Back to CEU courses
Facilitator notes Participation guide

Presenter study handout

Vision in OT Practice

3 contact hours · 0.3 AOTA CEUs · Module 3 · 17 slides

Presenter-side material. Each block shows the slide as the audience sees it, the talk track, and space for your own notes. Model answers appear here — do not hand this version to learners.

Module 3

3.1 — Screening vs. Assessment: The OT's Two-Step Workflow

Transition

Module 3

Screening vs. Assessment: The OT's Two-Step Workflow

0:52 – 1:18

Vision in OT Practice
1 / 17

Say this

Transition: "Screening vs. Assessment: The OT's Two-Step Workflow."

My notes

3.2 — Screening vs. Assessment

Title

Module 3

Screening vs. Assessment

The OT two-step workflow: rule in the need, then measure it.

Vision in OT Practice
2 / 17

Say this

Open here. "Screening vs. Assessment." The OT two-step workflow: rule in the need, then measure it.

Say why this section matters for their caseload, then advance.

My notes

3.3 — Your current practice

Poll

Poll

Your current practice

What happens in your setting after a vision screen flags a concern?

Select one.

Vision in OT Practice
3 / 17

Say this

Ask the poll: "What happens in your setting after a vision screen flags a concern?"

Options:

• We move straight to intervention

My notes

3.4 — Two different jobs

Comparison

Two different jobs

Screening

  • Fast, caseload-scale, pass/flag
  • Answers: is a closer look warranted?
  • Fast Screener and Mini VPA™
  • Never the basis for a plan of care

Assessment

  • Level-by-level performance measurement
  • Answers: where does performance break down?
  • Full VPA™ — 15 skills across 5 domains
  • Feeds goals, dosage, and disposition
Standard score report
Visual perception (total)92 · 30th %ile
Visual-motor integration88 · 21st %ile
Motor-reduced perception95 · 37th %ile

“Within normal limits.” No statement about copying from the board, near endurance, or output rate.

VPA™ domain profile
L1Acuity & sensory foundationincl. field & scanning
strong
L2Visual efficiency
limiting
L3Visual processing
emerging
L4Visual-motor integration
limiting
L5Functional integration
breaking down

Shape, not a single number: efficiency and output fall away while foundation holds.

A norm-referenced score answers “how does this student compare?”. A VPA™ profile answers “where in the visual performance chain does the school day break down?” Both are evidence; only one tells you what to change on Monday.
Vision in OT Practice
4 / 17

Say this

Contrast the two columns: Screening versus Assessment.

Screening:

• Fast, caseload-scale, pass/flag

My notes

3.5 — The two-step in practice

Teaching slide

Workflow

The two-step in practice

  • Step 1 — Screen: brief probes at each of the five levels; record flags, not diagnoses.
  • Step 2 — Assess: run the Full VPA™ on flagged domains and adjacent levels.
  • Interpret bottom-up: clear the floor before attributing failure to processing.
  • Disposition every finding: OT plan, refer, monitor, or no action.
Teacher / parentconcern raisedOT Screening (VPA Fast Screener)PASS / FLAG on 5 quick tasksPASSFLAGDocument. No further OT.Provide teacher-facingclassroom accommodationsif requested.OT Assessment (Mini or Full VPA)Score all 5 domainsPlan of careIEP goals · interventionAdapt-and-refer (Level 1)if acuity/health concern
Screening asks "Is there a concern?" Assessment asks "What exactly is the problem, and how do we intervene?" The path a referral takes depends on that answer.
Vision in OT Practice
5 / 17

Say this

Frame the slide: "The two-step in practice."

Walk each point, one sentence each:

• Step 1 — Screen: brief probes at each of the five levels; record flags, not diagnoses.

My notes

3.6 — Fast Screener mid-administration

Visual

Live artifact

Fast Screener mid-administration

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

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

Vision in OT Practice
6 / 17

Say this

Talk over the visual: "Fast Screener mid-administration."

Say the caption in your own words: Evaluator script, PASS/FLAG rubric, referral triggers, and the on-screen worksheet in a single view.

My notes

3.7 — What VML gives you at the screening step

Teaching slide

Screening tools

What VML gives you at the screening step

  • Fast Screener — brief acuity, contrast, efficiency, and a functional writing sample.
  • Pre-K Quick Screen (ages 3–4) — refer or simple activities, no scoring burden.
  • Mini VPA™ — one probe at each of Levels 1–5 to flag the domains to measure.
  • Free Vision Concern Quiz for teachers and families to start the referral conversation.
L1 · Access
Near acuity
Intermediate / distance acuity
Contrast tolerance
L2 · Efficiency
Fixation
Pursuits
Saccades / NPC & endurance
L3 · Processing
Discrimination & closure
Figure-ground
Visual memory & spatial
L4 · Visual-motor integration
Form reproduction
Copy accuracy
Timed written output
L5 · Functional integration
Sustained reading
Generative writing
Classroom-task simulation

Task rubric 0–3 → reported as VPL 1–5

0

Unable

1

Emerging, max support

2

Functional but inefficient

3

Accurate & efficient

Five domains, fifteen skills — one domain per framework level. Every task is rubric-scored 0–3; the highest task level scored 2 or better is the skill’s achieved level, reported as VPL 1–5 against the age-band expectation.
Vision in OT Practice
7 / 17

Say this

Frame the slide: "What VML gives you at the screening step."

Walk each point, one sentence each:

• Fast Screener — brief acuity, contrast, efficiency, and a functional writing sample.

