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Vision in OT Practice — participation guide

3 contact hours · 0.3 AOTA CEUs · Module 3 — follow along, take notes, and complete the reflection prompts.

Module 3

Screening vs. Assessment

Follow along

What this module covers

  • The two-step in practice
  • What VML gives you at the screening step
  • What turns a flag into a Full VPA™

Key ideas

Capture these as you listen

  • Screening asks 'is there a concern', 15 minutes, PASS/FLAG, no plan of care. Assessment asks 'what and what next', 30–60 minutes, VPL per level, generates the plan.
  • Every referral runs through the same pipeline: history → screen → decision → assessment (if warranted) → plan.
  • You can screen without instrumentation. Standardized rubrics help, they do not replace clinical observation.

Notes

My notes for this module

Reference figures

Keep these for practice

Fast Screener mid-administration
Fast Screener mid-administration. Evaluator script, PASS/FLAG rubric, referral triggers, and the on-screen worksheet in a single view.

Screenshot — Mini VPA™ probe in progress

Probe · Saccades (near, 40 cm)

Say

“Look at the star, then the circle, and keep going back and forth until I say stop. Move only your eyes.”

Do

Hold targets 20 cm apart at 40 cm, eye level. Time 30 s. Watch for head movement, undershoot, loss of place, and reported blur.

Score the level reached

L1Cannot localize both targets
L2Localizes with head movement / frequent loss
L3Accurate but effortful; slows within 30 s
L4Accurate and steady for the full trial
L5Accurate and steady while reading aloud (dual task)
Every probe is scripted: what you say, what you do, and the exact behavior that separates one level from the next. Scripting is what makes a re-probe eight weeks later comparable.

Photo — screening setup at 40 cm

Child holding a near-point card at midline while an occupational therapist observes and records, with a ruler on the desk to verify the working distance

Near probes · 40 cm

Card at midline and at eye level; measure from the spectacle plane, not the forehead.

Table/screen · 60 cm

Use the same distance at screening and re-probe — a distance change invalidates the comparison.

Base of support

Feet supported and hips at 90° before any oculomotor scoring; postural drift reads as an efficiency deficit.

Measure, don’t estimate. Near probes are administered at 40 cm and intermediate/table probes at 60 cm, with the page at midline, feet supported, and light from behind the shoulder rather than facing the student.

Apply it

Case prompt

A student is rereading lines and losing place during silent reading, and independent seatwork is not getting finished. She PASSed acuity and processing on the Fast Screener but FLAGged saccades. Do you refer to optometry, schedule the Mini VPA, or both, and why?

Practice

Mini exercise

Write out your current vision workflow in five arrows. Circle every step where a decision is made. If you cannot find a clear PASS/FLAG decision node, that is your first workflow fix.

Take it to work

Action step this week

Time yourself running the Fast Screener on a colleague. If you exceeded 20 minutes, note where the drag happened. Efficiency at the screen protects your caseload capacity.