What is the Frostig test, which areas of visual perception does it measure, who is it for and how does it relate to reading difficulty? A guide for parents.
In the second term of the first year of primary school, the teacher opens the exercise book at a parents' meeting and shows you: the letters "b" and "d" keep getting mixed up, lines drift across the page, and words are missing from sentences copied from the board. Similar things are happening at home: your child turns jigsaw pieces round and round without managing to fit them, and struggles to colour in without going over the lines in a colouring book. The teacher or the school guidance counsellor says, "Have a visual perception assessment done; it could be the Frostig test." The Frostig test is a visual perception test used to assess how children perceive and make sense of what they see. In this article I explain what the test measures, who it is given to, how the results relate to reading and writing difficulties, and why it is important not to overstate that relationship.
What Is Visual Perception, and How Is It Different From Seeing?
Seeing and visual perception are not the same thing. Seeing is the eye taking in light and forming a clear image; this is what an eye doctor measures. Visual perception, on the other hand, is the brain processing that image and making sense of it: recognising what a shape is, separating it from the background, knowing that it is still the same shape when it is rotated or made smaller, and grasping where two objects stand in relation to each other.
A child with completely healthy eyes may struggle with visual perception skills. The reverse is also possible: a child whose visual perception is age-appropriate may be unable to read the board because of an unnoticed vision problem. That is why the child's eye examination needs to be up to date before, or shortly after, any visual perception assessment. This simple step prevents unnecessary worry and misinterpretation.
Visual perception is involved in many tasks at school: distinguishing letters and numbers, following a line of text, copying from the board into an exercise book, recognising geometric shapes, looking at a map or a chart, and even catching a ball in PE.
What Is the Frostig Test?
The Frostig Developmental Test of Visual Perception was developed by the American psychologist and educator Marianne Frostig to assess the visual perception skills of school-age children. Working with children who had learning difficulties, Frostig argued that the different components of visual perception should be considered separately, and she designed the test to measure these components.
The Frostig test is generally given to children in the final years of pre-school and the first years of primary school. It is a pencil-and-paper test; following the practitioner's instructions, the child draws lines and finds, marks or completes shapes. It can be given individually or to small groups. Although the time it takes varies with the child's age and working pace, it is usually between half an hour and an hour.
Updated versions of the test have also been developed over time. The version used in clinical and school settings in Turkey may differ depending on the person and institution carrying out the assessment; what matters is that the version used is appropriate for the child's age and that the practitioner has been trained in it.
From the child's point of view, the test looks more like an activity book than an exam. On the pages put in front of them, they draw paths, find hidden triangles, mark the cat facing the same way, and copy a pattern by joining dots. Most children enjoy these activities. Even so, the word "test" can trigger school anxiety in some children. In particular, a child who is constantly corrected at school, whose exercise book is full of red pen, may not draw at all for fear of making mistakes, or may work very slowly. It is important for the practitioner to observe this attitude and reflect it in the report, because a low score sometimes comes not from a lack of skill but from fear of failure. Telling the child before the assessment, "You're going to do some picture and drawing activities, and it's fine to make mistakes" can reduce this anxiety.
Which Areas Does the Frostig Test Measure?
The classic form of the test consists of five subtests. Each looks at a different aspect of visual perception:
- Eye-motor coordination: The child is asked to draw straight, curved or angled lines between two boundaries without going over them. This shows how well the eye guides the hand. The skill is needed to stay on the line and form letters neatly when writing.
- Figure-ground perception: Finding and picking out a particular shape among overlapping shapes or on a complex background. This area matters for children who struggle to find the word they are looking for on a busy page, or who lose their place in a book.
- Form constancy: Recognising that a shape is still the same shape even when its size, colour, position or texture changes. Recognising the same letter in different fonts relies on this skill.
- Position in space: Finding the odd one out among versions of the same shape turned in different directions. Confusions such as "b-d", "p-q" or "6-9" are associated with this area.
- Spatial relationships: Copying a given model by joining dots; grasping the position of objects in relation to one another. This is used when copying from the board into an exercise book and when drawing shapes or maps.
When scored, a perceptual age can be calculated for each subtest, and an overall level of visual perception is derived from the total score. This shows whether the child struggles with visual perception in general or has difficulty in one particular area. The second piece of information is usually more useful, because a support plan can then be tailored precisely to that area.
Who Is the Frostig Test For?
This assessment is generally recommended when the following are observed:
- Frequently confusing letters, writing them backwards or skipping letters while learning to read and write
- Marked slowness and a large number of errors when copying from the board
- Writing that drifts off the line, and letter sizes that vary a great deal
- Clear difficulty, compared with peers, in colouring, cutting, jigsaws and block play
- Mixing up place values in maths, and columns drifting out of line in written sums
- A persistent complaint from the child coming home from school that "Writing is so tiring"
- As part of an assessment for specific learning difficulty or attention deficit
A word of caution is needed here: writing letters backwards is very common in children who are just starting to read and write, and is not worrying in itself. In most children this "mirror writing" gradually fades over the first and second years of primary school. What determines the need for assessment is whether these errors fail to decrease with age, appear together with other difficulties, or make the child's school life markedly harder.
The Frostig Test and Reading and Writing Difficulties
What families most want to know about this test is how it relates to reading and writing difficulties. Here it is important to know both the test's value and its limits.
