Tests of Visual Motor Integration by Arianny Savinon & Team

Test of Visual-Motor Integration:
Visual-Motor Skills
Developmental Test of Visual-Motor Integration-Berry VMI-5
Visual-Motor Bender Gestalt Test-2

Bender Visual-Motor Gestalt Test
Second Edition


Bender-Gestalt II
What does it measure?
-The Bender-Gestalt II measures visual-motor integration skills in children
and adults from 4 to 85+ years of age.
It also provides an assessment of memory for children and adults from 5 to
85+ years of age.
How was it designed?
The development of the test was guided by over 60 years of research on the
original test, contemporary methods of test construction, and current
standards of educational and psychological testing.
Why is this test important?
-The Bender-Gestalt II provides useful information for educational,
psychological, and neuropsychological assessment.


What are Visual-Motor Skills?
Visual motor skills refer to the ability to coordinate vision
with the movements of the body.
Visual-motor development implies much more than
handwriting. Children need to be able to use their hands
and eyes as paired tools.

 This test is derived from early work begun on assessment of
visual-motor skills by Lauretta Bender in 1938.
 The first version consisted of 9 geometric designs that
examinees were asked to copy. Then the examinees
reproduction of the designs were scored for accuracy.
 In 2003, Brannigan and Decker revised the original version to
produce the BVMGT-2, adding 7 new designs and using a
holistic scoring system to score the examinees’ reproduction
of the designs.
 One of the most frequently used instruments in psychological
assessment .
History


History: Scoring System
 Koppitz Scoring System
 In 1963, Elizabeth
Koppitz develop a 30 –
item method of scoring
the BVMGT, based on 4
criteria. This system was
widely used in schools
and clinical setting
between the mid-1960s
and early 2000s.
 In 2007, Reynolds
obtained rights to the
original version of this
scoring system and
introduced a the
Koppitz Developmental
Scoring System for the
Bender Gestalt Test-
2(Koppitz-2)

.
 They are used to assess
perceptual and perceptual-
motor problems in students
who are already
experiencing school learning
problems.
 Many professionals believe
that in order to remediate
leaning disabilities, we need
to address the perceptual-
motor problems, visual-
perceptual problems,
sensory integration and
psycholinguistic problems.
Students thought to be learning
disabled are often given these tests to
ascertain whether perceptual problems
coexist with learning disability.
Why do we assess Perceptual and
Perceptual-motor skills?


Why do we assess Perceptual and Perceptual-
motor skills?
•These tests are often used by clinical psychologists as an adjunct in the
diagnosis of brain injury or emotional disturbance.
•Many psychologists consider that perceptual-motor deficiencies such
as: difficulty writing, and copying, reversing letters and symbols,
distortion in figures, deficit in attention and focus are directly linked
with learning disability.
• Perceptual-motor tests are often used in assessments to determine
students’ eligibility for special education.
•This tests are used in the schools to assess students who may need
instruction to remediate or ameliorate visual or auditory perceptual
problems before they interfere with school learning.


 Norms are based on a stratified, random sampling
that closely matched the U.S. census data from the
year 2000 for sex, race/ethnicity, geographic region,
and socioeconomic level. The sample included 4,000
individuals ages 4 years to older than 85 years.
NORMS


Test - Features
Examiner’s Manual
 Provides a 167-page manual
(Brannigan & Decker, 2003) that
details:
 the historical background,
 Test development,
 administration and scoring
guidelines,
 Norming and standardization process
 Clinical and special populations
studied,
 Reliability and validity studies,
 Interpretation guidelines,
 Standard score tables for ages 4 to 85+
years, and
 Examples of the Global Scoring
System criteria for each design.
Stimulus Cards
 Includes sixteen stimulus cards divided
into two tests,
 Four additional designs are used for
subjects 4 through 7 years of age.
 There are 12 designs for test taker 8 years
of age or older.
 Both sets have 8 common designs.
 Stimulus cards are reproduced from
mechanically drawn designs for greater
clarity and precision and
 Are printed on durable plastic that can be
cleaned easily.


Test Description
•It’s a norm-reference test.
•It’s an individually administered test.
•Assesses visual-Motor integration skills.
•Assesses individuals from ages 4 years to 85 years.
•It’s a copying test.
•The test is untimed.


 Administration of the Bender-Gestalt II consists of
two phases:
 Copy Phase
 Examinee is shown stimulus cards with designs and
asked to copy each of the designs on a sheet of paper
 Recall Phase
 Examinee is asked to redraw designs from memory
 Motor and Perception supplemental tests screen for
specific motor and perceptual abilities/difficulties
Administration Process


 Kit consists of Examiner’s manual, 16 stimulus cards,
observation form, motor test, and a perception test
 Materials needed: Two pencils with erasers, 10 sheets
of drawing paper, and a
stopwatch (not included in
test kit).


 Examinee Information— Name, gender, hand preference
 Physical Observations— Sensory impairments or movement
restrictions
 Test-Taking Observations—Carelessness, indifference,
inattentiveness, unusual or unique behaviors
 Copy Observations— Examinee’s approach, drawing process
 Recall—Amount of time needed to recall designs and the order
in which designs are recalled
 Summary—Overview of information collected
Observation Form

 Administer test on a table, seated across from the
examinee if possible
 Supply one pencil and one sheet of paper (vertically in
front of examinee)
 Show the stimulus cards to the examinee one at a time
(aligned with the top of drawing paper)
 Administer stimulus cards in the correct numeric
sequence and do not allow examinee to turn or
manipulate them.
 Begin test with the appropriate card:
Ages Start Item End Item
4yr – 7yr 11mo 1 13
8yrs and older 5 16


 Copy Phase:
 Measure how long the examinee takes to complete
the items – record time in minutes and seconds
 Document your observations – carefully note the
examinee’s approach to drawing each design
 Recall Phase:
 Administered immediately following the copy phase
 Examinee is given a new sheet of paper an asked to
draw as many of the designs that were previously
shown.


