Lower levels

Pain and temperature are mediated at ________ of

the brain. (neurological injury)

Play audio for this term

Higher levels
Fine touch and proprioception are mediated at
___________ of the brain.(neurological injury)

Play audio for this term

Pain & temperature
If fine touch and proprioception are present, ______
& _______ will be intact. (neurological injury)

Play audio for this term

Be in tact
If fine touch and proprioception are present, pain &
temperature will ____________.

Play audio for this term

fine touch & proprioception
If pain and temperature are absent, ________&
_______ will also be absent.

Pain & temperature
In persons with severe cortical impairments, test
___________&_________ first.

Pain & temperature
In sensory recovery, what two senses tend to recover
first?

Damage to Anterior spinal cord
Results in loss of pain and temperature below the level
of the lesion, but touch, vibration & proprioception
remain intact.

Damage to Posterior spinal cord
Results in loss of light touch and vibration, but can feel
temperature and painful stimuli.

Damage to one side of the spinal cord (AKA: Brown-
Sequard syndrome)
Results in loss of touch, vibration, and propriocation
on the side of the lesion and loss of temperature and
pain on the opposite side of the lesion.

Damage to central spinal cord
Results in bilateral loss of pain and temperature below
the level of the lesion

The first year
Any sensory recover of the spinal cord after damage
occurs within _______.

6 months
The greatest amount of sensory recovery after SCI
occurs within ________.

On the same side of the lesion
Damage to one side of the spinal cord results in loss of
touch, vibration, and proprioception (where)?

On the opposite side of the lesion.
Damage to one side of the spinal cord results in loss of
temperature and pain (where)?

fine touch & proprioception
The senses most affected for someone with CVA or TBI
are __________.

Temperature
The next most affected sense for someone with CVA or
TBI is __________.

Pain
The least affected sense for someone with CVA or TBI
is __________.

For suspected median nerve injury
Test thumb tip, index tip, index proximal phalanx
(using peripheral nerve distribution).

For suspected ulnar nerve injury
Test distal and proximal little finger, proximal ulnar
palm (using peripheral nerve distribution).

For suspected radial nerve injury
Test thumb web space (using peripheral nerve
distribution).

1st
Object recognition using feature detection strategies is
the ______ stage of sensory reeducation program for
PNIs:

2nd
Refined grasp and pinch of objects is the _____ stage
of sensory reeducation program for PNIs.

3rd
Control of force while holding objects is the _____
stage of sensory reeducation program for PNIs.

4th and final
Object manipulation is the _______ stage of sensory
reeducation program for PNIs

COPD AKA
Chronic Obstructive Pulmonary Disease (COPD)

COPD - Define
damage to the alveolar walls and inflammation of the
conducting airways resulting in constriction and
inflammation of the airways and more mucus
production than usual.

COPD onset
gradual with dyspnea on exertion progressing to
dyspnea at rest

Leading cause of COPD
cigarette smoking

Signs and Symptoms of COPD
1. dyspnea
2. fatigue
3. chronic cough
4. chest tightness
5. sputum production

Ways to measure lung function?
Pulse Oximeter and Spirometer

Pulse Oximeter define
place on fingertip and will report amount of oxygen in
blood. needs to be greater than 90%

Spirometer define
breath into the device very slowly and exhale normally
for 10 repetitions. A patient should have 1000 ml
volume for reasonable amount of air inhaled.

Pneumonia define
inflammation of the lungs

Main types of Pneumonia
1. bacterial
2. viral
3. mycoplasmal
4. aspiration pneumonia

Bacterial Pneumonia define
most often streptococcus bacteria

Viral Pneumonia define
virus

Mycoplasmal Pneumonia define
same as bacterial but a specific and unique species of
bacteria

Aspiration Pneumonia define
when client inhales food or liquid and it goes into the
lungs and becomes infected. often in stroke clients

Methods of transmission of Pneumonia
1.Inhalation
2.Direct contact- secretions
3.Indirect contact with articles

Signs and Symptoms of Pneumonia
1.chills
2.chest pain
3. cough with rust or green colored mucus
4.fever 105 deg.
5. confused
6.increased breathing
7.lips and nail beds look blue

OT treatment of Pneumonia
1. graded activities to improve endurance and strength
2. functional activities- ADLs/IADLs , gradually
increase level of activity.
3. patient education in energy conservation and
simplification techniques.

