Sensory Integration and Learning From this analysis the authors gener-

ated yet another description of typologies

Disabilities: Ayres' Factor Analyses for sensory integrative dysfunction de-
Reappraised rived from Ayres' work:

• Vestibular bilateral integration dys-

Robert A. Cummins function
• Dyspraxia
• Left hemisphere dysfunction
Between 1965 and 1987 Ayres published eight papers that contain among them 10 • Right hemisphere dysfunction
multivariate analyses that bear upon her conception of sensory integration. These • Generalized dysfunction
analyses purport to have identified factors that emerge from the scores of children
with learning disabilities but not from the scores of academically nondisabled The reason for this diversity of views
children. A reappraisal of these analyses in combination finds no support for this is that Ayres has not attempted to cross-
claim. As a consequence, these data provide no validity for either the diagnostic validate her factors. Each analysis has
procedures or the remedial programs for children with learning disabilities that have been performed on a new combination of
been derived from this work. variables and so has produced a different
set of factors. One consequence of this

A yres has operationalized her concept

of sensory integration by conduct-
ing multivariate studies on the percep-
tual-motor performance of children with
learning disabilities (Cermak, 1988). Of
particular relevance is a series of factor
analyses from which Ayres claimed to
have identified perceptual-motor factors
that emerge from the scores of children
with learning disabilities but not from the
scores of normally learning children. The
perceptual-motor content of these factors
has been used to provide both the format
and the rationale for diagnostic and
remedial programs (e.g., Ayres, 1968,
1975, 1979).
Of concern, however, is the diversity
of opinion among reviewers of Ayres'
studies as to the precise nature and
nomenclature of the factors she dis-
covered. Although there seems to be a
majority opinion in favor of four factors
(i.e., Praxis, Form and Space Perception,
Tactile Defensiveness, and Bilateral In-
tegration), not all reviewers agree, and
several other factor names have been sug-
gested. Some examples are
• Tactile, kinesthetic, and visual percep-
tion dysfunction (Abbie, 1974)
• Auditory language problems (Wilson,
1975)
• Praxis and tactile functions (Kimball,
1977)
• Vestibular and bilateral integration
(Clark & Shuer, 1978)
• Left hemisphere dysfunction and right
hemisphere dysfunction (Clark &
Shuer, 1978)
• Unilateral cerebral dysfunction (Grim-
wood & Rutherford, 1980)
• Postural and bilateral integration (Ot-
tenbacher & Short, 1985)
The most comprehensive review of
Ayres' factor analytic work was pub-
lished by Clark, Mailloux, and Parham
(1985). Those authors examined the emer-
gent factors and concluded as follows
(P. 379):
• Apraxia: "Emerged in nearly all the
studies in which dysfunctional children
made up the sample."
• Deficits inform and space perception:
"Were more varied, and the configura-
tion and patterns of the clusters sug-
gested that there were at least two
kinds of visual perceptual problems.
The first seemed to be related to soma-
tosensory processing, the second to
functions associated with the right
hemisphere."
• Deficits in postural and bilateral inte-
gration: "Emerged relatively consis-
tently and in later studies were linked
to vestibular dysfunction."
• Auditory language dysfunctions:
"Seemed to bifurcate in the same way
that visual spatial perception had. One
type seemed to be related to the left
hemisphere and did not seem to be re-
lated to sensory integrative processes.
The second type was found in associa-
tion with vestibular dysfunction and
poor bilateral integration."
• Tactile defensiveness: "In nearly every
study a strong association between tac-
tile defensiveness and hyperactivity
was found."
is that factor labeling becomes a critical
issue. Since none are identical in com-
position, it might be assumed that all of
the factors would have been given unique
labels, but that is not so. Whereas some
factor labels have certainly been unique
to individual studies and have contrib-
uted to the diversity of views mentioned
previously, other labels have been more
commonly employed.
In the absence of cross-validated fac-
tors between studies, this use of common
factor labels is of special interest. It
implies that factors with a similar and
distinctive variable composition have
emerged from different studies. Indeed,
the previously cited reviewers of Ayres'
studies appear to have made just that
assumption when searching for factor
typologies.
It seems timely, therefore, to reexamine
Ayres' data and to question these con-
clusions, which assume a simple relation-
ship between factor labels and factor
composition. This will be achieved by
identifying the groups of similarly named
factors and examining each group to
determine (a) their distinctive, common
content, (b) whether their common con-
tent distinguishes them from factors that
have been differently labeled, and (c)
whether their common content distin-
guishes between scores derived from
children with learning disabilities and
nondisabled children.
An Overview of Ayres' Studies
Between 1965 and 1987 Ayres pub-
lished eight papers that contain among