Visual perception difficulties can help explain problems with handwriting, copying, page layout and some letter confusions. However, according to well-established findings in the field, the reading difficulty also known as dyslexia is mostly rooted not in visual but in language-based processes: distinguishing sounds, breaking a word down into its sounds, linking letters to sounds and recalling this quickly. In other words, not every child who struggles to read has their main difficulty in visual perception, and not every child with weak visual perception has difficulty reading.
This distinction matters greatly in practice. Let's say a child in the second year of primary school struggles to blend syllables when reading, and reads very slowly. The visual perception test comes out borderline, and the family spends months working only with visual perception workbooks. Because the child's phonological awareness has never been assessed, their real need goes unnoticed. That is why, when a reading difficulty is suspected, the Frostig test is meaningful not on its own but as part of a more comprehensive assessment. For details of how specific learning difficulties are assessed, you can read the article on specific learning difficulty.
The value of a test result is measured by how well it fits the question being asked; the right answer to the wrong question can lead a child in the wrong direction.
How Should the Results Be Read?
When reading the assessment results, asking these questions will make things easier:
- Which subtests are low, and which are age-appropriate? The subtest profile is more informative than the overall score.
- What does the low score correspond to in daily life? Ask the practitioner for concrete examples: "Spatial relationships are low" becomes meaningful when it is explained as "They may drift between lines when copying from the board."
- What frame of mind was the child in during the test? The performance of an anxious, tired or reluctant child may not reflect their real ability.
- To what extent did attention affect the result? Children with attention difficulties may make errors by missing the instruction or rushing, even if their visual perception is sound.
- What other assessments are needed? Such as an eye examination, a fine motor assessment, an examination of reading and language skills, or a child psychiatry assessment.
The result of the Frostig test is not a diagnosis. A single test is not enough to say "there is a visual perception disorder"; the result is interpreted together with observations and other assessments. For another tool frequently used to assess visual-motor skills, you can take a look at the article on the Bender Gestalt test.
How Can You Support Visual Perception at Home?
In Turkey, bookshops stock many workbooks with "visual perception" in the title. These can be enjoyable and useful for some children; however, pages completed at a desk cannot replace play within everyday life. Most activities that support visual perception can be done at home without special materials:
- Jigsaws and tangrams: Working out where pieces fit when they are rotated is a good exercise for form constancy and spatial relationships.
- Lego and block constructions: Copying a model by looking at it strengthens spatial thinking.
- "Spot the difference" and "hidden object" games: These support figure-ground perception. Even asking your child to find the reddest apple on the stall at the weekly market exercises this skill.
- Mazes and dot-to-dot: Useful for eye-motor coordination.
- Ball games: Catching, throwing and bouncing a ball combine visual perception with movement.
- Playing with direction words: Hide-and-seek style games with instructions such as "Hide it under the cushion, to the right of the box, behind the door."
It is important to frame these activities not as homework but as enjoyable time spent together. If a child is constantly corrected in an area they find difficult, they start to avoid it. Short, regular games that give a sense of success are far more effective than long, tiring sessions.
Some small adjustments at school can also make a difference: sitting close to the board, less crowded page layouts on worksheets, and widely spaced exercise books that make it easier to follow the line when writing. Discussing these adjustments with the teacher can prevent the child from experiencing constant failure at school. If needed, applying to a Guidance and Research Centre (RAM, the state centres for educational assessment) through the school's guidance service is also an option; this route makes it easier to discuss educational support that can be formally provided at school. A clear picture shared with the teacher also prevents the child from being labelled "careless" or "sloppy".
How Can a Psychologist Help in This Process?
Reading, writing and handwriting difficulties rarely remain just a skills problem. A child who constantly uses the rubber, whose exercise book fills up with red pen, and who stammers when asked to read aloud in class may over time develop beliefs such as "I'm stupid" or "I can't do it." Homework time can turn into fighting time at home.
The psychologist's role in this process is to make sense of the assessment results together with the family, refer to other specialists where necessary, and lighten the child's emotional load. The anxiety, anger and loss of self-confidence that come with struggling at school can be addressed through play and methods suited to the child's age. Child and play therapy gives children the opportunity to express these feelings without having to talk about them. In sessions with the family, the work focuses on organising homework routines, adjusting expectations to the child's real capacity, and making the child's strengths visible.
Frequently Asked Questions
Can the Frostig test replace an eye examination?
No. An eye examination assesses whether the eye sees clearly, whereas the Frostig test assesses how the brain processes the image. Because a vision problem can lower the test result, it is recommended that an up-to-date eye examination has been carried out before a visual perception assessment.
Do visual perception workbooks help?
They can be supportive for some children, but they are not enough on their own. Working through random pages without knowing which area needs support can tire the child and cause the real need to be missed. Short, regular, play-based activities are usually more sustainable.
Is the Frostig test used with older children or teenagers?
The classic form of the test was designed for younger age groups and may fall outside the age norms for older children. If a visual perception or visual-motor difficulty is suspected in a secondary or high school student, other tools with norms for that age group are preferred. The specialist carrying out the assessment decides which tool is appropriate.
Up to what age is writing letters backwards normal?
Writing letters and numbers backwards is common in children who are just learning to read and write, and it mostly fades over the first and second years of primary school. If these errors are still frequent by the third year, or appear together with other reading difficulties, it makes sense to have an assessment.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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