7
 CHAPTER 2.                
LITERATURE REVIEW. 
2.1: INTRODUCTION. 
The purpose of this study was to evaluate the effect that translating the MVPT-3?s 
instructions into Afrikaans had on its reliability, when using the test to evaluate visual 
perception in South African 8-year-old Afrikaans speaking children. Literature on the 
following topics was researched in order to gain a background for the study; 
? The characteristics and skills of 8-year-olds, including the differences between 
boys and girls, 
? Visual perception, including the occupational therapist?s role in the remediation 
of dysfunction, 
? Motor-Free Visual Perception test, and the impact of culture on testing, 
? Standardisation of tests to determine validity and reliability. 
 
2.2: CHARACTERISTICS AND SKILLS OF 8-YEAR-OLDS. 
 
According to Ambacher Mc Fall, Deitz and Crowe it is within the ages of 6 to 8 years that 
the most children get referred to occupational therapy. These children usually have one to 
two years schooling and are most commonly referred due to learning problems. 1 It was 
with this in mind that the researcher chose to investigate the 8-year-old population using 
the MVPT-3. 
 
In South Africa an 8-year-old is usually in grade two, having completed one year of 
schooling. 
 8
 2.2.1: GENERAL DEVELOPMENT. 
? Physical development: Up until the age of 8 the child?s physical growth has 
been fairly rapid. During the eighth year it starts to slow down, although the 
child?s physical development is still steady. They start gaining greater control 
over the large muscles in their legs and arms, although their gross motor 
coordination is still slightly inconsistent. Their finger and eye hand coordination 
is also developing. 10 
? Cognitive: According to Piaget, the 8-year-old is just entering the stage of 
?Concrete Operations?. This means that they are starting to understand and use 
different concepts that allow them to participate in their environment.11 They 
have a basic understanding of numbers and understand the value of, as well as the 
use of money, 10 and so enjoy bartering and bargaining, as they are able to 
evaluate an item?s value in a more mature manner.12 They have an attention span 
of approximately 20 minutes and are starting to understand the sequence in which 
events take place.10 Their ability to remember improves as well as their ability to 
deal with frustration and this allows them to reason deductively. 11 They are able 
to solve problems logically, 11 and can decide and think through actions that need 
to be taken in a given situation. 10 They tend to stick to and enjoy problem 
solving, 13 and being able to work independently when given direction.14 The 8-
 year-old is able to evaluate his/her own decisions deciding whether they were 
right or wrong. 12  
? Emotions:  According to Kohlberg the 8-year-old child is in the stage of 
?Preconventional Morality?. Within this period the child starts to become aware 
 9
 of the standards that are set by others.  11As a result of this, 8-year-olds develop 
realistic fears centered on their school, family and social circle, fearing that they 
might not measure up to the standards set.  Eight-year-olds then try to measure up 
to these standards to avoid being punished, and rather seek rewards for good 
behaviour. 11 Their self-image is built through experiences, which they felt were 
successful.  They are still very sensitive to criticism10 and do not take failure 
easily.13, 15 Eight-year-olds tend to be very critical of themselves as well as 
others.14 
? Social interaction: The 8-year-old is in what Eriksson describes as the stage of 
?industry versus inferiority.?  This means that they are able to separate reality 
from imagination and are starting to be able to do constructive work, because 
they are able to concentrate for longer periods of time. They are starting to master 
the expectations of their culture and are also learning to play with their peers, 15 
developing opinions about others10 as well as being aware of how others feel 
about them.14The 8-year-old releases pent-up emotional tension through physical 
activities. 10 Eight-year-olds tend to be outgoing, self-confident and social.14They 
are no longer totally dependant on their parents and their parent?s recognition. 
They interact more with their peers and teachers, using them to fulfill their 
personal needs. 15 They look for recognition and support from their parents10as 
they become more aware of themselves within a social world.14They enjoy new 
experiences and are interested in others and new cultures. 12, 14 Although they 
tend to be slightly egocentric, they are starting to see another child?s or person?s 
point of view. 13 Group work becomes more important as the 8-year-old matures 
 10
 allowing him/her to develop a sense of belonging and security in groups. 15 As 
the 8-year-old matures his friendships become closer and more positive. 14,10  
? Play: Eight-year-olds become aware that they are able to influence events as well 
as their environment and this becomes a strong incentive evident in their play.16 
This results in the 8-year-olds enjoying games with rules and regulations, which 
they will also make up as they go along.13, 14Friends are very important and they 
tend to have a best friend and an enemy.10, 13, 14 They become more interested in 
real life games and less interested in fantasy games, 14, 15 as this helps them to gain 
knowledge of a situation or experience, allowing them to learn how they should 
react .16 They will imitate new behaviours10 or friends to see how the experience 
feels, 10 and enjoy it when they have mastered the behaviour. 16 At this age you 
find that boys tend to play with boys and girls with girls.13, 14 
 
