VIP Disorders - Evaluation
What is the purpose of the Wold Sentence Copying Test?
Assess visual motor skills during copying a sentence onto a piece of paper
To analyze the DEM you need to calculate the _______ ________ for vertical, horizontal, and the __________.
adjusted time, ratio
What are the signs/symptoms of problems with motor-form perception? (2)
1) difficulty copying from the chalkboard 2) poor handwriting
What are the adjusted times and ratio for a vertical time of 52 seconds and 2 omissions and a horizontal time of 64 seconds and 2 additions?
Adjusted vertical time = 52 x 80 / (80 - 2) = 53.3 sec Adjusted horizontal time = 64 x 80 / (80 + 2) = 62.4 sec Ratio = 62.4 / 53.3 = 1.17
How is the AVIT scored? (6)
1) each correct response earns 1 point 2) zero is given for each incorrect response 3) calculate the raw score = number correct 4) find the Age Equivalency in the table 5) for children 3rd grade or below, 10 is a perfect score 6) for children 4th grade and above, 20 is a perfect score
What are the 3 sections of the Gardner Reversal Test?
1) execution 2) recognition 3) discrimination
Which cards are given to which ages on the AVIT? (3)
1) first 10 numbered test cards are presented to children in 3rd grade or below 2) all 20 items given to 4th grade and above 3) the test is discontinued after incorrect responses on three consecutive cards
What are the general characteristics of the Gardner Reversal Test? (2)
1) it has three sections and allows the patient to actually construct letters 2) it is generally considered to be an "easier" test than the Jordan
What are the 8 VIP disorders?
1) motor-bilateral integration/visual motor processing 2) visual discrimination 3) visual figure-ground discrimination 4) visual sequencing 5) long or short-term memory 6) visual spatial 7) visual closure 8) auditory-visual integration
How is the Monroe Visual III graded? (5)
1) one point is given for each correctly drawn symbol 2) ½ point is given for each partially correct symbol or reversal 3) total the points, # of correct items, and # of items tried 4) calculate the percent of correct/tried 5) compare to age based norms to find Age Equivalent
How is Part 2 (eidetic encoding) of TDS administered/scored? (3)
1) read the "Y" column words beginning with the last properly decoded word. Work backwards until 5 words are dictated 2) check for correct spelling and record the # of correctly spelled words 3) record the percentage of correctly spelled words
How is the Monroe Visual III administered? (5)
1) place the recording sheet and a pencil in front of the patient 2) "I'm going to show you a card with some drawings. You will be able to look at the card for a little while, then it will be taken away" 3) "when the card is gone, I want you to write down as many of the designs as you can remember" 4) show the cards for 10 seconds only 5) no time limit for the patient to record the images
How is the Wold Sentence Copying Test administered/scored? (5)
1) place the test on a slant board 2) "when I say go, I want you to copy this sentence. Go as fast as you can but try to be as neat as you can." 3) time for 1 minute ➙ if desired, can time to when complete 4) count the number of symbols completed (letters/min) 5) standardized by time (symbols/60 sec)
How is the Beery graded? (2)
1) point given for certain characteristics 2 find age-equivalent and percentile in grading handbook
What should you watch for when administering the Wold Sentence Copying Test? (5)
1) posture ➙ how do they approach this task? ➙ how close to the page are they sitting? ➙ tense? relaxed? nervous? 2) pencil grip/writing 3) organization on written page 4) copying/spacing 5) number of fixations per letter/word/words
How is the DEM administered? (3)
1) pre-test: call out 10 numbers 2) subtest A & B: vertical test ➙ call out 40 numbers (20 numbers on the left column and 20 on the right column) ➙ time it and repeat with a second page (total of 80 numbers) 3) horizontal test: subtest C ➙ call out the same 80 numbers, noting time and errors
What 3 things obtained from the DEM are compared to age-matched norms?
1) ratio 2) errors 3) vertical and horizontal times
How is Part 2 (phonetic encoding) of TDS administered/scored? (5)
1) read the "N" column words. Work forwards until 5 words are dictated 2) check for phonetic spelling (e.g. "shud" for "should") 3) record the # of correctly spelled words 4) record the percentage of correctly phonetically spelled words 5) this is the phonetic encoding score
The Wold Sentence Copying Test is indicated for any child complaining of... (4)
1) difficulty completing assignments 2) difficulty copying from the chalkboard 3) demonstrates poor penmanship 4) child struggling in school
What is recognition? What are the 2 types of recognition errors?
