- Bottom-heavy: what does the degradation curve tell you that a single accuracy score cannot?
- It separates capacity from endurance. The student can do the task; they cannot sustain it. A single early-session score would have been recorded as a pass and the referral question would have gone unanswered. The curve also gives you your progress measure — the minute at which accuracy drops.
- Bottom-heavy: what is the first disposition decision — treat, refer, or both?
- Both, in parallel. Refer to eye care if any symptom or acuity/contrast finding is present, and simultaneously begin OT work on the Level 2 floor plus an immediate access change the teacher can keep (chunked work periods, reduced copy volume, line guide).
- Top-heavy: which level do you target first, and why not start at the top?
- Target Level 4 (visual-motor integration). Starting at Level 5 with more writing practice loads the failing system without changing it — you get volume, fatigue, and no transfer. Stabilize the graded motor output, then re-embed it in the writing occupation.
- Top-heavy: how do you grade the writing task to isolate the visual-motor contribution?
- Hold the linguistic demand constant (copying, not composing), then vary only one visual-motor parameter at a time: line width and spacing, print size, model proximity (adjacent vs. far model), and speed. If legibility recovers with an adjacent model and wider ruling, the constraint is visual-motor, not language.
- Flat low: what validity threats must you rule out before interpreting?
- The five: setup drift (distance, lighting, positioning), state (illness, hunger, medication timing, time of day), attention/effort inconsistency across comparable items, language or instruction comprehension, and missing or outdated habitual correction. A flat low profile is a validity question until proven otherwise.
- Flat low: what is your referral obligation before writing an OT plan?
- Confirm a current eye examination with habitual correction verified. If there is none, or if any red-flag symptom is present, refer now and document that interpretation is deferred pending that information. You may still write access accommodations in the meantime.
- Spiky: what must you confirm before writing a goal on an isolated skill?
- Replicate it. Re-probe the same skill on a different day with a parallel item set and confirm the pattern holds; a single spike can be an attention or item-familiarity artifact. Also confirm that the skill actually constrains an occupation in this student’s day.
- Spiky: how do you tie a Level 3 finding to an occupational outcome?
- Name the classroom task that carries that demand: figure-ground shows up as locating a problem on a dense worksheet, a word in a glossary, or a locker in a crowded hallway; spatial relations shows up in graph paper math alignment, diagram reading, and map work. Write the goal at that task, not at the perceptual skill.