How Long to Wait Until Using the Vmi Again
SCIENTIFIC ARTICLES
Visual perception of 5-year-old English-speaking children in Bloemfontein using the Beery VMI-6, DTVP-3 and TVPS-three
Marieta VisserI; Riette NelIi; Tasmia JansenIii; Lauren KinmontThree; Susanna Terblanché3; Jorika van WykIii
IMSc (OT) (Wits)- Department of Occupational Therapy, Faculty of Wellness Sciences, Academy of the Free State, Bloemfontein, Due south Africa
II Μ MedSc (Biostatistics) (UFS)- Department of Biostatistics, Faculty of Health Sciences, Academy of the Free Country, Bloemfontein, South Africa
Three Β OT (UFS) ivth-twelvemonth students, Section of Occupational Therapy, Faculty of Wellness Sciences, University of the Free State, Bloemfontein, South Africa at the fourth dimension of study
Correspondence
Abstruse
BACKGROUND AND AIM: The Beery-Buktenica Developmental Test ofVisual-motor Integration 6thursday edition (Beery VMI-half dozen), Development Examination of Visual Perception 3rd edition (DTVP-three) and Exam of Visual Perceptual Skills 3rd edition (TVPS-3) are the latest editions of three commonly used visual perception tests, not yet widely studied in South Africa. Enquiry on previous editions of these tests on S African children has been reported. The aim of this study was to investigate the new versions of the tests that have more recently become available in Due south Africa.
METHODS: This article reports on a quantitative, cross-exclusive investigation into the visual perception and visual-motor performance of five-year-old English language-speaking children, by using the three tests mentioned above. Threescore-eight (68) children were selected from English language of Learning and Pedagogy (ELOLT) Bloemfontein schools. Children completed the tests co-ordinate to the prescribed procedures, in a specific society and with adequate breaks betwixt tests.
RESULTS: The findings showed that the children'south operation on the Beery VMI-6 and DTVP-iii compared well to the American normative sample. However, all the children in this study scored below average in all the subtests, with the exception of the test of visual retention, and all of the composite TVPS-three scores.
CONCLUSIONS: The TVPS-three should be used with caution and preferably non as the just visual perception measuring musical instrument. Occupational therapists in Southward Africa should consider the suitability of the tests and develop instruments specifically appropriate for the South African context.
Key words: visual perceptual tests; visual-motor functioning; five-year-old children; Beery VMI-6; DTVP-3; TVPS-three
INTRODUCTION
Visual perceptual and visual-motor abilities play an important part in the performance of daily children'southward activities such as building a puzzles, dressing, reading and writing. It is of import for occupational therapists to place with which of these aspects children may have difficulties before therapeutic intervention is implemented. Standardised measuring instruments provide occupational therapists and other professionals with a reliable mensurate of a kid's perceptual abilities, to guide goal setting and evaluate intervention outcomes'.
Internationally, previously released versions of the Beery-Buktenica Developmental Test of Visual-motor Integration (Beery-VMI), the Developmental Test of Visual Perception (DTVP) and the Test of Visual Perceptual Skills (TVPS) are among the virtually commonly used measuring instruments used past occupational therapists to assess the visual perception and visual-motor abilities of childrenii-iv. Even among South African occupational therapists, these iii tests are mostly preferred, despite all of them having been developed and standardised on an American sample5. The latest editions of these three instruments have been released and are now bachelor for use in South Africa. The Beery VMI-6 was published in 20 one 0vi, the DTVP-3 in 20147 and the TVPS-3 in 2006'.
Over an extended flow, inquiry on the previous versions of these 3 tests had been conducted in numerous countries across the world2,3,nine , 24. Some of these studies also investigated aspects of the validity and reliability of the tests9". Cultural variations18 and the relationship between test results and aspects such as visioneighteen,21 and achievement tests8, have been reported. Furthermore, avariety of age groups12 and specific populations, such as individuals with item diagnoses and/or impairments, on whom these tests had been performed, accept been described23 , 28. Comparative studies on subtests (such as VMI) of these tests take also been conducted29, 30. A review of the available literature on the Beery VMI-6 was published in 201231. Despite the extensive research and published reports on earlier versions of these tests, limited research findings on the latest versions are currently bachelor.
With regard to the South African context, research on the previous versions of these tests have found unique differences in the South African population32-10. Differences in the functioning of South African children as compared to the American norms were identified in the Beery VMI and DTVP-2, TVPS-R where children would score higher up, boilerplate or below average on sure subtests. These studies take been reported and applied to provide guidance to therapists in their clinical do, to ensure that these instruments are used with care.
Only one report that investigated the latest versions of these tests used on a minor sample of 48 South African children, was presented at the 35thursday OTASA conference in 201641. It is therefore imperative to question the suitability of administering these tests to describe the unique differences found among S African children, and to propose recommendations for practice when therapists convert to the latest editions and use these visual perception tests. The aim of this study was therefore to investigate the visual perceptual and visual-motor performance of v-year-old children attention English Language of Learning and Didactics (ELOLT) schools in Bloemfontein, using the Beery VMI-6, DTVP-3 and TVPS-3.
Literature review
Visual perception is the ability to identify, organise, attach meaning to and provide sense to what is seen1. It is a highly sophisticated and integrative ability that incorporates inter-related sub-skills such equally visual-motor integration, and motor-reduced visual perceptionone. According to the Occupational Therapy Practise Framework42, visual perception is an occupational performance skill needed to support engagement and participation in daily life occupations and both visual perception and visual-motor integration are considered functionally important to childhood occupations. Visual perceptual skills tin can exist assessed during clinical observations, informal assessment and past means of standardised measuring instruments43.
The lack of contextual-specific standardised assessment instruments is a universal problem in all fields of occupational therapy. In the field of paediatric do, no comprehensive visual perceptual skills measuring instruments that take been standardised on a representative South African population, are currently available. The Early Childhood Developmental Criteria (ECDC) is used to assess visual perception and fine and gross motor aspects, and has been standardised for application in Southward Africa. However, the ECDC is only used on children between iii and six years of age44. Consequently, occupational therapists use measuring instruments standardised in other countries to assess children'due south visual perceptual skills5'33'38.
Clinicians should be cautious about using an cess instrument on individuals in communities, with cultures and languages different from the ones on which the instrument had been standardised18. Sure factors need to exist taken into consideration with regard to this detail matter, and include the following:
Research has shown that children from different cultures develop at dissimilar rates. Therefore, applying a set of norms from one culture to another could atomic number 82 to the misrepresentation of the child's true developmental status45;
Several studies have evaluated the performance of children from different countries and/or cultural groups using American paediatric standardised tests and identified differences in the outcomes18;
The level of difficulty of test items might vary depending on the child's prior experiences and exposure to educational settings20;
Results obtained by means of inaccurate evaluations can lead to misinterpretations and implications on the intervention programme18;
It can be an ethical issue if cultural bias is not considered when using these standardised tests46.
Beery VMI
The Beery is widely considered to be the best researched and most valid test of its kindvi. The outset edition of the Beery VMI test was published in 1967 and has been standardised six times up to 2010, with a total of more than 13 000 children being included in its development6. Hence it is considered as ane of the almost popular, economic and valid measuring instruments used by a wide diversity of professionals8. The Beery tin can be administered to individuals and groups 2-100 years of age in approximately 10-xv minutes6. It consists of 3 sections, namely the visual-motor integration subtest and the visual perception and motor coordination supplementary tests. The 6th edition of the Beery includes a new section on reports, inquiry and other advances such every bit a department on VMI instruction tools6.
"For the reliability of a exam as the Beery VMI requires that there will be acceptable consistency in (I) the content of the items, (2) individuals' performance on the tests when it is re-administered, and (3) scoring performance by different examiners"vi:103. The reliability of the Beery sixth edition is considered to exceed standards for the three above-mentioned aspects (for a test to exist reliable information technology must approximate or exceed .80). With regard to the validity of the Beery VMI and its supplementary tests, content, concurrent, construct and predictive validity were examined and reported to measure at very high levels of between .fourscore and .956.
The Beery VMI has been claimed to be civilisation-free6. Dark-brown and Hockey11 found that the Beery VMI-6 was suitable for apply on the Australian population, every bit their findings did not show any cultural bias in an Australian context. Nonetheless, Lim et al.18 regarded information technology as sensitive to civilisation, since several studies have shown differences in children's performance when compared to the American norms. For case, in a study conducted in Singapore using the fifth edition of the Beery VMI, a significant deviation between the performance of the Singaporean pre-schoolers and the standardised sample of American children was constitute18. Unique differences were besides observed amid Due south African children32-35,39, such as: some of the SA population presenting with lower exam performance35, or higher operation in the Motor Coordination subtest than the American normative sample33, and performance differences observed in environmentally disadvantaged34 and socio-economic status groups32.