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them 10 multivariate analyses. All are
TABLE 1
concerned with the relationships between Subject Characteristics in Ayres' Multivariate Analyses
sensory and motor skills, with academic
skill variables sometimes being included Studies 1965 1965 1966a 1966c 1969 1971 1972b 1977 1987
as well. The broad characteristics of these Age range 5-10 5-8 4-0 4-0 6-1 5-10 7-6 6-0 4-0
studies are outlined in Table 1. There are 8-0 7-11 8-0 8-0 9-10 10-0 10-0 10-0 9-11
only nine columns because two different IQ 71- ? ? ? X 70- 70- ? ?
analyses were conducted on the scores of 139 93 132 132
the same children in 1972 (Ayres, 1972b). Academic
All children were aged between 4-0 and Disabled (N) 100 - 7 - 36 148 148 128 172
Nondisabled (N) - 50 93 64 - - - - -
10-0 years, were of normal intelligence Cerebral
(where this was reported), and comprised Palsy (N) - - 3 - - - - - -
a mixture of males and females (where Males (%) 69 70 ? ? 81 74 74 80 65
reported). Females (%) 31 30 ? ? 19 26 26 20 35
Variables (N) 36 36 19 19 64 48 46 19 19
Of the 10 studies, 9 were factor analy- Loading cutoff
ses and 1 a multiple regression. The latter for factor None None None
study (1971) will be considered separate- definition 0.3 0.3 used used 0.4 - 0.2 0.3 used
ly, as will the most recent factor analysis
Note. ? = not reported.
(Ayres, Mailloux, & Wendler, 1987). The
other eight analyses will be considered as
a group, with a view to comparing their 2. Raw scores/Ipsative scores. While this report contained one analysis that in-
factor structures. six of the factor analyses have used the volved children with "suspected dysfunc-
The factor analyses differed from one conventional raw scores derived from tion" and another analysis on nondis-
another on a number of dimensions as each test, the 1969 analysis and one of abled children. From the former group,
follows: the 1972b analyses used ipsative scores. Ayres located five factors that "were in-
1. Nondisabled/Learning disabled. This process led to the emergence of terpretable as hypothesized behavioral
Three of the studies (1965, 1966a, 1966c) quite different factor structures, as will correlates of patterns of neurological
involved nondisabled children. The 1965 be seen from the 1972b study, which per- dysfunction" (p. 345). From the nondis-
sample was "chosen from public and formed both raw score and ipsative score abled children, on the other hand, she
private schools and child care centers on analyses on the same set of data. For found that the emergent factors "on the
the basis of parental occupation so as to future reference, the studies involving whole were not comparable to the major
represent proportionately the working raw scores will be designated as (R), factors emerging from the dysfunction
population of the United States" (p. 339). while those using ipsative scores will be group." This apparent difference be-
In 1966c, all were adopted children liv- designated (I). tween factor structures from the two
ing in middle socioeconomic class fami- 3. Loading cut-off. As shown in Table groups led Ayres to hypothesize that in
lies. The 1966a children, however, were 1, the studies differed somewhat in the the case of the dysfunctional group
a bit different. Of the 92 subjects, Ayres minimum size of the variable loading "these factors were not due to normal
reported that "approximately 10 per cent that was used to define the content of developmental processes but to underly-
could be considered to have possible cen- factors. For comparative purposes, all ing deficits in specific mechanisms of
tral nervous system dysfunction" (p. 68). studies will be standardized such that a integration, resulting in symptom com-
No further information on these chil- minimum loading of 0.30 is required for plexes" (p. 465).
dren's specific problems was given, but any variable to be considered part of a Over the next 12 years Ayres con-
it seems likely that their disorders were factor. ducted six more analyses that sought to
minimal. In addition, three children had 4. Variables. Of the 113 different vari- validate the emergence of such "symptom
mild cerebral palsy. Since such a mixture ables used in these studies, only 8 were complexes" from the scores of children
of children would not be uncommon common to all analyses, while 50 were with learning disabilities. The labels or
within any unselected group of regular used on just one occasion each. A de- descriptions that Ayres gave to the fac-
school children, for the purposes of scription of the variable names and their tors from all of these analyses are shown
future comparisons the children from test protocols can be found in Ayres in Table 2. Where a simple label has been
1966a will also be considered nondis- (1965, 1966a, 1969). attached to a factor, such as "Praxis,"
abled. The remaining five studies all in- this label has been used. Where a factor
volved children with academic disabilities has not been named, but only described,
who had been classified as such using a EXAMINATION OF THE the major variables involved in the de-
variety of criteria. For future reference, FACTOR LABELS scription have been used as the title.
the studies involving children who are What is immediately clear from this
nondisabled will be designated (N) and Ayres' first two factor analyses (1965) listing is that relatively few factor titles
those involving children who are aca- set the conceptual stage for all of the or descriptors have emerged on more
demically disabled will be designated (D). analyses to follow. As shown in Table 1, than one occasion. To summarize:

