OT-APST

OT-APST Demonstration

Demonstration 1: http://www.facebook.com/#!/photo.php?v=653086311385162&set=vb.100000513979295&type=3&theater

Demonstration 2:

http://www.facebook.com/video/video.php?v=653086311385162&notif_t=video_processed#!/photo.php?v=653089044718222&set=vb.100000513979295&type=3&theater

Elements of the OT-APST

House Puzzle Item:

•As indicated in the first video demonstration the therapist asked the client to "copy the picture exactly the same as you see here (pointing to the picture of the house) using these puzzle pieces (pointing to the puzzle pieces)."

•The essential elements of the house are two walls, floor, ceiling, roof, door, chimney, smoke, and the two windows.

House Scoring:

•4: all essential elements placed with perfect or near perfect placement.

•3: four or five essential elements correctly placed

•2: 3 essential; elements correctly placed

•1: 2 or 3 essential elements correctly placed

•0: gross distortion, 1 or no essential elements correctly placed

Block Construction Item:

•There are six 3 cm blue cubes, the oblong block, long cylinder, red cylinder and rectangular baseboard.

•As indicated in the second video demonstration the therapist asked the client to "build this (indicate the model), out of these blocks (indicate blocks), on this board (indicate board). Make it exactly as you see it here."

•If the client changes the orientation of the board the therapist must say "keep the model in the same position to build your model."

•Then if the client starts to build the model on the table and not on the board ask them to "build all of your pieces on the board."

Block Construction Scoring:

• Cubes 1 point, oblong block 1 point, long cylinder 1 point, red cylinder 1 point, overall orientation on the board 1 point.

References

The OT-APST has various items across multiple sub-test areas. These sub-test areas and items include:

• Agnosia - sheet with different blocks of colour, a stapler, overlapping images sheet, assorted shapes, written passage

• Visuospatial Relations - house diagram, coloured blocks, clock drawing, body parts

• Constructional skills - blocks presented in a 2D diagram, house diagram

• Apraxia - stapler, pen

• Acalculia - mathematical calculations

• Functional Skills - stapler, mathematical calculations, clock

Several of the items contribute to assessment of more than

one area and are only performed once.

Brain areas engaged in the OT-APST during a construction task

Client Suitability

• Visual information: The visual stimuli of the constructional item is to be processed initially to be understood for it purpose and function. Involves the later geniculate, superior colliculi, primary visual cortex and occipital lobe.

• Cognition: Allows us to plan and organise motor actions and coordinate movements as well as register memory pathways. An array of steps need to occur to complete the construction of the 3D building. Involves the temporal lobe, parietal lobe, frontal lobe.

• Attention and memory: To recall past experiences of building and the motor planning steps that should be made in order to complete the construction and also to sustain attention. Involves hippocampus, mammilary bodies, thalamus and the frontal lobe.

• Spatial awareness: The knowledge of the location of the construction item, as well as where body is in relation to this. Involves the dorsal pathway to the posterior parietal lobe.

• Motor planning and sequencing: Generation of commands to move items for the construction and place the blocks into place. Involves the primary motor cortex and pre-motor cortex areas.

• Completion of the OT-APST requires adequate comprehension of simple verbal instructions.
• Not suitable for individuals:

- With severe auditory comprehension problems.

- Not suitable for individuals who are unable to use either hand for task completion.

- Whose level of arousal or attentional capacity precludes participation for the necessary time required for task completion.

- With receptive language problems, however, alternative methods of test administration are included for clients with expressive language problems.

The purpose of the OT-APST

• Designed to screen adults comprehensively for impairments of agnosia, visuospatial skills including body scheme and neglect, constructional skills, apraxia and acalculia that may occur as a result of acquired brain injury.

• Disorders may result in difficulties organizing, processing, and interpreting information perceived visually, and acting appropriately on the basis of this information.

Why Occupational Therapists use this screening tool

• Visual perceptual impairments are related to reduced independence and safety in self-care activities and community living tasks, and subsequently affect rehabilitation prognosis and discharge options

• Occupational therapists need to be able to identify the nature of visual perceptual performance impairments

Normative Data for the OT-APST

Cooke, D, M. Administration Manual, 2005, Brisbane: Function for Life Pty Ltd.

Cooke, D. M., McKenna, K., & Fleming, J. (2005). Development of a standardized occupational therapy screening tool for visual perception in adults. Scandinavian Journal Of Occupational Therapy, 12(2), 59-71. doi:10.1080/11038120410020683

Cooke, D. M., McKenna, K., Fleming, J., & Darnell, R. (2006). Australian normative data for the Occupational Therapy Adult Perceptual Screening Test. Australian Occupational Therapy Journal, 53, 325-336.

Grieve, J., & Gnanasekaran, L. (2008). Neuropsychology for occupational therapists: cognition in occupational performance. Oxford: Blackwell Publishing.

Russell, C., Deidda, C., Malhotra, P., Crinion, J., Merola, S., & Husain, M. (2010) A deficit of spatial remapping in constructional apraxia after right-hemisphere stroke. A Journal of Neurology, 133 (4), 1239-1251.

Stroke Engine. (2013). Stroke engine assess. Retrieved May 11, 2013, from http://strokengine.ca/assess/

Demonstration 1: http://www.facebook.com/#!/photo.php?v=653086311385162&set=vb.100000513979295&type=3&theater

Demonstration 2: http://www.facebook.com/video/video.php?v=653086311385162&notif_t=video_processed#!/photo.php?v=653089044718222&set=vb.100000513979295&type=3&theater

• The healthy normative group included 356 people living in Brisbane in the community (77%) and a retirement village (13%) and aged care hostels (10%). There were an equal number of males and females in the study.

•The two age groups for normative data presentation are 16-74 years and 75-97 years.

• Neither gender nor highest level of education significantly impacted on OT-APST performance in the healthy normative group. Increasing age significantly correlated with reduced performance on all OT-APST subscales except for body scheme.

• Based on the clients scoring of the assessment they will either be above or below the cut-off levels. If they are below these levels, this will indicate impaired performance.

The

OT-APST

Occupational Therapy Adult

Perceptual Screening Test

Alannah Santomartino, Kim Inglis and Lexie Martin