An overview and critique of the Test of Visual Perception Skills - fourth edition (TVPS-4).
Ted Brown, Lisa Peres
PMID 30643493WHAT IT FOUND
The TVPS-4 reliably identifies specific visual perception deficits in children and young adults, but its US-based norms may mislead clinicians outside the United States.
It also lacks data on how well it detects change after treatment or scores at extreme high or low ends.
Key findings
01The TVPS-4 demonstrates strong content and construct validity, with scores correlating well with age and distinguishing children with learning disabilities or autism from typically developing peers.
02The test has significant limitations for use outside the United States due to a lack of cross-cultural validation, and it does not report norms for adults older than 21.
03The manual omits information on whether the test can detect changes in a patient's status over time and whether scores cluster at the very top or bottom of the scale.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The normative sample was restricted to US residents, making scores potentially inaccurate for populations in other countries. There are no norms for individuals older than 21 years, limiting its use with adults. The test manual lacks data on responsiveness, meaning it is unclear if the test can detect meaningful changes in a patient's visual perception skills after therapy. Floor and ceiling effects were not reported, so it is unknown if the test accurately captures very high or very low ability levels. Reproducibility was rated poorly because the authors used an inappropriate statistical method (Pearson’s correlation) to report test-retest reliability.
Declared interests
The article does not declare any conflicts of interest or funding sources for this review.
The easy way to misread this
Do not use the TVPS-4 to evaluate whether a patient has improved after intervention. The review found no evidence that the test is sensitive to change over time, and it did not report whether scores are limited by floor or ceiling effects.