Volume 24, Number 3, March 1991 161

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 TABLE 2 It is interesting to relate these labels to
Factor Labels or Descriptions those actually used to describe the emer-
gent factors (see Table 2). With the possi-
Labels/ 1965 1965 1966a 1966c 1969 1972b 1972b 1977
Descriptions DR NR NR NR Dl DR Dl DR
ble exception of "Praxis," it seems rather
extravagant to claim their general emer-
Praxis (or apraxia) X X X X X gence. "Auditory language problems" was
Form and space perception X X X used as a label on only two occasions,
Tactile defensiveness X X X
whereas on no occasion had any factor
Bilateral integration X
Figure-ground been designated as a disorder of postural,
discrimination X X ocular, and bilateral integration.
General perceptual-motor
and cognitive ability X
Body balance X EXAMINATION OF
Visual perception X INDIVIDUAL FACTORS
Visual motor X
Interaction of sides of body Using Table 2 as a guide, each similar-
with tactile perception X ly labeled group of factors will now be
Auditory, language, examined to determine the nature of their
and sequencing X
Postural and bilateral
common content.
integration X
Left-side coordination, Praxis
posture, and bilateral
integration X
According to Meulders (1983), the
Academic achievement
and sensory perception X
concept of praxia derives from apraxia,
Auditory/visual association the latter term being defined by Liep-
and horizontal perception X mann (1908) as the impossibility of per-
Auditory, language, and forming intentionally certain movements,
intelligence X or sequences of movements, in spite of
Postural and ocular
mechanisms
the integrity of the primary motor path-
X X X
Reading, spelling, ways and the conservation of most of the
and intelligence X X elementary or automatic motor functions.
Eye-hand dominance and In the context of sensory integration
left-eye dominance X
theory, the term praxia is used to de-
Left-hand vs. right-
hand coordination X
scribe the ability to plan motor acts. The
Auditory-language deficit is usually referred to as develop-
problems X X mental dyspraxia, which Ayres et al.
Kinesthesia X (1987) describe as being caused by dis-
Somatosensory X ordered sensory integration resulting in
Use of one hand in
contralateral space
poor development of the ability to motor
X
Auditory-perception X
plan or to sense what sequence of move-
Uninterpreted factor X X ments will be needed in order to accom-
plish a motor task. According to Vezie
Note. D = Learning disabled; N = Normal; R = Raw scores; I == Ipsative scores.
(1975) it also implies that while specific
motor skills may be learned through
repetition, the growth of generalized
• One factor label ("Praxis") has emerged parameters to be considered functionally ability to motor plan is lacking.
five times. related aspects of human behavior. It is Ayres has claimed that this factor
• Three factors have emerged three times. hypothesized that they reflect neural sys- tends to emerge more readily from the
• Three factors have emerged on two tems in which disorder has been found in data of children with LD than from non-
occasions. children with learning problems" (p. 94). disabled children—an important finding,
• The remaining 19 factor labels have The terms Ayres (1972a) used to des- if true. Unfortunately, evaluating this
been used by Ayres on only one occa- ignate the five factors were: claim on the basis of Ayres' data is not
sion each. easy, for reasons that can be seen in
1. Disorder in postural, ocular, and bi- Table 3. There, under "A," are listed the
Despite this lack of consistency, in 1972a lateral integration compositions of all five factors Ayres has
Ayres summarized her findings as fol- 2. Apraxia labeled as "Praxis." (Note that a key im-
lows: "From the author's statistical anal- 3. Disorder in form and space perception mediately follows this table.) It can be
yses . . . five factors emerged with suffi- 4. Auditory-language problems seen that of the 32 variables included at
cient frequency and similarity of operative 5. Tactile defensiveness one time or another, only 5 have been

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included on three or more occasions, 17
TABLE 3
have been included on two or more oc- The Variable Composition off Praxis
casions, and the remaining 15 have ap-
peared only once. A B C

1965 1966a 1972b 1972b> 1977 1965 1966c 1969

Definition of the Praxis Factor Variables DR NR DR Dl DR Deffn NR NR Dl

Wire grommet
Even a casual glance at the five fac- manipulation 1 7.5 X X X . X X
tors under "A" will indicate their very S.Calif.Mot.Acc. Test 2 3 X X X . 7 X
heterogeneous composition. Ayres has Posture duplication 3.5 1 2.5 1 1 .. 2 12
proposed a content definition for these Finger identification 3.5 7.5 3.5 •• 7
praxis factors, which will be discussed Graphesthesia 5 5 . 1
Single stimulus
later. First, the factors will be examined localization 6 4 3.5 .. 8.5 11
for their similarity of content. Stereognosis 7 X 3.5 . 6 1
Table 3 permits the formulation of an Eye-motor coordination 8.5 X X X 6 X X
operational definition based on common Two-point discrimination 8.5 X X X X X X

elements: Praxis may be defined in terms Face-hand test 10 6 9 3.5 •• 3

Time and rhythm 11 X X X X X X
of those variables that have loaded 0.30 String winding 12 X X X X X X
or higher, on more than one occasion, Visual figure-ground 13 13.5 • 4 4
within a factor named by Ayres as Superimposed figures 14 X X X X X X
"Praxis." In terms of the data in Table Eye pursuit 15 X X X

