Fractioning the Hooper: A Multiple-Choice Response Format

Abstract

The Hooper Visual Organization Test (HVOT) provides an excellent illustration of the multifactorial nature of most neuropsychological tests. Although the HVOT clearly requires certain visual perceptual skills, the test also demands that the subject produce an overt verbal response - i.e., the name of the object that has been cut up and rearranged. Thus, individuals with disorders of confrontation naming may obtain low scores on the HVOT by virtue of their anomia, even if the primary perceptual skills that the HVOT purports to assess are intact. The present study was designed to minimize the demands of object naming on HVOT performance, by using a multiple choice format of the HVOT. Fourteen individuals with lateralized injury resulting from either cerebral vascular accident or cerebral contusion were administered the Boston Naming Test (BNT) and the standard version of the HVOT. Approximately 24 hours later, subjects were administered the Multiple-Choice Hooper Visual Organization Test (MC-HVOT). The MC-HVOT consisted of the 30 original HVOT stimuli presented with four response choices, including the correct response and three foils. A paired sample t test revealed that anomic subjects achieved a significantly greater number of correct responses on the MC-HVOT then under the standard HVOT administration. Subjects with both right and left hemisphere involvement benefited from diminished naming demands. Overall HVOT performance significantly improved when the object naming demand was reduced, resulting in a clearer assessment of visual integration skills. These findings may have significant implications for both interpretation of impairment and formulation of treatment recommendations.

Functional MRI neuroanatomic correlates of the Hooper Visual Organization Test

“…The object naming aspect of the VOT performance has also received critical review, since subjects that are intact to the visuospatial integration demands may score poorly if they suffer from compromised confrontational naming (Cirillo et al, 1999;Greve et al, 2000;Seidel, 1994). In an attempt to address this issue, a multiple choice derivative of the VOT has been proposed (Schultheis et al, 2000), and test results from the multiple-choice version indicated higher performance scores among anomic subjects.…”

Visual Perceptual Organization Ability in Autopsy-Verified Dementia with Lewy Bodies and Alzheimer’s Disease

“…Because the VOT comprises common, easily-named objects, the impact of naming might only be observed in individuals with significant anomia. This possibility is supported by a study of stroke patients with moderate to severe anomia that showed they were impaired on the standard version of the VOT, but significantly improved their performance on a multiple choice version that did not require naming (Schultheis, Caplan, Ricker, & Woessner, 2000).…”