In our office – as in most Vision Therapy clinics – Visual Perceptual testing has become a necessary step of the overall diagnosis. The goal of testing seems to be analyzing the visual perceptual skills necessary for learning and living, in hopes of discovering areas of strength and weakness. Conventional wisdom says this process provides a window into a patient’s perceptual world, which in turn, allows us to guide their treatment program while also providing benchmarks for overall developmental levels. But is it really necessary?
Generally speaking, I’ve never been a big fan of perceptual testing. Most probably because test taking was one my greatest academic struggles. While it’s agreed that testing remains the best available method for demonstrating progress in Vision Therapy, those results (good or bad) should be kept in perspective. My argument for this is simple: testing is a snapshot, nothing more.
Whether one hour or three, perceptual testing batteries provide a minute cross section of a lifetime spent learning, calibrating and re-calibrating. Mitigating or aggravating factors during testing could be the patient’s mood, how much they’ve eaten and slept, personality conflicts between tester and patient, and how well they can perform at a doctor’s office while working with a complete stranger for a few hours looking at pictures and duplicating drawings. There are also the intangibles to consider, such as sub-vocalization. Many patients have become so good at compensating by way of sub-vocalization, that their test results may produce false positives or other misleading results. Some will argue that testing results (good or bad) provide information on how patients normally function, and I agree. Still, lots of kids I’ve met have literally talked their way through the tests, and done quite well. As therapists, we always try to factor in these compensations, but we’ve got our own set of filters to contend with while trying to remain objective.
You’re probably wondering if I’m about to provide a better solution, and I’m not. I don’t have one. My thought here is simply to remind myself (and the world) that testing is a snapshot, and should not be considered the end all, and be all. Keep the results it in perspective. After all, if insurance companies judged our driving abilities on the snapshot of our driver’s license testing at 16 years old, there would be no good drivers in the world.
More important than any test results are the patient’s quality of learning and quality of life. Those are the areas they care about most. Not the test results.