The Concurrent Validity of Three Visual Perception Tests Used with Adults

Objective. Visual perception is a skill area commonly assessed by occupational therapists. Three newly revised tests of visual perception include the Developmental Test of Visual Perceptual Skills (Non-Motor)-Adolescent and Adult (DTVP-A), the Motor-Free Visual Perception Test-Third Edition (MVPT-3), and the Test of Visual Perceptual Skills-Third Edition (TVPS-3). The aim of this study was to investigate the concurrent validity of these three adult visual perceptual tests. Methods. Fifty healthy participants, aged 18–55 years, completed the DTVP-A, MVPT-3, and TVPS-3. Spearman rho correlation coefficients were used to evaluate the relationships among the three tests. Results. The total scale score correlations for the DTVP-A, MVPT-3, and TVPS-3 ranged from 0.39 to 0.51. Conclusion. The three tests exhibited a moderate level of correlation, supporting the concurrent validity of the DTVP-A, MVPT-3, and TVPS-3.     

Profile of paediatric occupational therapy practice in Australia

Background:  The purpose of the present study was to describe a profile of Australian paediatric occupational therapy practice in terms of theories, assessments and interventions used with the most frequently seen client groups.
Methods:  An ex post facto survey design was utilised. A purpose-designed survey was mailed to 600 occupational therapists identified by OT Australia as working in paediatrics.
Results:  The response rate was 55% ( n =  330). Respondents in the sample worked chiefly with children with developmental delays, learning disabilities, neurological impairments, and infants/toddlers. Theoretical models used by paediatric clinicians that were common to the most frequently seen client groups focused on sensory integration/multisensory approaches, occupational performance, and client-centred practice. Assessment tools most frequently used were the Test of Visual Motor Integration, Sensory Profile, Bruininks-Oseretsky Test of Motor Proficiency, Handwriting Speed Test, and Motor-Free Visual Perception Test. The most often used treatment methods across the four most frequently seen client groups were parent/caregiver education, sensory integration/stimulation techniques, and managing activities of daily living.
Conclusions:  Paediatric occupational therapists appeared to draw on a range of theoretical models. With the exception of the Sensory Profile, the assessment and treatment methods most frequently used are not congruent with the most commonly used theoretical models. It is critical that the assessment and treatment methods used are conceptually consistent with the theoretical models that guide practice. Occupational therapists need to examine the evidence and determine whether their clinical practice is grounded in the best contemporary theoretical models, assessments and interventions.     

Validity and Reliability of the Developmental Test of Visual Perception – Third Edition (DTVP-3)

The Developmental Test of Visual Perception – Third Edition (DTVP-3) is a recently published revision of a visual perceptual test from the United States, frequently used by occupational therapists. It is important that tests have adequate documented reliability and validity and are evaluated in cross-cultural contexts. The purpose of the study was to assess the reliability and validity of the DTVP-3 when completed by a group of Australian participants. Thirty-nine typically developing children 6–8 years of age completed the DTVP-3 and the Developmental Test of Visual-Motor Integration – 6th edition (VMI-6). The internal consistency of the DVTP-3 was assessed using Cronbach alpha coefficients and the DTVP-3's convergent validity was examined by correlating it with the VMI-6 and its two supplementary tests. The five DTVP-3 subscales’ Cronbach alpha coefficients ranged from.60 to.80 while its three composite indexes had coefficients all at the.80 level. The VMI-6 was significantly correlated with the DTVP-3 Figure Ground and Visual Closure subscales and the Motor-Reduced Visual Perception Index (MRVPI). The VMI-6 Visual Perception Supplementary Test was significantly correlated with the DTVP-3 Figure Ground, Visual Closure, Form Constancy, MRVPI, and General Visual Perception Index. The DTVP-3 exhibited acceptable levels of internal consistency and moderate levels of convergent validity with the VMI-6 when completed by a group of Australian children.     

Do prior knowledge,personality and visual perceptual ability predict student performance in microscopic pathology?