Tuberculosis define
infectious chronic disease caused by M. tuberculosis.

Methods of spreading TB
inhalation-coughing, sneezing, or talking.

Signs and Symptoms of TB
1. cough
2. hemoptysis (coughing up blood)
3.fever
4.weight loss

3 types of TB
1.Latent
2.Active
3.Extrapulmonary

Latent define
90-95% of the population have a latent infection,
where the bacteria remains dormant and the person
does not develop symptoms.

Active
5-10 % of the population move into the symptoms and
the active stage, where the symptoms and the ability to
spread the disease occur

Extrapulmonary
TB that settles in the bone or organ in the body

Treatment of TB
medication consists of chemotherapeutic agents, which
are administered daily and then three times a week.
under direct observation for 6 months.

TB skin test
1. test to verify previous exposure
2. health-care workers must have the test once a year.
3.antigen injected under skin
4.if no raised area, test is negative
5.if raised area, sent to dr. for chest x-ray to verify if
your infected.
6. Further test include mucus, bone, and tissue

Protect yourself by using
personal protective equipment (PPE)

OT treatment of TB
1.graded activities to improve endurance and strength
2. functional activities such as ADLs and IADLs by
gradually increasing level of activity
3. Patient education in energy conservation and
simplification techniques

Coronary Artery disease (CAD) define
condition in which plaque builds up inside the
coronary arteries. these arteries supply your heart
muscle with oxygen-rich blood.

What is plaque in CAD
plaque is made up of fat, cholesterol, calcium, and
other substances found in the blood.

When plaque builds up in the arteries the condition
is called
atherosclerosis

Plaque causes problems
plaque narrows the arteries and reduces blood flow to
your heart muscle. It also makes it more likely that
blood clots will form in your arteries. Blood clots can
partially or completely block blood flow.

What does Angina or heart attack/ myocardial
infraction MI may cause
when your coronary arteries are narrowed or blocked,
oxygen-rich blood cant reach your heart muscle.

Angina define
chest pain or discomfort that occurs when not enough
oxygen-rich blood is flowing to an area of your heart
muscle.

Angina may feel like
pressure or squeezing in your chest. the pain also may
occur in your shoulders, arms, neck, jaw, or back.

Angina tends to get worse and better when
this pain gets worse with activity and goes away when
you rest. emotional stress also can trigger the pain.

Other names for Coronary Artery disease
1.atherosclerosis
2.coronary heart disease
3.hardening of the arteries
4.heart disease
5.ischemic heart disease
6.narrowing of the arteries

What causes Coronary artery disease?
research suggest that coronary artery disease (CAD)
starts when certain factors damage the inner layers of
the coronary arteries.

Coronary artery disease factors are
1.smoking
2.high amounts of fats and cholesterol in the blood
3.high blood pressure
4.high amounts of sugar in the blood due to insulin
resistance or diabetes

The most common type of heart disease is
Coronary artery disease (CAD)

The leading cause of death in the U.S. for both men
and women is what
Coronary artery disease (CAD)

Help prevent/ treat CAD by
1.life style changes
2.medicine
3.medical procedures

Arrhythmia define
problems with the speed or rhythm of your heartbeat.

Over time, CAD can weaken the heart muscle and
lead to
congestive heart failure and arrhythmias

Heart failure is when
your heart cant pump enough blood throughout your
body

You may notice with an arrhythmia that
your heart is skipping beats or beating too fast.

A fluttering feeling is called
palpitations

Arrhythmia may also cause
your to heart to suddenly stop beating

Sudden Cardiac Arrest (SCA) define
The heart stops beating. It can make you faint and
cause death if not treated right away.

Heart attack or a myocardial infraction (MI) define
when an area of plaque in a coronary artery breaks
apart, causing a blood clot to form. The blood clot cuts
off most or all blood to the part of the heart muscle
thats fed by the artery. Cells in the heart muscle die b/c
they dont receive enough oxygen-rich blood. This can
cause lasting damage to your heart.

Symptoms of a Heart attack
intense radiating chest pain or discomfort.
Chest pain- comes and goes in the center of chest.
Discomfort- pressure, squeezing, fullness, or pain.

