Initial Analysis of the ChoRo: A Visual Perceptual Test Related to Driving

SIGNIFICANCE: Visual perception encompasses a variety of skills that affect daily functioning, such as the instrumental activity of daily living (IADL) of driving. One primary tool related to visual perception used for adults in a rehabilitation setting is the Motor Free Visual Perceptual Test—Third Edition (MVPT–3). This tool uses line drawings of shapes to assess visual perceptual skills. It has been found to have acceptable validity and reliability for adults, but it may not relate specifically to driving. Thus, therapists in the community requested an occupation-based assessment tool more directly related to this complex set of tasks. In response, the research team—including the principal investigator (PI), community-based occupational therapists, and graduate students—began the assessment tool development process. The result was the prototype test, the ChoRo, a test of visual perception related to driving. Phase I was the development of a hard copy test. Phase II involves the transformation to an online tool, which may be more valid for the intended purpose than what is currently available.

INNOVATION: The ChoRo uses photos and concepts related specifically to the occupation of driving. Initial analysis of a community sample demonstrated that the ChoRo shows promise as a hard copy test, but the research team determined that an online venue may offer easier access, may seem more realistic to clients, and will enable the research team to gather de-identified data. The plan, pending institutional review board (IRB) approval, is to put a link to the revised ChoRo on the university website (to be accessed by qualified therapists only). In return for the tool’s use, the clinicians will provide de-identified client demographic and test data, which will then be analyzed to continually improve the test.

APPROACH: Our research hypothesis was that the ChoRo will display adequate validity and reliability in assessing visual perception as a predriving assessment. There are few assessment tools available to assess visual perception in adults. What is available does not necessarily include test items based on real-life scenarios. The field of occupational therapy needs ecologically valid and reliable assessment tools in the field of rehabilitation.

METHOD: Phase I of this research project involved a quasi-experimental design commonly used in assessment tool development. After attaining IRB approval, a snowball approach was used to recruit a convenience sample of 109 community-dwelling adults. Each participant agreed to take the ChoRo (and a subsample of 32 participants also took the MVPT–3). SPSS and SAS statistical programs are being used to complete classical testing analysis (e.g., reliability and concurrent validity). Testing was conducted in the community in private, convenient settings.

RESULTS AND CONCLUSION: Discriminative analysis completed on the test items revealed 12 questions that failed to have an adequate level of discrimination. A preliminary concurrent validity analysis was completed on the ChoRo and the MVPT–3 on the subsample of initial respondents. The correlation of the ChoRo and the MVPT–3 was .62 (p = .000). This moderate correlation demonstrates that the ChoRo, although related to the MVPT–3, does offer unique information with regard to visual perception. Tests of internal consistency of the 48 remaining test items and factor analysis on the test items are in process. Although these results are preliminary, the research team will continue to perfect the ChoRo for clinical use, through the innovative process previously described.