 Motor Test:
 2 – 4 minutes are allowed to complete the subtest.
 Draw a line between the dots in each figure without touching the borders.
 This test consists of 4 test items and each item contains three figures. Test takers
are required to connect dots, in each figure without lifting their pencils, erasing
or tilting their paper.
 Perception Test:
 This test consist of 10 items that require a test taker to match a design in a
multiple-choice array to a stimulus design.
 2 – 4 minutes are allowed to complete the task.
 Circle or point to a design in each row that best matches the design in the box


 Generally, moderate to severe deviations in the drawings,
including characteristics such as:
 Misalignment (rotations),
 Reduction of elements (e.g., the number of dots in Figure 6),
 Increase of elements (e.g., the number of dots in Figure 6),
 Simplification of elements (e.g., using lines in Figure 10),
 Omission of elements (e.g., a line of dots in Figure 10),
 Substitution of elements (e.g., drawing dots for circles in Figure 7),
 Integration of elements(e.g., not joining the circle and square in
Figure 5).
These errors are typically scored in the 0 to 2 range, depending on the
degree of severity and the overall intactness of the drawings.
Examinees’ Common Errors


 Global Scoring System used to evaluate each design
the examinee draws during the Copy and Recall
phases
 5 point rating scale
 Higher scores  better performance
Scoring
The Global Scoring System
0 No resemblance, random drawing, scribbling, lack of design
1 Slight – vague resemblance
2 Some – moderate resemblance
3 Strong – close resemblance, accurate reproduction
4 Nearly perfect


 Using the different areas of the Observation Form:
 Total the raw scores
 Record any observations noted during administration
 Calculate:
 The examinee’s age
 Test–taking times for the Copy and Recall phases
 Supplemental tests scores
 Percentile ranges
 Now refer to the appendixes in the manual for the
corresponding standard scores, percentile ranks, and
other scores.
Scoring


 Scoring the supplemental tests:
 Motor Test:
Each figure on the motor and perception subtests are scored
pass or fail.
 Perception Test
 Each correct response is scored one (1) point
 Each incorrect response is scored zero (0) points
Scoring
Criteria for Scoring the Motor Test
1 Line touches both end points and does not leave the box. Line
may touch the border but cannot go over it.
0 Line extends outside the box or does not touch both end points


 To achieve a score at a particular level, a drawing must be as
good as or better than the examples at that level.
 If not, the lower score must be assigned.
 When in doubt, examiners should always give the lower score.
 This policy may be difficult to adhere to at first, because some
drawings may have some characteristics of the scoring
examples for the higher score.
 However, the complete drawing clearly must be judged to be
as good as or better than the examples to get credit at that level.
Scoring

 Raw scores for Copy and Recall phases are converted
into scaled scores and percentiles
 Mean = 100
 SD = 15
 Standard
Score can
range from
40 to 160
Test Scores
Classification Labels for Standard Scores
145 - 160 Extremely high or extremely advanced
130 – 144 Very high or very advanced
120 – 129 High or advanced
110 – 119 High average
90 – 109 Average
80 – 89 Low average
70 – 79 Low or borderline delayed
55 – 69 Very low or moderately delayed
40 – 54 Extremely low of moderately delayed

Identify the errors
Instructions:
1. Make groups of 2.
2.Analyze the drawings and determine what is the error.
3.Assign a score


 ITEM 5-----Severe distortion, especially integration
 ITEM 6---Moderate distortion, especially spacing
 ITEM 7--Moderate distortion, especially spacing and
shape
 ITEM 8--Moderate distortion, especially spacing and
shape
 ITEM 9--Severe distortion, especially integration and
rotation
 ITEM 10---Moderate distortion, especially shape
 ITEM 12--Severe distortion, especially shape and
integration
 ITEM 13--Severe distortion, especially shape
 ITEM 14--No resemblance-
 ITEM 15-- -Severe distortion, especially shape
 ITEM 16--No resemblance-
ANSWERS


 Information gained through observation of test-
taking behaviors is crucial
 Indicators of potential behavioral or learning
difficulties: length of task, tracing with finger before
drawing, frequent erasures, motor incoordination
Test Behavior


 Split- Half Reliability
 A group average coefficient of .91
 Standard Error of Measurement of 4.55
 Test-Retest Reliability
 Varied from .80 to .87 when corrected for the first
test
 Overall good reliability for use in making
important education decisions.
Internal Consistency

 Correlation of scoring between examiners was high:
Five inter scorers scored 30 protocols independently,
this was the result:
 Copy Phase: .83 to.94 (average of .90)
 Recall Phase: .94 to .97 (average of .96)
 Thus, the scoring of copied designs may not
consistently have sufficient reliability for use in
making important educational decisions on behalf
students.
Inter-scorer Consistency


 No reliability data of any kind are presented for the
motor or perceptual subtests.
Subtests-Reliability

 No evidence of content validity is presented for the
recall, motor, or perception subtests.
 Correlation with other visual motor tests:
 When matched with the Beery VMI:
 .65 for the Copy Phase
 .44 for the Recall Phase
 Do you consider this valid?
Validity


 Correlation with other tests
 Tests of achievement: WJ-III _ACH and WIAT
 Ranges from .20 to .53 for the Copy Phase
 Ranges from .17 to .47 for the Recall phase
 Test DTVMI
 Ranges from .55- copying score
 to .32- recall score
Validity


 Correlations with other tests
 Tests of intelligence: Stanford Binet 5 and WAIS III
 Ranged from .47 to .54 for the copy phase
 Ranged from .21 to .48 for the recall phase
 Evidence is presented for differential performance by groups of
individuals with disabilities. The means of these individuals in
the different subjects are significantly lower than those of
nondisabled individuals on both subtests.
 Gifted students earned significantly higher scores on both subtests.
Validity


Standardization and
Norming

 Based on a carefully designed, stratified, random
plan that closely matched the U.S. 2000 census
 4,000 individuals from 4 to 85+ years of age
 Additional samples were collected for validity
studies (e.g., individuals with mental retardation,
learning disabilities, ADHD, autism, Alzheimer’s
disease, and examinees identified as gifted)
 Data was collected over a 12-month period in 2001
through 2002
Standardization Sample