Heart attack symptoms may also feel like
indigestion or heartburn

Other symptoms of a heart attack or cardiac distress
are
1. UE discomfort in one or both arms, back, neck, jaw,
or stomach.
2.Dyspnea, fatigue- may occur with or before
3.Nausea
4. lightheadedness
5.diaphoresis- cold sweat
6.cynanosis- turning blue
7.unable to conversate
8.heart palpitations
9.if blood pressure falls >20 mm Hg or HR >20bpm
over resting rate or Orthostatic Hypotension

Orthostatic Hypotension define
falling blood pressure

Heart attack treatment/surgery
Angioplasty
or 
Coronary Artery Bypass Graft (CABG)

Angioplasty define
balloon catheter guided through artery pushing plaque
against the arterial wall to open blockage. to keep
artery open, a wire mesh tube or a stent is implanted.

Coronary Artery Bypass Graft (CABG) define
Surgeon opens chest through sternum with saw and
spreads ribs to get to heart. Diseased sections of the
coronary arteries are bypassed with healthy blood
vessels from veins in the legs.

Sternal Precautions
No lifting, pushing, or pulling <10 lbs
Do not use arms to sit down, stand up, or push up from
side lying to sit
Use legs only to move wheel chair
Hold pillow to chest
Avoid activities that reach over head

Diuretics define
to reduce edema. cardiac medication

Vasodilators define
open arteries. cardiac medication

Anticoagulants define
thins blood to reduce clots. cardiac med.

Antiarrhythmics define
keep heart beating regularly. cardiac med.

Beta Blockers and calcium channel blockers define
lowers bp, manages angina, and controls CHF. cardiac
med.

Nitrates define
relaxes blood vessels, increases blood flow. cardiac
med.

Cholesterol lowering drugs define
lowers LDL (bad cholestrol) such as Statins. cardiac
med.

What OTA should know about cardiac meds
calcium channel blockers, nitrate, and diuretics can
cause client to have orthostatic hypertension. OTA
should watch closely with supine to sit and transfer or
any activities that require sudden postural changes.
Anticoagulants- coumadin or heparin can cause the
client to bleed easily. Dont let client cut themselves.

Side effects to report to nurse when treating patient
on meds
nausea, palpitations, vomiting, abdominal cramps,
arrhythmia. DOCUMENT

Cardiac rehab Acute phase define
1 to 3 days- stabilization of patients condition

Cardiac rehab phase 1 define
acute but stable- this includes:
vital signs after activity,
performing activities that decrease effects of prolonged
inactivity,
monitored low lvl physical activity and seflcare (MET
lvl),
reinforce safety precautions,
graded activity,
teach energy conservation,
guildlines for activity lvls at discharge

Cardiac rehab phase 2 define
outpatient (about 12wks) cont. everything in phase 1.
monitored HR and BP while increasing exercise

Cardiac rehab phase 3 define
community based exercise- cont. endurance training
and safety precautions and modifications. prepare to
return to work.

Cardiac rehab rates and tables to use are
Borg Rate of Perceived Exertion (RPE)- for client to
monitor self.
and
Metabolic Equivalent Table (MET)- for client to slowly
increase activity.
 Ot groups:
Evaluation group
enable client and therapist to asses client's skills,
assets, limitations regarding group interaction
Role of OT: select and orient clients to group purpose,
select activities that require collaboration and
interaction, OT not to intervene only observe

Thematic group
assist members in acquiring knowledge, skills, and/or
attitudes needed to perform a specific activity
Assumptions: improvement of ability to engage in
activity outside of group can result from teaching of
these activities within group; learning is facilitated by
practicing and experiencing needed behavior with
reinforcement of appropriate behaviors given

topical group
to discuss specific activities that members engage in
outside of group to enable them to engage in activities
in a more effective, need-satisfying manner
concurrent-concerned with activities already engaged
in outside of group
anticipatory-concerned with activity that is expected to
be done in future

task oriented group
to increase client's awareness of needs, values, ideas,
feelings, and behavior as they engage in a group task
improves intra and inter psychic functioning by
focusing on problems which emerge in the process of
choosing, planning, and implementing a group activity

Developmental group
a continuum of groups consisting of parallel, project,
egocentric cooperative, cooperative, and mature
groups. Purpose to teach and develop members' group
interaction skills