DTVP -3
The first edition of the DTVP was published in 1961, revised into the DTVP-2 in 1993 and the tertiary edition (DTVP-three) was improved and published in 2014. The normative sample consisted of ane, 035 children from 27 states in the The states. The DTVP-three was designed for use with children 4 through 12. The testing time will range from twenty to 40 minutes depending on the kid's age and abilities. Reliability with regard to content, time and scorer, proved to exceed a coefficient of 0.80. Three types of validity were established in the DTVP-three, namely content description, benchmark-prediction and construct-identification7.
The DTVP-3 consists of five subtests. Some of the improvements in the third edition include the following7:
All-new normative information were collected in 2010 and 2011, recruiting a representative American sample (based on the 2010 U.s. Census Bureau).
Three subtests were dropped, considering the authors recognised shortcomings such as position in space, spatial relations and visual-motor speed. Position in space (PS) and Spatial Relations (SR) were dropped considering the authors recognised that there were also few hard items for children aged viii years and older. The Visual Motor speed (VMS) sub-tests was found to correlate poorly with other visual-motor integration subtest and therefore dropped.
The age range has been extended to include 12-year-onetime children.
The DTVP-3 consists of eye-hand coordination (EH), copying (CO), figure-ground (FG), visual closure (VC) and form constancy (FC) subtests.
Express research has been done on the DTVP-three after it was published in 2014. Brown and Murdoloxv stated the following in a review of the exam: "The DTVP-3 is a reliable and valid instrument, although more research is needed to assess its psychometric properties and to validate its use in other cross-cultural contexts. It is a much improved version compared to its predecessor"15 351. The construct validity of the DTVP-3 for the ii constructs visual-motor integration and reduced visual perception were confirmed for a small (N-91) sample of typical developing Australian children. Yet the copying subtest exhibited some factor complexity and further inquiry is recommended47.
Studies done on the apply of the previous edition (DTVP-two) in countries such equally Hong Kong, showed that certain subtests were too piece of cake for the children20. A factor constitute to have an influence on the lower difficulty level of these tests, was that Hong Kong children start to read and write at the age of five years20, which is a year or even two years earlier than most American children. Since Southward African children have to nourish Form I only in the yr in which they turn seven48 they are also not always exposed to reading and writing activities from an early age. Similar results were found for children from Thailand, where children enter schoolhouse at the age of three and, therefore, have early on exposure to activities that encourage writing24.
Three South African studies reported that children's scores were significantly lower in the visual closure subtest and ended that information technology was non a valid measuring tool to assess their visual closure abilities38. In other subtests (copying, figure-footing and spatial relations), children scored to a higher place the American norm. The researchers emphasised the importance for occupational therapists to keep this information in listen "in guild to translate DTVP-two results with care for the South African population"3825.
Therefore, it is clear that certain cultural experiences can affect the suitability of the use of the DTVP-two in countries other than America. The researchers from Hong Kong ended by stating that "...there is a need to ensure that norms for all tests are appropriate for the specific civilisation groups being assessed"2041.
TVPS -three
The previous TVPS editions were published in 1982 (TVPS)49 and 1996 (TVPS-R)50, followed past a few other variations, with the TVPS-3 beingness published in 2006'. The TVPS-three provides new American stratified norms based on a sample of over two 000 children. Information technology assesses an individual's visual perceptual abilities, requiring equally little as possible motor involvement when making a response1. The TVPS-3 can be completed in approximately xxx minutes, and consists of seven subtests: visual discrimination (VD), visual memory (VM), spatial relations (SR), form constancy (FC), sequential memory (SM), figure-ground (FG) and visual closure (VC). Granting that the quaternary edition, the TVPS-4 was published in 2017, it was not bachelor to the researchers at the fourth dimension of this report51.
The TVPS-3 has a high level of reliability considering it provides a consistent measure out, relatively free of mistake, the exam content has a high level of homogeneity, provides consistent measurement from one testing to the next, and shows consistency past dissimilar examiners'. The 3 types of validity, namely content, criterion-related and construct were examined and proved to be appropriate to assess construct visual perceptionone.