2.2.2: DIFFERENCES BETWEEN GENDERS AT EIGHT YEARS OLD. 
According to Snell, 17 Fong and Resnick there is no significant difference in the 
intelligence of males and females. 9 During Snell?s study of three different socio- 
economic groups, ranging from low to high, she found that South African boys were 
better listeners than girls in each socio economic group, which resulted in boys at this 
stage having better language development. Snell also found that girls did better on 
perceptual type tests, which involved an element of fine hand coordination. 17 Boys on the 
other hand out performed girls in spatial related problems and this tendency increased 
until adolescence.17 
 11
 However in motor development girls tended to out perform boys in fine eye hand 
coordination,17, 9 and enjoyed doing schoolwork as it involved writing. Girls tended to 
write faster than boys and because of this, participate in activities that use their manual 
dexterity. Girls also have a better concentration and are more motivated than boys.17 Girls 
tend to accept class discipline more readily than boys and are more persistent when it 
comes to task completion. 17  
  
Boys on the other hand tend to perform better in activities using gross muscle 
development 9 and eye hand coordination, using gross movement skills. 18 This means 
that they prefer being involved in physical activities and find it difficult to sit still in the 
classroom. Boys tend to be involved in activities like kicking and throwing where their 
eye hand coordination is used. Boys also tend to be more aggressive than girls and so 
view school in a more negative light and have problems with obeying rules as set out in a 
classroom situation. 17 Snell felt it was because of these negative behaviours and the fact 
that boys are harder to motivate, that more of them are referred for therapy than girls. 17 
 
Further differences between boys and girls are felt to be a reflection of social and cultural 
expectations and stimulations, 9, 17, 19 rather than development.  At this age a lot of gender 
related development takes place. Girls are expected to play with ?girl? toys and boys with 
?boy? toys and participate in ?girl? and ?boy? activities. This may be the reason why they 
tend to segregate into different gender groups. 19 
 
 12
 2.3: VISUAL PERCEPTION. 
According to Chandler, humans endeavor to understand and interpret the stimuli that they 
experience, by giving them meaning. He reports that the understanding and interpretation 
of the visual stimuli is the underlying process of human visual perception. 20  
 
Visual stimuli are constantly experienced and fed to the central nervous system. Vision 
tends to dominate how we see the world and has a major influence on how we 
communicate with others, by influencing how we describe things in the world around 
about us.20 
 
2.3.1: DEVELOPMENT OF VISUAL PERCEPTION. 
Zeitschel, Kalish and Colarusso proposed that visual perception develops firstly by 
recognizing an object (gross visual discrimination), secondly by analyzing the object (this 
is the ability to react to a specific component of the object), and finally by synthesizing 
(which is the ability to recognize the linear components). 6 
 
Newborns have rudimentary visual perceptual abilities that enable them to detect size 
constancy. They are able to see an object as a whole, but do not detect the fine details of 
that object. Within the first 4 months babies start to perceive motion because moving 
objects supply the child with more stimulation. They tend to see fast moving objects 
easier than stationary or slow moving objects.21 At the age of 4 months a child can fixate 
on a single object with both eyes. They also start to observe shape. Depth perception 
starts to develop between 5 months and 7 months. It is only at the age of 10 months that 
 13
 an infant starts to observe the different parts of an object realizing that it makes a whole. 
21 Below the age of 6 years whole objects are mainly observed and after this age the child 
starts to observe the different parts that make up a whole. 21 According to Zeitschel, 
Kalish and Colarusso the development of visual perception is most active between the 
ages of 5 to 8 years of age. 6 
 