3 (A), this definition has been used to Vertical perception 16 X X X X X

provide two different definitional struc-

Design copying 17.5 X 6 • X
Kinesthetic memory 17.5 9 • 8.5
tures: a "hard" definition, consisting of Space relations 15 X X X 1 X
only those variables that have appeared Form constancy 12 X X X 5 X
on three or more occasions (marked •• Bilateral motor control X 2 5 2 •• X 5
under column B), and a "soft" definition, Standing balance-eyes
consisting of variables that have been in-
open 10 7.5 • X 5
Tactile defensiveness 11 2.5 X .
cluded at least twice (designated • in col- Position in space 13.5 3 • X
umn B). Each of these two operational Hyperactivity 16 1 X •
definitions has then been applied back to Right-left discrimination 17 X

the five praxis factors to gauge the ex- Hands crossing body
tent of their internal conformity, both in
midline X 4 4 . 2
Muscle co-contraction X X 7.5 X X
terms of the 5 "hard" and the 17 "soft" Standing b a l a n c e -
definitional variables indicated under eyes closed X 10 X
"B." Ayres space test 11
ITPA sound blending X X 5.5 X X
Unfortunately, this process is compli-
Muscle tone X X 5.5 X X
cated by the fact that each of the studies
to be compared failed to include some Note. A = those factors labeled by Ayres as "Praxis"; B = hard (••) or soft (•) definitional
of the definitional variables. For exam- variables; C = factors not labeled by Ayres as "Praxis," but being the factor in that study
with a variable structure most conforming to the definitional variables; D = data from dis-
ple, the 1965 study did not include the
abled children; N = data from nondisabled children; R = raw data; I == ipsatized data
variable "Bilateral motor control" and so The variable list comprises all variables loading 0.3 or more on the Praxis factors under
it was not available to form part of the "A." It is not a complete list of variables comprising the factors under" C." Each blank space
Praxis factor in that study. To compen- in the table indicates that the variable was used irl the study but did not load 0.30 or above
sate for such differences, the extent of on the factor. Each "x" in the table indicates that the variable was not used in the par-
ticular study, and therefore could not have formed part of the factor. Numbers in the table
definitional conformity has been judged
indicate the rank order of variable loading s within each factor. The variable numbered " 1 "
only on the basis of the definitional had the highest loading, and equally ranked loadings are indicated as the combined rank
variables available to each study. Thus, midpoint.
the extent of definitional conformity, for
both the hard and soft definitions, is ex-
pressed as a percentage calculated as: In other words, definitional conformity tween studies, ranging from 40% to
is to be judged only on the basis of the 100% for the hard definition and from
% conformity = — x ^ definitional variables available to each 27% to 100% for the soft definition. In-
study. terestingly, the only factor to contain
P = Number of definitional variables The results of these calculations are 100% conformity with both hard and
included within the named factor. shown in the upper-left-hand quadrant soft definitions was derived from the
Q = Number of definitional variables of Table 4. As can be seen, there are con- scores of nondisabled children (1966a).
included within the study. siderable differences in conformity be- These discrepancies are highlighted by

