Assessment of Performance Skills/Client Factors: Vision, Visual Perception & Cognition Flashcards
Executive Function Performance Test Assessment (EFPTA)
Client performs 4 IADL activities with graded cues.
- Level of independence recorded & categorized into 5 executive function constructs: initiation, organization, sequencing, judgment & safety, & completion
Performance Assessment of Self-Care Skills (PASS)
26 core tasks, categorized into - 4 functional domains
- 5 functional mobility
- 3 personal (self) care
- 14 IADL with cognitive emphasis
- 4 IADL with physical emphasis
Performance rated for independence, safety, and adequacy
- Two versions: PASS-Clinic & PASS-Home with the same tasks, subtask criteria, and directions
Co-Op - Cognitive Orientation to Daily Occupational Performance
- Clients learn best when they succeed according to their OWN goals!
- Emphasis on self-discovery
- Assist client to develop an individualized approach to therapeutic treatment
- Performance-based, problem-solving, intervention approach
- Enables skill-acquisition (strategy use & guided discovery)
- Developed as an alternative to motor interventions that focused on remediation of deficits
Co-Op - Goals
- Skill acquisition
- Cognitive strategy use
- Generalization of learning
- Transfer of learning
Co-Op - Theories
It’s a combination of contemporary task-oriented motor theory with learning theory!
- Thinking patterns change behaviors
- Teach thinking patterns that will support desired behaviors
- Develop self-instructional training
- Executive strategy: goal-plan-do-check
- Use of self-talk
- Metacognitive training: reflect, evaluate, change goal/plan
Co-Op: Performance
- Right fit (person, environment, occupation)
- Environmental supports/barriers
- Identify performance problems & possibly strategies
- Therapist needs a baseline knowledge of the performance skill
Co-Op: Domain-Specific Strategies
Body position Attention to task Task specification/modification Supplementing task knowledge Feeling movement Verbal mnemonic Verbal script Mental imagery Relaxation techniques
Complex Task Performance Assessment
Work-Simulation-Library Primary task - Inventory control Secondary task - Phone messages Delayed intentions - Tell time - Give the examiner a message
Mini-Mental State Examination (MMSE)
Screening tool with 11 questions related to the following areas:
- Calculation, abstraction, orientation, attention, learning, information, construction, and delayed recall
Score ranges between 0-30
Scores 24 or less are indicative of possible cognitive disorders
5-10 minutes to administer
Good screening tool, but bias towards verbal items and insensitive to right-sided brain damage and mild cognitive deficits
Lowenstein Occupational Therapy Cognitive Assessment (LOTCA)
Microbattery with 20 subtests
Orientation, perception, visuomotor operations, and thinking operations are assessed
30-45 minutes to administer
Gives a snapshot of a number of cognitive capacities; however, not sensitive towards clients with mild injuries and does not have a measure of memory
Cognitive Assessment of Minnesota (CAM)
Microbattery of 17 subtests
Includes the areas of: money & math skills, planning and abstract reasoning, problem-solving, attention, memory, orientation, neglect, and following directions
45 minutes to administer
Provides an overview of cognitive functioning but has little literature on its use in rehabilitation; also has possible ceiling effect for mild or subtle cognitive deficits
The Montreal Cognitive Assessment (MoCA)
Validated in the setting of mild cognitive impairment
1-page, 30-point test
Administered in 10 minutes
Includes short-term memory recall task, visuospatial abilities, executive function, verbal abstraction, attention, concentration, working memory, orientation, and language
St. Louis University Mental Status Exam (SLUMS)
Screening tool which identifies mild cognitive problems
Administered in approximately 7 minutes
1-page, 30-point test
Tasks include: simple math computation, naming animals, recalling facts, and drawing the hands on a clock
Activity Card Sort
Flexible
Measure of occupation
Help clients describe IADL, leisure activity, and social activities
Assists in building routines of meaningful and healthy activities for clients
Cognitive Performance Test (CPT)
Standardized, performance-based assessment
Originally designed for the objective evaluation for people with Alzheimer’s Disease
Based on Allen Cognitive Disability Theory
Assesses 6 areas of ADL tasks, for which the information-processing requirements can be systematically varied
- Dress
- Shop
- Toast
- Phone
- Wash
- Travel
Weekly Calendar Planning Activity (WCPA)
Useful to occupational therapists as a performance measure of executive function
Allows evaluation of complex task performance, strategy use, self-evaluation of performance, and error patterns
Those evaluated areas can be utilized to create intervention strategies
Used across a variety of populations
Snellen Eye Chart
Screen visual acuity
The numerator denotes the distance at which the client recognizes the stimulus, and the denominator is the distance at which it would be recognized by someone with normal vision
Person with 20/200 vision is able to recognize a stimulus at 20 feet that a person with normal vision would see at 200 feet
Eye alignment screening
Generally measured by observation of the reflection of light on the cornea (see text: p. 240 for specifics) Light reflection should be in the same position in both eyes.
Convergence
Client follows a target moving slowly toward and away from the face (double vision normally occurs when the target is within 2-4 inches of the face, & recovery of a single image takes place at 4-6 inches
Accommodation
Ability to adjust the focus of vision at a range of distances, such as the automatic focusing of the eyes when you look at the speedometer and back at the road while driving
Visual tracking (smooth pursuits)
Eye movements that maintain continued fixation on a moving target; if smooth pursuits are impaired, acuity is impaired when motion is involved.
Saccades
Quick eye movements that change fixation from one point to another and allow us to redirect our line of sight (procedures on page 242 in L & R).
Visual field testing
Testing which is done for visual fields should be used in conjunction with functional observations, because if done alone, have been proven to be unreliable through research.
Let brain know what’s going on in environment
Register visual scene…ensure that CNS receives complete visual information
The Motor-Free Visual Perception Test (MVPT)
3 Areas of Visual Function:
- Visual perception
- Visual neglect
- Visual processing time
New version released = MVPT-3
A static assessment of visual perception (decontextualized)
General screening instrument with no subtest scores
Individually administered; takes about 25 minutes plus 10 min to score
Ages 4-85; over 10 yrs begin with the example for #14-22 and continue through 65
Instructions are precise; no clues allowed; no feedback other than “ok” or “good”;
Read the instruction-record the response
Measures: spatial relationships, visual discrimination, figure-ground, visual closure, visual memory Measures: item response time = perceptual time plus motoric response saying or pointing
Raw score, standard score (can be used to compare with other testing), percentile rank, age equivalent: never use that
Vertical presentation for people with hemifield neglect