At the age of 8 a child learns to understand and make sense of letters and numbers. They 
also learn to write from the board allowing them to improve their visual motor integration 
skills.22 The 8-year-olds will still reverse certain letters, 13 showing that their spatial 
perception is not fully developed, although they should know their right and left sides. 
13Their memory is improving 16which helps with the development of their visual 
memory. Following this age, visual perception becomes more refined and then reaches a 
plateau at the age of approximately 12 years.3  
 
2.3.2: PROCESS OF VISUAL PERCEPTION. 
Visual perception is a function of our eyes as well as our brain and is associated with 
reasoning. 20 Visual images are seen as a whole rather than as parts but can be broken 
down into visual elements, for example line, shape, colour and texture. 23 These images 
are received and interpreted by the brain. 4 According to Colarusso and Hammill, visual 
perception is not an independent process but involves the continuous interpretation and 
understanding of what is being seen at a given time. 3 
 
 14
 Visual perception develops as the central nervous system matures but also depends on the 
experiences of a child.5, 6 Chandler states that visual perception is partly learned, but is 
also influenced by an individual?s spatial skills, personality, gender, roles, environment, 
prejudice, age, values, motivators, motives and religious beliefs.  He advocates that the 
basic processes of human perception are the same in all people, but that different 
interpretations are due to different environmental and temporal factors.20  
 
Visual perception is also influenced by sensory elements, i.e. light, sound, as well as 
cognition and language.21 Usually there is more than one sensory element present at any 
one time and so there is a process by which the stimuli are selected, segmented and 
integrated so that the person is able to understand the information.21 This course of 
processing and integrating the sensory stimulus greatly influences the result of what is 
perceived. 21  
 
Visual perception is reputed to involve different types of skills, which include form 
perception, spatial relations as well as constructional abilities.24 Visual discrimination is 
said to be the foundation ability of visual perception and all processes develop from it. 
The different processes of perception (spatial relations, figure ground, visual closure, 
visual discrimination and visual memory) are interlinked but interdependent working 
together to enable a person to perceive and interpret an object correctly.3 Colarusso and 
Hammill believe that the critical factor of visual perception is how a child observes an 
object within his environment. This means that the child should be able to ?see? an object: 
? in different spatial orientations,  
 15
 ? among other objects at a close distance,  
?  in relation to other objects or persons, and  
? when only part of the object is seen. 3 
 
Colarusso and Hammill proposed that there is a reciprocal relationship between visual 
perception and cognition. 3 Brekke, Williams and Follman supported this finding in 
identifying that spatial ability and the understanding of spatial relations is independent of 
intelligence, although intelligence is needed in understanding spatial cues in instructions 
as well as spatial relations.25 Aslin and Smith found that language and cognitive- related 
factors influence the perceptual tasks of preschoolers and of older children.21 As a person 
ages it becomes more difficult to discriminate whether perceptual abilities are a result of 
perceptual mechanisms or of cognitive operations. 21 Southey further reported that 
deficiencies in language, attention and memory have a more lasting affect on a person?s 
functioning, than does visual perception.5 
 
Jane Ayres, a well know occupational therapist, believed that visual processing was 
central to learning, and that visual processing included the other sensory systems, i.e. the 
vestibular system.26 Hammill, Pearson and Voress suggested that visual perception is that 
function of the brain that organizes and interprets the physical elements of the visual 
stimulus, rather than the sensory elements of an object.27 In order to understand the visual 
processes, it appears that visual perception of an object takes place before visual 
processing where the physical elements are processed along with other sensory stimuli. 
 