Medical Education 2010: 44: 621–629 Objectives There has been long‐standing controversy regarding aptitude testing and selection for medical education. Visual perception is considered particularly important for detecting signs of disease as part of diagnostic procedures in, for example, microscopic pathology, radiology and dermatology and as a component of perceptual motor skills in medical procedures such as surgery. In 1968 the Perceptual Ability Test (PAT) was introduced in dental education. The aim of the present pilot study was to explore possible predictors of performance in diagnostic classification based on microscopic observation in the context of an undergraduate pathology course. Methods A pre‐ and post‐test of diagnostic classification performance, test of visual perceptual skill (Test of Visual Perceptual Skills, 3rd edition [TVPS‐3]) and a self‐report instrument of personality (Big Five Personality Inventory) were administered. In addition, data on academic performance (performance in histology and cell biology, a compulsory course taken the previous year, in addition to performance on the microscopy examination and final examination) were collected. Results The results indicated that one personality factor (Conscientiousness) and one element of visual perceptual ability (spatial relationship awareness) predicted performance on the pre‐test. The only factor to predict performance on the post‐test was performance on the pre‐test. Similarly, the microscopy examination score was predicted by the pre‐test score, in addition to the histology and cell biology grade. The course examination score was predicted by two personality factors (Conscientiousness and lack of Openness) and the histology and cell biology grade. Conclusions Visual spatial ability may be related to performance in the initial phase of training in microscopic pathology. However, from a practical point of view, medical students are able to learn basic microscopic pathology using worked‐out examples, independently of measures of personality or visual perceptual ability. This finding should reassure students about their abilities to improve with training independently of their scores on tests on basic abilities and personality.     

The Use of Standardized Assessments in Occupational Therapy in the United States

ABSTRACT

The purpose of this study was to investigate the use of standardized assessments in occupational therapy practice. Five-thousand surveys were mailed to recipients of ADVANCE for OT who indicated their primary role to be a “clinician.” With a response rate of 16%, 794 responses were analyzed. Results include occupational therapists in a pediatric practice setting reporting using standardized assessments more frequently to determine eligibility of services than do adult setting practitioners. Respondents also perceived they have the highest knowledge or skill level in their ability to communicate the results of standardized assessments to their clients and other health professionals, but lacked knowledge or skill level in knowing the difference between criterion and norm-referenced measures. Implications for practice, research, as well as academic and continuing professional education are discussed.     

The Impact of Occupational Therapy on a Child's Playfulness

The constant changing health care system has made it imperative for occupational therapists (OTs) to examine the effectiveness of treatment interventions with children. Few studies exist examining play as the desired outcome of the intervention. Previous studies in occupational therapy (OT) have focused on the motor aspects of play in children (Anderson, Hinojosa & Strauch, 1987; Florey, 1981; Morrison, Bundy, & Fisher, 1991). In these studies, the researchers hypothesize that improving motor skills will improve play skills in children.

OTs frequently evaluate play using the Preschool Play Scale (PPS) (Bledsoe & Shephard, 1982; Knox, 1997) which provides a developmental age for play skills. Therapists also use developmental assessments designed to examine the skills used during play (Bundy, 1991). Skills used in play are important but fail to look at a child's approach or attitude during play. A child's approach to activities of play is termed “playfulness” (Bundy, 1997). The Test of Playfulness (TOP) (Bundy, 1997) was developed to measure this construct. The TOP provides information that can assist therapists working with children in designing measurable playfulness goals.

This study examined the playfulness of four children who received OT intervention specifically designed to improve play behaviors in comparison to four children who did not receive this intervention. The results provide therapists with information and insight for treating children with play deficits. This information will help therapists design effective treatment to increase playfulness in children.     