A few structural changes that were made to the test include the following:
The TVPS-3 is now i test, instead of ii, for utilise with individuals 4-18 years of age.
The subtest structure changed to be more uniform - all subtests have a uniform length of 16 items each and two case items (instead of one), which can exist used to teach the task.
A new optional scoring component for the composite scores was included (basic processes, sequential processing and complex processing) to allow the examiner to evaluate related skills.
Simply ane study could exist establish on the use of the TVPS-3 in countries other than the Usa. This study (aimed to investigate the convergent validity of the DTVP-2 with Beery VMI and TVPS-3) found that the TVPS-3 was suitable to use on the Australian population xi, showing that these visual perception tests that were standardised in America could by and large exist suitable for use in Australia.
AIM
The aim of this study was to describe the visual perception and visual-motor functioning of five-twelvemonth-quondam (v years 6 months to five years I I months) English-speaking children in Bloemfontein, South Africa, past using the Beery VMI-6, DTVP-3 and TVPS-iii measuring instruments' accepted norms. The objectives of the report were firstly, to depict and compare the Beery VMI-6, DTVP-3 and TVPS-iii visual-perceptual and visual motor subtests and secondly to investigate the gender differences in operation of the Beery VMI-6, DTVP-and TVPS-3 on a sample of five-year old English-speaking children in Bloemfontein.
METHODOLOGY
Design
A quantitative, cross-sectional study design was employed.
Population and sampling
Since the DTVP-2 was standardised in English and is not available in any other language, the written report population focused on children who were able to understand and speak English. The study sample was therefore recruited from English language Language of Learning and Teaching (ELOLT) public and private schools with Course pre-R and Grade R classes in Bloemfontein. English is considered the language medium through which learning and didactics, including assessment occurs52 at these schools.
From the 22 schools identified through the Free State Department of Basic Education (personal communication; Corina Botha 16/02/2016), seven schools were eligible to be included in the written report. The remaining schools either were not suitable (east.1000. did non have a grade R form), did not agree to participate, had insufficient contact details, or did not reply to phone calls and emails afterwards several attempts to contact them. Written informed consent was obtained from the principals and the teachers involved at the eligible schools prior to the written report.
The seven participating schools were contacted to obtain information with regard to the number of Course pre-R and Form R classes they had, how many children at that place were, how many were boys and girls, and how many of the children in these classes cruel within the age subclass of this study.
Children were included in the written report if they were anile betwixt 5 years 6 months and v years I I months of historic period, had been attending an ELOLT school since January 201 6, and were able to speak and understand English. This specific age was selected equally other similar studies had been done on the aforementioned age group, and therefore the findings of this study could be compared to those reported by those studies36, 53.
Children were excluded from the written report if any of the post-obit aspects were indicated on the parent/caregiver questionnaire:
the child had concrete and/or cognitive disabilities or limitations due to a pathology that could negatively influence their participation during the tests;
the kid presented with any sensory, concrete or emotional harm or any condition that could influence their participation and/or test results;
the child had been tested by ways of the three tests within the preceding six months earlier the research was conducted;
the child had received occupational therapy intervention or whatsoever other type of therapy, such as seeing a psychologist earlier the study;
the parents/guardians did not give consent for the child's participation in the report; and
A full number of 187 potential children, of which 97 (51.9%) were boys, were identified. The parents/guardians of these 187 children received data letters and parent questionnaires. With only 122 of these questionnaires beingness completed and returned inside the planned research execution time frame, the response rate was 65.2%. However, 53 of these did not meet the inclusion/ exclusion criteria and one kid was absent-minded during data collection, giving a total of 68 children who participated in the study.
As a effect of express returned consent forms received from parents, express time and finances bachelor to resend questionnaires or transport reminders to parents who had not returned the questionnaires, a convenience sampling method was used instead of the originally planned randomised sampling. Consequently, a small subpoena to the protocol was submitted and approved past the Health Sciences Research Ethics Committee of the Academy of the Gratis State.
Data collection
The fourth year occupational therapy student researchers, who nerveless the information, had theoretical and clinical grooming in the use of all three tests from their second year. To ensure that all the administration and scoring were done according to the prescribed guidelines, revised preparation and competency evaluation was done by the enquiry supervisor (who is a qualified occupational therapist with paediatric feel in all three the tests), prior to information collection.
