Application, limits, scoring and improvements of Groffman Visual Tracing test


  • Alessio Facchin University of Milano Bicocca
  • Lavinia Giordano
  • Giovanni Brebbia
  • Silvio Maffioletti



Eye movements, Groffman test, Visual tracing, Saccade


The Groffman Visual Tracing (GVT) test is a psychometric oculomotor test comprising two cards with five contorted and intersected lines, and which is available for the clinical evaluation of ocular movements. The participant starts from the letter at the top, follows the line, and reports the corresponding number at the bottom of each line. The aim of this study is to evaluate two claims made when details of the GVT test were originally reported: whether it is a developmental test, and the feasibility of its application starting from primary school children up to adults. This was achieved by using the GVT test and a simplified version of it. In two consecutive experiments, we tested two groups of children and adults. In the first experiment, 75 children (1st, 3rd, and 5th grade) and 25 adults underwent the GVT test. In the second experiment, 115 children from 1st to 5th grade underwent a simplified version of the test. Total scoring, accuracy and time to complete the test were evaluated. In the first experiment, 24% of children in the 1st and 3rd grades did not follow any lines correctly due to the difficulty of the test. In the second experiment, all participants were able to perform the test with both cards, and the accuracy improved significantly with age (p<0.0001). The time required to follow the lines was found to decrease with age (p<0.0001), and the accuracy improves (p<0.0001) compared with the standard version. The standard version of the GVT test has proven to be too difficult for younger children and a modified version produced improved results. Children at or below the 5th grade should to be tested using the modified version. Older children and adults can be tested with the standard version. Specific norms based on execution times and accuracy should to be established.


Ayton, L. N., Abel, L. A., Fricke, T. R., & McBrien, N. A. (2009). Developmental eye movement test: what is it really measuring? Optometry and Vision Science, 86, 722–730.

Baptista, A. M., de Sousa, R. A., de Morais Guerra Casal, C. C., Marques, R. J., & da Silva, C. M. (2011). Norms for the developmental eye movement test for portuguese children. Optometry and Vision Science, 88, 864–871. 1097/OPX.0b013e3182195dae

Chinn, S. (2014). The Routledge International Handbook of Dyscalculia and Mathematical Learning Difficulties. Taylor & Francis.

Cui, J., Zhang, Y., Cheng, D., Li, D., & Zhou, X. (2017). Visual Form Perception Can Be a Cognitive Correlate of Lower Level Math Categories for Teenagers.

Facchin, A., Maffioletti, S., & Carnevali, T. (2011). Validity reassessment of developmental

eye movement (DEM) test in the Italian population. Optometry and Vision Development, 42, 155–167.

Facchin, A., & Maffioletti, S. (2018). The reliability of the DEM test in the clinical environment. Frontiers in psychology, 9.

Facchin, A., Maffioletti, S., & Carnevali, T. (2012). The developmental eye movement

(DEM) test: normative data for Italian population. Optometry and Vision Development, 43.

Galetta, K. M., Liu, M., Leong, D. F., Ventura, R. E., Galetta, S. L., & Balcer, L. J. (2016). The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature. Concussion, 1(2).

Gallaway, M., Scheiman, M., & Mitchell, G. L. (2017). Vision therapy for postconcussion vision disorders. Optometry and vision science, 94(1), 68–73.

Groffman, S. (1966). Visual tracing. Journal of American Optometric Association,

, 139–141.

Groffman, S. (1993). Correlation between cognitive processing and ocular motility. Optometry and Vision Science, 70(5), 380–383.

Jimenez, R., Gonzalez, M. D., Perez, M. A., & Garcia, J. A. (2003). Evolution of accommodative function and development of ocular movements in children. Ophthalmic Physiological Optics, 23, 97–107. 1313. 2003.00093.x

King, A. T. (1976). The proposed King-Devick Test and its relation to the Pierce Saccade and reading level. Available from the Carl Shepherd Memorial Library.

King, D., Brughelli, M., Hume, P., & Gissane, C. (2013). Concussions in amateur rugby union identified with the use of a rapid visual screening tool. Journal of the Neurological Sciences, 326(1-2), 59–63.