"Find it!" - this test gives more insight into the consistency of the child's left-right knowledge Two types of errors: 1) omissions 2) commissions - indicates the child is unsure or guessing
What is discrimination?
"Match it!" - we don't typically use this subtest because we get this information in a later VIP test
What is execution? What are the 2 types of execution errors?
"Write it!" - this is the test that reflects what the child does at home that causes parental concern Two types of errors: 1) unknowns 2) reversals
Where does Oklahoma rank in the "fastest talking states"?
#35 - they also use the fewest words per interaction
How is the Beery administered? (3)
1) 24 symbols total, 3 symbols per sheet 2) "make this shape, copy the symbol just like you see it" 3) NO ERASING!
What are the general steps for using the MVPT-3? (3)
1) 65 plates with four black and white choices 2) plates 1-40 used for ages 1-10, plates 14-65 used for ages >10 3) clinician reads the instructions on the back of the page VERBATIM
What are the 7 VIP tests?
1) DEM 2) TDS 3) MVPT-3 4) Wold Sentence Copy 5) Beery/VMI 6) Monroe Visual III 7) Birch Belmont
What are the 2 VIP oculomotor saccadic tests?
1) Developmental Eye Movement Test (DEM) 2) King Devick
What are the 4 VIP tests used for directional concept testing?
1) Gardner Reversal Test 2) Jordan Reversal Test 3) Piaget Left-Right Awareness Test 4) The Dyslexia Screener
Which VIP tests test visual memory? (2)
1) Monroe Visual III 2) Readalyzer/RightEye
How is part 1 of TDS administered/scored? (5)
1) Patient reads aloud the words from the word list ➙ no more than 2 secs are allowed for each word 2) mark "Y" if the word is properly pronounced, 3) mark "N" if the word is not properly pronounced ➙ continue until 3+ "N's" are marked in a grade level 4) the Decoding Level is one grade below where there were 3+ "N's" 5) continue to the next higher grade levels until there are 5 N's above the decoding level
How is the MVPT-3 scored? (2)
1) Raw Score = the number they got correct 2) find the Age Equivalent, Standard Scores, and Percentile by looking up values in grading book
Why do we do VIP testing? (2)
1) VIP testing allows you to relate the vision processing to everyday skills ➙ reading comprehension, writing, etc. 2) VIP testing allows for a common thread of communication with parents, teachers, and other professionals
Which VIP tests are used to test motor-form perception? (2)
1) Wold Sentence Copy 2) Beery Developmental Test of Visual Motor Integration
What is decoding? (2)
1) ability to read the word listed 2) words are decoded two ways: ➙ recognize words by sight which are phonetically irregular such as "should, enough" etc. ➙ phonetically break down words into units or syllables
What is encoding? (2)
1) ability to spell words 2) words are spelled two ways: ➙ spelling by sight or visualizing the word as a whole ➙ spelling by sound or breaking the word down into its sound parts
What are the general steps for performing the AVIT? (3)
1) child is shown a series of cards, each with three visual spatial patterns 2) examiner holds a pencil to tap out a pattern that corresponds to one of the stimulus patterns 3) pencil must be hidden
What are the characteristics of the Jordan Left-Right Reversals Test? (5)
1) claims to allow for early detection of learning disabilities by assessing letter, number, and word reversals 2) two overall scores: correct responses and errors 3) takes about 20 minutes 4) normal values for ages 5-18 5) the Jordan is a level B (meaning you have to have your bachelors to administer this test
What are the signs and symptoms of problems with form perception? (4)
1) confusing similar forms or symbols 2) unable to discriminate fonts 3) unable to see items in clutter 4) unable to determine the main idea
What are the 2 parts of TDS?
1) decoding 2) encoding
What is the purpose of the MVPT-3? (2)
1) determine visual perception without motor interference and compare to age-based norms 2) great test to show before and after growth
The MVPT-3 is especially helpful for which 3 groups?
1) developmentally delayed 2) traumatic brain injuries ➙ stroke victims score significantly lower than age-matched controls ➙ if MVPT raw score was 30 or less, adult stroke patients were more than 9x more likely to fail on-road driver's testing 3) learning-disabled
What are the subtests within Part II on the Jordan?