 16
 2.3.3: THE IMPACT OF DYSFUNCTION OF VISUAL PERCEPTION ON         
PERFORMANCE. 
Visual perception is necessary in order to allow a child or adult to plan a movement, as 
well as for reading and writing. 3,16In order to execute or complete a given task an 
individual calls on various systems within the body to help him/her to plan and 
effectively complete the task. Some of the systems he/she uses are the perceptual, 
cognitive, neurological and musculo-skeletal systems. The perceptual system helps the 
person to plan present, as well as future movements or actions, using the cognitive system 
to recall past performances in order to adapt these movements or actions. Impairment in 
any one of the systems can greatly influence how an action is planned and followed 
through which influences occupational performance.16 Reid and Jutai?s finding that 
failure to receive and interpret visual information correctly, greatly influences a person?s 
ability to function and go about their daily tasks, also confirm this.4 
 
According to Chandler vision is closely linked to reasoning, especially in the western 
cultures. He suggests that vision influences how we see our world, and thus influences 
our descriptive language and vocabulary. 20 Colarusso and Hammill state that a child with 
visual problems has difficulty understanding letter forms and direction and this will limit 
progress with reading and consequently academic work.3 Furthermore if a child has visual 
perceptual problems and has not caught up to his peers by the age of 12 years of age he 
will develop into an adult with reading problems, 3 this will then limit his future by 
narrowing his work opportunities.  Occupational therapists assess and intervene to help a 
 17
 child improve their performance in academic learning, 3 and consequently their long-term 
opportunities. 
 
2.3.4: THE ROLE OF THE OCCUPATIONAL THERAPIST WITH CHILDREN 
WITH VISUAL PERCEPTION DYSFUNCTION. 
The occupational therapist?s job is to assess a child and then explore ways in which the 
child can be helped to become fully functional in their daily lives. 26 According to Bundy, 
Lane and Murray, occupational therapists help develop a child?s ?self actualization?, 26 
which means helping the child to perform and interact as best they can within their 
physical and socio-cultural environment. This facilitates the child in the development of 
his/her motor abilities, self-concept and social identities. 16  
 
To achieve this the occupational therapist assesses the child?s performance within the 
areas of his/her play, activity of daily living i.e. self-care, schoolwork, and 
communication abilities. 16 The occupational therapist assesses the underlying 
mechanisms that support learning. These include fine motor skills as well as visual 
perceptual skills. 3 The assessment would be incomplete without the use of a standardised 
perceptual test to assess the child?s visual perceptual processing. The occupational 
therapist, based on evidence, believes that the standardised tests are valid and reliable so 
when they are used in the correct context for which they were designed, will identify 
learning difficulties in a child. 3 In addition non-standardised assessment scales, 
supported by a series of clinical observations, based on the development of the child are 
also used. 5 
 18
 Research has proved that the areas of visual perception and visual motor coordination are 
a problem in clumsy children with learning difficulties.28 It is these children that are 
referred to occupational therapy 29 needing to be diagnosed and effectively treated, 
assuming there is a direct relationship between visual perception and the learning 
processes in a child.30  
 
It is also important to observe a child?s attitude to his schoolwork / activity as well as in 
new tasks, and to observe how he copes with frustrations. 31 The occupational therapist 
must also be aware of the environment in which a child lives and how this could 
influence his/ her ability to perform academically. The environment can influence the 
child by giving the freedom to act or to ignore a problem, or by demanding a certain type 
of behaviour. 16 
 
 The occupational therapist then treats the child in order to help with his/her occupational 
performance, which in the instance of a child is his/her scholastic achievement. 26 Each 
child?s treatment is then designed to meet his/her own specific dysfunction. 18 
Standardised tests are then once again used, considering the correct test/retest conditions 
for which the test was standardised, to monitor how a child has improved and so direct 
any further treatment. 3 
 
 
 
 
 19
 2.4: MOTOR-FREE VISUAL PERCEPTION TEST. 
 
Research indicates that a greater number of children with poor visual perceptual skills 
have poor motor skills, compared to those without, 28 but poor motor coordination 
appears to be characteristic of most children with learning problems. 24 While Leonard, 
Foxcroft and Kroukamp proved that visual perceptual and motor skills were two separate 
abilities, 32, 2 Murray, Cermak and O?Brien suggested that some aspects of visual 
perception were related to clumsiness but that clumsiness did not necessarily mean that a 
child had visual perceptual problems.24 On the basis of the above, Newcomer and 
Hammill proposed that the two abilities, visual perception and motor coordination, had to 
be separated and that a test had to be designed to test visual perceptual skills which 
excluded motor skills or coordination. 33 It was with this in mind that the original MVPT 
was designed. 
 
