Visual Perceptual Evaluation
(Answers to Your Questions)

Why has a visual perceptual evaluation been recommended?
Based on the initial vision evaluation and information you provided about school performance, we found your child has a vision problem that cannot be successfully treated with glasses alone. Approximately 10%-15% of the patients we examine have these types of vision problems. The problem may involve the ability to process and analyze visual information, which is referred to as visual perception. Your child has, therefore, been referred for a visual perceptual evaluation. If a visual perceptual problem is detected, vision therapy may be recommended.

Because you may not be familiar with this type of evaluation, we are providing the following information.

Description of a visual perceptual evaluation
The evaluation will take approximately 45 minutes and will consist of the following testing to evaluate your child's ability to process and analyze visual information. 

The specific areas evaluated will include:

Lateral Awareness and Directional Concepts
Lateral awareness is an important developmental skill, which involves the establishment of internal coordinates from which visual spatial organizational skills can develop. Directionality is the ability to project this set of internal coordinates into space.

The test used to probe laterality is a cognitively based probe of self-lateralization called the Southern California Test of Right/Left discrimination. 

To test directionality, we administer the Reversal Frequency Test to explore the existence, nature and frequency of occurrence of expressive and receptive letter and number reversals. The Recognition Subtest requires the child to mark off letters and numbers which are written backwards or reversed. The Execution Subtest requires the child to write numbers and letters (lower case) as they were dictated in a random order. Confusion in the area of directionality may result in reversal of forms, letters such as "b" and "d" and words such as "on" and "no" and "was" and "saw".

Visual Form Perception
These skills allow the child to be aware of specific form, to discriminate similarities and differences in shape and orientation between forms, to identify embedded visual forms and to identify a common object or word from incomplete visual information. We administer the Test of Visual Perceptual Skills, which is an un-timed test that probes the areas of visual discrimination, form constancy, spatial relationships, figure ground and visual closure without the need for motor involvement. 
Visual form perception and discrimination problems may result in his/her confusing similar beginnings, endings and even entire words.

Visual Memory and Visualization
Obtaining maximum information in the shortest possible time provides for optimal performance. The ability to retain this information over an adequate period of time is essential for reading comprehension and spelling. The Test of Visual Perceptual Skills is administered to evaluate visual memory.

Dysfunctions in visual memory may cause prolonged time copying assignments, difficulty recognizing the same word on the next page and trouble retaining what is seen or read.

Visual Motor and Form Reproduction Skills
Hand eye coordination skill is essential to the accurate production of written language symbols. The Detroit Speed and Precision Test is a fine motor coordination task requiring both speed and accuracy. This test also requires a child to utilize visual attention, visually guided behavior and visual feedback, left to right sequential tracking, fine motor planning and concentration.

In order to accurately reproduce a visual stimulus, an individual must be able to see that the pattern is made up of a finite number of parts, which interrelate in a very specific manner. These abilities are referred to as analytical skills. In order to reproduce the pattern, the child must call upon these analytical skills, integrate this information with other systems and generate a motor response. The Beery Test of Visual Motor Integration and The Test of Visual Analysis Skills can be used to assess these skills.

Deficiencies in the area of visual motor integration skills may make handwriting more difficult. This may result in poor spacing, the inability to stay on the line and excessive erasures. The child's ability to complete written work within an allotted period of time may also be affected.

What happens after testing is complete?
After testing is complete, the findings will be reviewed and Dr. Scheiman will explain the results and implications. The various treatment options will then be presented.

(7.29.2010)