Visual Processing Testing- what does it mean?

[Guest cincyboys]

Long story short, after several years of struggling in school and not getting much help or advice from the school, we decided to have our son tested privately this past summer. He is now 10.5 yrs old and in 5th grade. The testing revealed many things, but what I am getting at here is that we were referred to a Developmental Optometrist for visual processing evaluations.

 

I just received the report, though we have already begun vision therapy. Now I just need help knowing what the test results mean. My husband, the skeptic, wonders how much of what these tests show really means anything in real life. He wants to know how many kids score all over the board on these things (Will's was very inconsistent) and what does it mean for them.

 

Can you help me? What do these results mean?

 

Visual Acuity (Distance and Near/ Right and Left): 20/20

Refractive Status: mild hyperopia

The Developmental Eye Movement Test: Age equivalent- 8 yrs-8yrs 11 mo.

 

Beery Developmental Test of Visual-Motor Integration:

Perceptual Age Equivalence: 7 yrs, 8 mo.

Standard Score: 85

Percentile Rank: 16%

 

Gardner Reversals Frequency Test:

Execution: >8 years

Recognition: 7 years

Matching: >8 years

 

Piaget Right/Left Awareness Test: 8-10 year expectancy

 

Gardner Test of Visual-Perceptual Skills: Lower level administered

Visual Discrimination: 84%

Visual Memory: 84%

Visual Spatial Relations: 99.6%

Visual Form Constancy: 2%

Visual Sequential Memory: 63%

Visual Figure-Ground 2%

Visual Closure: 91%

Perceptual Quotient: 103

Percentile Rank 58%

 

Summary-

The following conditions are present-

Convergence Insufficiency

Divergence Excess

Exophoria

Binocular Dysfunction

Accommodative Insufficiency

 

Thank you, thank you for helping out a newbie!

Jenny

[wapiti]

The only one I'm familiar with is the Beery VMI. My son had that test performed by a school OT. Look carefully at the breakdown of the scores - the score is composed of two very different things, visual perception (or something similar) and motor skills. To give an example, my ds's visual perception was in the 99th percentile but his motor score was like the 13th percentile, which averaged out to some percentile that meant he did NOT qualify for school OT. :tongue_smilie: His visual perception compensated for his motor issues on that particular test.

 

As for your other tests, I know nothing, but I'd pay close attention to score scatter - areas that are exceptionally high or low in comparison to the rest of the scores. In particular:

 

Gardner Test of Visual-Perceptual Skills: Lower level administered

Visual Spatial Relations: 99.6%

Visual Form Constancy: 2%

Visual Sequential Memory: 63%

Visual Figure-Ground 2%

 

 

Note those ones that are 2%. I have no idea what they are about specifically, but that's where I would start googling. I would also note that visual spatial relations is an exceptional strength. The difference between the strength and weaknesses is astronomical.

 

As far as your DH the skeptic (right there with you on the skeptical DH :)), note that things like convergence insufficiency, binocular dysfunction and accommodative insufficiency should all be easy for an experienced optometrist to diagnose without these fancy scored tests. My dd had vt for binocular issues. And now a few years later she has accommodative issues (we're getting bifocals for now; eventually I'll take her back to our vt guy for a checkup).

 

just my two cents - good luck with VT!!

[sbgrace]

My son didn't have those types of tests that I specifically recall. But if you're really dealing with things like convergence insufficiency in my experience vision therapy was extremely helpful.

 

All I can say is my son went from severe issues (unable to converge to catch a ball or steer a trike properly let alone focus on school stuff) to a complete turn around. He was the most severe case the opt. had seen and now he can converge and track (and read, catch, steer, etc.). I would hardly believe it if I hadn't seen it myself in my own living room. The exercises we did at home were unbelievably difficult but very necessary for his success I'm certain.

 

For the right conditions I believe vision therapy can be very helpful. Whether you're dealing with the right optometrist/therapist etc. I don't know of course. If you can speak with people who used this facility it might help make the decision.

Edited November 16, 2010 by sbgrace

[Guest cincyboys]

Thank you both for your responses! I am definitely googling and gathering all the info I can on the tests and subtests. I am also very pleased with the vision therapy he is receiving and agree that it will eventually, hopefully, make a big difference.

 

Still wondering why the scores are so radically different from eachother, but I do have an email out to the doctor to get her take on it.

 

Thanks!

[PeterPan]

Long story short, after several years of struggling in school and not getting much help or advice from the school, we decided to have our son tested privately this past summer. He is now 10.5 yrs old and in 5th grade. The testing revealed many things, but what I am getting at here is that we were referred to a Developmental Optometrist for visual processing evaluations.

 

I just received the report, though we have already begun vision therapy. Now I just need help knowing what the test results mean. My husband, the skeptic, wonders how much of what these tests show really means anything in real life. He wants to know how many kids score all over the board on these things (Will's was very inconsistent) and what does it mean for them.