1) subtest 2-A presents 20 rows of words; the student indicates which letters are reversed 2) subtest 2-B shows 20 sentences; the student indicates reversed words (saw vs. was) 3) subtest 2-C (new) presents two columns of letter sequences; the student compares them and identifies which letters in the second column are out of sequence
How is the Jordan administered and scored? (4)
1) the Jordan-3 can be administered to individuals or small groups in 20-30 minutes 2) two scores are derived: ➙ correct responses (reversals correctly identified) ➙ errors (non-reversed items that were incorrectly identified as reversals, plus reversals that were not identified) 3) both scores are converted to percentile ranks and interpreted using cutoff scores based on score frequencies in the normative sample 4) age equivalents are also provided
What are some general considerations to keep in mind when doing VIP testing? (3)
1) use the slant boards during testing 2) make sure the patient is wearing their best correction 3) observe your patient ➙ do they show signs of stress? ➙ are they fatiguing? would it be better to test another day? ➙ good visual hygiene
What perceptual skills are tested with the MVPT-3? (6)
1) visual discrimination 2) form constancy 3) visual memory 4) visual closure 5) spatial orientation 6) figure ground
Plates 1-40 on the MVPT-3 are used for what age?
1-10
The Wold Sentence Copying Test provides normative data for what grades?
1-5
What are the levels of development regarding copying/drawing in children? (4)
2 years, 10 months - copies vertical lines 3 years - copies horizontal line and circle 3 years - copies cross (horizontal and vertical line combo) 4 years, 11 months - oblique cross
The Beery provides normative data for which ages?
2-100
The MVPT-3 provides normative data for which ages?
4-94
What was determined in the study that looked at accommodative and binocular function in dyslexia? (4)
43 control and 39 dyslexic children were matched for age, gender and IQ The dyslexic group showed significantly lower convergence and divergence reserves at near. Their accommodative amplitudes were also reduced Several other binocular measures were taken between the two groups showing no difference between the control and dyslexic children A simulated reading visual search task suggested that accommodative and vergence dysfunction were not the major cause of dyslexia.
The Monroe Visual III provides normative data for which ages?
5-10
The DEM has normative data for which ages?
6-13
Plates 14-65 on the MVPT-3 are used for what age?
> 10
Which VIP test tests for auditory/visual-auditory integration?
Birch Belmont: Auditory Visual Integration Test (AVIT)
What are the subtests within Part I on the Jordan? Who takes this part?
Children ages 5-8 take only Part 1 ➙ subtest 1-A (new) presents line drawings in rows; the student indicates which are reversed ➙ subtest 1-B presents letters and numbers; the student identifies reversals
How are scores interpreted for TDS?
Compare the patient's grade level and percentages to the table to determine deficiencies
What is the purpose of the AVIT?
Determine development level of audio/visual integration ➙ poor intersensory integration is correlated with poor reading ability
What is the purpose of the Beery?
Determine the level of visual-motor development and detect visual motor integration difficulties
What is dyslexia?
Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities
How is the Gardner Reversal Test scored?
Errors in letter construction (pt. I), in letter discrimination (pt. II) or letter matching (pt. III) are tabulated ➙ norms exist from the age of 5-15 for parts I and II & for ages 5-9 for part III ➙ separate norms exist for male and females ➙ separate norms exist for each sub-test
True or false: in order to score correctly on Beery, the drawings have to be perfect.
False - the drawings do not have to be perfect, some incorrect drawings are developmentally normal for some ages
Plates 51-55 on the MVPT-3 test what? What are the instructions? (3)
Figure ground Instructions: 1) point to the single circle 2) how many circles do you find here? 3) it could be a different size, but it has to be the EXACT same shape
Plates 9-13 on the MVPT-3 test what? What are the instructions? (3)
Form constancy Instructions: 1) look at this (point to top figure) 2) now find it here (point to four choices) 3) it could be smaller, bigger, darker, or turned on it's side
The AVIT provides normative data for which grades?
Kindergarten through 5th grade ➙ most meaningful results obtained with 1st and 2nd grades ➙ many Kindergarten aged children achieved scores equivalent to guessing
What is dysphoneidesia?
Mixed pattern deficiency of both decoding and encoding
Which VIP test is used to test form perception?