A pilot written report was done on four children at two of the participating schools using the prescribed guidelines of each test. It was conducted in guild to orientate each of the 4 educatee researchers and teachers to the inquiry procedure, to determine how long the tests might take on boilerplate, to determine whether the children understood the assent forms, whether the study setting was advisable, and to identify whether the break times between tests were sufficient. Since no adjustments were required to the prescribed administration and scoring of the tests, the data nerveless from the pilot study were included in the results of the principal written report.
Two educatee researchers were assigned per school and assessed 4 children individually per day. The allocated venue was prepared to ensure minimal distractions and was equipped with age-advisable tables and chairs. Afterward assent was obtained from the child, the TVPS-iii was administered, after which the child received a 60 infinitesimal break during which he/she went dorsum to course.
To enhance reliability, the three tests were administered in the same social club, by all four researchers, in the same language (English) and co-ordinate to the prescribed method of each musical instrument'southward Examiner'south Manualane,6,seven. The researchers used the original tests - and scoring booklets to comply with copyright of the publishing companies.
The researchers used the corresponding tables in each musical instrument'due south Examiner's Manuali,6,7 to convert the raw scores of all the subtests to the standard scores for each of the three tests. Furthermore, to foreclose possible clerical errors, the scoring of the three tests was verified on the exam booklets past a researcher who did not conduct the examination. After scores were verified, the raw- and standard scores were transferred to information score sheets past 2 researches and verified by the two other researches. Lastly, a biostatistician verified the data on the score sheets before data analysis.
Information assay
Descriptive statistics, namely frequencies and percentages for categorical data and medians and percentiles for continuous data, were calculated per subtest/gender, and compared past ways of 95% confidence intervals (95% CI) for the median differences.
The data management procedure that was used for this study is the filing and storing of the data within the Department of Occupational Therapy, in a locked chiffonier where it will remain for fifteen years.
Upstanding considerations
Approval for this study was obtained from the Health Science Inquiry Ethics Committee of the Faculty of Health Sciences, University of the Free Land (reference HSREC-S 15/2016). To ensure upstanding deport, written permission was granted by the Free Country Department of Bones Education, the participating schools' principals and class teachers. Consent was obtained from all the parents/guardians of the participating children and assent from the children was obtained prior to the written report.
RESULTS AND DISCUSSION
Demographic data
7 schools were included in the study and all of the children were in Grade R. The largest function of the sample was from the 2 schools from which the nigh parent consent forms were obtained (76.five% of the sample; n=52). Of the 68 children, 40 (58.viii%) were girls. The sample consisted of a heterogeneous grouping of 61 (89.7%) black, five (7.four%) coloured and ii (2.9%) white children. The median age was 5 years 8 months, ranging between v years 6 months and 5 years 11 months.
Beery VMI-6
Tabular array I on folio 20 indicates that for all the subtests of the Beery VMI-6, the children scored below the American standard score (SS) norm of 100, but inside the normative range of 85 to I 15half dozen. Children performed the best in the motor coordination subtest (SS 98), followed past the visual-motor integration (SS 96) and the visual perception (SS 92) subtests.
These findings were similar to those reported by Doney et al.54, who found that Aboriginal children in a remote region of Australia obtained slightly lower mean standard scores (motor coordination SS 95.i; visual perception SS 97.nine; and visual-motor integration SS 89.6) than the American norms, but within the range of 85 to I I v. Conversely, Green et al.55 reported that a group of typical developing American children obtained higher mean visual-motor integration standard scores (105.17). The hateful visual-motor integration scaled score of 9 measured in this written report was like to a previous Due south African report on the aforementioned examination version, in which the children obtained a scaled score for visual-motor integration of 9.4741.
A statistically significant divergence was found in the motor coordination subtest when comparison the genders, with girls performing ameliorate. This finding was comparable to a similar study20 where improve performance was noticed amongst girls in the visual-motor integration sub-test, which had been attributed to the girls' tendency to be more cautious and slower in performing these visual-motor taskstwenty. Parsa56 too found that girls are decumbent to cull more figurative, soothing and fine motor activities, in comparison to boys who tend to participate in lively activities (as well called gross motor activities). These gender differences imply that therapists should take this finding into account in clinical practice.
