, age-normed achievement tests. The present study includes
standardized achievement scores from the Kaufman Test of Educational Achieve-
ment (KTEA-II; Kaufman & Kaufman, 2004; n = 24), WJ-III (McGrew & Wood-
cock, 2001; n = 44), and the Wechsler Individual Achievement Test (WIAT-II;
Psychological Corporation, 2001; n = 28). All three assessments are very similar
in terms of the types of constructs that are measured, with correlations among
measures ranging from .84 to .99 (Kaufman & Kaufman, 2004). Type of test
 Carlson et al. 523

completed was included in the analyses as a control variable to account for any
differences in performance based on the measure.
All three broad outcome measures of achievement provide composite scores
for math, reading, written language, and oral language; there are substantial sim-
ilarities across the three achievement measures. Reliability for these composites
was good. Math reliability scores ranged from .95 to .96, reading reliability ranged
from .94 to .98, written language reliability ranged from .94, and oral language
reliability ranged from .87 to .89 (Kaufman & Kaufman, 2004; McGrew & Wood-
cock, 2001; Psychological Corporation, 2001).
Mathematics portions of the tests include assessments of age-appropriate
math calculation abilities, as well as a subset of applied math problems that assess
math problem solving in the context of more real-world situations.
Reading scales contain a reading comprehension section as well as a letter-
word reading subtest. Comprehension is evaluated through examinee’s responses
to questions related to different passages they have read, requiring them to use
literal recall as well as make inferences based on what they’ve read.
Written language assesses alphabet writing skills, sentence and essay com-
position, and spelling. Alphabet writing and spelling skills are assessed, as well
as the ability to create grammatically correct sentences and comprehend syntax.
Written expression is evaluated through an assessment of children’s writing and
composition skills.
The oral language composites assess children’s listening comprehension and
oral expression abilities. More specifically, the listening comprehension portion of
the oral language assessment focuses on receptive vocabulary and oral discourse.
The oral expression portion of the oral language assessment focuses on expressive
vocabulary, oral fluency, and sentence repetition.

Results

Data Analysis

Multiple imputation was used to account for the small amount of missing
data (1–5%). NORM software (Version, 2.02; Schafer, 1999) was used to create
five imputed data sets and subsequent analyses were run using these iterations.
Resulting statistics were averaged across the analyses of the five imputed datasets.
Multiple imputation is a preferable way of handling missing data, as it leads to less-
biased estimates than deletion approaches (Acock, 2005). Separate hierarchical
regressions were run for math, reading, written expression, and oral language
achievement outcomes. The same predictors were entered in the same order for
each of the four regressions. Step 1 included the control variables of gender, fee for
services (as a proxy for SES), and FSIQ. Step 2 included dummy-coded variables
controlling for the type of achievement test completed. This accounts for any
524 The Journal of Genetic Psychology

TABLE 1. Descriptive Statistics

Variable n Missing M SD Minimum Maximum

Gender
Female 40
Male 57
IQ 92 5 107.15 14.36 72 141
Fee ($) 96 1 975.47 409.23 0 1200
DTVMI visual-spatial 97 92.96 12.46 70 134
DTVMI motor coordination 97 87.02 13.15 60 123
Reading achievement 93 4 106.28 13.61 70 143
Written expression 92 5 100.93 12.57 73 132
Oral language 87 10 106.85 15.28 63 143
Math achievement 95 2 104.34 17.38 66 147

Note. Fee is a proxy for socioeconomic status. DTVMI = Beery-Buktenica Developmental

Test of Visual-Motor Integration.

possible differences in performance on math, reading, written expression, and oral

language resulting from any differences across achievement tests. Step 3 included
VMC. Step 4 included VSI, in order to determine what variance in achievement
is explained by children’s VSI skills after accounting for VMC abilities. Effect
size (f 2) was calculated for each predictor. Cohen’s f 2 gives the size of the effect
for the proportion of unique variance in achievement outcomes explained by each
predictor. Based on Cohen’s (1992) guidelines, an effect of .02 is considered small,
.15 is considered moderate, and .35 and above is considered large. See Table 1
for descriptive statistics of all predictor and outcome variables. See Table 2 for
correlations among predictor and outcome variables.