Parallel group
enable members to perform individual tasks in
presence of others
minimal interaction

project group
develop ability to perform shared, short term activities
with another member in a comfortable, cooperative
manner to enable members to give and seek assistance

egocentric cooperative group
enable members to select and implement long-range
activity which requires group interaction, enable
members to identify and meet needs of selves and
others (ex: safety and self esteem)

cooperative group
enable members to engage in group activity which
facilitates the free expression of ideas and feelings,
develop sense of trust, love, belonging, cohesion

mature group
enable members to assume all functional socio-
emotional and task roles within a group, enable
members to reinforce behaviors which result in need
satisfaction and task completion

Instrumental group
to help members function at their highest possible level
for as long as possible and meet mental health needs
assumes mental health members have reached highest
potential and have not made progress in tx
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Group Development: The stages groups typically go

from their initial beginnings to their termination.
ORIGIN PHASE
Leader composing the group protocol and planning
group.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
ORIENTATION PHASE
Members learning what the group is about.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
INTERMEDIATE PHASE
Members developing interpersonal bonds, group
norms, members roles.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
CONFLICT PHASE
Characterized by dissension and disagreement among
members.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
COHESION PHASE
Members regrouping after the conflict with a clearer
sense of purpose.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
MATURATION PHASE
Members use their energies and skills to be productive
and to achieve group's goals.

Group Development: The stages groups typically go
from their initial beginnings to their termination.
TERMINATION PHASE
Dissolution of the group due to lack of engagement of
members, inability to resolve conflict, administrative
constraints.

Group Roles: Instrumental
Help the group select, plan, and complete the group's
task (e.g., initiator, organizer)

Group Roles: Expressive
Support and maintain the overall group and to meet
members' needs (e.g., encourager, compromiser).

Group Roles: Individual
Dysfunctional and contrary to group roles (e.g.,
aggressor, blocker).

Group Norms
Standards of behaviors and attitudes that are
considered appropriate and acceptable to the group.
Norms can be explicit and clearly verbalized, or non-
explicit and not verbalized.

Group Goals
Desired outcomes of the group.

Group Communication
The process of giving, receiving, and interpreting
information through verbal and non verbal expression.

Group Cohesiveness
The degree to which members are committed to a
group and the extent of members' liking for the group.

Group Decision Making
The process of agreeing on a resolution to a problem, it
may be obtained through different processes:
-Unanimous -Majority rule (no re evaluation)
-Consensus (retain rights to reconsider) -Compromise

Group leadership styles: Directive
When therapists is responsible for much of what takes
place in the group. Needed when members' cognitive,
social, and verbal skills, as well as engagement, are
limited.

Group leadership styles: Facilitative
When therapist shares responsibility with members.
Advised when members' skill level and engagement is
moderate.

Group leadership styles: Advisory
When the therapist functions as a resource to the
members. 
Advised when members' skill level and engagement is
high.

Co-leadership
Sharing of group leadership between two or more
therapists. 
+ each leader can assume differed leadership role,
mutual support, objectivity and observation, co-leaders
can model effective Bx, and share knowledge and skills
- Splitting, excessive competitions, unequal
responsibilities.

Curative factorsof groups:
...

Altruism
The giving of oneself to help others

Catharsis
The relieving of emotions by expressing one's feelings.

Universality
Comes from recognizing shared feelings and that one's
problem are not unique.

Existential Factors
Address accepting the fact that the responsibility for
change comes from within oneself.

Guidance
Comes from accepting advice from other group
members.

Identification
Involves benefiting from imitation of the positive B of
other group members.

Instillation of Hope
Experiencing optimism through observing the
improvement of others in the group.

Interpersonal Learning
Occurs when receiving feedback from group members
regarding one's behavior (input), or by learning
successful ways of relating to group members (output).

Group types: Evaluation Group
Enable client and therapist to assess client's skills,
assets, limitations regarding group interaction.

Group types: Thematic Group
To assist members in acquiring the knowledge, skills,
and/or attitudes needed to perform a specific activity.
Simulated, clearly defined, structured activities.

Group types: Topical Group
To discuss specific activities that members are engaged
in outside of group to enable them to engage in the
activities in a more effective, need-satisfying manner. 
Concurrent topical group.
Anticipatory topical group.

Group types: Task-oriented Group
To increase clients' awareness of their needs, values,
ideas, feelings, and behaviors as they engage in a group
task.

