The Assessment of Perceptual Therapy Study (APTS)

Purpose: The purpose of this study was to determine if using the Perceptual Therapy System II: PTS II iNet (PTS II), a computerized visual perception therapy program, would improve performance on standardized tests of visual perception and decrease the frequency of any reported problem behaviors. Methods: We recruited children ages 6 to 13 with below age-level performance on a standardized test of visual perception (the Beery-Buktenica Developmental Test of Visual Motor Integration, 5th Edition [VMI], the Beery VMI supplemental test of Visual Perception [VP], or the Test of Visual Perceptual Skills, 3rd Edition [TVPS-3]). Children who scored 80 or below on the Kaufman Brief Intelligence Test, 2nd edition (KBIT-2) were excluded. All patients were given the PTS II software and prescribed 16 weeks of home therapy. Baseline and outcome testing included the VMI, the VP, the TVPS-3 (Visual Discrimination, Visual Memory and Visual Sequential Memory), the Cognitive Assessment System (CAS) Figure Memory subtest and the Conners’ Parental Rating Scales-Revised (S) (Conners’). One sample t-tests were performed to compare the scores of participating children to normative values. Mann-Whitney analysis was used to compare scores at baseline to those at outcome. A multiple linear regression controlling for age, compliance and baseline score was used to evaluate whether there was a relation between change in test score and compliance. Results: Twenty children enrolled and sixteen children (mean age = 9.6 years) completed the study. At baseline, children scored on average significantly above the mean (indicating a higher frequency of problem behaviors) on the Conners’ (Cognitive Problems/Inattention scale, Hyperactivity scale, and ADHD Index) (p < 0.03 for all analyses) and significantly below the mean for all visual perceptual tests (p < 0.03 for all analyses) except the TVPS-3 Visual Memory (p = 0.28) and the CAS Figure Memory (p = 0.13). Children also scored below the mean on the KBIT-2 Non-verbal at baseline. Overall, excluding those who did not finish the study, the children completed an average of 59.5 sessions (range: 10.8 to 99.0 sessions). The outcome exam occurred on average at 19.5 weeks (range: 15.6 to 28.1 weeks). The frequency of problem behaviors as reported by the Conners’ decreased significantly from baseline to outcome: Oppositional (p=0.04); Cognitive Problems/Inattention (p = 0.001); and ADHD Index (p = 0.002). No significant changes in visual perceptual skill were found.Conclusion: The use of the PTS II resulted in a decreased frequency of parent-reported problem behaviors as measured by the Conners’. Further research with a larger sample size and a control group is needed.