Fractioning the Hooper: A multiple-choice response format

The Hooper Visual Organization Test (HVOT) provides an excellent illustrati on of the multifactorial nature of most neuropsychological tests. Although the HVOT clearly requires certain visual perceptual skills, the test also d emands that the subject produce an overt verbal response - i.e., the name o f the object that has been cut up and rearranged. Thus, individuals with di sorders of confrontation naming may obtain low scores on the HVOT by virtue of their anomia, even if the primary perceptual skills that the HVOT purpo rts to assess are intact. The present study was designed to minimize the de mands of object naming on HVOT performance, by using a multiple choice form at 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. Approxim ately 24 hours later, subjects were administered the Multiple-Choice Hooper Visual Organization Test (MC-HVOT). The MC-HVOT consisted of the 30 origin al HVOT stimuli presented with four response choices, including the correct response and three foils. A paired sample t test revealed that anomic subj ects 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 dema nd was reduced, resulting in a clearer assessment of visual integration ski lls. These findings may have significant implications for both interpretati on of impairment and formulation of treatment recommendations.