Visual-Perception and Visual-

Motor Skills
 Client Factors Related to Vision
• Visual acuity
• Visual fields
• Oculomotor control
• Visual perception
• Visual-motor skills
 Visual Perception
Development
• Warren’s Hierarchy of Visual Perceptual Skill
Development
Adaptation
Through
Vision

Visuocognition

Visual Memory

Pattern Recognition

Scanning

Attention: Alert and Attending

Oculomotor control, visual fields, visual acuity

Kaldenberg (2005)
 Visual Acuity
• Clarity of vision
• Immature at birth
• 4 weeks – 20/1200
• 17 weeks – 20/200
• 1 year – 20/60
• 2 years – 20/30
 Visual Fields
• Total area of vision when looking straight ahead
• Normal (adult) dimensions
– 50-60° superior
– 70-75° inferior
– 90-100° temporal (side)

http://
www.ssc.education.ed.ac.uk/courses/vi&multi/vnov072i.
html
 Visual Fields
Examples of Impairments

http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-
medical-conditions/stroke/effect-daily-living-activities.shtml
 Oculomotor Control
• Ability to control eye movements
• Can be affected by conditions such as
strabismus, nystagmus
 Visual Attention
• Ability to attend to a visual stimulus and
perceive details
• Important foundational skill
 Visual-Motor Skills
• Scanning
• Saccadic eye movements (saccades)
• Visual pursuit tracking movements
• Visual-motor coordination
– Eye-hand
– Eye-foot
• Related to handwriting, drawing,
throwing/catching/kicking/striking skills
 Visual Scanning
Searching the
visual environment
to locate objects or
gather information

http://www.visuallearningforlife.com/visual-perception-
worksheets.php?area=92&
 Visual Scanning
• Develops quickly in infants, continues to
mature.

http://web.uvic.ca/~lalonde/psyc335/notes/lecture04.html
 Pattern Recognition
• Ability to identify and define features of an
object
• Related to visual discrimination
• Assists with recognition, matching, and
categorization
• Visual perception begins
 Visual Discrimination
• Ability to identify similarities and/or
differences between different visual stimuli
 Visual Memory
• Ability to mentally store and recall a visual
image
Visual Memory
 Visuo-Cognition
• Ability to use visual information to solve
problems, plan, and make decisions
• Includes:
– Form constancy
– Visual closure
– Figure ground
– Spatial perception
• These are all considered visual perceptual
skills
 Form Constancy
• Ability to determine whether a visual stimulus
is the same when it is presented in different
ways

A a a A a A a A A
 Spatial Perception
• Awareness of position of an object in
relationship to self (laterality) and to other
objects (directionality)

ɘ ə e

• Depth perception – ability to identify distance

from self to object
 Visual Closure
• Ability to fill in the blanks in an incomplete
image