Perceptual,motor and cognitive performance components of Bedouin children in Israel

The purpose of this study was to evaluate the perceptual, motor and cognitive performance abilities of Bedouin children as compared with mainstream Israeli children of the same age. The study population comprised two age groups (6–8 year olds and 10–12 year olds) living in two different types of settlements (rural and town). Participants included 20 children in each group. The Test of Visual‐Perceptual Skills (TVPS), the Developmental Test of Visual‐Motor Integration (VMI), selected subtests from the Bruininks‐Oseretsky Test of Motor Proficiency and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were used. Older participants in all three groups performed better than the younger subjects. There were no significant differences between the two Bedouin groups in either age category. The mainstream Israeli subjects scored significantly higher than the two Bedouin groups on most variables tested. The lack of differences between the two Bedouin groups may indicate that the transition from nomadic communities to urban communities is mainly external and has not caused a significant change in perception, perceptual‐motor and cognitive performance abilities. The results of this study may be used as a base for developing preventive intervention programmes to meet the specific needs of Bedouin children. A limitation of this study was the classification of the Bedouin population according to their dwelling place and not according to their sociodemographic background, such as parents' economic status, parents' education and so on. Recommendations for future research include expanding the number of participants, including children from additional rural schools of various distant tribes and incorporating more detailed cognitive assessments. Copyright © 2000 Whurr Publishers Ltd.     

Occupational therapy practice with children with perceptual motor dysfunction: Findings of a literature review and survey

The aim of this study was to determine the current assessment and management practices of occupational therapists working with children with perceptual motor dysfunction. Current practices were identified through a review of literature and a survey of occupational therapists in Sydney, New South Wales, and the surrounding area. It was found that standardized and non-standardized assessments are used by the respondents, and intervention is planned according to children's individual needs. Also, a variety of management practices are used with sensory integration being the predominant approach. Traditional research methods cannot be easily applied to these individualized occupational therapy programmes; either alternative methodologies need to be developed or homogeneous subgroups of children identified for investigation.     

Factors Associated with Comfort Level of School-Based Occupational Therapists in Providing Low-Vision Services

This study identified factors associated with the comfort level of school-based occupational therapists in providing services to children with visual impairments. Sixty-one school-based occupational therapists completed an on-line survey. Fifty-four percent of respondents were comfortable or somewhat comfortable when choosing assessments and 84% were comfortable or somewhat comfortable in providing occupational therapy services for children with visual impairments. Multivariable linear regression analyses indicated years of professional experience, history of a caseload of children with visual impairments, and training received in treating children with visual impairments from continuing education were uniquely and significantly associated with the respondents’ comfort level. Though not included in the final model, collaboration with other low vision service providers (e.g., teachers, optometrists, ophthalmologists, and orientation/mobility specialists) was also significantly associated with respondents’ comfort level in the univariate analysis. Findings provide an initial direction and strategies to improve occupational therapists’ comfort level in providing services to children with visual impairments in school settings.     

The measurement properties of the Occupational Circumstances Interview and Rating Scale - Sweden (OCAIRS-S V2)

Abstract

Aim: This paper reports the measurement properties of the Occupational Circumstances Assessment Interview and Rating Scale - Sweden (OCAIRS-S V2). The OCAIRS is a semi-structured interview and rating scale designed to capture, in detail, a person's occupational participation. The English version 4.0 has been translated into Swedish. The psychometric properties of the Swedish version are unknown. Methods: Eleven Swedish occupational therapists working in mental health completed 38 OCAIRS-S (V2) assessments in addition to linking videotapes. A total of 60 clients were, therefore, entered into the analysis. Many-faceted Rasch analysis was used to analyse the data. Results and conclusions: Results supported internal, construct, and person response validity of the OCAIRS-S (V2). Inter-rater reliability was established. The scale was shown to discriminate between people who were living in the community. In addition, the results indicate a need to explore the skill items.     

Development of a standardized occupational therapy screening tool for visual perception in adults

Occupational therapy assessment and treatment of visual perceptual impairments are integral to the rehabilitation of clients following stroke and other acquired brain injuries. Occupational therapists need to identify the nature of visual perceptual performance impairments in order to choose rehabilitation intervention strategies appropriate for remediation of specific problems or to compensate for limitations in daily function. This paper describes the variations in visual perception terminology and occupational therapy approaches to visual perceptual assessment. Limitations of existing assessment tools for visual perception are highlighted in terms of reliability, validity, normative information, length of time to administer, and comprehensiveness in screening for visual perceptual impairment. In response to these limitations, a battery of items, called the Occupational Therapy Adult Perceptual Screening Test (OT-APST) was selected to screen adults comprehensively for impairments of agnosia, visuospatial skills including body scheme and neglect, constructional skills, apraxia, and acalculia. It also includes a subtest to evaluate functional skills directly observed during screening. This new battery has established reliability, validity and age-stratified normative data for adults 16 to 97 years of age. The OT-APST is recommended for use in conjunction with observational assessment of activities of daily living for clients with stroke and acquired brain injury.     

