Association between Visual Perception and Socioeconomic Status in Malaysian Preschool Children: Results from the Test of Visual Perceptual Skills-4

Visual perception in children can be evaluated using the Test of Visual Perceptual Skills-4th edition (TVPS-4) with normative data developed for the U.S. population. It is widely used by healthcare practitioners in Malaysia, despite reports that children in Asia outperform their U.S. peers in visual perception assessment. We compared TVPS-4 scores among 72 Malaysian preschool children (mean age: 5.06 +/- 0.11 years) with U.S. norms and investigated the association between socioeconomic factors and TVPS-4 scores. Malaysian preschoolers had significantly higher standard scores (116.60 +/- 7.16) than the U.S. norms (100 +/- 15; p < 0.001). They also had significantly higher scaled scores (between 12.57 +/- 2.10 and 13.89 +/- 2.54) than the U.S. norms (10 +/- 3, all p < 0.001) for all subtests. Multiple linear regression analyses revealed that socioeconomic variables were not significant predictors for five visual perception subtests and the overall standard score. The visual form constancy score could be predicted by ethnicity (beta = -1.874, p = 0.03). The visual sequential memory score could be predicted by the father's employment status (beta = 2.399, p < 0.001), mother's employment status (beta = 1.303, p = 0.007), and low household income (beta = -1.430, p < 0.037). In conclusion, Malaysian preschoolers outperformed their U.S. peers in all TVPS-4 subtests. Socioeconomic variables were associated with visual form constancy and visual sequential memory, but not with the other five subtests or TVPS-4's overall standard scores.