http://1.bp.blogspot.com/-B5oO-zT8FK0/UJ1uyU_SFxI/AAAAAAAAAG0/3F0OoptFJZU/s1600/closur17.gif
http://2.bp.blogspot.com/_AsW-lOVBuzE/S7ILyBq1SFI/AAAAAAAABE0/DnnWvM2NanI/s1600/dot-11.gif
 Figure-Ground
• Ability to pick specific
items out of a
background
• Varies based on
complexity of the image
 Goals of OT Re: Visual Skills
• Evaluate functional status
– Visual system, ocular movement, visual perception,
attention and memory, home and school functioning
• Assess impact of visual dysfunction
• Provide developmentally appropriate remediation
• Provide education re: impairments and interventions
• Provide appropriate referrals/recommendations
 Assessment Tools
Not limited to:
• Motor-Free Visual Perception Test (MVPT-3)
• Beery-Buktenica Developmental Test of Visual-
Motor Integration (VMI)
• Test of Visual Perceptual Skills Non Motor (TVPS)
• Test of Visual Motor Skills (TVMS)
• Developmental Test of Visual Perception (DTVP-2)
• Bruininks Oseretsky Test of Motor Proficiency
(BOT)
 Motor-free Visual Perception Test
(MVPT-3)
• Ages 4-85 years
• About 20 minutes to administer
• Assesses the following areas of visual
perception:
– Visual discrimination
– Visual memory
– Form constancy
– Spatial relations
– Visual closure
– Figure-ground
DEVELOPMENTAL TEST OF VISUAL
MOTOR INTEGRATION (BEERY VMI)
 Developmental Test of Visual Motor
Integration (Beery VMI)
• Standardized for ages 2-100 years
• 10-15 minutes to administer full-format test
• 5 additional minutes for each supplemental
form
– Visual Perception
– Motor Coordination
• Teaching materials available
 Beery VMI: Getting Started
Anticipated Skill Level < 5 yrs
• Start on p. 2 (imitation): “Watch me. I’m going
to draw a line here.”
• Draw vertical line.
• “Make one like that. Make yours right here.”
• Then draw horizontal and circular lines (same
instructions).
• If successful, skip scribbling (items 1-3).
 Beery VMI: Getting Started
Anticipated Skill Level > 5 yrs
• Start on item 7.
• Point to item and then to the blank space below
it. “Make one like that. Make yours right here.”
• Encourage if needed, but do NOT trace the form
in any way.
• Do NOT call the form by its name or describe it.
• Re-prompt if needed by saying, “Make one like
this.”
• Allow one try per task, no erasing.
 Beery VMI
General Instructions
• Allow only single line strokes.
• After correct response, say, “Good. Go ahead
and do the rest of them. Turn to the next
page when you finish this one.”
• “Do your best on both the easy and the hard
ones; do not skip any.” (Repeat as needed)
• This section (green form) is NOT timed.
 Beery VMI
Scoring
• Score 1 or 0 based on criteria in manual
• Basal level – if items 7, 8, and 9 are passed,
give credit for items 1-6.
• Ceiling level – stop scoring after three “0”s
(can continue drawing)
 VMI - Visual Perception Subtest:
Getting Started
• Start on item 4
• Say: “See this line? There is one more line that
is just the same down below.”
• Sweep one finger downward from the box to
the responses, saying, “Let’s find it! You point to
it!”
• Make a small mark next to subject’s choice,
whether correct or not.
• Teach the task on items 4-6.
 VMI – Visual Perception Subtest:
Timing and Scoring
• Start timing at item 7
• Time limit of 3 minutes
• At the end say, “Good job! You really tried on
even the ones that are hard.”
• Score 1 for correct, 0 for incorrect.
 VMI Motor Coordination Subtest:
Getting Started
• Start on Item 4.
• Say: “Watch me draw a dark line from the black
dot to the gray dot and try to stay inside the
road.”
• Draw line inside 4A.
• Point to 4B. Say: “Now you do it. Draw a dark
line from the black dot to the gray dot. Try to
stay inside the road.”
• Teach as needed for items 5 and 6.
 VMI Motor Coordination Subtest:
Timing and Instructions
• Start timing after instructions for item 7.
• Time limit of 5 minutes
• Instruct for item 7: “Draw a dark line from the black dots
to the gray dots. Try to stay inside the road.”
• “Go ahead, do as many as you can. But do not rush. Draw
carefully. Draw the forms in order. Do not skip any.”
• Coach if needed “Go ahead and lift your pencil to start
new lines like this.”
• For items 17-21 only: If a subject omits a part, coach one
time per item: “Have you done all the parts you see in the
little one? Be sure to do all of the parts on yours!”
 VMI Motor Coordination Subtest:
Instructions
• After first page, say, “Some forms on this page
have only a few dots and some do not have
any dots at all. If a form has a black dot, start
there. If it has no dot, start wherever you like.
Stay within the roads and make each form
look like the small example just above it.”
VMI Motor Coordination Subtest: Scoring

• For score of “1”, must meet all three criteria:

A. There are pencil marks within all parts of the roads
and between all dots. The marks do not have to be
complete. (see p. 89)
B. No mark clearly goes over a road line. It is ok to
touch or even be on a road line, but it is not ok to go
over a road line. Exception: If a line touches a dot and
goes too far out the end of a road, that is ok. (see p. 90)
C. There must be at least one overlap on item 27 and
one over/underlap on item 30.
 References
• Kaldenberg, J. (2005). Visual perceptual dysfunction
and low vision rehabilitation. Foundations of Pediatric
Practice for the Occupational Therapy Assistant,
Wagenfeld & Kaldenberg (Eds.). SLACK Incorporated.
• http://
www.pearsonassessments.com/HAIWEB/Cultures/en
-us/Productdetail.htm?Pid=46228&Mode=summary
• http://
www.proedinc.com/customer/productView.aspx?ID=
1330
• http://
strokengine.ca/assess/module_mvpt_indepth-en.htm