Volume 24, Number 3, March 1991 163

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 TABLE 4 On the basis of these calculations it is
Conformity Between Actual and Definitional Factor Structures for Praxis apparent that the factor labeled by Ayres
as "Interaction of sides of body with tac-
Hard Soft Ayres' tile perception" (1966c) has, in fact, a
definition definition definition
greater claim to be called "Praxis" than
Soft any of the factors so named, since the
Study P Q % P Q % Loading % % Loading % nine Praxis variables made up 100% of
1965 DR 4 4 100 11 16 69 68 70 40
the factor loadings. It must again be con-
1966a NR 5 5 100 14 14 100 87 89 47 cluded that Ayres' factor titles and fac-
Factors Named 1972b DR 3 5 60 8 15 53 78 27 25 tor compositions are not in accord. The
"Praxis" 1972b Dl 2 5 40 4 15 27 75 18 34 major question, however, is whether the
1977 DR 4 5 80 5 13 38 - 33 - Praxis factor can be used to distinguish
Factors with 1965 NR 1 4 25 3 16 19 40 20 31 between the scores of academically dis-
Other 1966c NR 4 5 80 9 14 64 100 67 66 abled and nondisabled children. In this
Names 1969 Dl 2 5 40 4 14 29 - 33 - regard Ayres has claimed that one of the
Note. P = Number of definitional variables included within the Praxis factor; Q = Number
"clearest differences" between the factors
of definitional variables included within the study. derived from nondisabled and dysfunc-
% = P x 100 tional children is "the failure for the
Q 1 dimension of praxis . . . to appear as
Soft Loading % = Loading contribution of the soft definitional variables (A) to the total separate factors in the normal group"
loading of variables (0.30 or above) on the factor. (1966c, p. 289).
Ayres Loading % = Loading contribution of Ayres' definitional variables to the total loading
of variables (0.30 or above) on the factor.
The data presented in Table 4 show
quite clearly that this is not so. In terms
of either the number of Praxis variables
a comparison with the three studies the Praxis factor. Loading is a measure or their relative loadings onto the factors,
wherein Ayres did not name a Praxis fac- of the extent to which each variable con- it can be seen that Praxis may emerge
tor. In each of these studies the factor tributes to the factor, a high loading in- either strongly or weakly from the scores
has been selected that most closely con- dicating a major contribution. The "Soft of either group. It is interesting to see,
forms to the operational definition of Loading %" is the contribution of the indeed, that the two factors carrying the
Praxis. The names that Ayres had given soft definitional variables to the total highest Praxis loadings (1966c-NR and
these factors are as follows: variable loadings on the'factor. For ex- 1966a-NR) are both derived from the
ample, in 1965-DR, the Praxis factor was scores of nondisabled children.
1965-NR General perceptual-motor composed of 18 variables in all, and their
and cognitive ability combined numerical loading amounted Ayres' Definitions
1966c-NR Interaction of sides of body to 806. The 11 soft definition variables
with tactile perception found within this factor structure had a Ayres has provided a verbal descrip-
1969-DI Postural and bilateral inte- combined numerical loading of 552. The tion of the Praxis factor composition on
gration contrasted with Praxis proportion of the total loading contri- a number of different occasions (1963,
buted by the definitional variables is 1965, 1966a, 1967, 1971, 1972a, 1972b,
The extent to which these factor com- then: 1977). In general these descriptions re-
positions conform with the hard and soft 552 100 flect the heterogeneous factor composi-
definition criteria is set out in the lower Soft Loading % — x - r = 68% tion displayed in Table 3, with not one
oUo 1
left quadrant of Table 4. And what is description being totally consistent with
clear from these comparisons is that, In other words, the soft definitional vari- any other. The two most recent descrip-
despite Ayres' labeling procedures, two ables made up 68% of the total variable tions are as follows.
of these differently named factors cor- loadings onto this factor. Ayres (1972a) defined the "Syndrome
responded to the ideal Praxis structure Two further matters require clarifica- of developmental apraxia" primarily by
just as well as the 1972b-DI factor that tion in these calculations: (1) In the ip- a deficit in the variable Imitation of
had been labeled as Praxis. In fact, the sative data comprising 1972b-DI, the Postures. Other, related deficits were
differently named 1966c-NR factor cor- numerical loadings were summed regard- stated to be in the Motor Accuracy Test
responded to the definitional composi- less of sign. (2) Loading percentage could and Bilateral Motor Coordination, Tac-
tion better than three of the named not be calculated for either 1969-DI or tile Tests, Kinesthesia, Extraocular Mus-
Praxis factors. 1977-DR. In the former case the variable cle Control, and Behavior Problems. It
Further data relevant to these com- loadings were not given, while in the is difficult to reconcile this definition
parisons are presented in the column latter study "composite" variables were with Table 3. Of the seven variable types,
labeled "Soft Loading %" (see Table 4). used in the analysis, thereby rendering only two were included on three or more
The basis of these calculations is the the loadings noncomparable with those occasions (Posture Duplication and Bi-
numerical loading of each variable onto of previous analyses. lateral Motor Control), three had been

