Prenatal Risk Factors and Left Hemisphere Grapho-Motor Integration in Childhood Neurodevelopmental Differences: A Proposal for a New Clinical Screening and Differential Diagnosis Protocol

The aim of this study is to examine the sensitivity and differential diagnostic power of a new 3-stage clinical screening protocol consisting of the Modified Clock Drawing Test (m-CDT) and Neuro-linguistic Dictation in children and adolescents with prenatal/postnatal risk mapping for Asperger's Syndrome and Developmental Dyslexia. In a retrospective study conducted with 50 cases aged between 9 and 20 years; it was found that in 84% of the participants (n=42), the grapho-motor drawing direction developed counter-clockwise (from left to right) due to left hemisphere connectivity anomaly, and chronic hesitation was experienced in analog clock reading.

While Asperger's cases in this group wrote the dictated sentence grammatically and with punctuation; dyslexic cases showed graphomotor mirror illusion (D-d, b-p letter inversions) and punctuation omission. In 16% of the cases (n=8), despite the correct drawing of the clock, two new micro-motor biomarkers, "writing the number 9 starting from the tail" and "insistence on the minute hand fixing at the 3 o'clock position", which showed a high correlation with dyslexia, were detected.