Motor Free Visual Perception Test - 3rd edition (MVPT-3)
What is a type I DEM pattern?
Normal performance
What is the purpose of the DEM?
Objectively measure eye movements and oculomotor ability ➙ tests for oculomotor and automaticity deficiencies ➙ one way to test for saccadic deficiencies ➙ allows comparison of child's performance
Score interpreting example for TDS
Our patient was in 1st Grade ➙ Part 1 Decoding: decoding at grade placement ➙ Part 2 Encoding: Eidetic Score = 80% → Above Normal ➙ Part 2 Encoding: Phonetic Score = 60% → Normal
How many parts are in the Jordan Left-Right Reversals Test?
Part I and Part II
What is dysphonesia?
Poor phonetic ability to decode unfamiliar words
What is dyseidesia?
Poor sight word recognition
How do you get the DEM ratio?
Ratio = horizontal adjusted time / vertical adjusted time
What was determined by the study that looked at what the DEM what truly measuring?
Results: there was no significant correlation between any component of DEM test performance and quantitative eye movement parameters (gain, latency, asymptomatic peak velocity, and number of corrected saccades) or symptomatology. There were significant correlations between DEM test outcome and reading performance, and which visual processing speed. Conclusion: DEM test performance does not correlate with saccadic eye movement skills or symptomatology. However, it is related to reading performance and visual processing speed. This study suggests that although DEM test times may not correlate directly with eye movement parameters, they do correlate with aspects of reading performance and thus serve a diagnostic role in clinical practice.
What is the purpose of The Dyslexia Screener (TDS)?
Screening test for three types of dyslexic coding patterns (dyseidesia, dysphonesia, dysphoneidesia). This test was developed by optometrists as a quick screener and is not widely used outside of optometry
How is the Gardner Reversal Test administered?
Section I and II are to be given to each child. Section III is simple matching and children usually do very well on this section ➙ section I: the child writes down numbers and lower case letters that are said aloud to him ➙ section II: the child discriminates between pairs of letters/numbers. He/she is to mark through the reversed symbol of the set ➙ section III: the child must match a template symbol (number or letter) to one of 4 alternatives presented
What is a type III DEM pattern?
Slow horizontal and vertical time but a normal ratio - difficulty with naming (automaticity)
What is a type II DEM pattern?
Slow horizontal time - eye movement problem
What is a type IV DEM pattern?
Slow times but an abnormal ratio - both automaticity and oculomotor problem
Plates 35-50 on the MVPT-3 test what? What are the instructions?
Spatial orientation Instructions: 1) which one of these is different from all the others? It could be turned around or a part of it could be different
What is visual memory? What are the signs of symptoms of problems with visual memory?
The ability to recall information that was seen Difficulty spelling, poor reading comprehension
What is adjusted time for the DEM? What is the formula?
The time for the vertical and horizontal scores is adjusted for additional numbers read or skipped Adj. time formula = time x 80 / (80 - o + a)
What is the purpose of the Monroe Visual III?
To assess short term visual memory and visual motor integration
True or false: there is a correlation between auditory integration and reading ability.
True
What is motor-form perception?
Understanding the visual input, but then being able to tell the hands what the eyes are seeing. Patients who struggle with form perception will likely struggle with motor-form perception
What does the King Devick look like? Where is it used?
Used at sporting events
What are the vertical and horizontal DEM tests measuring?
Vertical: automaticity time Horizontal: automaticity and eye movements
What is another name for the Beery test?
Visual Motor Integration (VMI)
Plates 22-34 and 56-60 on the MVPT-3 test what? What are the instructions?
Visual closure Instructions: 1) if we finished drawing these figures and didn't move any of the lines, which one would look JUST like the one on top? (point to the top figure)
Plates 1-8 on the MVPT-3 test what? What are the instructions? (2)
Visual discrimination Instructions: 1) look at this (point to top figure) 2) now find the one exactly like it here (point to four choices)
Plates 14-21 on the MVPT-3 test what? What are the instructions? (2)
Visual memory Instructions: 1) I'm going to show you a shape and then you'll find it on the NEXT page. Look at this one (present this page for 5 seconds.) 2) now find it here (point to four choices)
When do you have to calculate the adjusted time on DEM?
You must use the adjusted time formula if there are any addition or omission errors ➙ this is true for both the vertical and horizontal times