This frame of reference adapts a top-down approach to identify visual perceptual factors that limit an individual’s daily participation, and adaptive and compensation approaches are used to facilitate engagement in meaningful occupation. It uses theories from cognition, developmental psychology, education, and Warren’s developmental hierarchy of visual perceptual skills. Visual Perceptual skill development is viewed to be developed from a hierarchy, starting from oculomotor control, visual fields, visual acuity. The next levels are sequential attention, scanning, pattern recognition, visual memory, visuocogntion, and eventually adaptation through vision. This frame of reference assumed that learning does not necessarily follow this hierarchy, which means that deficit in one area does not predict deficit in another area. Visual perception processing is learned and developed from experience and practice. It involves a receptive component and a cognitive component. Stimulation is necessary for children to acquire this skill. In evaluation, therapist asks and observes how visual perceptual difficulties limit occupational performance and participation, and identifies underlying influencing visual perceptual factors in the process. Visual processing involves input, processing, and output, followed by feedback, and this pattern is used when applying this frame of reference in intervention planning. Therapists can apply environmental adaptations within the visual input stage and employ techniques of remediation, strategies and environmental adaptations within the visual processing and output stages. The ultimate goal of the interventions is to facilitate children to engage in meaning, age-appropriate occupations.
Frame of reference
Visual perceptual disorder
Domain of occupation
Acquisition of visual perceptual skills is the primary goal of this frame of reference
Schneck, C. M. (2010). A frame of reference for visual perception. In P. Kramer & J. Hinojosa (Eds.), Frames of reference for pediatric occupational therapy (3rd ed., pp. 349-389). Philadelphia: Lippincott Williams & Wilkins.
This frame of reference identifies functions and dysfunctions in five areas of handwriting for children, including proximal posture, components, use of writing tools, grasp, and handwriting. Good proximal control is required for functional and effective distal control of the writing tools. Either excessive postural stability or lack of postural stability during writing tasks is considered as dysfunctions. Components including ocular-motor skills, attention, and memory are considered as essential.
The dynamic system theory model of visual perception aims to facilitate practitioners in understanding the development of visual perception from a dynamic systems theory perspective. This model views vision and ocular motor abilities as a part (instead of the foundation) of the complex interaction of components of the experience of vision.
This model presents a hierarchy of family-therapist involvement in occupational therapy services, with associated attitudes, specific knowledge, and skills that enable therapists to operate at each level.
The first level, no family involvement, outlines the traditional medical model of intervention. This level focuses on technical skills which are expected of entry-level therapists, with no awareness of the role of the family and client’s social context. It provides the basis for alternative types of family involvement.
The model of social interaction (MSI) is designed for occupational therapists to guide practice in social interactions within the context of activities of self-care, work, and play/leisure. It views individuals as an open system, who are influenced by actions and events within a variety of social and cultural environments, through a process of intake, throughput, output, and feedback. Each person’s internal makeup consists of three hierarchically arranged systems, including volition, habituation, and social performance.
Sensory Integration Theory aims to explain behaviors, plan intervention, and predict behavioral change through intervention, and provide specific intervention strategies to remediate the underlying sensory issues that affect functional performance. It purposes therapeutic interventions that incorporate sensation to affect multi-sensory perception to influence learning and behavior, as the central nervous system does not process sensory information in isolation.