Colarusso and Hammill used the following construction in designing the Motor-Free 
Visual Perceptual Test (MVPT). They described that the processes involved in visual 
perception are not independent of each other, but rather are interdependent and occur 
simultaneously. 3 They also felt that the sub areas of perception were theoretical, but 
practically they were inseparable. They also felt that visual discrimination is the 
core/foundational ability underlying all visual perception, giving the person the ability to 
observe the differences and similarities between objects and pictures. 3 
 
The MVPT-3 is an updated version of the MVPT and MVPT-R test. New items have 
been added to the test and new standardisation data has enabled the test to be used over a 
 20
 greater range of ages. The details of the new test items will not be discussed as they are 
not pertinent to the 8- year- old age group, but rather to the older age group. The new 
visual perceptual test items developed for the MVPT-3 reflect the understanding that 
perception and cognition go hand in hand and so does not provide different scores for the 
different processes of perception but rather results in a general score. 3  
 
The MVPT has been found to be an affective screening test especially when a large 
number of children need to be tested. The test takes only 10 ?15 minutes to administer, 
not requiring a long period of concentration. 2 The MVPT was found to be one of the top 
9 tests used by American occupational therapists used to assess children.34 It is also 
widely used in South Africa as a screening test 30although there has been criticism of the 
test because the MVPT only gives a global score of visual perception. Therapists find this 
problematic, as it does not really indicate where to start intervention.4    
 
Brekke, Williams and Follman suggested that the MVPT was more useful in the 
evaluation of higher functioning children than those who were mentally challenged.25 
This may be due to the assumption of the authors that cognition goes hand in hand with 
visual perception, 3 thus influencing their choice in test plates. The test was also 
standardised on children from the normal population. 3 
 
 Due to the lack of funds in developing countries the occupational therapist as well as 
other professionals, i.e. psychologists, use assessment tools like the MVPT-3 that have 
been developed in another country, for example the USA. 35 These tests are often 
culturally biased, with contents specific to that culture. 36 Professionals often fail to 
 21
 recognize the uniqueness of the culture and assume that the content of the test does not 
influence the ability of the child to perform. This can lead to misinterpretation of 
dysfunction as it has been proved that children from different cultures develop at 
different rates. 36 
 
When a test is translated into another language it raises concerns about the language of 
standardisation versus the language of implementation. This can compromise the validity 
and reliability of the test as the translation may either cause subtle changes in meanings, 
or cultural interpretations of words may be evident. 35 Neuman, Greenberg, Labovitz and 
Suzuki translated Dunn?s Sensory profile into Hebrew and found that the literal 
translation was difficult to achieve because of the change in the linguistic structure of the 
target language compared to the source language .35 They also found that cultural 
influences on the language caused the children to react differently as they tended to 
interpret the questions differently, achieving a higher score when the test was presented in 
Hebrew than when given to them in English. 35 Language interpretations often also 
influence how a specific activity is undertaken. 37  
 
Linge and Cameron evaluated the original MVPT?s reliability using white, English 
speaking, South African children and proved the test to be temporally reliable.6   Southey 
also tested the temporal and internal reliability of the MVPT and found it to be valid 
when testing black South African children aged 6.0 to 6.9 years.5 Southey did not 
translate the test but administered it in English although English could have been their 
second language and this could have influenced her scoring. 5 
 22
  
Bonder suggested that if a person is to fully comprehend the role that culture has on a 
person?s performance, there should be a detailed evaluation of both the culture and the 
individual. 37 This leads to the question: What is culture? 
 
2.4.1: CULTURE. 
Krefting and Krefting describe culture as systems of learned behaviour patterns which are 
passed on from one generation to the next. These behavioural patterns are group 
orientated, directing group interaction with others and their environment. The behavioural 
patterns include everything that an individual learns as a member of the society. 38 
According to Krefting an individual learns the guidelines for behaviour from his family, 
peers, and school as well as from his community in which he lives, he then interprets 
these guidelines individually. 38 Krefting suggests that culture has an unconscious affect 
on how an individual behaves. 38 Bonder suggests that culture is necessary for a human to 
develop, and that the cultural influences on an individual are not static but change as the 
person develops. 37 According to Krefting, culture is different to ethnicity.  
 
