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The VPA™: Assessment & Clinical Reasoning — participation guide

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

Module 4

The Classroom Screen and the Print-Card Skills

Follow along

What this module covers

  • Script discipline
  • What sends a student to the Full VPA™
  • Near point of convergence — the penlight trials
  • What to watch while they work

Key ideas

Capture these as you listen

  • Ask screen raters to check only behaviors seen in the past few weeks during ordinary work; record who completed it, when, and where. Disagreement between raters is information.
  • Run the materials checklist before the student arrives. Print cards at 100 percent scale, matte, toner saving off, and check the calibration mark.
  • Acuity, contrast, saccades, and pursuits run from printed cards at a measured 40 cm with habitual correction on.
  • Occlude with a card, never a palm. Measure convergence over three trials and record break and recovery separately.
  • Say the script, then stop talking. One standard re-instruction at most, and record it.

Notes

My notes for this module

Reference figures

Keep these for practice

Screenshot — Say/Do script card

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 — clinician observing eye movements

Occupational therapist seated across from a child at eye level, holding a near target while observing the child’s eyes

Eye level, off midline

Sit level with the student’s eyes and roughly 30° off midline so both eyes stay visible.

Target at eye level

Held at eye level, not above — an elevated target forces chin-up posture and false head substitution.

Score sheet within reach

Record each trial as it happens; retrospective scoring loses the qualitative signal.

You cannot score what you cannot see. Sit slightly off-midline and level with the student’s eyes so pursuits, undershoot, and head substitution are visible — not behind or above the shoulder.

Apply it

Case prompt

During the convergence trials, the student never reports doubling, but you see the left eye drift outward at 12 cm and return at 18 cm, and the break moves to 15 cm by the third trial. What do you record, what do you write in the report, and what do you deliberately not write?

Practice

Mini exercise

Name the four skills that run from printed cards and the one setup error that most often invalidates each.

Take it to work

Action step this week

Print one set of VPA™ cards this week, check the calibration mark, and run the print-card skills with a colleague while a second colleague scores you on the 20-item fidelity checklist.