Are other tests that are not on recommended lists — such as the Hand Chart, Patti Pics™, and the Lighthouse Symbols — appropriate for preschool- and kindergarten-aged children?
The Hand Chart is confusing to children. The child may be unable to distinguish between the hands — they may blur together. This chart requires a combination of motor and visual discrimination/perception skills, which may yield an inaccurate visual acuity result (Warash, oral communication, March 2007). Patti Pics™ symbols are a recent creation whose effectiveness has not been established in peer-reviewed journals, to our knowledge. Items in the original Lighthouse Symbols (house, apple, umbrella) test are recognizable to many preschool children. However, Lighthouse International switched to LEA Symbols® in 1991.
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