 Utilizing U.S. 2000 census data, the Bender-Gestalt II
normative sample was designed to be nationally
representative and matched to percentages of the U.S.
population for five demographic variables:
1. Age
2. Sex
3. Race/Ethnicity (including Hispanic origin)
4. Geographic Region:
(Northeast, Midwest, South, and West)
5. Socioeconomic Level (Educational Attainment)
Normative Specifications


 Individual with limited English proficiency, severe
sensory or communication deficits, traumatic brain
injury, and severe behavioral or emotional disorders
were excluded from the normative sample.
 Students place in special education for more than 50
% of the school day were also excluded.
Normative Specifications


 21 age groups, differing in size and age, were defined
 More refined age categories used at the earliest and
latest age groups because of higher rate of change in
scores due to age-related development or decline
Age and Sex


 The Bender-Gestalt II standardization included
approximately equal percentages of males and
females for each age group except for ages 60 and
above where differences in sex also occur in the
census
60 – 69  Females (55.5) and Males (44.5)
70 – 79  Females (61.0) and Males (39.0)
80+  Females (66.0) and Males (34.0)
Sex


 Examinees’ racial and ethnic origins were identified
on the consent forms by the examinees or their
parents or legal guardians
 American Indian or Alaskan Native, Asian, Native
Hawaiian, or other Pacific Islander
 Black or African American
 White
 Hispanic
 Multiple ethnicities (classified as “Other”)
Race/Ethnicity


 Four regions: Northwest, Midwest, South and West
 Examinee’s home or residence was used to define his
or her geographic regions
 Educational attainment was used as an indicator of
socioeconomic level
 Adults: levels measured by years of education
completed
 Minors: levels measured by the years of education
completed by their parents or guardians
Geographic Region and
Socioeconomic Level


Bender Visual-Motor Gestalt Test
The BVMGT-2 is a norm-referenced, individually administered test intended
to assess the visual-motor integration skills of individuals ages 4 years to
older than 85 years. It assesses the individual’s ability to copy and recall
geometric designs as well as to connect dots and perform match –to-sample
tasks with such designed.
The norms for school-age people appear generally representative, although
they exclude some of the very individuals with whom the test is intended to be
used.
No reliability data of any kind are presented for the motor and perception
subtests.
The copying test appears generally to have adequate internal consistency, but
when compare with the recall test, both seem to have poor stability, and may
have inadequate inters-corer agreement. Evidence for the content validity for
the copying test is adequate, but the correlations to establish criterion-related
validity are too low to be compelling.
Although the copying and recall tests can discriminate groups of individuals
known to have disabilities, no evidence is presented regarding tests’ accuracy in
categorizing undiagnosed individuals.
Reliability and validity evidence for the subtests is absent . Therefore, this
subtests should not be used in educational decision making and are of
unknown value in clinical situations.

The Beery-Buktenica Developmental Test of
Visual-Motor Integration
Fifth Edition


“From amoebas to humans and from
infants to adults, successful
development is characterized by
increasing articulation and
integration of parts with wholes.”
 Beery VMI


 Developed in 1967 – Largely due to the inadequacies
of the Bender:
 Too difficult for young children
 Questionable reliability and validity
 Theoretical Framework:
- Piaget’s theory of Sensory-Motor
bases for achievement
- Higher levels of thinking and
behavior require integration among
sensory inputs and motor action
History


 Primary purpose:
 Help identify significant difficulties that some children have
integrating or coordinating their visual-perceptual and
motor abilities
 Visual Development
 Interpretation of visual stimuli  Simple visual sensation
and cognition
 Motor Development
 Manipulative ability
 Visual – Motor Integration
 Degree to which visual perception
and finger-hand movements are
well coordinated
Overview


 Beery VMI
 Developmental sequence of geometric forms to be imitated
or copied with paper and pencil.
 Virtually culture-free  uses geometric forms rather than
letter or numeric forms. The set of forms is arranged in a
developmental sequence from easy to more difficult.
 Assesses ability to integrate visual and motor abilities
 Visual Perception (supplemental)
 Identify parts of their own bodies then point at matching
pictures .
 Motor Coordination (supplemental)
 Trace stimulus forms with a pen and pencil without going
outside the double-lined paths
Overview


 Help identify significant difficulties in visual-motor
integration
 Obtain needed services for individuals for exhibit
difficulties
 Assess the effectiveness of educational and other
intervention programs
 Serve as a research tool
 Interpretation of test results
requires educational background
and experience of specialists in
psychology, learning disabilities,
or similar professions
Clinical Uses


 Can be validly administered as either a group
screening test or for individual assessment purposes
 Preschool children should be tested individually
 Kindergartners are best in groups of about six
 Children in first grade and above can be tested as an
entire class
 Administer test and supplemental
tests in order
 Beery VMI
 Visual Perception
 Motor Coordination
Administration


 Two forms
 Short form (ages 2 – 7)
 Full form (ages 2 – 18)
 Kit includes: Administration manual, Short Form,
Full Form, Visual Perception Form, Motor
Coordination Form
 Materials needed: Test booklet,
pencil without an eraser, or a ball
point pen.
Administration


 Should take 10 – 15 minutes to administer
Administration


If a child performs poorly on the VMI,
1. It could be because he or she has adequate visual
perceptual and/or motor coordination abilities, but has
not yet learned to integrate, or coordinate, these two
domains.
2. Alternatively, it is possible that the child’s visual and/ or
motor abilities are deficient.
3. Examiners frequently follow up a VMI with an
assessment of visual perceptual and motor abilities
What may happen to a child who performs
poorly on the VMI?