Group types: Developmental Group
A continuum of groups consisting of parallel, projects,
eccentric-cooperative, cooperative, and mature groups.
-Parallel: To enable members to perform individual
tasks in the presence of others. 
-Project: To develop the ability to select and implement
a long range-activity with another member in a
comfortable, cooperative manner. 
-Egocentric-cooperative: To enable members to select
an implement a long-range activity which requires
group interaction to complete.
-Cooperative: To enable members to engage in group
activity which facilitates the free expression of ideas
and feelings. 
-Mature group: To enable members to assume
functional socio-emotional and task roles within a
group.

Group types: Instrumental Group
To help members function at their highest possible
level for as long as possible.

:Developmental assessments

Overall Components
...

Information regarding the mother's pregnancy and
specifics of birth history:
a. Apgar score of the infant's heart rate, respiration,
reflex irritability, muscle tone, and color is measured at
one, five and 10 minutes after birth, each item receives
a rating f 0,1, or 2. The highest score possible is 10
points indicating a newborn's well-being.
b. Number of weeks premature, adjusted age
c. number of days/weeks in incubator, intubated
and/or ventilator, or nasogastric tube

Medical History
admissions and length of hospitalizations for illness,
disease, surgery, and medications

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
Developmental History:
important developmental milestones, their time of
achievement, and any difficulties or problems
surrounding their attainment

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

...
Parent interview to address the above, and the parent's
perspective on developmental progress and/or
concerns, home situation, family history, school
history, support systems, and insurance coverage

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

Neurobehavioral organization: signs of stress or
stability.
a. Neurobehavioral subsystems: based on synactive
theory of development (ex. subsystems continuously
interact with each other and with the environment as
evidenced by the infant's levels of stress or stability.
(1) Autonomic system: physiological instability or
stability
(2) motor system: fluctuating tone with uncontrolled
activity or consistent tone with controlled activity.
(3) Emotional state: disorganized, calm, alert.
(4) Attention-interaction: stress signals upon attempts
at attending to stimuli, difficulty shifting attention,
focused responsiveness to stimuli, and fluid shifting of
attention
(5) self-regulation: ability to self-organize and balance
of subsystems
b. testing of reflex integration
c. muscle tone

Musculoskeletal status
a. skeletal status including extremity and spine
deformities
b. Range of motion status
c. posture at rest and posture during active movement
(see neuromotor assessments)
d. see Ch. 6 on evaluation and intervention for
musculoskeletal dysfunction

Developmental Assessments
a. There are many published tools that measure
neonate, infant, and child development

Developemental Assessments of Neonates
...

Assessment of Preterm Infant's Behavior (APIB)
FOCUS: assesses infant's pattern of developing
behavioral organization in response to increasing
sensory and environmental stimuli
(1) an extension and refinement of the Neonatal
Behavioral Assessment Scale (NBAS)
METHOD: a behavior checklist and scale
SCORING & INTERPRETATION: 
(1) scores are obtained prior to administration for a
baseline, during administration and following
administration
(2) scores reflect the degree of facilitation provided by
the examiner
(3) eye movements and asymmetry of performance are
measured
(4) function and integration of the physiological,
motor, state, attentional/interactive, and regulatory
systems are determined
(5) Interpretation of scores allow the therapist to plan
interventions, measure outcomes, and plan follow-up.
POPULATION: pre-term and full-term infants

Neurological Assessment of Pre-term and Full-term
New-born Infant (NAPFI)
FOCUS: a rating scale consisting of a brief neurological
examination incorporated into routine assessment 
(1) can be used with newborns in an incubator and/or
on a ventilator if handling can be tolerated
(2) Habituation, movement and tone, reflexes, and
neurobehavioral responses including state transition,
level of arousal and alertness, auditory and visual
orientation, irritability, consolability, and cry are
assessed
METHOD: items are administered in a sequence; first
in a quiet or sleep state, followed by items not
influenced by state, then during the awake state.
SCORING & INTERPRETATION: 
(1) the infant's state is recored, based on 6 gradings of
state, for each item
(2) interpretation of scored allows the therapist to
document a pattern of responses to reflect neurological
functions and identify deviations for diagnosis
(3) a comparison of pre-term with full-term infant
behavior is provided
POPULATION: pre-term and full-term infants

OVERALL Developmental Assessments
...