Ethnicity is that part of the individual?s identity that comes from being a member of a 
specific racial, religious or linguistic group. Ethnic groups can then differ within 
themselves due to education, and higher or lower socio-economic groupings. 38 In terms 
of this research this means that the Afrikaans group in the east of Pretoria will differ from 
that of the west due to the different educational and socio-economical levels. The 
expectations of the parents for their children will also differ, 39 for example parents in the 
 23
 west may only expect their children to get jobs, whereas those in the east may expect 
their children to get college and university educations in order to get jobs.  
 
All the above will have an affect on the outcome of a specific test administered to a 
specific culture and may lead to the level of difficulty of test items being different from 
culture to culture.36 Baumgart and Halse question whether a test can ever be culture free, 
40 although Whitford and Wilcock assure us that occupational therapy assessment 
protocols and guidelines are designed to be free of cultural influences, 39 but there has 
been criticism about cross-cultural validity of assessments that occupational therapists 
use. It is reported by Whitford and Willock that there is a gap between the therapists? 
knowledge of the different cultures and the theory they implement, 39 resulting in 
therapists having difficulty working with people from different cultures to themselves. 37 
 
2.4.2: RELIABILITY AND VALIDITY OF A STANDARDISED ASSESSMENT 
TEST. 
When choosing an instrument with which to test a child, it is very important that the 
therapist studies the test to make sure that it will provide her with the correct diagnostic 
results within the academic environment.41 The therapist must choose a test which 
competently measures the required area of function which the therapist wants it to 
measure (validity), and yields consistent results when repeated over a period of time 
(reliability). 2 According to Bailey it is also important to consider subject fatigue, 
motivation, learning, ability, the tester?s skill and the test environment, all of which can 
 24
 influence the test?s reliability and should be considered when any standardised test is 
administrated to any type of child. 7 
 
2.4.2.1: RELIABILITY. 
 
Reliability can be defined as the ?consistency? or ? repeatability? of a test like the 
MVPT-3. In other words does the test give us the same results each time it is 
implemented?   Trochim says that reliability cannot be calculated but can only be 
estimated, due to the errors in tests, and for this reason there are different types of 
reliablity.8   
The traditional types of reliability are: 
a. Temporal stability, 42 Test retest Reliability 8 ? refers to when a test instrument is 
given on two different occasions to the same people and similar results are 
obtained over time. The only problem with this type of reliability is that there 
could be learning/maturation that takes place due to the application of the test and 
the second group of results may differ from the first. 42 
b. Form equivalence, 42 Parallel forms Reliability 8- is where two different test 
instruments based on the same content are given to the subjects. 42 The problem 
with this type of reliability is that you have to have a lot of questions that cover 
the same content or area being examined. 8 
c. Internal consistency 42, 8 - this is where the Cronbach?s alpha for the test scores is 
worked out. 8 If no pattern is found in the students? answers it can be assumed that 
the test was too difficult and the students had to guess the answers. 42 In this 
measure the consistency of the results are observed for various items within the 
construction of the test instrument. (MVPT-3) 8  
 25
 The Internal consistency is the reliability that is most frequently calculated, using the 
Cronbach?s alpha to determine the reliability of a test. 8 
 
The authors of the MVPT-3 looked at different elements of reliability: The internal 
consistency3 of the test, to determine whether the MVPT-3 tests what it set out to test and 
test re-test (temporal) reliability to determine whether the tests results are consistent over 
time. Both of these positively concluded that the MVPT-3 can be used with individuals 
aged five and above.3 
 
According to Chong Ho Yu reliability is necessary but not always sufficient for the 
validity of a test, as a test can be reliable (e.g. giving a constant weight) but not always 
valid (e.g. always being 500g out). 42 This means that reliability does not necessarily 
mean that a test is valid, it is thus equally important to look at test validity. 
 
2.4.2.2: VALIDITY. 
 