Instructions:
1. Look at the picture
2. Describe what you see
3. Draw what you see


 One point for each imitated or copied item
 Discontinue after three consecutive failures
 Raw scores are converted to scaled score and
percentiles
 Mean = 100 SD = 15
 Age norms
Scoring


 The manual includes two pages of scoring
information for each of the 30 designs. The child's
reproduction is scored pass or fail.
 A raw score for total test is obtained by adding the
number of reproductions copied correctly before the
test taker has 3 consecutive failures.
 The statistically true score is +/- 5
Scoring


Score Range Interpretation
>129 very high
120-129 high
110-119 above average
90-109 average
80-89 below average
70-79 low
<70 very low
Score Interpretation


 The VMI has been standardized in the US five times
since its initial development tin 1967.
 The questions on the VMI correlate to the 600
stepping stones of gross, fine visual and visual-
motor development.
 The 5th ed. Norms correlated .99 with the 2003
sample
 The demographic characteristics of the 2003 sample
matched very closely to the 2000 US census sample
Norm-Sampling


 Although the norms collectively were representative
of the US population, cross-tabulations are shown
only for age by gender, ethnicity, socioeconomic
status, and geographic region.
 It’s also unknown whether, all the African American
students included, were from middle-socioeconomic
status families, from the East, and so on.
Norm-Sampling


 Odd/even split-half correlation: .88
 Coefficient alpha: .82
 here is high level of consistency among test items
and the test measures what it says it does.
Internal Consistency


 Content Sampling
Rasch-Wright Item Separations
by Age and Total Sample
Reliability


 Internal Consistency
 In the third edition Beery VMI norming studies, odd-even
correlations ranged from .76 to .91, with a median of .85
 Other studies have yielded single-grade split-half
correlations ranging from .53 to .92, with a median of .78
Internal Consistency by Age and Total Sample Odd-Even (0-E) Split-Half
and Coefficient Alpha
Reliability


 Time Sampling
 Assessed with a group of 115 children between the ages of 5
and 11. With a re-test average time of 10 days
Raw Score Coefficients
The VMI test has adequate reliability for screening purposes.
Reliability


 Interscorer Reliability
 Evaluated with two professionals independently
scoring 100 randomly selected testings from the
norming group
Interscorer Reliabilities
Reliability


Summary of Beery VMI, Visual Perception, and Motor
Coordination Reliabilities
Overall Reliability


 Although the behavior sampling of the VIM is
limited, this test has relatively high reliability and
validity in comparison with other measures of
perceptual-motor skills.
Conclusion


 Predictive Validity
 Generally, researchers have found the Beery VMI to be
a valuable predictor, particularly when used in
combination with other measures, of:
 Reading difficulties
 Reading, Language Arts, Mathematics scores between
entering kindergarten and the end of first grade
 School achievement
 School failures or retentions
 Visual-motor predictive correlations appear to
decline as children move-up the grade levels
Validity

The purpose of the VMI and its supplemental tests are to
1. Identify significant difficulties in visual-motor
integration,
2. Obtain needed services
3. Assess the effectiveness of educational and other
intervention programs
4. Serve as a research tool.


Visual-Motor Skills
builder Activities

“No single test or score is sufficient for making a
diagnosis or creating a treatment plan. Team
evaluation and planning is always best whenever
possible.”

Using Measures Of Infants, Toddlers,
And Preschoolers

By Iris Peguero
 Using
Measures Of
Infants,
Toddlers, And
Preschoolers

 Background Information
 Different Appraisals Used For the Assessment Of Young Children.
 Important Facts Regarding The Assessment Of Toddler And
Preschoolers.
 Why Is Difficult To Assess Young Children?
 Why Do We Assess Infants, Toddlers And Preschoolers?
 Commonly Used Measures for Infants, Toddlers and Preschoolers.
 Bayley Scales Of Infant and Toddler Development - Third Edition, By
Nancy Bayley.

Background Information
 On October 8, 1986, Public Law 99-457 was signed into law by
President Ronald Reagan. This federal Law is well known as
the Education For all Handicapped Children Act (EAH).
 Public Law 99-457(EHA), was created with the main purpose of:
 Extending Special Education services to disabled young
children, from three through five (3-5).
 “To establish a new Early Intervention State Grant Program for
Infants and toddlers from birth through age two” (0-2).

Developmental Needs Of Young Children
 All the Early Intervention Programs created by the states, must be designed to
satisfy the developmental needs of young children in one or more of the
following areas:
 A) Physical Development: refers to the development of a child's physical skills,
such as the gross motor skills (walking, jumping) and the fine motor skills
(cutting using scissors).
 B) Cognitive Development: refers to the development of “any mental skills
used in the process of acquiring knowledge; these skills include reasoning,
perception, and intuition”.
 C) Language And Speech Development: “ is the process by which children
come to understand and communicate Language during early childhood”.
 D) Self-Help Skills: are people’s behaviors that facilitate personal care in the
area of feeding, dressing, bathing, and toileting.

Early Intervention Services
 Family Training
 Counseling
 Home Visits
 Speech Pathology and
Audiology
 Nutrition Services
 Occupational Therapy
 Physical Therapy
 Psychological Services
 Medical Services (only for
diagnosis or evaluation).
 Early Identification, Screening,
and Assessment.

 All the services provided in the early intervention
programs should meet the state standards and a
qualified staff member must offer those services at
no cost.
 There is an exception for where Federal or State
law provides for a system of payments by families.
 “The services must also be provided in
accordance with an Individualized Family Service
Plan (IFSP)”.

 On June 4, 1997, Public Law 99-457 (EAH) became part of
Public Law 94-142 (IDEA).
 IDEA, was modified by the congress and signed into law by
President Clinton.
 Acronym: IDEA

Individual With Disabilities Education Act
(IDEA)
 Under Public Law 99-142 (IDEA), “all school districts have a
mandate to provide special education and services for all qualified
children with exceptional needs between the ages of 3-5”.
 IDEA, makes grants available to all states in order to expand the
protection and services to disabled children.
 IDEA, “entitles every student to receive a Free and Appropriate
Public Education (FAPE) and in the Least Restrictive Environment
(LRE)”.

Least Restrictive Environment (LRE) :
 LRE: Means that any disabled student should have the opportunity to be
educated with non-disabled peers.
*For instance: A Learning disabled student could be
assigned in an inclusion classroom, where he /she
spends most of her educational time with regular
students.
 In addition, Schools are “required to develop and implement an IEP (Individualized
Education Program) for each disabled student.
 The IEP should “meet the standards of federal and state educational agencies”.