Denver Developmental Screening Test II
FOCUS: standardized task performance and
observation screening tool for early identification of
children at risk for developmental delays in four areas
including personal-social, fine motor-adaptive,
language, and gross motor skills
METHOD:
(1) Test includes 125 test items
(2) Test items below the child's chronological age level
are administered with sequential progression toward
higher level chronological items until the child fails
three items 
(3) Behaviors observed during the screening are
marked on a checklist
(4) Questionnaires for home screening of
environments and prescreening of development are
available to administer to parents/caregivers
POPULATION: 1 month to 6 years
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Bayley Scales of Infant Development, 3rd Edition
(BSID-III)
FOCUS: standardized rating scales that assess multiple
areas of development to attain a baseline for
intervention and to monitor progress 
(1) Evaluates 5 domains: cognitive, language, and
motor, which are performance based tasks, and social-
emotional and adaptive behavior skills.
METHOD:
(1) age appropriate items are selected from items on
the different domain scales
(2) involves parent(s) completing two questionnaires 
POPULATION: 1 - 42 months
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First STEP Screening Test for Evaluating
Preschoolers
FOCUS: a checklist and rating scale which identifies
preschool students at risk and in need of a more
comprehensive evaluation
METHOD:
(1) it assesses five areas/domains as identified by IDEA
which include cognition, communication, physical,
social and emotional, and adaptive functioning 
(a) table-top tasks are administered while sitting
across from the child; additional space is needed for
gross motor tasks.
(2) an optional Social-Emotional Rating Scale is rated
by the examiner based on the child's behavior during
testing
(3) An optional Adaptive Behavior Checklist is rated by
the examiner according to the info obtained from a
parent or caregiver interview regarding daily
functioning
(4) an optional Parent-Teacher Scale provides
additional info not obtained during the testing
POPULATION: 2 years 9 months through 6 years 2
months
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Hawaii Early Learning Profile, Revised (HELP)
FOCUS: non-standardized scale of developmental
levels. An educational curriculum-referenced test that
assesses six areas of function including cognitive,
language, gross motor, fine motor, social-emotional,
and self-help
METHOD:
(1) administered in the child's natural environment
and in the context of the family during typical routines
(2) Developmentally appropriate items are
administered according to established protocols
(3) a protocol using a warm-up period, structured play,
and snack time is recommended
POPULATION: children, ages birth through 3 years,
with developmental delay, disabilities, or at risk. HELP
for Preschoolers is available for children ages 3 to 6,
with and without delays

Miller Assessment for Preschoolers (MAP)
FOCUS: standardized task performance screening tool
that assesses sensory and motor abilities consisting of
foundation and coordination indexes, cognitive
abilities including verbal and nonverbal indexes, and
combined abilities which include a complex tasks index
METHOD:
(1) items are administered that relate to the age of the
subject
(2) Supplemental nonstandardized observations may
be administered
POPULATION: 2 years 9 months to 5 years 8 months
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Pediatric Evaluation of Disability Inventory (PEDI)
FOCUS: standardized behavior checklist and rating
scale that assesses capabilities and detects functional
deficits, to determine developmental level, monitor the
child's progress and/or to complete a program
evaluation
(1) modifications and Caregiver Assistance Scales
determine the level of assistance and adaptations
needed to enhance participation 
METHOD:
(1) observation, interview, and scoring of the three
domains
(a) self-care, mobility, and social skills and their
functional sub-units are assessed 
POPULATION: 6 months to 7.5 years

Motor Assessments
...
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Bruininks-Oseretsky Test of Motor Proficiency (2nd
ed.) (BOT-2)
FOCUS: standardized test assesses and provides an
index of overall motor proficiency; fine and gross
motor composites, including consideration of speed,
duration, and accuracy or performance, and hand
and/or foot preferences
METHOD:
(1) there is a long and short form with 8 subtests: fine
motor precision, fine motor integration, manual
dexterity, bilateral coordination, balance, running
speed and agility, upper limb coordination and
strength
(a) hand and foot preference is initially determined
POPULATION: 4 years to 21 years
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Developmental Test of Visual Perception (DTVP-2)
and Developmental Test of Visual Perception -
Adolescent and Adult (DTVP-A)
FOCUS: assesses visual perceptual skills and visual
motor integration for levels of performance and for
designing interventions and monitoring progress
METHOD:
(1) DTVP-2 is comprised of 8 subtests including eye-
hand coordination, copying, spatial relations, visual-
motor speed, position in space, figure-ground, visual-
closure, form-constancy
(2) DTVP-A is comprised of 4 subtests of visual motor
integration, composite index, and motor-reduced
visual perception composite index
POPULATION: children aged 4 to 10 years for the
DTVP-2; adolescents and adults aged 11 to 74 years for
the DTVP-A