Langaas, T., Aadne, R., Dahle, E. C., Hansen, A. M. H., Horgen, G., Myhren, D. J. T., Myklebust, A., Rønnestad, T., Storengen, T., & Wiik, M. S. (2002). Clinical assessment of eye movements in children with reading disabilities and with Developmental Coordination Disorder (DCD). Investigative Ophthalmology & Visual Science, 43(13), 4661.

Levi, D. M., & Carney, T. (2009). Crowding in Peripheral Vision: Why Bigger Is Better. Current Biology, 19(23), 1988–1993. 09.056

Maples, W. C., & Ficklin, T. (1990). Comparison of eye movement skills between above average and below average readers. Journal of behavioural optometry, 1(4), 87–91.

Moiroud, L., Gerard, C. L., Peyre, H., & Bucci, M. P. (2018). Developmental Eye Movement test and dyslexic children: A pilot study with eye movement recordings. PloS One, 13(9), e0200907.

Okumura, T., & Wakamiya, E. (2010). Visual Skills in Children with Learning Difficulties. Meijitosho Shuppan Corporation.

Pang, P. C., Lam, C. S., & Woo, G. C. (2010). The Developmental Eye Movement (DEM) test and Cantonese-speaking children in Hong Kong SAR, China. Clinical and Experimental Optometry, 93, 213–223.

Journal Article Australia journal of the Australian Optometrical Association Press, L. J. (2008). Applied Concepts in Vision Therapy. Optometric Extension Program Foundation. Press, L. J., & Moore, B. D. (1993). Clinical Pediatric Optometry. Butterworth-Heinemann.

Richman, J. E. (2009). Developmental Eye Movement Test, Examiner’s Manual, version 2.0. Bernell Corp.

Richman, J. E., & Garzia, R. P. (1987). Developmental Eye Movement Test, Examiners Booklet, version 1. Bernell Corp.

Rizzo, J.-R., Hudson, T. E., Dai, W., Birkemeier, J., Pasculli, R. M., Selesnick, I., Balcer, L. J., Galetta, S. L., & Rucker, J. C. (2016). Rapid number naming in chronic concussion: eye movements in the King–Devick test. Annals of clinical and translational neurology, 3(10), 801–811. Scheiman, M., & Rouse, M. W. (2006). Optometric management of learningrelated vision problems. Elsevier Health Sciences.

Scheiman, M., Talasan, H., Mitchell, G. L., & Alvarez, T. L. (2017). Objective assessment of vergence after treatment of concussion-related CI: a pilot study. Optometry and Vision Science, 94(1), 74. https : / / doi . org / 10 . 1097 / OPX . 0000000000000936

Scheiman, M., & Wick, B. (2019). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders (5th). Lippincott Williams & Wilkins.

Serdjukova, J., Ekimane, L., Valeinis, J., Skilters, J., & Krumina, G. (2016). How strong and weak readers perform on the Developmental Eye Movement test (DEM): norms for Latvian school-aged children. Reading and Writing, 1–20.

Smaakjær, P., Tødten, S. T., & Rasmussen, R. S. (2018). Therapist-assisted vision therapy improves outcome for stroke patients with homonymous hemianopia alone or combined with oculomotor dysfunction. Neurological Research, 40(9), 752–757. doi: 10.1080/01616412.2018.1475321

Solan, H. A. (1982). The treatment and management of children with learning disabilities. Charles C Thomas Pub Ltd.

Taub, M. B., Bartuccio, M., & Maino, D. (2012). Visual Diagnosis and Care of the Patient with Special Needs. Wolters Kluwer Health.

Tjarks, B. J., Dorman, J. C., Valentine, V. D., Munce, T. A., Thompson, P. A., Kindt, S. L., & Bergeron, M. F. (2013). Comparison and utility of King-Devick and ImPACT® composite scores in adolescent concussion patients. Journal of the neurological sciences, 334(1-2), 148–153.

Xie, Y., Shi, C., Tong, M., Zhang, M., Li, T., Xu, Y., Guo, X., Hong, Q., & Chi, X. (2016). Developmental Eye Movement (DEM) test norms for Mandarin Chinesespeaking Chinese children.




How to Cite

Facchin, A., Giordano, L., Brebbia, G., & Maffioletti, S. (2020). Application, limits, scoring and improvements of Groffman Visual Tracing test. Scandinavian Journal of Optometry and Visual Science, 13(1), 2–9.



Scientific Article