Mathematics Outcomes

Fine motor coordination did not account for a significant amount of the
variance in math achievement after controlling for gender, SES, and IQ. The
addition of VSI skills in the third step of the analysis explained an additional
7.4% of the variance in math achievement, F(1, 91) = 11.03, p < .01, R2 =
.07. This was a moderately large effect (f 2 = .33). While increases in fine motor
performance did not have a significant association with children’s math scores
(β = .08), children with higher VSI scores also showed better math performance
(β = .32).
 Carlson et al. 525

TABLE 2. Correlations Among Predictors and Outcome Variables

1 2 3 4 5 6 7 8 9

1 Gender (male = 1) —
2 IQ −.05 —
3 Fee ($) .03 .29∗ —
4 DTVMI visual-spatial −.08 .37∗ .24∗∗ —
5 DTVMI motor Coordination .04 .27∗ .24∗∗ .47∗ —
6 Math achievement −.29∗ .47∗ .17 .44∗ .17 —
7 Reading achievement −.10 .53∗ .19 .26∗ .21∗∗ .37∗ —
8 Written expression .20 .53∗ .22 .43∗ .26∗ .36∗ .69∗ —
9 Oral language −.02 .69∗ .25∗∗ .31∗ .24∗∗ .32∗ .49∗ .38∗ —

Note. Fee is a proxy for socioeconomic status. DTVMI = Beery-Buktenica Developmental

Test of Visual-Motor Integration.
∗ p < .05. ∗∗ p < .01.

Language Outcomes

Reading. Fine motor coordination did not account for significant variance in read-
ing scores after controlling for gender, SES, and IQ. The VSI variable was exam-
ined while controlling for gender, SES, IQ, and motor skills, and it also was not a
significant predictor of reading performance.

Written expression. As with prior outcomes, VMC did not account for significant
variance in children’s written expression abilities after accounting for the effects
of control variables. Conversely, VSI was a significant predictor of written ex-
pression, accounting for 5.3% of the variance in performance after controlling for
gender, SES, IQ, and motor coordination, F(1, 88) = 7.91, p < .01, R2 = .05.
This was a small effect (f 2 = .09). Increases in VMC did not have a strong effect
on writing scores (β = .10), but increases in VSI skills resulted in significant
increases in written expression scores (β = .27).

Oral language. Neither VMC nor VSI skills explained significant variance in
children’s oral language scores. This variance was primarily accounted for by the
gender, SES, and IQ control variables, F(3, 92) = 26.40, p < .01, R2 = .46. See
Table 3 for regression coefficients.

Discussion

This study extends previous findings regarding the association between fine
motor skills and academic achievement, further differentiating between the VMC
 526

TABLE 3. Hierarchical Regression Analysis Predicting Math, Reading, Written Expression, and Oral Language Achievement
Scores

Math Reading Written Expression Oral Language

Variable b SE β R2 F b SE β R2 F b SE β R2 F b SE β R2 F

The Journal of Genetic Psychology

Step 1 0.286 12.31∗ 0.293 12.73∗ 0.322 14.60∗ 0.462 26.40∗

IQ 0.96 0.11 0.43∗ 0.49 0.09 0.52∗ 0.45 0.08 0.51∗ 0.70 0.08 0.67∗
SES 0.00 0.00 0.06 0.00 0.00 0.04 0.00 0.00 0.06 0.00 0.00 0.03
Gender −9.54 3.10 −0.27 −1.86 2.41 −0.07 5.73 2.20 0.22∗ 0.36 2.35 0.01
Step 2 0.019 1.23 0.088 6.38∗ 0.030 2.07 0.044 4.04∗
WIAT vs. WCJ 5.41 3.60 0.14 3.32 2.66 0.11 2.81 2.53 0.10 7.37 2.65 0.22∗
KTEA vs. WCJ 3.70 3.88 0.09 10.20 2.86 0.33∗ 5.37 2.73 0.19∗∗ 2.93 2.85 0.08
Step 3 0.006 0.78 0.004 0.53 0.009 1.27 0.005 0.86
Visual-Motor 0.11 0.12 0.08 0.06 0.09 0.06 0.09 0.09 0.10 0.05 0.10 0.05
Coordination
Step 4 0.074 10.53∗ 0.014 1.99 0.053 7.91∗ 0.003 0.65
Visual-Spatial 0.45 0.14 0.32∗ 0.15 0.11 0.14 0.28 0.10 0.27∗ 0.08 0.11 0.06
Integration
∗p < .01, ∗∗ p < .05
 Carlson et al. 527

and VSI components of fine motor skills. The present study evaluated this rela-
tionship by separating out the different components of fine motor skill, examining
differential effects on achievement for VMC and VSI, as well as determining the
strength of the association between VSI and achievement by controlling for chil-
dren’s VMC abilities. Two major findings emerged from the present study. First,
the association between fine motor skills and academic achievement can be at-
tributed to children’s VSI skills, not their VMC skills, and notably, this association
remains strong even after controlling for children’s full scale IQs and their motor
coordination skills. Second, VSI is associated with math and written expression,
but does not explain significant variance in children’s reading or oral expression
abilities. The present sample consisted of children between 5 and 18 years old,
suggesting that these associations remain meaningful throughout childhood and
adolescence.

