3 Using the Visual Perceptual Hierarchy to Guide the OT Process

Warren (1993) organized the way we think about visual skills into a hierarchy, with foundational vision skills at the bottom and progressively more complex skills building on the previous ones. Within the hierarchy, each visual skill is supported by those that precede it. She organized the 8 visual perceptual processes within a pyramid. Occupational therapy practitioners use the visual perceptual hierarchy to organize their thinking about assessing visual skills, starting at the bottom of the pyramid.

Click on each of the visual skills below to learn more.

Occupational Therapy Process

• Purpose of OT visual assessment:
  • Describe the effect of visual impairment on the performance of daily activity
  • Gather information about occupational performance and visual skills to develop an individualized plan of care in collaboration with the client
  • NOT to diagnose a visual impairment
• When is vision screening or evaluation indicated?
  • Complaint/observation of vision limiting occupational performance
  • Eye disorders affecting the anterior visual system
  • When working with older adults (case-by-case for age-related changes)
  • Conditions of the central nervous system (stroke, brain injury, others)

References

Warren, M. (1993a). A hierarchical model for evaluation and treatment of visual perceptual dysfunction in adult acquired brain injury, part 1. The American Journal of Occupational Therapy, 47(1), 42–54. https://doi.org/10.5014/ajot.47.1.42