Background: Visual motor integration plays an important role in academic skills of learners in the early school years and can have an impact on their overall academic performance. Aim: This study aimed to determine the influence of socio-economic status (SES) on changes in visual-motor integration, visual perception and motor coordination over a period of three years. Setting: Four school districts in the North West province of South Africa were used. Methods: Five hundred and seventy-three learners (282 boys, 291 girls) were randomly selected (representing different SES schools) and evaluated at baseline during 2010 when they were in Grade 1 (6.9 years [plus or minus] 0.38), and again 2013 (9.9 years [plus or minus] 0.42), as part of a longitudinal research study. The Beery Visual-Motor Integration Test 4th edition was used to evaluate the visual-motor integration, visual perception and motor coordination skills at baseline and three years later. Results: Baseline measurements were higher among high SES learners in all three skills. Although learners from high SES still outperformed the learners from low SES three years later, low SES learners showed statistically significant improvements over the three years in visualmotor integration (88.24 to 89.85, p = 0.041) and visual perception (89.69 to 90.04, p = 0.001). Conclusion: Age-related development and improvement of the visual-motor integration skills were reported over the three-year period. However, more learners from the low SES still showed delays in these skills. Delays in the development of these skills could contribute to poorer academic and learning-related achievements.