Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

Dr. Stacey Reynolds



Comparing Parent-report and Performance-based Measures of Vestibular Processing

By Elisha Chambers, MS. OTR/L

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2020

Major Director: Stacey Reynolds, Ph.D OTR/L

Associate Professor, Department of Occupational Therapy

In the field of occupational therapy, there is a need to explore the relationship between performance based-measures and parent-report measures of vestibular functioning because thorough assessment sets the foundation for effective intervention. Time constraints, child distractibility, and limited participation are all issues that pediatric occupational therapists face during evaluations. It is important for clinicians to streamline the evaluation process, determining which assessments are most likely to yield the most valuable information in the time allowed. Assessing the relationship between assessment methods has the potential to uncover possible redundancies in the evaluation process. If there is a strong predictive relationship between parent responses and performance-based measures, clinicians may conclude that performance-based measures and parent-report measures are measuring the same or very similar aspects of vestibular processing and opt to only administer parent questionnaires, which require less time and equipment. If there is little correlation between assessment methods, clinicians may conclude that the assessments are measuring different aspects of vestibular processing and justify administering both types. Moreover, a better understanding of how parent-report measures and performance-based measures relate to one another will also inform clinicians about what information can, and should, be inferred from test results and, equally as important, what inferences cannot, or should not, be made.

We hypothesized that the information collected from the Sensory Processing Measure could be used to predict the child’s performance on at least one of the performance-based measures of vestibular function. We found a meaningful relationship between the Balance and Motion T-score on the SPM and the child’s performance on the Balance subtest of the Bruininks Osteretsky Test of Motor Proficiency-2nd Ed. The BAL T-score was determined to be a fairly useful predictor of the child’s performance on the Balance subtest of the BOT-2 while the Body Awareness T-score was found not to be a useful predictor of the child’s objective performance on the BOT-2 or any of the direct measures of vestibular function. Furthermore, we found that the SPM’s T-score cutoff of 60 had an accuracy of 73.3% in identifying those with a vestibular disorder, which was close to our targeted 80%. Next, after entering in all the parent-report data and performance-based data into an adjusted model, the SWAY Balance variable was found to be the only assessment related to predicting the child’s performance on the Balance subtest of the BOT-2. Lastly, in the exploratory analysis we found that, there were moderate correlations seen at the subtest and item level when examining the relationship between parent responses on the BAL subtest and the performance-based measures and moderate to large correlations observed between item level parent responses on the BOD subtest and the performance-based measures. The findings of this study support the relationship between parent reporting and their child’s performance on objective measures, more specifically technology-assisted measures. Further research is needed to explore the role that technology-assisted assessment of sensory processing has in quantifying baseline sensory processing skills and tracking the response to intervention overtime.


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