Development of a standardized occupational therapy screening tool for visual perception in adults

Occupational therapy assessment and treatment of visual perceptual impairments are integral to the rehabilitation of clients following stroke and other acquired brain injuries. Occupational therapists need to identify the nature of visual perceptual performance impairments in order to choose rehabilitation intervention strategies appropriate for remediation of specific problems or to compensate for limitations in daily function. This paper describes the variations in visual perception terminology and occupational therapy approaches to visual perceptual assessment. Limitations of existing assessment tools for visual perception are highlighted in terms of reliability, validity, normative information, length of time to administer, and comprehensiveness in screening for visual perceptual impairment. In response to these limitations, a battery of items, called the Occupational Therapy Adult Perceptual Screening Test (OT-APST) was selected to screen adults comprehensively for impairments of agnosia, visuospatial skills including body scheme and neglect, constructional skills, apraxia, and acalculia. It also includes a subtest to evaluate functional skills directly observed during screening. This new battery has established reliability, validity and age-stratified normative data for adults 16 to 97 years of age. The OT-APST is recommended for use in conjunction with observational assessment of activities of daily living for clients with stroke and acquired brain injury.     

Reading Difficulties and Optometry — A Review

Changing trends in the field of learning disabilities compel occupational therapists to keep up with trends and new approaches and to be able to view these objectively and scientifically. In this perspective, it is timely that the practice of optometry with learning disabled children is reviewed, as many occupational therapists refer children to optometrists for further assessment or to compliment their own treatment regimes. A review of the literature highlights definitional problems and conflicting findings. Although there is some support for the efficacy of optometric therapy, much of the published literature lacks an empirical scientific basis. It seems that vision training programmes are useful with some children, however visual or perceptual training techniques are not applicable to all types of reading difficulties.     

A comparison of Canadian and Australian paediatric occupational therapists

Paediatric occupational therapists were surveyed regarding their practices in Canada and Australia. Two hundred and eighty-nine Canadian occupational therapists and 330 Australian occupational therapists participated representing response rates of 28.9% and 55% respectively. The majority of respondents were female (98%), between 30 and 49 years of age (69%), had a bachelor's degree, worked on average 10.5 years in paediatrics and spent well over 50% of their work time in direct client care. The largest client diagnostic groups in both countries were those with developmental delays, learning disabilities and neurological disorders. Diagnostic groups were used as an organizing framework to portray theory, assessment and intervention use. Overall, the theoretical models cited most frequently in both countries were: Sensory Integration, Sensory Processing/Sensory Diet, Client-Centred Practice, and Occupational Performance Model. Australian therapists employed the Occupational Performance Model (Australia) for all groups, while it was rarely utilized in Canada. Common assessment tools in both Australia and Canada were the Peabody Developmental Motor Scales, Developmental Test of Visual Motor Integration, and the Bruininks-Oseretsky Test of Motor Proficiency. Intervention methods focused on: parental/care-giver education; activities of daily living/self-care skills training; client education; environmental modification; assistive devices; sensory integration techniques; sensory stimulation and sensory diet treatment methods; and neurodevelopmental techniques.     

Occupational therapists as expert witnesses on work capacity

Aim: The aim of this study was to explore the particular challenges for occupational therapists during their cross‐examination as an expert witness on work capacity. Methods: Grounded theory methodology was used to collect and analyse data. Interviews were conducted with 31 participants with direct experience of occupational therapy work capacity assessments. Of these, 19 were occupational therapists, six were medical specialists and six were lawyers. Results: All participant groups perceived that maintaining one’s credibility in the witness box was of paramount importance. The occupational therapists identified 11 strategies that barristers may use to challenge their credibility as an expert witness. Conclusions: The three professional groups proposed practices that maintain occupational therapists’ credibility as expert witnesses on the work capacity of personal injury claimants.     

