Assessment of Performance Skills/Client Factors: Vision, Visual Perception & Cognition

Question 1

Executive Function Performance Test Assessment (EFPTA)

Answer 1

Client performs 4 IADL activities with graded cues.
- Level of independence recorded & categorized into 5 executive function constructs: initiation, organization, sequencing, judgment & safety, & completion

Question 2

Performance Assessment of Self-Care Skills (PASS)

Answer 2

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

Question 3

Co-Op - Cognitive Orientation to Daily Occupational Performance

Answer 3

• 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

Question 4

Co-Op - Goals

Answer 4

• Skill acquisition
• Cognitive strategy use
• Generalization of learning
• Transfer of learning

Question 5

Co-Op - Theories

Answer 5

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

Question 6

Co-Op: Performance

Answer 6

• Right fit (person, environment, occupation)
• Environmental supports/barriers
• Identify performance problems & possibly strategies
• Therapist needs a baseline knowledge of the performance skill

Question 7

Co-Op: Domain-Specific Strategies

Answer 7

Body position
Attention to task
Task specification/modification
Supplementing task knowledge
Feeling movement
Verbal mnemonic
Verbal script
Mental imagery
Relaxation techniques

Question 8

Complex Task Performance Assessment

Answer 8

Work-Simulation-Library
Primary task
- Inventory control
Secondary task
- Phone messages
Delayed intentions
- Tell time
- Give the examiner a message

Question 9

Mini-Mental State Examination (MMSE)

Answer 9

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

Question 10

Lowenstein Occupational Therapy Cognitive Assessment (LOTCA)

Answer 10

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

Question 11

Cognitive Assessment of Minnesota (CAM)

Answer 11

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

Question 12

The Montreal Cognitive Assessment (MoCA)

Answer 12

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

Question 13

St. Louis University Mental Status Exam (SLUMS)

Answer 13

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

Question 14

Activity Card Sort

Answer 14

Flexible
Measure of occupation
Help clients describe IADL, leisure activity, and social activities
Assists in building routines of meaningful and healthy activities for clients

Question 15

Cognitive Performance Test (CPT)

Answer 15

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

Question 16

Weekly Calendar Planning Activity (WCPA)

Answer 16

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

Question 17

Snellen Eye Chart

Answer 17

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

Question 18

Eye alignment screening

Answer 18

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.

Question 19

Convergence

Answer 19

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

Question 20

Accommodation

Answer 20

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

Question 21

Visual tracking (smooth pursuits)

Answer 21

Eye movements that maintain continued fixation on a moving target; if smooth pursuits are impaired, acuity is impaired when motion is involved.

Question 22

Saccades

Answer 22

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).

Question 23

Visual field testing

Answer 23

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

Question 24

The Motor-Free Visual Perception Test (MVPT)

Answer 24

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

Question 25

The Brain Injury Visual Assessment Battery for Adults (BiVABA)

Answer 25

Guided by 4 principles emphasizing the significance of functional performance to testing, interpretation and treatment planning.
Tests visual foundation skills, visual attention with scanning
Rather than norms, offers test interpretation guidelines.
Suggests modifying test administration to determine nature of problem and strengths.
Based on Contemporary Perspective (dynamic, functional, contextual)