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The Occupational Therapy Adult Perceptual screening Test (OT-APST) was developed by Dieter M. Cooke in 1993 and was revised in 2001. The PT-APST is a standardized screening measure with 25 items in 7 subtest areas examining visual perceptual deficits. Subtest areas include Agnosia, visuospatial (body scheme and unilateral neglect), constructional skills, apraxia, acalculia, and functional skills.  Behavioral observations and information processing are also observed. The assessment requires approximately 20-25 minutes to complete and includes normative data for adults 16-97 years.
(Cooke, N.D.)

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Cost:

Kit: $659.64 includes 25 Assessment forms (including        shipping)

Additional Forms: $67.04 (including shipping)

Functionforlife.com.au

Strengths:

Normative data established for a wide range of individuals, 16-97 years.

Brief assessment, 20-25 minutes

Inter-rater, intra-rater, and test-retest reliability

Tests functional skills for establishing level of independence

Provides adaptive instruction for those unable to utilize upper extremities

Weaknesses:

Not suitable for individuals with severe auditory comprehension problems.

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

Not suitable for individuals whose attention capacity limits engagement for the time required to complete the assessment.

Not suitable for individuals with receptive language problems, however, alternative methods of test administration are included for clients with expressive language challenges.

Has not been formally translated or validated in other languages

(Zeltzer, 2005).

Target Population: Clients 16-97 years with dx such as stroke

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Agnosia Subtest

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0:00 / 3:29•Watch full video

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Background:
Linda is a 65-year-old female who has recently experienced a  brain bleed and required burr holes during her time in the acute care setting. She has recently been transferred to an inpatient rehabilitation facility. Linda presents with difficulties with visual perception such as unilateral neglect. During her initial OT evaluation, the OT-APST was performed.

OT-APST Scores:

Agnosia

Colour naming….6/6

Object name (stapler)....1/1

Figure-ground….2/5

Shape constancy….6/10

Reading (alexia)....2/4

Total: 20/26, impaired

Visuospatial Relations
Body Scheme

Body parts self…7/8

Body parts therapist…3/4

Left/Right on self….2/4

Directions/position….3/6

Total: 15/22, impaired

Unilateral Neglect

Clock…1/3

House…2/4

Hand writing…1/1

Reading…3/4

Telling the time…0/1

Total: 7/13, impaired

Constructional Skills

Graphic construction

-Clock…1/3

-House…2/4

2 dimensional construction…20/26

3 dimensional construction…15/20

Total: 39/53, impaired

Functional Skills

Reading…2/4

Writing…1/1

Calculations…4/4

Telling the time…0/1

Stapler hold and use to command 0/1

Total: 7/11, impaired

Praxis

Facial gesture

-Smile command…1/1

-Smile copy…1/1

Wave right hand

-To command…1/1

-To copy…1/1

Wave left hand

-To command…1/1

-To copy…1/1

Stapler manipulation

-Hold and use to command…0/1

-Hold and use to copy…0/1

Pen use for writing…1/1

Handwriting…1/1

Total: 8/10, intact

Acalculia

Calculations…4/4

Total: 4/4, intact

Intervention Strategies:
1. Encourage use of the affected side
-use affected side as much as possible during ADLs, can use HOH guiding

2. Anchoring
-provide visual cues such as a bright post-it note or tape and have the client scan to the affected side (also known as "lighthouse strategy"

3. Visual scanning activities
-word finds, letter cancellation worksheets, seek and finds

4. Mirror therapy
-use a mirror while performing ADLs to provide visual feedback

5. Eye patch/partial visual occlusion
-trains the patient to use the affected side while covering up the unaffected side

(Stromsdorfer, 2020)

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Cooke, D. (N.D.) Occupational Therapy Adult Perceptual Screening Test (OT-APST). Function for Life PTY LTD. https://www.functionforlife.com.au

Cooke, D. M., McKenna, K., Fleming, J., & Darnell, R. (2006). Construct and ecological validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST). Scandinavian journal of occupational therapy, 13(1), 49–61. https://doi.org/10.1080/11038120500363014

Cooke, D. M., McKenna, K., Fleming, J., & Darnell, R. (2006). Criterion validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST). Scandinavian journal of occupational therapy, 13(1), 38–48. https://doi.org/10.1080/11038120500363006

Cooke, D. M., McKenna, K., Fleming, J., & Darnell, R. (2005). The Reliability of the Occupational Therapy Adult Perceptual Screening Test (OT-APST). British Journal of Occupational Therapy, 68(11), 509–517. https://doi.org/10.1177/030802260506801105

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

Razemba, Fadzai, Jacobs, Lizelle, & Franzsen, Denise. (2017). Convergent validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST) with two other cognitive-perceptual tools in a South African context. South African Journal of Occupational Therapy, 47(2), 3-10. https://dx.doi.org/10.17159/2310-3833/2017/v47n2a2

Stromsdorfer, S. (2020, June 10). Start using these 5 easy interventions for unilateral neglect. myotspot.com. https://www.myotspot.com/interventions-unilateral-neglect/

Zeltzer, L. (2008). Occupational Therapy Adult Perceptual Screening Test (OT-APST). Stroke Engine. https://strokengine.ca/en/assessments/occupational-therapy-adult-perceptual-screening-test-ot-apst/

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The OT-APST was found to have adequate to excellent levels of internal consistency, intra-rater and inter-rater reliability, and excellent test-retest reliability. Concurrent validity and convergent validity were both found to have poor to excellent correlations (Zeltzer, 2008).

An article by Cooke, McKenna, Fleming, and Darnell (2005), found that the OT-APST was found to have good interrater, interrater, and test-retest reliability and was determined by the researchers to be a reliable screening tool.

Cooke, McKenna, Fleming and Darnell conducted a study on 208 people following a stroke and concluded that the OT-APST demonstrated concurrent criterion validity for the assessment of visual perception and is an ecologically valid tool (Cooke et al., 2006).

One study in South Africa compared the OT-APST to two other screening instruments commonly used in South Africa, the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the Rivermead Perceptual Assessment Battery (RPAB). These tools evaluate similar constructs such as visual agnosia, body scheme, unilateral neglect and constructional skills but are too lengthy to use as screening tools and found the OT-APST to have a shorter administration time and functional components (Razemba et al., 2017).

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Scoring:
Scores for items subtest areas are added for interpretation of patterns and to compare with normative data, but not to produce a total score (Zeltzer, 2008).

Example:
Subtest Total Score for Agnosias =23
Sum of item scores:
Color Agnosia-5
Object Agnosia- 1
Figure ground 5
Shape constancy- 9
Reading-alexia 3
=23 of 26 possible
Continue for each subtest.

Cut off scores indicative of impairment:
Age 16-74  ≤24 Example client demonstrates impairment in the area of agnosia if 16-74 years.

Age 75-97 Agnosia ≤22, Example client does not demonstrate impairment in the area of agnosia if 75-97 years.