 

Can you help me? What do these results mean?

 

Visual Acuity (Distance and Near/ Right and Left): 20/20

Refractive Status: mild hyperopia

The Developmental Eye Movement Test: Age equivalent- 8 yrs-8yrs 11 mo.

 

Beery Developmental Test of Visual-Motor Integration:

Perceptual Age Equivalence: 7 yrs, 8 mo.

Standard Score: 85

Percentile Rank: 16%

 

Gardner Reversals Frequency Test:

Execution: >8 years

Recognition: 7 years

Matching: >8 years

 

Piaget Right/Left Awareness Test: 8-10 year expectancy

 

Gardner Test of Visual-Perceptual Skills: Lower level administered

Visual Discrimination: 84%

Visual Memory: 84%

Visual Spatial Relations: 99.6%

Visual Form Constancy: 2%

Visual Sequential Memory: 63%

Visual Figure-Ground 2%

Visual Closure: 91%

Perceptual Quotient: 103

Percentile Rank 58%

 

Summary-

The following conditions are present-

Convergence Insufficiency

Divergence Excess

Exophoria

Binocular Dysfunction

Accommodative Insufficiency

 

Thank you, thank you for helping out a newbie!

Jenny

 

Jenny, do I take your name to mean you're in Cincy? The doc we use for VT is at the Solution Center in Columbus. The docs and therapists there are FABULOUS, if you don't feel like you're getting the answers you want. Anyways, at our practice they work on the convergence, focusing, etc. and THEN, when the eyes are working together properly, they can start working on the processing. The visual processing test our place uses turns out raw scores, percentiles (not sure actually what they mean) and age-equivalents. The age-equivalents are the things that make the most sense to me.

 

You can have very different scores in different aspects of visual processing, because they are different skills. If you were in the room when they administered the test, you may have seen them going through a variety of exercises. Our our place they test tracking with infrared googles connected to a computer, very cool. So I didn't feel like the results we got were faulty, but let's say they were SHOCKING. They tested my dd at her initial evaluation and then redid the testing after three months of just working on the convergence and focusing and whatnot. With some kids that totally takes care of the processing issues (the brain kicks in, all is well), and some kids have to go on to that next stage. Just for perspective, here are the results of my dd after 3 months of conv/focusing therapy, not working on the processing yet.

 

V. Discrimination-9%

V. Memory-9%

Sequential Memory-25%

Visual Closure-50%

 

And if that blows your mind, I'll tell you that three of those numbers are 3,4,and 5 times higher than they were at the initial evaluation!

 

So now after two months of doing the visual processing stage of her therapy, her scores are 63%, 91%, 98%, 63%. In other words, she has made TREMENDOUS progress! The more important thing is I can see it in her work and her functioning. I tried a new handwriting program with her, and she could imitate the uppercase cursive letters. (She couldn't even remember how to form certain letters before.) She now actively attacks puzzles and enjoys them. She's a whiz at wordsearches and things requiring scanning now. It's like night and day. They project she'll be done in just another month!

 

So I don't know how those numbers strike you. Let's just say when the doc said the age-equivalent on one of those initial scores was that of a two year old! No wonder the poor thing had trouble with spelling, handwriting, etc. And lest you think she's dumb or something, I would consider her gifted (2E). She does Math Olympiad problems joyfully and always does well on standardized testing. She just happened to have astoundingly poor visual skills. She didn't crawl right as a child, and apparently that is when early focusing occurs. She's doing OT now as well. But that's another rabbit trail!

 

VT really varies with the practitioner. KarenAnne often warns people about paper-only therapy or computer-only. Therapy should NOT take a long time or be this extended, drawn out process, not for most kids. Our place gives written estimates, has monthly reassessments, and has been on-time with their results with us and others I've talked to. If you aren't confident in your choice or don't see the results you're looking for, I wouldn't hesitate to suggest driving to Columbus. We drive to Cincy for speech and Columbus for OT and VT. I need reindeer antlers on my car this year, I'm in it so much. :D

 

Honestly, looking back at your scores, they don't look that bad. It might be just correcting the basic stuff will take care of it. Don't know, not a therapist. You just have to take it one step at a time. The tracking and reversal issues improved with the initial three months of therapy working on convergence and focusing. I had them retest with the googles, so I could see it for myself. It's actually really fascinating and might be helpful to your dh. There's no arguing with it, kwim? The computer tracks their eye movements, then they can replay it, slowing the cursor so you can see them. It's really quite fascinating. You see the line skills, the reversals, everything. Then they can tell you what amount is normal (a small amount is) and where it's not. I would trust that more than a paper test, but that's just me.