164 Journal of Learning Disabilities

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included on two occasions, and Extra-
ocular Muscle Control (i.e., eye pursuit)
had been included only once. In addi-
tion, the three other hard definitional
variables had been excluded.
On the most recent occasion (1977),
Ayres labeled a factor as Praxis and com-
mented: "Most apraxic children show the
symptoms complex that appears as Fac-
tor D in Table 2. These children usually
have low scores on IP and tactile tests of
the SCSIT [Southern California Sensory
Integration Test]. The more severe cases
usually score poorly on Kinesthesia and
SVCU" (p. 366). That statement trans-
lates into the following list of variables:
(1) Figure Ground, (2) Position in Space,
(3) Ayres Space Test, (4) Right-Left Dis-
crimination, (5) Illinois Test of Psycho-
linguistic Ability (ITPA) Visual Sequen-
tial Memory, (6) Posture Duplication, (7)
Stereognosis, (8) Graphesthesia, (9) Sin-
gle Stimulus Localization, (10) Face-
Hand Test, (11) Kinesthetic Memory,
and (12) Space Visualization Contra-
lateral Use (SVCU).
The following points are relevant to
this list:
• Two variables (5 and 12) have never
formed a significant part of a Praxis
factor.
• Two variables (3 and 4) have formed
part of the Praxis factor on only one
occasion each. Hence they did not
even rate inclusion in the soft defini-
tion formulated earlier.
• Two other variables (Finger Identifica-
tion and Bilateral Motor Control) have
been omitted, even though they were
included in three out of five of the fac-
tors labeled by Ayres as Praxis.
Despite these shortcomings, the same
calculations have been performed using
these 12 definitional variables as were
reported using the hard and soft defini-
tions. Once again, "%" refers to the pro-
portion of 12 variables available to the
study that were included in each Praxis
factor. "Loading %" refers to the loading
contribution of the available definitional
variables to each factor. The results of
the calculations are presented on the right
side of Table 4.
As can be seen, the pattern of results
is quite similar to that of the operational
definition. Again, the factors labeled as
Praxis show no greater conformity to the
Volume 24, Number 3, March 1991
definition than factors labeled otherwise.
But most importantly, the application of
Ayres' definition to these data failed to
discriminate the scores derived from chil-
dren with learning disabilities and non-
disabled children. It must be concluded
from these data that there is no evidence
that a factor of Praxis emerges more
readily from the data of children with
learning disabilities as compared to those
of nondisabled children.
Ayres, Mailloux, and Wendler
(1987)
After an interval of 10 years, Ayres
reported another factor analysis, which
confirms that a simple Praxis factor does
not reliably emerge from the scores of
children with learning disabilities. This
study was not included in the previous
group analysis because a quite different
set of test scores were used. They in-
cluded six different measures of praxis
and a number of scores derived from
combinations of the individual tests listed
in Table 3.
Three factors emerged from the data.
One was labeled "Kinesthesia," a title
Ayres has used once before, in the 1972b-
DI study (see Table 2). Another was
labeled "Auditory memory," which Ayres
has not used before. But the major fac-
tor, which included in its composition the
praxis measures and a mixture of other
scores, was labeled "Visuosomatopraxis
function with elements linked by concept
formation" (abstract). Although the
precise meaning of this factor may be
obscure, the conclusion that may be
drawn is not. As the authors conclude,
this study failed to support the emergence
of a unitary Praxis factor from the scores
of children with learning disabilities.
FORM AND SPACE
PERCEPTION
The analyses of this and subsequent
factor compositions will omit the tables
that show the variable composition for
each; these may be obtained from the
author on request.
The investigation of this factor pro-
ceeded in the same manner described for
Praxis. A "Form and Perception" factor
has been named by Ayres on three occa-
sions (1965, 1972b-DR, 1972b-DI). The
hard definition involved four variables
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(Position in Space, Ayres* Space Test,
Figure-ground Perception, and Design
Copying), with the soft definition in-
cluding three more (Kinesthetic Memory,
Stereognosis, and ITPA-Visual closure).
Table 5 shows the degree of conformity
between the actual number (%) or vari-
able loading (soft loading %) of defini-
tional variables within the factors.
In terms of the hard definition, six of
eight studies contained a factor that in-
cluded 100% of the available variables.
However, it should be noted that two of
these came from the scores of nondis-
abled children, and the 1977-DR factor
had been labeled by Ayres as "Auditory
language functions." Using the soft def-
inition, one certainly finds a more ap-
propriate separation. However, the two
distributions did overlap and the factor
Ayres labeled "Visual Perception" (1966a-
NR) from nondisabled children exceeded
the "Form and Space Perception" factor
from 1972b-DI.
When the factor loadings are compared
(soft loading %), it can again be seen
that, though they tend to favor the
named factors from groups with learn-
ing disabilities, the five top scores are
