Computer Scoring of a Visual-Motor Assessment�

Randy Fall

Azusa Pacific University

rfall@apu.edu

AERA 2025

Friday, April 25^th, 2025

Denver, CO

�Abstract

• Traditional paper-and-pencil measures of visual-motor functioning have significant limitations in reliability of scoring, construct validity and interpretability of scores. This study reports results of an investigation of a visual-motor assessment on the iPad, comparing a traditional pencil-and-paper measure to a measure of the same items using a stylus on a tablet and to finger on a tablet.

�Abstract cont.

• Findings indicate no effect of order of presentation, and substantial similarities in performance across modes of presentation. These findings indicate that visual-motor performance on a tablet is functionally similar to pencil-and-paper drawing. Potential benefits of iPad assessment, including additional forms of data and greater accuracy through automated scoring are discussed.

Computer-Scored Visual Motor Assessment

The Problem

The Developmental Test of Visual Motor Integration (VMI) was a critical step forward in visual-motor assessment in its time, adding developmentally relevant scoring criteria and standardization.

Current visual-motor measures have significant scoring limitations

For example, the Developmental Test of Visual Motor Integration (VMI) scores each item 1 or 0, based on 3-7 criteria. The test produces only a single overall score.

Some of the scoring requires precise measurements that practitioners often estimate (e.g., angle 60 degrees or less, horizontal axis between 170 degrees and 190 degrees)

Psymark Shapes

Computer-Scored Visual Motor Assessment

• Electronic tests are becoming more common
• No equivalency studies exist comparing visual-motor on pencil-and-paper vs. electronic
• Visual-motor is implicated in a wide variety of disorders, including learning disabilities, autism, Parkinson’s, Alzheimer’s, intellectual disability, ADHD, and more (Fall, Silberman, Khudaverdyan & Helm-Stevens, 2018)

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Computer-Scored Visual Motor Assessment

• Determine whether visual-motor functioning on the iPad is equivalent to visual-motor functioning on pencil-and-paper measures
• Compare finger-on-iPad to stylus-on-iPad to determine equivalency and subject preferences

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Computer-Scored Visual Motor Assessment

• Instrument
• 12 items : 1) horizontal line; 2) X-shape; 3) diagonal line; 4) L-shape; 5) square; 6) rectangle; 7) circle; 8) modified phi symbol (circle with bisecting curved line); 9) tilted right angle; 10) three-dimensional cube; 11) pyramid; 12) square with embedded X-shape. Each item was presented in black ink, using lines approximately 1mm wide, in a 4” x 4” square, with a blank square below for the subject’s copy of the drawing.

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Computer-Scored Visual Motor Assessment

• Participants
• The sample included 67 participants, ranging in age from 5 to 69 years old. The sample was 58% female and 42% male. The sample was 49% white, 24% Hispanic, and 20% Armenian, with small percentages of Asian, Black and American Indian participants.

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Computer-Scored Visual Motor Assessment

• Order was counterbalanced
• Participants’ drawings were measured using calipers for accurate measurement to 1/10 millimeter

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Computer-Scored Visual Motor Assessment

• Among the 75 variables measured, none had statistically significant differences by input mode.
• Most measured criteria showed a remarkable similarity across modes. For example, the means for the horizontal line were:
• Finger on iPad 86.72
• Stylus on iPad 86.53
• Pencil and Paper 86.65

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• No effect of order on drawings (F (5,67)=.455, p=.77)

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Computer-Scored Visual Motor Assessment

Three factors emerged:

• 1. Overall size control – ability to draw items of the same approximate size as the stimuli
• 2. Distortion
• 3. Size control within items – ability to draw segments in proportion within an item

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Computer-Scored Visual Motor Assessment

• Drawings on iPad appear to be functionally similar to drawings on pencil and paper
• Traditional visual-motor items have substantial shared variance
• Computerized scoring could focus on size control within and between times, and distortion.
• Computerized visual-motor assessments have the potential to use learning software to improve diagnostic accuracy.

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Computer-Scored Visual Motor Assessment

Update:

Standardization is ongoing

Concurrent validity study just concluded, Pearson correlation of .65 between the VMI and Psymark Shapes for a sample of 65 adults.

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Psymark Shapes is currently being studied in doctoral dissertation studies at two universities

Psymark Shapes is in use by teachers at several districts as a screener for 4-6 year olds

Occupational Therapists and teachers have found it particularly useful, even before standardization, for progress monitoring.