VSI—Not VMC—Affects Achievement

VMC alone was not significantly related to children’s achievement after con-
trolling for gender, SES, or IQ. Although previous research has suggested that
fine motor skills are linked to academic achievement, it is likely that this effect is
not being driven by the VMC component of this skill, but by VSI skills. VMC,
which involves the coordination of small muscle movements in the hand may be
linked to the early development of cognitive skills (Adolph, 2005; Campos et al.,
2000; Diamond, 2000), but this relation does not appear to extend to academic
achievement among older children.
Further differentiation of the fine motor construct reveals that it is likely VSI
that is driving the association with achievement. This set of skills, which involves
processing visual information from the environment and integrating it with fine
motor movements (Sorter & Kulp, 2003), had a substantial association with chil-
dren’s performance on the math and written expression portions of standardized
achievement tests. Specifically, children with better VSI abilities demonstrated
better performance on both of these subtests. This effect was larger for math
(f 2 = .33) than written expression (f 2 = .09) abilities, suggesting that VSI skills
have a stronger association with math than with reading.
The lack of a significant association between VMC and academic achievement
may be the result of matching skills to the classroom. The tasks that are affected
by strong VMC abilities may not be as important to academic performance and
learning when children enter formal schooling and these skills become less salient.
As school places less of an emphasis on VMC skills, their benefits likely dissipate;
however, VSI skills continue to develop and are likely still beneficial to school
performance. For instance, VSI skills such as writing are frequently used in school
settings (McHale & Cermak, 1992), so it may be that as children struggle to prop-
erly write letters and numbers, cognitive resources are being deployed to writing
instead of the lesson at hand. This distinction may contribute to the differential
528 The Journal of Genetic Psychology

associations these two skill sets have with achievement, because children with
poor VSI skills miss more and more classroom content and consequently fall
behind. This redeployment of cognitive resources could easily apply to lessons
related to math or written expression.
It may also be that learning new motor coordination skills have a point at which
they are no longer beneficial to cognitive development because they reach a ceiling
of skill development; however children can continue to learn more advanced
visual-spatial skills with age, so visual-spatial learning may continue to promote
cognitive ability for a longer period of time. While infants develop cognitive skills
through VMC, visual-spatial activities like writing and drawing are not pertinent
at such an early age. However, it could be that as children become older, this same
overarching relation exists, but becomes more dependent on the development
of VSI skills as opposed to VMC because these skills are continuing salient
development. Thus, it may be that motor coordination drives very early cognitive
development, while VSI drives later cognitive development throughout childhood.
The developmental nature of these associations is a topic for future research.

VSI Affects Mathematics and Written Expression

Mathematics. Math achievement requires problem solving skills and an under-

standing of age-appropriate numerical operations. Performance of numerical op-
erations has been linked to specific areas of the brain, and these brain areas have
also been tied to visual-spatial processing abilities, suggesting a link between the
two abilities (Dehaene, Molko, Cohen, & Wilson, 2004). For instance, damage
to the cerebellum—specifically the parietal cortex—often results in impairments
to both spatial and numerical perception (Bueti & Walsh, 2009). An understand-
ing of numbers and numerical processing is thought to be found in the parietal
cortex of the cerebellum because individuals learn about quantity through motor-
based interactions with the world. Through such physical interactions we develop
the ability to judge distance and spatial location—to comprehend magnitude and
amount through comparisons of size, location, and speed in everyday lives. An
understanding of numbers and quantities is tied to an understanding of spatial
organization and related movements within this brain structure, in part because
number knowledge needs to exist in the same area as understanding of general
magnitude (Bueti & Walsh, 2009). For this reason, children with more sophisti-
cated VSI skills are likely to have more well-developed numerical abilities, leading
to superior performance in math achievement, even after controlling for typical
predictors such as IQ and nontypical but related predictors such as VMC.
Applied math tasks measure children’s skills at solving math-related prob-
lems within the context of a more real-world scenario. Such problems rely on
mathematical understanding, but they also require children to perform novel cog-
nitive tasks as they solve unfamiliar problems. The DPFC and the cerebellum
have been linked to performance on such novel cognitive tasks, specifically those
 Carlson et al. 529

that require increased attention (Diamond, 2000). Mathematical problem solving

requires children to attend to a novel problem, and performance on such problems
activates similar brain regions as does that of many novel fine motor tasks. There-
fore, children with increased VSI skills are likely to be more equipped to perform
well on these types of tasks.
Not all problems that children encounter on these tests will be completely
novel to them, but the association between VSI and mathematical problem solving
can still be understood in such contexts. The cerebellum consolidates various
independent cognitive functions into a coordinated approach to solving familiar
problems (Thach, 1998), so once again, children with good VSI skills may have
an advantage during problem-solving tasks that rely on familiar problem-solving
routines supported by the cerebellum.

