CHAPTER 101: OCCUPATIONAL THERAPY ADULT PERCEPTUAL SCREENING TEST (OT-APST)
Description
The Occupational Therapy Adult Perceptual Screening Test (OT-APST), developed by Cooke (1992) and further revised in 2001, was created to quantify visual perceptual acuity which is considered the dynamic process of receiving and perceiving the environment through the senses. The measure has proved to be valid in a number of patient populations because disorders of visual perception can occur as a result of acquired brain injury, stroke, or disease often resulting in difficulties organizing, processing, and interpreting information perceived and acting appropriately on that information (Cooke, McKenna, & Fleming, 2005). The OT-APST is an amalgamation of several previously published tests in an inclusive battery format that measures functional skill level in areas commonly impacted by visual perceptual impairment and has 25 items across 7 domains. An example item of the assessment is shape constancy, where the subject must identify 4 common shapes in a mixed array of 10 shapes of varying sizes, positioned at differing angles (Cooke, McKenna, & Flemming, 2005). The design of the OT-APST requires test completion using only simple cueing and all of the test items are administered and scored according to standardized format. Achieving a score inside of normal limits is considered to be within two standard deviations of the norm, thus the OT-APST is not intended to gauge the upper limits of functioning (Cooke, McKenna, & Flemming, 2005). The OT-APST can be completed in less than 30 minutes, where only the subtest scores are used to interpret results. However, the authors suggest that the battery be completed in its entirety to maintain a reliable and valid interpretation of its results (Cooke, McKenna, & Flemming, 2005).
TABLE 101-1
DOMAINS OF THE OCCUPATIONAL THERAPY ADULT PERCEPTUAL SCREENING TEST
| DOMAIN | DESCRIPTION |
| Agnosia | Inability to recognize and classify objects shapes, people, words, and colors |
| Visuospatial relations | Ability to relate oneself to the position, direction, or movement of objects, or direction of points in space, including unilateral neglect |
| Body schema | Body awareness |
| Visuoconstructional skills | Ability to organize a number of parts into a whole, including two three-dimensional building and assembly tasks |
| Apraxia | Inability to perform learned and skilled purposeful movements in the absence of loss of motor power, sensation, coordination, or language comprehension problems |
| Acalculia | Difficulty calculating arithmetic problems as a result of confusion in understanding the relative position of numbers and the meaning of mathematical symbols |
| Functional skills | Reading, writing, ability to complete simple mathematical calculations, tell the time, and use a stapler |
Adapted from Cooke, D., McKenna, K., & Fleming, J. (2005). Development of a standardized occupational therapy screening tool for visual perception in adults. Scandinavian Journal of Occupational Therapy, 12, 66.
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