 Special Educational Services are only provided to children suffering from:
1. Autism
2. Deaf- blindness
3. Hearing Impairment
4. Mental Retardation
5. Orthopedic Impairment
6. Traumatic Brain Injury
7. Serious Emotional Disturbance
8. Speech or Language Impairment
9. Visual Impairment
10. Other Health Impairment:
(ADHD : Attention Deficit Disorder, Epilepsy)

Educational Programs For Young Children
 All states should demonstrate that the funds granted have been utilized for the
development of new skills and appropriate social relations in young children.
 There are programs created with the support of the federal government to address
students with low socioeconomic backgrounds such as:
a) Early Head Starts (0-2).
b) Head Start (3-5).

Different Appraisals Used For The
Assessment Of Young Children
Infants Assessment
 Infants assessment involves the neurobiological (biological study of the nervous
system) appraisal of four areas:
1. Neurological Integrity: (Examples: reflexes and postural responses).
2. Behavior Organization: ( Examples: attention and response to stimuli).
3. Temperament: ( Examples: Outgoing, quiet and highly active).
4. State Of Consciousness: ( Example: sleeping patterns).

Assessment Of Toddlers
And Preschoolers
 Assessment of toddlers and preschoolers involves appraisal of:
1) Communication:
(Examples: pronunciation of words and use of sentences).
2) Cognition:
(Examples: remembering, understanding language and solving problems).
3) Personal- Social Behavior:
(Examples: Interacting with peers, adults and parents)
(Sharing, asking permission, joining an activity)
4) Motor Behavior:
Examples: Gross Motor skills: (stand, walk, run, jump and kick ).
Fine Motor Skills: ( coloring, grasping a pencil).

Important Facts Regarding The Assessment
Of Toddlers And Preschoolers
 “The evaluation of toddlers and preschoolers generally relies on
their achievement of developmental milestones”.
 Milestones: are major developmental accomplishments such the use of
words and walking.
 Children are considered to be at risk for later problems when their attainment
of developmental milestones is delayed.
 Examiners must know information about infants, toddlers and preschoolers’ cultural
background, to understand the environment in which they are developing.
 When assessing young children who are diagnosed with severe disabilities, it is
essential to take into consideration the family emotional reaction.

Why is difficult to assess young Children?
 “Assessment of young children involves observation of structure play activities and
caregivers rating behavior”.
 Bailey and Rouse(1989), have reported some of the reasons why young children are
difficult to test.
1) “Infants between 6 and 18 months are distressed by unfamiliar adults”.
2) “Infants and preschoolers may be very active, inattentive, and
distractible”.
3) Young children might not completely understand questions asked, even
when those questions are simple because, their language is underdeveloped.

Commonly Used Measures
For Infants, Toddlers, and
Preschoolers

references
Technological Sources:
 Google Webpage. “Public Law 99-457: a new challenge to early intervention”. 22
November, 2011.<http://www.ncbi.nlm.nih.gov/pubmed/2801456>.
 Google Webpage. “Preschool (3-5) Education Services”. 22 November, 2011.
<http://lilly6.tripod.com/3_5.html> .
 Wikipedia Free Encyclopedia. “ Neurobiological Definition” 27 November 2011.
<http://www.thefreedictionary.com/neurobiological>.
 Google Webpage. “New Law To Impact Services To disabled Infants, Toddlers, And
Preschoolers”. 22 November 2011. <http://www.nfb.org/images/nfb/ Publications/f
r/fr9/3Issue3/f090308.html>.

How to evaluate infants, toddlers & preschoolers
Early Childhood Programs
• Make policy decisions regarding what is and is not appropriate for children.
• Determine how well and to what extent programs and services children receive are beneficial
and appropriate.
Early Childhood Teachers
• Identify children's skills, abilities, and needs.
• Make lesson and activity plans and set goals.
• Create new classroom arrangements.
• Select materials.
• Make decisions about how to implement learning activities.
• Report to parents and families about children's developmental status and achievement.
• Monitor and improve the teaching-learning process.
• Meet the individual needs of children.
• Group for instruction.

Bayley Scales of Infant & Toddler
Development, 3rd edition
A standard series of measurements originally developed by psychologist
Nancy Bayley. She believed in without focusing on one theory over
another but focus on the research in the child development. BSID-II was
first introduced in 1993 with administered scales of mental and
psychomotor. In 2006, was revised to Bayley III, added cognition, language
and motor scales. This assessment is used primarily to assess the motor
(fine and gross), language (receptive and expressive), and cognitive
development of infants and toddlers.
“The Bayley-III is used to identify areas of impairment or delay,
to develop steps for interventions and evaluate the outcome of
these interventions. Not a diagnostic tool but indicates areas
that might require intervention.”

Bayley Scales of Infant and Toddler
Development, Third Edition
• Individually administer to children ages 1 – 42 months.
• 1 – 12 months estimated at 50 minutes; 13 – 42 months estimated at 90 minutes.
• Trained practitioners, including early intervention and child development
specialists, school psychologists, assessment specialists.
• 5 subtests: Cognitive, Language, Motor, Social-Emotional, Adaptive Behavior.
• Only English; Norm Referenced Test.
Benefits:
• Ideal for use when you suspect delays or problems in early development.
• Determines the need for further in-depth assessment.
• Indicates strengths, weaknesses, and competencies so that parents and
professionals can properly plan for the child.
• Aligns with IDEA requirements for support and intervention.
• Allows for more caregiver involvement in test items.
• Administered individually and can be administered at home as long as examiner
follows standard procedures.

Cont. BAYLEY-III
Helping you link assessment with intervention.
• Identifies infant and toddler strengths and competencies, as well as their weaknesses.
• Provides normative information consistent with developmental domains identified by current IDEA
early childhood legislation.
• Valid and reliable measure of a child’s abilities.
• Comparison data for children with high-incidence clinical diagnoses.
• Flexible – can administer one or more domain subtests individually.
Pros
• How your child is doing compared to the norm of the test at the time.
• It allows for such variables as age, sex, region, race and ethnicity, and parental education – at least
to certain extent.
Cons
• Does not measure future ability.
• It is still new to the market.

