Date of Award


Document Type



Edith Cowan University

Degree Name

Bachelor of Science (Occupational Therapy) Honours


School of Exercise and Health Sciences


Faculty of Health, Engineering and Science

First Supervisor

Dr Janet Richmond


Background: With several assessments available that purport to measure the letter reversal rates of young school-aged children, the question was raised how reliable and comparable these assessments are and to what extent each assessment addresses the concept of letter reversals? A systematic review of these assessments was performed to evaluate the measurement properties and administration guidelines, and to compare the reversal content of these assessments.

Method: Relevant assessments and studies were identified through literature searches. For each of the assessments the measurement properties, quality of the studies that report the measurement properties, and administration guidelines were evaluated, and the content of the assessments were compared.

Results: Insufficient evidence existed for the measurement properties of all three assessments. None of the current assessments clearly explain to what extent they address the concept of letter reversal. Due to the differences in design and scoring, comparison of the results between the different assessments will be difficult.

Conclusion: The value of the current assessments are questionable due to the low level of evidence supporting their measurement properties, and the lack of clarity surrounding the types of reversals and the underlying construct the assessments are measuring.

Keywords: letter reversals, measurement properties, administration guidelines