Based on these findings, the Beery VMI-6 appears to be a suitable musical instrument for this sample of SA children, not displaying extreme functioning differences in whatsoever of the subtests31. The implication for clinical practice is that the Beery VMI-6 may exist used as a skilful initial measurement instrument31 as role of a comprehensive cess.
DTVP -3
Table Ii below summarises the median scaled scores obtained by children for the heart-hand coordination subtest (SS 9), copying (SS 10), figure-basis (SS 8) and form constancy (SS 8.5), as compared to the American normative scaled score of 10 for all these subtests and a normative range of 7 to I three.
Table II -Click to enlarge
The eye-hand coordination subtest in the DTVP-iii (SS nine) had a lower normative median scaled score compared to the American norm, only was consistent with Harris41 who obtained ascaled score of 8.vii in the DTVP-3 for children aged six-9 years and Visser37, who established a mean scaled score of 9.2 in South African children anile 5 years and 6 years, using the DTVP-ii. On the contrary, Smith36 and Visser et al.38 found that their South African sample scored higher on the eye-paw coordination subtest of the DTVP-2 than the American normative sample.
The results on the copying subtest (SS ten) were similar to those reported by Smith36, with a scaled score of 9.three on the DTVP-2. However, Harris41 obtained a higher scaled score of I I. I for copying in the DTVP-iii. The effigy-ground (SS 8) and form continuance (SS eight.v) subtests' results of the DTVP-3 were lower in comparing to a previous study using the DTVP-2, for which scaled scores of 10.v and I i.eight, respectively, were obtained36. This finding could be indicative of these specific subtests probably beingness more hard to perform on the DTVP-three compared to the previous version of the exam. Harris41, all the same, obtained higher scaled scores for figure-ground (10.2) and class constancy (10.ii) with the DTVP-iii.
Compared to results from the other subtests, the children's performance in the visual closure subtest did not autumn inside the normative range and yielded the lowest score (SS 7.5). This observation was reported earlier in South African studies on the DTVP-2, and questioned the contextual ceremoniousness of specifically the visual closure subtests36 , 38. In all three of these studies visual closure scores were below the normative range for these South African samples. However, this subtest was non removed, the particular linearity was changed and a scaled score of 9.7 was obtained by Harris41 on the DTVP-3 in SA. Farther investigation is even so recommended.
The children's median composite scaled scores for visual-motor integration (98.5), motor-reduced visual perception (88) and general visual perception (93) scored below the American norm of 100 but within the normative range of 85 to I 15. When comparing genders, it was noted that for the subtests on eye-mitt coordination, copying and figure-ground, both boys and girls obtained the same median scaled scores. At that place was a tendency, however, for boys to perform meliorate than the girls on the visual closure subtest. Although girls performed better with regard to form constancy, motor-reduced visual perception and general visual perception, none of these gender differences were statistically significant.
TVPS -3
According to the information shown in Table III below, all the children obtained a median scaled score lower than the normative range (SS viii to x), and lower than the American norm of 10 on six of the seven subtests, namely visual bigotry SS seven), special relations (SS 6), class continuance (SS half-dozen), sequential memory (SS 6), effigy-ground (SS seven) and visual closure (SS 7). The children obtained a median scaled score within the normative range only in the visual memory subtest (SS 8).
Table Three -Click to overstate
It is evident from the results that between the tree tests, the children's functioning on the TVPS-3 were the lowest, and therefore can perhaps be considered as the most difficult of the three tests. The clinical implication of this finding is that therapists should be aware of the findings and should therefore not use the TVPS-3 equally their only visual perceptual assessment instrument.
Nevertheless, higher scaled scores were obtained on all the subtests in another South African study on the TVPS-341, with scaled scores ranging betwixt eight.8 for both visual bigotry and class constancy and I 3.one for spatial relations. Critical investigative questions need to be asked in society to understand possible reasons for the large differences observed in the specific population of South African children investigated in this study. The children'due south poor performance on this exam cannot be ascribed to fatigue, since this was the kickoff test administered.
The spatial relations subtest requires the children to sympathise and comprehend the word "different". In the Curriculum and Assessment Policy Statements of South Africa57, it is expected of a Course R learner to match objects that vest together and compare objects showing differences. Therefore, it is expected of the children to understand the concept of "different"57. However, the median enrolment historic period for the ELOTL schools in our study was 4 months 8 days. It does not necessarily mean that the children have a rich academic vocabulary in their language of learning (for nigh in the sample perchance their 2d language), in order for them to understand the term "different". This subtest provides ii examples before the answers are scored, with the outset example beingness a elementary detail and the 2d case beingness very circuitous. It could possibly be argued that this subtest shows a lack of linearity (pregnant that levels of item difficulty are non gradually progressive).