ASSESSED FROM CHILD
Cognitive
Infants – attention and interaction to new,
familiar and unfamiliar objects.
Toddlers – Explore new objects and
experiences, solve problems and ability to
complete puzzle.
Preschoolers – objects that measure pretend
play, activities as building, color matching,
counting and solving complex puzzles.
Language
1. Receptive Communication (RC) - child
recognizes sounds and understands
spoken words/directions.
- Infants – items to measure the sounds,
objects and people in the environment.
- Toddlers – ask to identify
pictures/objects, follow simple direction,
social routines.
- Preschool – direction, identify action
pictures, measure basic understanding of
grammar.
2. Expressive Communication (EC) – child
communicates using sounds, gestures or
words.
- Infants -- babbling, gesturing.
- Toddlers – use words by naming objects,
pictures and answering questions.
- Preschoolers – use words and answer
more complex questions.

cont. ASSESSED FROM CHILD
Motor Scale
1. Fine Motor (FM) – how well child uses their fingers and hands to make things
happen.
Infants – muscle control (following their eyes, taking hand to mouth, reaching for
objects.
Toddlers – observe stacking blocks, drawing simple shapes, placing small items.
Preschoolers – asked to draw more complex shapes, build simple structures with
blocks, use scissors to cut paper.
2. Gross Motor (GM) – how well child moves their body.
Infants – monitor for head control and performance rolling from one side to side,
sitting upright, and crawling motion.
Toddlers – measure their ability to crawl, make stepping motions, balance, stand and
walk without assistance.
Preschoolers – measure ability to climb stairs, run, maintain balance, activities
requiring full body control or coordination.

PARENT & CAREGIVER
Social –Emotional (SE)
Infants – level of interest in
colorful/bright things, ease of getting
child’s attention, calming down, how
often child’s responds to sounds and
changing facial expression.
Toddlers – ability to get their needs mets,
imitate others at play, imagination in play
and words to communicate.
Preschoolers – child’s interaction with
peers/adults, ability to explain what they
need & why, use emotions in an
interactive.
Adaptive Behavior
Communication - speech, language,
listening and nonverbal communication
skills.
Functional Pre-Academics – letter
recognition and counting.
Self-Direction – self-control, following
directions, making choices.
Leisure – playing and following rules.
Social – getting along with people, using
manners, helping others and recognizing
emotions.
Community use – activities outside
home.
Self-Care – eating, toileting and bathing.
Health/Safety – knowledge of basic
health activities, physical dangers.

SCORE
• The examiner rates the child’s performance on each task and scores are
totaled. Raw scores are compared to tables of scores of children the child’s
age. This process yields a standard score that allows the examiner to
estimate the child’s development compared to other children the child’s
age. Raw scores of successfully completed items are converted to scale
scores and to composite scores. The assessment is often used in
conjunction with the Social-Emotional & Adaptive Behavior Questionnaire.
Completed by the parent or caregiver, this questionnaire establishes the
range of adaptive behaviors that the child can currently achieve and
enables comparison with age norms. This information can be used to help
the early service providers with diagnosing disabilities and help the child’s
pediatrician in identifying early signs of delays and potential learning
disabilities.
• The scores states how well your child performed compared to a group of
children with the same age range across the United States.
• Highest score on a subtest is 19 and lowest is 1.
• Scores between 8 to 12 are considered average.

NORMS
A pilot study was conducted on 353 children included items from
Bayley-II and along with new subtest from the Bayley-III edition. Data
from children born prematurely and with developmental delays. The
information from this pilot was used to assemble a preliminary version of
the test. This result was then administered to 1,923 in a national try out,
information from this try out was used to create a test that was applied
to a minipilot with twenty children, with these results a final version of
Bayley-III was created.
1,700 children (ages 16 days to 43 months 15 days) from the United
States population, for cognitive, language and motor scales. Children
from “special groups” are based on of race-ethnicity, age, sex, parent
educational level and geographic location (2000 U.S. Census). For the
social-emotional scale, 456 children; for the adaptive behavior scale,
1350 children.

RELIABILITY
• Based on several studies with investigations of internal consistency, test-
retest stability studies and examination of interrater reliability of the
Adaptive Behavior scale.
• The Social Emotional scale showed slightly high coefficients (average range
.83 & .90).
• The Adaptive Behavior scale showed slightly high coefficients (average
range .79 & .92).
• Test-retest showed lower coefficients, which is common when evaluating
infants and toddlers, with a average range of .67 & .80.
• Ages 9-13 months coefficients ranged from .77 - .86.
• Interrater reliability coefficient in general adaptive composite (GAC) score
.82.
• Coefficients for 3 adaptive domains averaged .79.
• Average for the skills areas is .73.

VALIDITY
• The validity is based on test content, evidence of internal structure and relations of
other variables. The Language subtests are highly correlated with each other than the
Motor subtests and are moderately correlated with the Cognitive scale. Nancy Bayley
believes the proof for moderate correlations between the scores on Language and
Cognitive scales shows the close relationship in the domains.
• Evidence of the validity and data presented is based on the outcomes form Bayley-III
and Bayley-II of Infant Development, WPPSI-III, Preschool Language Scale 4, Peabody
Developmental Motor Scales-II and Adaptive Behavior Assessment-2. In comparing
these studies Bayley-III scores with these tests to support the validity of the Bayley-III as
a thorough diagnostic evaluation tool through with some special group studies. The
special groups studies, were children with Down syndrome, pervasive development
disorders, Cerebral palsy, language impairment, at risk for development delay,
asphyxiation at birth, prenatal alcohol exposure and premature or low birth weight.
• The special group studies also included a review from the Adaptive Behavior scale with
children from other groups. To show evidence the construct validity of the instrument
has a factor analysis of the subtests. This study used the sample of the 1700 children,
results supported a 3 factor model and confirmed that the instrument measures motor,
language and cognitive development.