Erhardt Developmental Prehension Assessment
(EDVA) Revised and Short Screening Form (EDVA-
S)
FOCUS: a behavior rating scale to determine
visuomotor development that assesses involuntary
visual patterns including eyelid reflexes, pupillary
reactions, doll's eye responses, and voluntary patterns
including fixation, localization, ocular pursuit, and
gaze shift
METHOD:
(1) there are 271 test items organized developmentally
into 7 clusters
(2) the clusters are presented and items are sequenced
developmentally
(3) Upon administration of each item, a response is
scored for each eye
(4) models for assessment and management, and items
required for testing are provided
POPULATION: birth to 6 months. Since the 6 month
level is considered the norm, the EDVA-S can be used
for assessing older children

Preschool Visual Motor Integration Assessment
(PVMIA)
FOCUS: a standardized norm referenced assessment
which evaluates visual motor integration and visual
perceptual skills of preschoolers, including perception
in space, awareness of spatial relationships, color and
space discrimination, matching two attributes
simultaneously and the ability to reproduce what is
seen and interpreted
METHOD: two performance subtests and two
behavioral observation checklists
(1) The Drawing subtest requires the child to recognize
and reproduce lines and shapes that increase in level of
complexity 
(2) The Block Patterns subtest requires the child to
recognize color and shape and reproduce block
patterns and match block pictures using three-
dimensional blocks
(3) It has a section that first predetermines that the
child has the requisite skills to continue with the test
items
(4) The behavioral observation checklists are
completed during testing by the administrator to
document observed behaviors in an orderly manner to
be used in test interpretation
POPULATION: preschoolers ages 3 1/2 to 5 1/2 years
old
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Motor-Free Visual Perception Test (MVPT-3)
FOCUS: a standardized, quick evaluation to assess
visual perception (excludes motor components) in 5
areas including spatial relationships, visual
discrimination, figure-ground, visual closure, and
visual memory
METHOD:
(1) the number of items administered depends on the
child's age
(a) for children aged 4 to 10 years, items 1-40 are
administered; for persons aged 10 years or older, items
14-65 are administered
POPULATION: children and adults aged 4 to 95 years

Motor-Free Visual Perception Test-Vertical (MVPT-
V)
FOCUS: evaluations of individuals with spatial deficits,
due to hemi-field visual neglect or abnormal visual
saccades
METHOD: 36 items vertically placed are used to assess
spatial relationships, visual discrimination, figure-
ground, visual closure, and visual memory (excluding
motor components) 
POPULATION: children and adults with visual field
cuts or without visual impairments
(1) appropriate for individuals with brain injury since it
reduces confounding variables

Test of Visual-Motor Skills (TVMS and Test of
Visual-Motor Skills: Upper Level (TVMS-UL)
FOCUS: assesses eye hand coordination skills for
copying geometric designs
METHOD:
(1) the individual copies and draws geometric designs
which become sequentially more complex
(a) there are 23 geometric forms in the TVMS which
are scored for 8 possible errors and 12 in the TVMS:
UL which are scored for 9-22 possible errors in motor
accuracy, motor control, motor coordination, and
psychomotor speed.
(2) Test behavior is also documented
POPULATION:
(1) TVMS: 2- 13 years
(2) TVMS-UL: 12- 40 years

Test of Visual-Perceptual Skills (3rd ed.) (TVPS3)
FOCUS: assesses visual-perceptual skills and
differentiates these from motor dysfunction, as a motor
response is not required
METHOD:
(1) 7 visual-perceptual skills including visual
discrimination, visual memory, visual-spatial
relationships, visual form constancy, visual sequential
memory, visual figure-ground and visual closure are
assessed
(2) test items are presented in a multiple choice format
and are sequenced in complexity 
(a) if subjects have 3 consecutive errors, the test is
discontinued
(3) the individual looks at the test item and then selects
the correct choice among all possible responses on the
test plate
(4) Behavior observed during testing is also recorded
POPULATION: 4 - 19 years
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Sensory Processing Assessments
...
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Sensory Profile: Infant/Toddler Sensory Profile
FOCUS: measures reactions to daily sensory
experiences
METHOD:
(1) obtains caregiver's judgement and observation of a
child's sensory processing, modulation, and behavioral
and emotional responses in each sensory system via a
caregiver questionnaire 
POPULATION: infants and toddlers from birth to 36
months

Sensory Profile: Adolescent/Adult Sensory Profile
FOCUS: allows clients to identify their personal
behavioral responses and develop strategies for
enhanced participation 
METHOD: a questionnaire measures individual's
reactions to daily sensory experiences
POPULATION: individuals from 11 - 65 years old

Psychological and Cognitive Assessments
...
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Childhood Autism Rating Scale (CARS)
FOCUS: determines the severity of autism (ex. mild,
moderate or severe) and distinguishes children with
autism from children with developmental delays who
do not have autism
METHOD: an observational tool is used to rate
behavior
(a) 15 descriptive statements include characteristics,
abilities, and behaviors that deviate from the norm
POPULATION: children over 2 years of age who have
mild, moderate, or severe autism

Coping Inventory and Early Coping Inventory
FOCUS: assesses coping habits, skills, and behaviors,
including effectiveness, style, strengths, and
vulnerabilities to develop intervention plans for coping
skills 
METHOD:
(1) Coping Inventory: questionnaire assesses coping
with self and coping with environment according to
three categories of coping skills: productive, active, and
flexible
(2) Early Coping Inventory: questionnaire assesses the
effectiveness of behaviors according to sensorimotor
organization, reactive behavior, and self-initiated
behavior
POPULATION:
(1) coping inventory: 15 years and above
(2) Early coping inventory: 4 to 35 months

Play Assessments
...
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Play History
FOCUS: assesses play behavior and play opportunities 
METHOD:
(1) the primary caregiver provides info about the child
in 3 categories including general info, previous play
experience, and actual play that occurs over 3 days of
play
(a) previous play experiences and actual play,
consisting of 9 aspects that address the form and
content of behavior, are analyzed according to
materials, action, people, and setting
POPULATION: children and adolescents

Revised Knox Preschool Play Scale (RKPPS)
FOCUS: observations of play skills to differentiate
developmental play abilities, strengths and weakness,
and interests areas
METHOD:
(1) administered in a natural indoor and outdoor
environment with peers
(a) two 30-minute periods of observations are
completed indoors and outdoors
(2) observations are organized according to 6-month
increments up to the age 3
(3) 4 dimensions of play including space management,
material management, pretense/symbolic (including
imitation), and participation are assessed
POPULATION: 0 - 6 years
(1) it is useful with children for whom standardized
testing may not be appropriate

Test of Playfulness (ToP) Revised Version 3.5
FOCUS: assesses a child's playfulness based on
observations according to 4 aspects of play
METHOD:
(1) observed behaviors are rated according to intrinsic
motivation, internal control, disengagement from
constraints of reality, and framing
(2) the extent, intensity, and skillfulness of play are
also observed and rated
POPULATION: 15 months to 10 years

Transdisciplinary Play-Based Assessment (TPBA)
FOCUS: measures child's development, learning style,
interaction patterns, and behaviors to determine need
for services
METHOD:
(1) Non-standardized play assessment employing team
observations based on 6 phases
(2) observations are categorized into the
developmental domains of cognitive, social-emtional,
communication and language and sensorimotor
POPULATION: Infancy to 6 years

Social Participation Assessments
...
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Participation Scale (P Scale)
FOCUS: a measure of restrictions in social
participation related to community mobility, access to
work, recreation, and social interaction with family,
peers, neighbors, etc.
METHOD:
(1) 18 - item questionnaire addressing the 9 domains of
participation identified in the International
Classification of Function, Disability, and Health
(2) Self-care, mobility, and social function and heir
functional sub-units are assessed
(a) the score forms include the areas of functional
skills, caregiver assistance and modifications
POPULATION: 15 years and older with physical
disabilities
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School Function Assessment (SFA)
FOCUS: assess and monitors functional performance
in order to promote participation in a school
environment 
(1) it DOSE NOT measure academic performance
METHOD: a criterion referenced questionnaire
assesses the student's: level of participation, type of
support currently required, and performance on school
related tasks