The form constancy subtest included unfamiliar and circuitous shapes that the children are maybe not exposed to in class, which may make the subtest hard for the sample population. The children's lower operation in the sequential memory subtest mayhap could be attributed to non fully understanding the instructions, as well as the increasing number of items to remember within the aforementioned time limit, which might be an activity that is not practiced in class. Boys scored significantly higher than girls for the composite score of complex processes (95% CI -iv; -1).
Herbst and Huysamen34 reported a departure between the results of children from similar backgrounds only with unlike levels of exposure to appropriate pre-school experiences, and emphasise the importance of using civilization-specific tests.
On a pre-school level, emphasis is ofttimes placed on the achievement and outcome of school-related activities such as letter and number formation, and mathematics. However, the importance of underlying visual perceptual skills evolution does not necessarily receive the same degree of emphasis. Furthermore, focus is put on activities such as "tracing" and "copying" and may be an explanation for children performing meliorate overall on the motor tasks in this report, compared to the visual perceptual motor-free tasks. The visual perceptual skills development of children is non an automated achievement (such as the milestone of sitting, for example), if the opportunity for learning has non been created in the home or educational setting, and the feel is not internalised. Investment in more organised learning by ways of work sheets, visual perceptual activities and games is essential for the development of visual perceptual skills; hence the importance of grade activities, the environs and also the educators acting as part models, to stimulate the evolution of an aspect such as visual perception58.
Comparison of the subtests of the three tests
In Table 4 below, the results of subtests of the three tests that were comparable are summarised. The visual perceptual supplementary exam of the Beery VMI-6 is a single subtest and was therefore not compared to the multiple subtests comprising the blended visual perceptual component of the other two tests. This difference between the tests prevented the comparison of the children's performance on the Beery VMI-6 with the DTVP-3 and TVPS-3 with regard to visual perception.
Table Iv - Click to overstate
A statistically significant deviation was found when the form constancy subtests of the DTVP-3 (SS 8.five) and the TVPS-3 (SS 6) were compared. This finding could possibly be attributed to the fact that the DTVP-3 uses basic and familiar geometric shapes, such equally circles and squares, whereas the TVPS-3 uses more complicated shapes and unfamiliar figures and patterns.
Children also performed meliorate in the figure-ground subtest of the DTVP-three (SS eight) than that of the TVPS-3 (SS 7). Although this difference was not significantly unlike, the clinical significance needs to be considered since a single point-scaled score consists of several items. For the visual closure subtest, similar results were obtained with both the DTVP-3 (SS 7.5) and the TVPS-three (SS 7).
A statistically meaning difference was calculated between the motor coordination subtest of the Beery VMI-6 and the center-hand coordination subtest of the DTVP-3, where the children performed improve in the Beery motor coordination subtest. Several factors were identified that might contribute to this finding. Firstly, the parallel lines between which the children had to describe were spaced further apart in the Beery VMI-6 subtest than those of the DTVP-3. Secondly, for the DTVP-3 subtest, the children scored zero out of a total of 4 when they picked upwards their pencils. Since it was found that the children ofttimes picked up their pencil, this influenced their scores negatively, whereas this dominion does not apply to the Beery VMI-6.
When the visual motor integration subtest of the Beery VMI-six was compared to the copying subtest of the DTVP-three, no statistically significant difference was found. All the same, the children performed better in the DTVP-3 subtest, which besides puts focus on an important implication for clinical practice. This finding could be due to DTVP-3 copying subtest assuasive the child to score betwixt 0 and 2, with more lenient scoring criteria than the Beery VMI-6, where the child tin can only score 0 or I, with each particular having very specific marking criteria.
Comparison of the composite scores
The total of all of the subtests' scores represent the overall scores. When the median overall score of the Beery VMI-vi was compared to that of the DTVP-three, the children performed significantly meliorate overall on the Beery VMI-vi (95% CI I; 4.7). These findings could be due to the Beery VMI-6 having three subtests compared to five in the DTVP-3. Furthermore, 2 of the three Beery VMI-6 subtests require a motor output, whereas a motor output is required for simply two of the five DTVP-3 subtests.
