Reliability, Validity, and Responsiveness of the Visual Perceptual and Fine Motor Function Tests in School-Aged Children With Mild Intellectual Disabilities.
Ying-Chun Chou, Yi-Wen Chen, Yee-Pay Wuang
Two of three commonly used hand and visual-perceptual tests (JTHFT, TVPS-4) reliably track change in children with mild intellectual disability, but the Box and Block Test is too imprecise to detect individual-level improvement in this group.
Key findings
1The TVPS-4 and JTHFT demonstrate strong reliability, acceptable validity, and adequate responsiveness in children with mild intellectual disability, while the BBT showed comparatively lower measurement precision and responsiveness.
2The BBT showed no significant correlations with its criterion measure (MABC-2 MD component) at either pretest or posttest, while the JTHFT showed significant moderate correlations with the same criterion at both time points.
3The TVPS-4 total score MDC was 13.89, meaning a change of more than 14 points is required to be interpreted as true change beyond measurement error for an individual child.
Still to come
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
No control group: children received 4 months of therapy, so observed score changes could reflect maturation or practice effects rather than the intervention itself. All participants were in an occupational therapy programme, so the findings apply to children who are already receiving structured treatment, not to untreated children. The test-retest interval was 14 days; the authors note that reliability of the JTHFT and BBT may decline over longer intervals, so these numbers may not hold for annual re-assessments. Single-centre recruitment (Kaohsiung Medical University Hospital, 20 schools, 15 clinics); generalisability to other severity levels of intellectual disability or to older children is uncertain. The visual closure subtest of the TVPS-4 showed the lowest reliability (ICC 0.68) and the smallest effect size (ES 0.18), so that specific domain should be interpreted with extra caution.
Declared interests
No funding was received for this manuscript. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the BBT's 62% and 55% of participants exceeding the MDC as evidence of good responsiveness — those high percentages reflect large measurement error (the SEM exceeded SD/2 for both hands), and the effect sizes were only 0.35 and 0.28, which the paper classifies as small. A high MDC percentage means the test is noisy, not that it is sensitive.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →