The VPA™: Assessment & Clinical Reasoning — participation guide

• The same four questions in every case

• The referral word is a hypothesis, not a finding. In all three cases it pointed away from the actual limiter.
• Time course discriminates efficiency from processing: efficiency degrades over minutes, processing is impaired from the first item.
• Intact discrimination and form constancy argue against a perceptual explanation for reversals; look lower or elsewhere.
• Repeated model-rechecking with intact Domain 3 is the behavioral signature of a Domain 4 production limiter.
• Referral and OT intervention proceed in parallel, neither waits for the other.

Re-read Case B. Write the two-sentence explanation you would give the classroom teacher for why "he can do it when he tries" is consistent with the finding rather than evidence against it.

For each of the three cases, name the domain that carried the finding and the domain the referral word pointed to. Note how often they differed.

Pick one student on your caseload whose referral concern you have accepted at face value. Re-read their data and ask which domain the evidence actually implicates.