Occupational therapy assessments used in acute physical care settings

Abstract

Objective: The aim of this study was to identify the assessments used by occupational therapists in acute care practice, their purpose, and the role of home visits and standardized tests. Methods: A cross-sectional survey containing closed and open questions was sent to therapists working in physical acute care settings using convenience sampling. This article reports on the responses of 70 New Zealand occupational therapists (response rate = 74%). Results: The study found that informal assessments (i.e. interviews and observations) were commonly used to evaluate daily living skills and to provide information about the home environment, cognition, transferring, leisure, and upper limb function. When situations were particularly complex, cognitive assessments and home visits were used judiciously to further investigate assumptions related to safety in discharge procedures. Standardized assessments were not widely used but were typically considered when cognitive ability needed to be confirmed. Conclusions: Occupational therapists' expertise lies in interviewing clients and in skilled observations of function. Standardized ADL assessments could complement occupational therapy practice but further research is needed to determine their value. In the final analysis, assessments should ensure that that both safety and client/carer concerns are at the centre of decision-making.     

Novice occupational therapists' perceptions of readiness to undertake fieldwork supervision

Aim: This study investigated new graduate occupational therapists’ perceived readiness for the fieldwork supervisor role at a metropolitan Melbourne Hospital. Methods: Data from four in‐depth individual interviews and a focus group conducted with seven Grade 1 occupational therapists were analysed thematically. An iterative process was used to develop themes from the categories of data. Results: The new graduate occupational therapists’ perceived readiness for supervising students was strongly influenced by a sense of still learning themselves. High expectations were expressed of the supervisory role. Active support and supervision from the workplace and the university are seen as neccessary. Conclusions: A deeper understanding of the supervisory role and associated skills required for new graduate therapists is needed. Support from senior colleagues and workshops conducted by the university to up‐skill the therapists are recommended.     

Occupational therapy with people with depression: Using nominal group technique to collate clinician opinion

Aims. This aim of this study was to obtain a consensus from clinicians regarding occupational therapy for people with depression, for the assessments and practices they use that are not currently supported by research evidence directly related to functional performance. The study also aimed to discover how many of these assessments and practices were currently supported by research evidence. Methods. Following a previously reported systematic review of assessments and practices used in occupational therapy for people with depression, a modified nominal group technique was used to discover which assessments and practices occupational therapists currently utilize. Three online surveys gathered initial data on therapeutic options (survey 1), which were then ranked (survey 2) and re-ranked (survey 3) to gain the final consensus. Twelve therapists completed the first survey, whilst 10 clinicians completed both the second and third surveys. Major findings. Only 30% of the assessments and practices identified by the clinicians were supported by research evidence. A consensus was obtained on a total of 35 other assessments and interventions. These included both occupational-therapy-specific and generic assessments and interventions. Principle conclusion. Very few of the assessments and interventions identified were supported by research evidence directly related to functional performance. While a large number of options were generated, the majority of these were not occupational therapy specific.     

Evaluating a school skills programme for Australian indigenous children: A pilot study

The purpose of this study was to evaluate the effectiveness of an occupational therapy skill development programme in improving handwriting, scissor use, visual motor co-ordination and classroom behaviour, in a group of grade-one Australian urban Indigenous students. The sample (N = 13) was randomly assigned to an experimental group or comparison group. Both groups were exposed to the intervention. The experimental group received a six week school skills programme in addition to regular schooling, while the comparison group received regular schooling only. Following this, the comparison group received the same six week programme. Participants underwent pre- and post-testing using Beery-Buktenica's Developmental Test of Visual Motor Integration, Conner's Abbreviated Symptom Questionnaire, and two non-standardized handwriting and scissor skill measures. Results indicated that participants significantly improved in aspects of handwriting, scissor skills, and behaviour, but not visual motor co-ordination, following participation in the programme. The experimental group demonstrated greater improvements only in handwriting ability scores (p = 0.037), compared to a comparison group. It was concluded that a school-based occupational therapy programme was effective in improving handwriting, in a group of grade-one Australian Indigenous children.