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The VPA™: Assessment & Clinical Reasoning — participation guide

4 contact hours · 0.4 AOTA CEUs · Module 3 — follow along, take notes, and complete the reflection prompts.

Module 3

Age Bands, Stimuli, and Setup

Follow along

What this module covers

  • Non-negotiables before the first item
  • Why stimuli change with the band
  • Eye dominance: Porta and Miles tests
  • Below the floor of the VPA™

Key ideas

Capture these as you listen

  • Setup is the measurement condition. Age band, distance, lighting, and positioning are part of the instrument, not preliminaries.
  • Chronological age selects the band by default; language or reading access can justify selecting down, advanced material can justify selecting up, record the substitution and the reason either way.
  • Intermediate (60 cm) and near (40 cm) are separate measurements with distance-matched card sizes. Never substitute one card set for the other distance.
  • Band-adaptation is real and partial: language- and print-loaded tasks (saccade columns, reading passages, writing prompts, discrimination sets, fixation load, all Functional Integration scripts) swap by band; geometric tasks (form constancy, closure, spatial, memory, VMI figures) are held constant by design.
  • Postural instability recruits head movement into oculomotor tasks and produces false efficiency deficits. Stabilize the base or flag it.
  • Complete the intake before the first stimulus, lens status and date of last eye exam change Domain 1 interpretation before you measure anything.

Notes

My notes for this module

Reference figures

Keep these for practice

Photo — measured setup at 60 cm and 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.

Screenshot — age band selection screen

VPA™ · Age band

5–7 years

Shorter probes, picture-based stimuli, heavier modeling

8–11 years

Full ladder, standard stimuli, timed output introduced

12–16 years

Academic-load stimuli, endurance probes, self-report added

17+ years

Transition/vocational tasks, driving-adjacent scanning demands

Band selection sets stimulus size, pacing, and expected ceiling. Choose by chronological age unless a documented developmental profile makes a lower band the fairer test of performance — and record that decision.

Apply it

Case prompt

A 12-year-old with a documented reading level of mid-first grade is referred for copy difficulty. Which age band do you administer, what do you record about the choice, and which single domain is most at risk of being misinterpreted if you get this wrong?

Practice

Mini exercise

Name the two VPA™ working distances and the occupation each one represents. Then name what happens to interpretability if you present a near-sized card at the intermediate distance.

Take it to work

Action step this week

Measure your usual testing setup with a tape: chair-to-table height, the distance at which you actually hold a near card, and the illumination at the task surface. Write the numbers down and correct anything more than 5 cm off.