[PeterPan]

Btw, we were at exactly the same stage last year, 10 1/2 and 5th grade! It's a really common age, 4th/5th grade, to start therapy, because the compensating measures they have been using before can't cover for them anymore. Our VT has been a LOT of work. Because it costs so much, we totally worked our butts off that first three months. Every month less was $500 less! The visual processing stage is MUCH less toilsome than the convergence and focusing. I let her do the work herself, mainly because I'm too busy with driving to speech to do anything more. We also have not been doing a lot of schoolwork. A lot of the things you might be worrying about or thinking you need to teach out will either correct themselves or be MUCH easier to work on later if you focus on the VT first.

[Guest cincyboys]

Yes, Elizabeth, we are close to Cincy. I actually drove 2 hours northwest to get the original evaluation done, as there were no good recommendations for Developmental Optometrists in this general area. But we have found someone local who does the VT that we are very happy with, so far. She does so many different activities with him. And none are really paper or computer. It is a lot of hands on and whole body activity. Working on both vision issues and sensory issues. He really enjoys going, which is a huge plus.

 

Thank you for your insight. Especially on the variances in the subtest scores. I think you are right. Different skills and therefore different performance. Now that I have the report in hand and our VT has it, I expect what we have been doing will be a bit more fine tuned to what his individual struggles are. I look forward to his reevaluation when the time comes to see if he has improved.

[PeterPan]

Ooo, your VT sounds fabulous! That's exactly what you want to hear. Well definitely let them explain how the categories impact life. I never quizzed them on this, but I've just noticed things from talking with other people.

 

Are you coming to the Cincy convention next spring? http://www.cincinnatihomeschoolconvention.com It's terrific, and we often have a board get together. :)

[Guest cincyboys]

I am a wanna-be homeschooler. Sort of. Years ago, when our oldest was getting ready to start Kindergarten we were not in a great school district and seriously considered homeschooling. I also had a sense that he just kind of learned differently. Ironically, this is the same child I've been writing about! Momma's intuition is worth a lot!

 

Anyway, we ended up moving into a great school district, so he started public school. And has ever since, along with his younger brother. I do envy homeschoolers and love hearing about what folks are doing. The educational/vision issues we have run into have made me seriously contemplate homeschooling, though currently I feel as though the school is handling everything the way I would like them to. And my son is being successful right now. Though, I would not rule out anything in our future!

 

I found this board when I was googling Vision Therapy and came back a couple weeks later to post my question! You all have been so helpful and seem to have lots of info!

[laundrycrisis]

Our son had a lot of testing done at the first optometrist but I didn't get those printed results. At the second optometrist, he added this to what had already been done:

 

Gardner Test of Visual-Perceptual Skills: Lower level administered

 

DS scored in the 95-98th percentile in all of these, except around 25 in visual closure, but he was at around 1-2 % in form constancy and visual sequential memory. The results of these tests have matched up perfectly to the things he has struggled with learning. After they finished the therapy for his more physical issues (convergence, tracking, focus changing) they started working on these visual processing areas. I agree:

 

The visual processing stage is MUCH less toilsome than the convergence and focusing.

 

Our VT homework has been so much easier since we moved into visual processing. His therapy sessions are more enjoyable too.

[gardenmom5]

Summary-

The following conditions are present-

Convergence Insufficiency

Divergence Excess

Exophoria

Binocular Dysfunction

Accommodative Insufficiency

 

Thank you, thank you for helping out a newbie!

Jenny

convergence is how the "focus" of both works together as the eyes are watching things move.

normal vision is binocular - if his eyes are NOT working together correctly, he has monocular vision. at this age, that's a problem. (left untreated, it only get's worse. and the earlier treatment is done, the better the outcome.)

these are things that should respond well to VT, which is training the brain-eye function to work how they're supposed to.

[Laurie4b]

You really should ask your optometrist to sit down and explain it all to you. Our experience with the Gardner test is that it was very unreliable: it was administered to ds 3 times over the years and his scores swung wildly and without a pattern to the swings (ie one test might be over 90% one go-round and under 20% the next time, while other subtests went up.) I would take any Gardner results with a grain of salt.

 

The Beery VMI is a more reliable test. Hopefully, with visual processing problems, they gave the additional subtests, which tease out visual processing from motor skills; however, it looks like they gave the shorter form only.

 

But make sure that YOUR optometrist explains his/her findings to you and how his/her treatment plan is going to deal with them. After thousands of $$'s worth of vision therapy, ds still cannot read without skipping words and phrases, which is what I primarily took him in for. Do be a watchful consumer; there is really no research base for vision therapy. Doesn't mean that there won't be some time down the road, but don't accept it blindly. (haha)

[PeterPan]

Just to supplement what Laurie is saying, I think the test our doc used (the results of which I gave above) is different from the one yours and Laurie's used. They have administered it several times, and the scores have been consistent and gone up. Well I take that back. A few of the things went down on one administration, but they said the timing of it indicated the brain was rethinking how it did things. But in general they have gone up consistently. Even the downs were proportional, not erratic or bizarre.

 

And I totally ditto that there can be variations in practitioners. Results are what matter. If you go more than 3 months without serious results or reasonable explanations, I'd go looking elsewhere.