separated by only 15 percentage points,
and two of these five come from non-
disabled children.
In conclusion, these data do not pre-
sent convincing evidence that a Form and
Space Perception factor could be used to
reliably separate the scores of children
with learning disabilities and nondisabled
children.
Ayres' Definition
Ayres provided a verbal description of
this factor on six occasions (1963, 1965,
1967, 1971, 1972a, 1972b). While these
are fairly heterogeneous, she makes it
clear that a central component comprises
variables measuring form and space per-
ception across the three modalities of
visual, tactile, and kinesthetic perception.
In 1972a, Ayres defined the factor as
consisting of the variables "visual form
and space perception, kinesthetic memo-
ry, stereognosis, visual figure ground
perception and perception in other sen-
sory modalities that involve some kind
of form perception" (p. 191). This is con-
sistent with the soft definition that has
been investigated.
165
TACTILE DEFENSIVENESS alertness of distractibility, the flight-like does not support the use of tactile defen-
One apparently unique feature of behavior of hyperactivity, and a tendency siveness as a diagnostic device.
Ayres' theory is the idea that children toward negative affect (flight)" (1972a,
with learning disabilities suffer from Tac- p. 255). It should be noted, however, that BILATERAL INTEGRATION
tile Defensiveness. This is described as Head's dichotomy has not been experi-
physical or emotional discomfort when mentally validated (Miller, 1978, pp. Whereas Ayres described factors by
touched by an examiner during tests of 318-324). the simple terms "Bilateral integration"
tactile perception (see Ayres, 1965, for The investigation of this factor pro- (1965-DR) and "Postural and bilateral in-
a description of the testing procedure). ceeded as before, with two minor modi- tegration" (1969-DI) on one occasion
Ayres has described this condition in fications: first, that no factor has been each, on two other occasions she used
considerable detail (1964, 1966b, 1972a) included from 1977-DR, because the key terms that seem to implicate Bilateral In-
and uses the work of Head (1920) as her variables of Tactile Defensiveness and tegration as a central component. These
theoretical basis. Head proposed a duality Hyperactivity were not included in the are:
in the cutaneous systems: The "Proto- study. Second, due to the small number 1966c-NR "An interaction of function
pathic system," so named because of its of shared variables between the three fac- of the two sides of the body
supposedly primitive characteristics, tors Ayres labeled as "Tactile Defensive- with emphasis on tactile
serves to protect and warn the organism ness," only the soft form of the opera- perception" (p. 288).
against potential harm. The "Epicritic tional definition has been produced. 1969-DI(2) "Poorer coordination on
system" is concerned with higher, dis- The calculations shown in Table 6 the left than on the right
criminatory functions. have been performed as before. Once side of the body along with
Ayres used this presumed dichotomy again, it is clear that the definitional deficiencies in postural and
to reason that the tactile defensive reac- variables are unable to reliably differen- bilateral integration" (p.
tions in children with learning disabilities tiate either between factors carrying the 166).
are caused by the dominance of the pro- title of "Tactile defensiveness" or between
topathic system. Hence, tactile stimuli the scores of children who are academi- It should be noted that two of these fac-
imposed upon these children warn them cally disabled and children who are non- tors are drawn from the 1969 study and
of "danger" and this leads to the "over- disabled. This lack of discrimination will be referred to as (1) and (2), re-
spectively.
It can be seen from Table 7 that once
again the operational definition fails to
TABLE 5 discriminate between the scores of non-
Conformity Between Actual and Definitional Factor Structure for Form and Space Perception disabled children and children with learn-
Hard Soft ing disabilities. It can also be seen that
definition definition Soft Ayres' labeling of factors as "Bilateral In-
Loading tegration" seems to bear little relationship
Study P Q % P Q % to their variable content.
%
Factors Named 1965 DR 4 4 100 6 6 100 51
"Form and 1972b DR 4 4 100 7 7 100 62 FIGURE-GROUND
Space Perception 1972b Dl 4 4 100 5 7 71 64
DISCRIMINATION
1965 NR 1 4 25 1 6 17 13
Factors with 1966a NR 3 3 100 3 4 75 49 Ayres has asserted on a number of oc-
Other Names 1966c NR 3 3 100 3 5 60 58 casions (1963, 1975) that Figure-Ground
1969 Dl 2 3 67 2 6 33 — Discrimination is a factor that discrimi-
1977 DR 4 4 100 4 7 57 - nates between children with learning dis-
abilities and nondisabled children. It is
curious to note, therefore, that a factor
TABLE 6
Conformity Between Actual and Definitional Factor Structures for Tactile Defensiveness
has only been given this simple designa-
tion on two occasions (1965), when it was
Definition found to emerge once each from the
Loading
%
scores of nondisabled children and chil-
Study %
dren with learning disabilities.
Factors Named 1965 DR 100 75
"Tactile 1966c NR 60 81
Defensiveness" 1972b Dl 80 43
POSTURAL AND OCULAR
1965 NR 20 49 REACTIONS
Factors with 1966a NR 100 29
Other Names 1969 Dl 40 According to Ayres, "postural mecha-
1972b DR 60 32
nisms are among the more important