SUMMARY
• Bayley-III is a test of development, we have to remember a
child’s test score can be influenced by motivation, attention,
interests, and opportunities for learning.
• Useful tool for comprehensive evaluations, in early
intervention team assessment and as an instrument for
documenting progress overtime.
• The Bayley-III is still new to the market.
• Revised from Bayley-II, the third edition is solid with evidence
of strong reliability, convergent and validity and research with
special populations.
• Bayley-III should be recommended as the instrument of
choice for evaluating infants and toddlers. This instrument is
strongly recommended.

Using Measures of
Perceptual and Perceptual
–Motor Skills
Chapter 15
By: Alexandra Diaz
Arianny Savinon

VISUAL PERCEPTION
BY ALEXA WEIL

What is Perception?
 Ability to process stimuli
meaningfully
 To organize and interpret sensory
stimuli
 Ability to make judgment about and
attach meaning to incoming stimuli
 Ability to ascribe meaning to sensory
information of all kinds(auditory,
visual, gustatory, olfactory, tactile,
and kinesthetic stimuli).

What is Perceptual Motor
Development ?
 Perceptual motor development is
defined as one’s ability to receive,
interpret and respond successfully to
sensory information
 Motor refers to output or responsive
movement.
 A perceptual motor, uses movement
activities to enhance academic or
cognitive skills.

Why Perceptual Involvement
is important?
 Gross motor activities (locomotor)
 Vestibular activities
 Visual motor activities (Manipulative)
 Auditory motor activities
 Tactile activities
 Lateralisation activities
 Body awareness
 Spatial awareness

Children at Risk cont.
 Children with sensory input problems I.e
cannot filter out irrelevant sounds and
stimuli, easily distracted, talk loudly to
drown out background noise.
 Children with poor eye contact.
 Children with immature head movement
development e.g moves their head
while reading instead of moving their
eyes or jerky head movement while
reading.

Children at Risk cont.
 Children who display poor fine
motor co-ordination, have problems
with all manual skills such as
managing buttons, pencil grip,
avoiding colouring activities,
dislikes jigsaws and trouble
managing scissors.
 Children who display a difficulty in
expressing themselves properly
(poor speech, stuttering)

What are Motor Skills?
 Fundamental skills are those utilitarian
skills that children need for living &
being
 Fundamental motor skills are the
foundation movements or precursor
patterns to more specialised, complex
skills in games, sports, dance, aquatics,
gymnastics and recreational activities”

What are Motor Skills cont.
 Early development of motor skills is an important step
towards ensuring an individual’s involvement in
physical activity is lifelong, safe and healthy
 Without competence in a range of skills such as
running, skipping and balancing, students are less
likely to access the range of options available to
establish an active lifestyle (DECCD, 1997)
 Research has indicated that the improvements in self
esteem and confidence that are associated with a
sound development in FMS has a flow on effect to
other areas of a child’s education (DECCD, 1997)

3 Motor Skill Categories
 Locomotor
 Nonlocomotor (body
management)
 Manipulative

Locomotor Skills
 Are used to move the body from
1 place to another or to project
the body upward, eg. walking,
skipping, jumping & landing,
hopping, running, leaping,
galloping, & dodging
 Form the foundation of gross
motor coordination & involve
large muscle movement

Nonlocomotor or Body
Management Skills
 Are performed without
appreciable movement from
place to place, eg. bending,
stretching, pushing & pulling,
twisting & turning, balancing, &
rolling.

Manipulative Skills
 Are involved when a child handles
some object.
 Usually involve the hands & feet but
other parts of the body can also be
used.
 Leads to better hand-eye & foot-eye
coordination.
 Form the foundation for many game
skills.
 Eg. catching, throwing, striking,
dribbling, kicking.

Why is so important to assess
Perceptual motor -Skills
 At early age Children GRADE 1
– children have the neurological
& anatomical ability to develop
skills in ALL fundamental motor
skills.
 By the time children reaches
their ten years they have
established their belief in
physical activity & sport.

Developmental Visual
Qualities
 Four key components that affect
movement:
1) Visual Acuity
2) Depth Perception
3) Visual-Motor Coordination
4) Figure-Ground Perception

Visual Perception
 Visual discrimination: identify dominant features in
different objects and to discriminate among a variety of
objects.
 Visual figure-ground discrimination: distinguish an
object from its background.
 Object recognition: recognize essential nature of an
object
 Spacial relations: determine the position of physical
objects in space.
 Visual memory: recall the dominant features of a
stimulus that is no longer present.
 Visual closure: identify figures that are presented in
incomplete form.

VISUAL PERCEPTION
 Visual coordination
 Visual
discrimination
 Visual association
 Visual long-term
memory
 Visual short-term
memory
 Visual sequential
memory
 Visual sequential
memory
 Visual vocal
expression
 Visual motoric
expression
 Visual figure
ground
discrimination
 Visual spatial
relationships
 Visual form
perception

VISUAL PERCEPTION
ASSESSMENT
 Bender Visual Motor
Gestalt Test
(BVMGT)
 Developmental Test
of Visual Perception-
2 (DTVP-2)
 Motor-Free
Perceptual Test-
Revised (MVPT-R)
of Visual Motor
Integration- 4th
Edition (VMI-4)
of Visual Motor
Integration- 4th
Edition (VMI-4)
•Developmental Test of Visual
Motor Integration- 4th Edition
(VMI-4)
•Test of Gross Motor
Development- 2nd Edition
(TGMD-2) Visual coordination
•Visual discrimination
•Visual association
•Visual long-term memory
•Visual short-term memory
•Visual sequential memory
•Visual vocal expression
•Visual motoric expression
•Visual figure ground
discrimination
•Visual spatial relationships
•Visual form perception
Marianne Frostig Developmental
Test of Visual Perception (DTVP)

Visual perception Test of
Visual Perception , 2nd Edition
The DTVP-2 is the 1993 revision of Marianne
Frostig's popular Developmental Test of
Visual Perception (DTVP). The original
version of the test was administered to more
than 6 million children. The new edition
includes numerous improvements, is suitable
for children ages 4-10, measures both visual
perception and visual-motor integration skills,
has eight subtests, is based on updated
theories of visual perceptual development,
and can be administered to individuals in 35
minutes.