The validity determines how well the test evaluates the field it is supposed to evaluate.43 
In the case of the MVPT-3 this would be how well it assesses visual perception. This is 
then called the construct validity, with visual perception being the construct. 43  
 
According to Trochim construct validity can be divided up into: 
a. ?Translation validity? which determines whether the test is a good representation 
of the construct of visual perception. This is done by assessing the face validity, 
 26
 (on face value does it assess visual perception?), and content validity, (where the 
test is checked to contain the relevant areas of visual perception). 
b. ? Criterion-related validity?, which assesses whether the test evaluates the 
construct according to the theory that a person has about visual perception. In 
other words the performance of the test is checked against different criteria. 43 
Trochim further breaks the Criterion-related validity into; 
1. The predicative validity that asks the question whether the test is able to 
predict ability that it is theoretically constructed to predict. i.e. visual 
perception. 43 
2. The concurrent validity, which evaluates whether the test distinguishes 
between groups that it should be able to distinguish between. 43 The 
authors of the MVPT-3 assessed this validity using the theory about visual 
perception when it comes to chronological age (visual perception skills 
increase as the individual gets older), cognitive ability (there being some 
type of correlation between visual perception skills and cognitive ability), 
academic achievement (showing a low correlation as visual perceptual 
skills are needed for learning) and other exceptional groups (a patient with 
head injuries is not expected to do as well as those without). 3 They also 
assessed their theoretical view of the perceptual process, that it develops 
globally rather than in isolated parts.3 
3. The convergent validity, which measures how well the test fares when 
compared to other tests that assess visual perception. 43 In the case of the 
MVPT-3 the authors assessed the correlation between the MVPT-3 and 
 27
 the DTVP by Frostig, the DTVP-2, The Metropolitan Readiness Tests and 
the Durell Analysis of Reading difficulties. The tests were proved to have 
significant correlation supporting a common variance. 3     
 
2.5: CONCLUSIONS FROM THE LITERATURE REVIEW. 
An 8-year-old has reached the age where he/she is not growing physically fast, but 
steadily and is now developing cognitively. They have started to understand concepts and 
enjoy working on problems. Their concentration has improved and they are starting to 
become aware of the people around them. They are also becoming aware of the 
expectations that their culture, family and friends are putting on them, trying to avoid 
situations that prevent them from meeting these standards.  
 
There is no significant difference between the genders as far as intelligence is concerned, 
although boys tend to do better in spatial related activities. Girls do better in fine hand 
coordination than boys, who tend to be more developed in gross motor coordination. 
 
Their memory has improved which helps them with their visual memory. Their improved 
problem solving abilities allow the 8-year-olds to understand and interpret visual stimuli, 
which helps them when they are planning different types of movements, including 
moving within the environment, as well as writing.  This means that the 8-year-old child 
is able to recognize and make sense of letters and words, being able to copy them from a 
blackboard. 
 
 28
 Failure in any area will have a detrimental effect on the 8-year-old as he/she is sensitive 
to criticism, and this can lead to a poor self-image and impacting on his/her schoolwork. 
 
It is the work of the occupational therapist to assess a child who is struggling at school 
with academic work to determine if he/she has deficits that occupational therapy can 
help, and then put together a treatment program that will be beneficial to that specific 
child. To enable the occupational therapist to do this she needs a perceptual test that is 
reliable, valid, appropriate and suitable for the specific culture of the child. 
 
The MVPT-3 is a standardised test used to screen for visual perceptual problems. It is 
easy to use, does not have a motor element, does not take more than 10-15 minutes and is 
easy to score. In the standardisation of this test the authors tested its reliability and 
validity using an American and a Canadian population but each time the test was 
administered in English, even though it was administered to different ethnic groups. This 
led to the purpose of this study, which is to see if the test is reliable when translated into 
another language (i.e Afrikaans) and administered to another population with another 
culture (Afrikaans). 
 
In order for the occupational therapist to assess a child she might have to translate the 
instructions of the standardised test so that it is appropriate for the language of the child. 
This can lead to problems, as it may influence the validity and reliability of the test.  
Neuman, Greenberg, Labovitz, Suzuku found that due to the difference in the original 
and target language it was not always possible to translate the test exactly from the 
 29
 original language. They also found that sometimes there were different nuances in the 
target language for the words that would be lost/or gained in a literal translation and this 
could lead to the instructions being misinterpreted .35