Fine motor skills at preschool age and later academic skills: an indirect-effects analysis involving executive function in high-altitude Tibetan preschoolers.

Fine motor skills are associated with later academic development, but the role of executive function in this association remains insufficiently understood, particularly in high-altitude preschool populations. This two-wave half-longitudinal study examined the statistical indirect association between early fine motor skills and subsequent early academic skills involving executive function among high-altitude Tibetan preschoolers. The primary analytic cohort included 202 children born and raised in Lhasa, China (approximately 3,650 m). Fine motor skills, executive function, and early academic skills were assessed at baseline, with executive function and early academic skills reassessed approximately 10 months later. The primary structural equation model, adjusting for T2 child age, sex, T2 nonverbal intelligence, and family socioeconomic status, examined baseline fine motor skills in relation to follow-up executive function and early academic skills, with the latter specified as a latent factor indicated by mathematics, receptive vocabulary, and expressive vocabulary. T1 fine motor skills were positively associated with T2 executive function (β = 0.121,