The median overall score of the Beery VMI-6 showed that the children performed significantly ameliorate in this exam, compared to the TVPS-three (95% CI x.3; xv.3). A possible caption for this finding could be that the children constitute the not-motor ii-dimensional based shapes and concepts used in the TVPS-3 more challenging.
When comparing the DTVP-3 to the TVPS-3, it was constitute that the children performed significantly improve overall on the DTVP-3 (95% CI 7; Ii). This finding could maybe be due to insufficient exposure to circuitous two-dimensional visual perceptual activities in the current curriculum and/or limitations in the teachers' repertoire. It could too exist attributed to the TVPS-iii having more subtests, or the absenteeism of motor components in the TVPS-three may take a substantial influence on the child's performance.
Atkinson and Braddick (cited by Tsaia26) reported that visual perception is a developing process that is very well developed by the age of 12 years. In our study, the sample population was at an historic period where they were still developing these skills.
LIMITATIONS, IMPLICATIONS FOR PRACTICE AND RECOMMENDATIONS
The limitations associated with this study were, firstly, that convenience sampling was used for including the children into the study and consequently, they were not sampled randomly; hence, a larger proportion of children were sourced from two of the participating schools. Secondly, due to the poor response rate and limited data collection fourth dimension, an amendment was made to the original protocol and children who attended an ELOLT school for the median of 4 months 8 days were included, opposed to the initial inclusion benchmark of at least i twelvemonth. Thirdly, differences in the school settings and educational backgrounds among children were not taken into account. Finally, no differences other than language and ethnicity have been taken into account in this small sample.
Despite these limitations, the implication for practice is that the results can just be generalised to similar South African populations. Recommendations with regard to clinical exercise include the following:
Since the latest editions of the Beery VMI-6, DTVP-three and TVPS-three visual perceptual tests have been developed based on research and specific reviews and feedback from the users recognising these new versions as being an improvement, clinical occupational therapy practices should consider purchasing these tests.
Although children'due south subtest performances are valuable in the evaluation and interpretation of results, important decisions with regard to intervention should rest primarily on the composite indexes of these tests.
Undergraduate students should exist trained in the utilise of a variety of instruments (preferably on the latest editions), the limitations of the instruments and on the validity and reliability of a examination so that they can choose the all-time ane.
These tests' prescribed instructions should be translated into the South African official languages in order to avoid conceptual misunderstanding, which might affect test results.
The TVPS-three should not exist used as the only visual perceptual test in the cess procedure to guide intervention planning, but should be used in combination with the Beery VMI-6 and/ or DTVP-iii.
These tests aim to assess children's skills and practice not accept into consideration cogent factors, such as the child's living and educational surroundings, personal factors, and activity-participation features14. Therefore, these tests demand to be used in conjunction with other activity-participation cess instruments.
This written report provides preliminary information equally a reference for future studies. Based on the results and conclusions drawn from this enquiry, the authors make the following recommendations with regards to future research on the Beery VMI-6, DTVP-3 and TVPS-3:
An investigation into the validity and reliability of these tests on larger samples representing different cultural and language groups and from different educational settings in South Africa;
the development of contextual-specific instruments; and
the standardisation of existing international instruments in the South African context.
Conclusion
This report describes the visual perception and visual-motor operation of a sample of S African v-yr-quondam, English-speaking children by means of the Beery VMI-6, DTVP-3 and TVPS-3 visual perceptual tests. The findings provide occupational therapists using these tests with testify of how the norms of the South African study sample compare to those of the American normative sample. Although these tests are considered as standardised measuring instruments, normally used internationally, it is evident that certain aspects of these tests are unsuitable in its electric current country. While no context-specific visual perceptual measuring instruments instrument is currently available in South Africa, occupational therapists should be mindful of the manner in which they use these tests, interpret results and make recommendations for practice.
ACKNOWLEDGEMENTS
The participants, their parents and school staff; Dr Daleen Struwig, medical author/editor, Faculty of Wellness Sciences, Academy of the Gratuitous Land, for technical and editorial preparation of the manuscript.
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Marieta Visser
Telephone: +2751 401 2831
E-mail address: vissermm@ufs.air conditioning.za
Source: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2310-38332017000300004
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