Written language. Written language subtests assess children’s alphabet writing

skills, sentence and essay composition, and spelling abilities. An inadvertent result
of these measures involves a reliance on handwriting abilities, and visual-spatial
copying skills have been closely linked to handwriting ability (Daly, Kelley, &
Krauss, 2003). It stands to reason that those who have an easier time writing also
have more cognitive resources available to devote to producing grammatically
correct sentences and accurate syntax, thus resulting in better performance on this
achievement assessment.
Written language subtests require children to tackle a novel problem and
produce their own writing. Unautomated tasks such as this require increased
attention, and rely heavily on the DPFC and cerebellum (Diamond, 2000), which
also show increased activation during motor tasks that require attention. Children
with stronger VSI skills may have also developed stronger abilities regarding
completion of tasks such as this one, leading to higher written achievement.
Additionally, as with the more basic components of writing assessed in this subtest,
because children are constructing novel sentences and essays through writing,
more advanced VSI skills likely result in additional cognitive resources to devote
to this task.

Neither VSI nor VMC Is Related to Reading and Oral Expression

There was no association between either of these fine motor elements and
reading or oral language scores. Both of these skills involve assessments of re-
call, interpretation, and understanding, none of which involve manipulation and
integration of visual information, so strong visual-spatial skills are not likely to
influence these two elements of language after controlling for IQ. Unlike written
language, reading and oral expression subtests do not require children to write
during the assessment. While strong VSI skills will lighten children’s cognitive
load during the written language assessment, this is not the case during the other
two language assessments.
530 The Journal of Genetic Psychology

Additionally, reading disability research suggests that it is phonological pro-

cessing skills that matter most for reading performance, as opposed to visual-
spatial processing skills (Fletcher-Flinn, Elmes, & Strugnell, 1997). Children’s
ability to understand the individual sounds of their language and how these sounds
are represented in writing lays a framework for their reading development, and
it has been suggested that this foundational skill is the principal contributor to
reading skills. Visual-spatial processing can be associated with reading, but these
skills may be ancillary when compared to phonological skills (Fletcher-Flinn
et al., 1997). Based on this phonological deficit hypothesis, it is phonological
skills that matter for reading performance as opposed to visual-spatial processing
and integration skills (Fletcher-Flinn et al., 1997).

Limitations, Future Direction, and Implications

A causal relation cannot be assumed in the present study. The motor and
achievement tasks were administered at the same time, so the analyses were
correlational in nature. Thus, it can only be concluded that strong VSI skills at
one time point are related to strong math and writing performance at that same
time. Future researchers should examine this association within a longitudinal
framework.
An additional limitation exists regarding the generalizability of the sample.
All participants were children who were referred by their parents for a com-
prehensive assessment at a university training clinic. While the sample was a
clinic-based sample, the students’ mean FSIQ and achievement scores were in the
average range, and the scores were normally distributed. Moreover, the majority
of test scores related to particular academic domains were within the average
range or higher (97% reading; 94% mathematics; 93% written expression; 92%
oral language). Overall, then, most of the students’ scores were in the range one
would expect for a typical classroom, and most students did not appear to have
severe difficulties in academic skills. If our outcome variables were systematically
different from those found among most students, the generalizability of our find-
ings would be limited to similar groups of children and adolescents. At the same
time, we cannot assume that the present results generalize to all students, so future
researchers should consider this same question among a non-referred population.
These findings do offer insight into improving targeted interventions aimed at
children’s academic achievement. Interventions that attempt to influence achieve-
ment by improving fine motor skills should focus on enhancing children’s VSI
skills as opposed to their fine motor coordination skills. Additionally, these in-
terventions should be used for children struggling with math and writing, as VSI
seems to have a particularly strong association with these two areas of achieve-
ment. The large effect found here for math achievement suggests that such an
intervention would have an especially strong impact on children’s math perfor-
mance.
 Carlson et al. 531

AUTHOR NOTES

Abby G. Carlson is an assessment and evaluation manager for AppleTree

Early Learning Public Charter Schools. She received her PhD in applied devel-
opmental psychology from George Mason University. Her current work focuses
on early predictors of academic achievement. Ellen Rowe is an associate profes-
sor of school psychology at George Mason University. She received her PhD in
educational psychology from the University of Georgia. Her research focuses on
the assessment of children and adolescents. Timothy W. Curby is an assistant
professor of applied developmental psychology at George Mason University. He
received his PhD in educational psychology from the Curry School of Education
at the University of Virginia. His work focuses on classroom social processes that
promote children’s development.

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Original manuscript received March 22, 2012

Final version accepted June 27, 2012