Visual perception Test of Visual
Perception , 2nd Edition Cont..
Of all the tests of visual perception and
visual-motor integration, DTVP-2 is unique in
that its scores are reliable at the .8 or .9
levels for all age groups; its scores are
validated by many studies; its norms are
based on a large representative sample
keyed to the 1990 U.S. census data; it yields
scores for both pure visual perception
(no motor response) and for visual-motor
integration ability; and it has been proven to
be unbiased relative to race, gender, and
handedness.

Perception , 2nd Edition
subtest
 Eye-Hand Coordination
 Copying
 Spatial Relations
 Position in Space
 Figure –Ground
 Visual Closure
 Visual-Motor Speed
 Form Constancy.

Norm
The DTVP-2 was standardized on
1,972 children from 12 states.
Characteristics of the normative
sample approximate those provided
in the 1990 Statistical Abstract of the
United States with regard to gender,
geographical region, ethnicity, race,
and urban/rural residence. Standard
scores, NCEs, percentiles, and age
equivalents are provided in the
Examiner's Manual.

Validity
 Criterion-related validity is evidenced by
correlating
DTVP-2 scores with those from the DevelopmentalTest
of Visual-Motor Test.
Integration (visual motor integration VMI) and Motor-
Free Visual Perception.
 Construct validity is supported by correlations
with mental ability tests, achievement tests, and age.
Studies also show that the subtests are Interco related
and that groups known to have visual perceptual
difficulties do poorly on the DTVP-2. Results of factor
structure and gender/race/handedness bias studies
also reinforce the validity of the DTVP-2.

Reliability
 Internal consistency reliabilities (i.e.,
alphas) and stability reliabilities (i.e., test-
retest) for all scores exceed .8 at all ages.
 Internal-consistency estimates
for all subtests at all ages exceed .80, and
composite scores were .93+
 Test-retest estimates (based on 88
students from one test site, with a 2-
week interval) ranged from .71-.86 for
subtests and .89-.93 for the three
composite scores.

KOPPITZ-2 Developmental
Scoring System
 Description is an extensive revision
and extension of the Bender Gestalt
Test for Young Children by Koppitz.
 Purpose: Assesses the ability to relate
visual stimuli accurately to motor
responses and to organize the drawing
task independently
 Ages: 5 to 85 years
 Administration Time: 5-10 minutes
 Scores: Standard Score, (called the Visual
Motor Index), Percentile Ranks, T-scores,
zz-scores, Age Equivalents

Scoring System
 Koppitz-2 developed the Developmental Bender
Scoring System in 1963. It consists of 30 discrete
errors that are scored when present. The number of
errors scored for each design ranges from 2 to 4.
The errors selected were thought to be sensitive
predictors of school performance, differentiating
between students who were either above or below
average in achievement.
 The Koppitz-2 is Individually administered in just 5
to 10 minutes.

Scoring System cont..
The KOPPITZ-2 requires the examinee to
draw increasingly complex figures from a
model (the Bender designs) on a plain
sheet of white paper and to organize the
task independently. It assesses the ability
to relate visual stimuli accurately to motor
responses.
This new test is to be used by psychologists,
educational diagnosticians, licensed
professional counselors, occupational
therapists, and others with proper training
in the use of psychologically based tests of
visual-motor integration.

Scoring System
The KOPPITZ-2 can be used to determine the
presence and degree of any of the following:
 extant visual-motor problems
 identify candidates for remedial program
 visual-motor training, to evaluate the effectiveness
of intervention programs
 monitor recovery
 following acute injury,
 monitor the progression of
progressive degenerative disease processes that affect
visual-motor integration skills,
 gather research regarding the visual-motor
integration process.

KOPPITZ-2 includes the
following Key Features
 New norms based on a nationally representative sample of 3,600
people.
 An expanded age range -- from 5 to 85 years (which allows
evaluation of special education students up to age 21)
 Separate scoring systems for young children (ages 5 to 7 years)
and older children and adults (ages 8 to 85+ years)
 The addition of two- and three-dimensional drawings for older
children and adults -- drawings that can reveal subtle visual-
motor integration deficits.
 A completely nonverbal format that makes the test appropriate
for individuals from all cultural and ethnic backgrounds.
 High reliability across age, gender, and ethnicity.
 Detailed scoring guidelines that insure high interscorer reliability.
 A variety of scores -- standard scores, percentile ranks,
specialized scores, and age equivalents -- to meet the needs of
all practitioners.
 A separate section of the Manual explaining how to use Koppitz
Emotional Indicators (EIs) and a specialized form for this
purpose
 determine the presence and degree of visual-motor problems;
identify candidates for remediation or visual-motor training;
monitor progress in cases of acute injury or degenerative
disease.
 evaluate the effectiveness of intervention efforts.

Koppitz’s Developmental
Bender Scoring
System
 The Qualitative Scoring System (Brannigan & Brunner,
1989, 1996, 2002) evaluates the accuracy of each
drawing on a 6-point scale ranging from 0 to 5.
In addition to providing general guidelines, this system
also provides specific guidelines and examples for
scoring each design. It was created to assess the
overall quality of the reproductions of children from
ages 4 years, 6 months to 8 years, 5 months.
This scoring system is similar to the Global Scoring
System and uses the same strict scoring approach
that requires drawings to be “as good as or better than
the examples at a particular level” to receive credit at
that level.
The scoring system was designed to be used with a
modified version of the test (six designs), which is
more appropriate in predicting school achievement in
young children.

 Testing time is between 5 and 10 minutes on an
individual basis. Completely non verbal and useful
with individuals from widely varied cultural and
ethnic backgrounds, this test maintains a
developmental view of visual-motor integration and
provides separate scoring systems for young
children, 5-7 years, and older children and adults 8-
85 years.
Detailed scoring guides and a clear template are
provided for the developmental scoring systems that
result in high levels of interscorer reliability.
Standard scores and percentile ranks along with
specialized scores and age equivalents are
provided to meet the needs of all practitioners.

Tests of Visual Motor Integration by Arianny Savinon & Team

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