166 Journal of Learning Disabilities

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 TABLE 7
Conformity Between Actual and Definitional Factor Structures for Bilateral Integration
Study
Factors Named 1965 DR
"Bilateral 1966c NR
Integration" 1969 Dl(1)
1969 Dl(2)
1965 NR
Factors with 1966a NR
Other Names 1972b DR
1972b Dl
1977 DR
areas of assessment of children with
learning disorders" (1972a, p. 98). In-
deed, a very substantial component of her
remedial program is directed to this area.
Specific therapeutic targets are the inhibi-
tion of primitive reflexes, increased
functioning of antagonistic muscle con-
traction, development of muscle tone,
improved extraocular muscle control,
and vestibular system functioning.
While Ayres has labeled factors as
"Postural and Ocular Reactions" on three
occasions, this factor is unfortunately not
amenable to analysis. The variables com-
mon to the named factors are not suffi-
ciently represented within the other
studies for comparisons to be made.
EVIDENCE FROM MULTIPLE
REGRESSION
If one desires to validate the hypoth-
eses arising from a factor analysis, then
a useful approach is to employ another
multivariate technique, called multiple
regression. This statistic seeks to "ex-
plain" a single known, observed, and
measured dependent variable in terms of
groups of independent variables. In other
words, the factors discovered by factor
analysis can be tested for explanatory
power against some other performance
variable.
Ayres has used multiple regression for
this purpose on one occasion (1972b).
Unfortunately, the result from that study
is rendered uninterpretable due to the
uncertain composition of the independent
variables that were generated according
to the following procedure:
By perusing the scores of each child and us-
ing previously factorially determined criteria tion of scores into each category.
Volume 24, Number 3, March 1991
Definition
Loading
P Q % %
2 6 33
6 6 100
2 7 29
4 7 57
2 6 33
5 5 100
2 7 29
2 7 29
1 7 14
(Ayres 1965, 1969) for identification of pat-
terns of syndromes of perceptual-motor dys-
function, each child was assigned a system or
syndrome score indicative of the degree of
dysfunction in five hypothesized neural sys-
tems. (p. 329, emphasis added)
The five "hypothesized neural systems"
that were defined by the children's "syn-
drome scores" were as follows:
1. Postural and bilateral integration
2. Praxis
3. Functions of the left side of the body
4. Form and space perception
5. Auditory-language functions
In relation to Ayres' claim that the results
from the 1965 and 1969 studies could be
used to divine "previously factorially
determined criteria," the following points
can be made:
1. Neither study cited yielded all five fac-
tors, and each yielded factors other
than the ones listed.
2. The 1969 report contained two analy-
ses, one using raw data and one us-
ing ipsative data. The factors derived
from each form of analysis differed
not only between the two analyses but
also differed from the 1965 analysis.
3. Ayres separated the syndrome scores
within each factor into three classes,
depending on the "frequency and
severity of the disorder" indicated by
the score. Thus, each factor was sub-
divided in terms of the "degree of
dysfunction" into definite, mild, or
none. Unfortunately, this separation
further confuses the picture, because
no criteria are provided for the alloca-
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Moreover, the interpretation in terms
of degrees of dysfunction is highly
equivocal, as no pathology has been
shown to be linked to the levels of
functioning on these variables.
61
These deficiencies render the multiple
67
- regression analysis uninterpretable, pri-
— marily because the composition of the
independent variables (factors and levels
76
of dysfunction) cannot be determined
31
19 from the available data. As a conse-
35 quence, this study will not be given fur-
- ther consideration.
SUMMARY
Between 1965 and 1977 Ayres published
the results of eight factor analyses. The
data from these studies had been derived
from a variety of perceptual-motor and
other tests applied to either children with
learning disabilities or nondisabled chil-
dren. The factors that emerged were
claimed to discriminate between the two
groups of children and have subsequently
formed the basis of an elaborate diagnos-
tic and remedial training protocol for
children with learning disabilities.
This claim, that the data from children
with learning disabilities gives rise to
characteristic factor structures, has not
been adequately tested. The claim is
made solely on the basis that certain fac-
tor labels, such as Praxis, have been dif-
ferentially applied to data derived from
such children. Factor labels, however,
are fairly arbitrary devices that do not
necessarily reflect true factor content.
The present paper explored the relation-
ship between factor labels and factor
content in Ayres' studies.
The investigation of these data pro-
ceeded in a multistep process. Initially the
eight analyses were scanned for common
factor labels. Seven labels were found to
have been used on more than one occa-
sion each. Each group of similarly labeled
factors was then examined to determine
whether their content could be used to
reliably distinguish them from other fac-
tors. The core of common content within
each group was identified as those vari-
ables that loaded 0.30 or more onto each
factor. These core clusters were then
compared against the content of other
factors using two approaches. The first
involved a simple numerical comparison
167
of the number of core variables also
found in other factors. The second com-
pared the accumulated factor loadings of
the core variables with the same variable
loadings found in other factors. In each
case, no evidence was found for any
variable cluster that could reliably dis-
tinguish the similarly labeled factors
from other factors that had been dif-
ferently named.
A different approach to this discrimi-
nation problem used Ayres' definitions
to determine the optimal variable content
of the similarly named factors. Compari-
sons using these different sets of defin-
ing variables yielded no better result.
Again, these variable clusters could not
reliably distinguish the similarly named
factors from some other factors that car-
ried different names.
It was concluded that there is a lack
of consistency between Ayres' factor
labels and composition. Indeed, no core
group of variables could be detected that
allowed the similarly named factors to be
reliably identified by their content.
The final set of comparisons was be-
tween data produced from the scores of
children with learning disabilities and
data from nondisabled children. Ayres
has claimed that the factors that emerge
from these two sets of data are reliably
different. Within each group of similarly
labeled factors, content was examined to
determine the extent to which the shared
core of variables could be used to dis-
criminate the scores from the two types
of children. Both numerical comparisons
and factor loading comparisons were
utilized, as previously described. The
result of this examination revealed that
not one of the named factors had a con-
tent that reliably distinguished between
the scores from children with learning dis-
abilities and from nondisabled children.
It is concluded that the body of data
that has been examined provides no
validity for either the diagnostic proce-
dures or the remedial programs for chil-
dren with LD that have been derived
from Ayres' multivariate studies.
168 Downloaded from ldx.sagepub.com at MCMASTER UNIV LIBRARY on March 2, 2015
ABOUT THE AUTHOR
Robert A. Cummins, PhD, is senior lecturer in psy-
chology at Victoria College-Toorak. In addition he
is principal investigator with the Disability Program
Evaluation Unit, which has major responsibility for
evaluating government services to people with in-
tellectual disabilities in Victoria. His research and
writing activities focus on debunking remedial
education myths, the effects of deinstitutionaliza-
tion, and quality of life measurement. Address:
Robert A. Cummins, Victoria College-Toorak, PO
Box 224, Malvern, Victoria 3144, Australia.
AUTHOR'S NOTE
An extended version of this paper is available from
the author on request.
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