My notes

3.8 — What turns a flag into a Full VPA™

Teaching slide

Flag logic

What turns a flag into a Full VPA™

  • Any probe failed at or below the expected level for the age band.
  • A probe passed only with degraded rate, endurance, or heavy strategy use.
  • Teacher or caregiver report that conflicts with a passed probe.
  • Any red-flag ocular symptom — refer regardless of the screen result.

CVI

Variable function, latency, color/movement preference

Optic nerve hypoplasia

Reduced acuity, field loss, nystagmus

Albinism

Photophobia, nystagmus, reduced acuity

Strabismus

Eye turn, suppression, depth judgment errors

Amblyopia

Monocular acuity gap, crowding effects

Nystagmus

Null point head posture, reading endurance loss

Recognize and refer. The OT contribution is the functional description of each pattern during occupation — the diagnosis belongs to eye care.
Vision in OT Practice
8 / 17

Say this

Frame the slide: "What turns a flag into a Full VPA™."

Walk each point, one sentence each:

• Any probe failed at or below the expected level for the age band.

My notes

3.9 — Conditions that make a screen interpretable

Comparison

Setup fidelity

Conditions that make a screen interpretable

Measure it

  • Intermediate tasks at 60 cm, near tasks at 40 cm
  • Even, glare-free lighting on the stimulus plane
  • Feet supported, surface at elbow height
  • Habitual correction worn — note if absent

Record it

  • Time of day and time on task
  • Any deviation from the standard setup
  • Prompts given beyond the single permitted repetition
  • Observed strategy, not just pass/fail
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.
Vision in OT Practice
9 / 17

Say this

Contrast the two columns: Measure it versus Record it.

Measure it:

• Intermediate tasks at 60 cm, near tasks at 40 cm

My notes

3.10 — Module 3 video — screening vs. assessment

Video

Lecture

Module 3 video — screening vs. assessment

VIDEO SLOT

Live narration of the two-step workflow.

Slides tab → set “url” to your YouTube/Vimeo/Loom embed link

Vision in OT Practice
10 / 17

Say this

Set up the clip in one sentence, play it, then debrief with "what did you notice?"

My notes

3.11 — Screenshot — Mini VPA™ probe in progress

Visual

Import

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.
Vision in OT Practice
11 / 17

Say this

Describe what belongs here: Capture the Say/Do card, level ladder, and scoring panel together..

My notes

3.12 — Photo — screening setup at 40 cm

Visual

Import

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.
Vision in OT Practice
12 / 17

Say this

Describe what belongs here: Photo of measured working distance, lighting, and seating during a screen..

My notes

3.13 — So what? Screening is a routing decision, not a result

So what?

So what?

So what? Screening is a routing decision, not a result

A screening tells you where to send the student next. It never produces a score you can put in a present level.

Screening is sensitive by design and cannot separate a capacity limit from a demand mismatch. Assessment does that, under controlled setup.

What you do with it

  • Use the Fast Screen to decide: refer, assess, or monitor.
  • Only move to Mini or Full VPA when you are prepared to change the plan based on the result.
  • Say "screening indicated" in writing, never "the student has."

Watch for

Anyone quoting a screening result as a score — correct it in the meeting, in one sentence.

Vision in OT Practice
13 / 17

Say this

Land the "so what": A screening tells you where to send the student next. It never produces a score you can put in a present level.

Explain the mechanism plainly: Screening is sensitive by design and cannot separate a capacity limit from a demand mismatch. Assessment does that, under controlled setup.

Then give them the moves — say each one as something they can do Monday:

My notes

3.14 — Postural setup changes what you are measuring

Before / after

Change the setup

Postural setup changes what you are measuring

Before — unsupported

Feet unsupported, trunk collapsed, page about 15 cm from the eyes.

Feet unsupported, trunk collapsed, page about 15 cm from the eyes.

  • • Near demand is far higher than the task requires
  • • Fatigue and avoidance appear within minutes

After — supported

Feet supported, hips back, page raised toward a slant, working distance near Harmon distance.

Feet supported, hips back, page raised toward a slant, working distance near Harmon distance.

  • • Working distance is now a controlled variable, not a confound
  • • Endurance findings become interpretable

Fix posture and distance before you score anything. Otherwise you are documenting the setup, not the student.

Vision in OT Practice
14 / 17

Say this

Set up the contrast: "Postural setup changes what you are measuring."

Point at the before panel first. Feet unsupported, trunk collapsed, page about 15 cm from the eyes.

Then the after panel. Feet supported, hips back, page raised toward a slant, working distance near Harmon distance.

My notes

3.15 — Two-minute case: screen, assess, or refer?

Mini case

Two-minute case

Two-minute case: screen, assess, or refer?

A Grade 5 student passed the school nurse vision screening in September. In November he holds his book at 12 cm, closes one eye during reading, and has fallen behind on written output.

What is your next step, and why is the passed screening not the answer?

Vision in OT Practice
15 / 17

Say this

Two-minute case. Read it aloud:

A Grade 5 student passed the school nurse vision screening in September. In November he holds his book at 12 cm, closes one eye during reading, and has fallen behind on written output.

Put the question to them: "What is your next step, and why is the passed screening not the answer?" Give 60 seconds, no talking.

My notes

3.16 — Reflect and share

Reflection

Reflect and share

Reflect and share

Write the decision rule you will use to move a student from screening to full assessment. Be specific enough that a colleague could apply it.

THINKPROCESSSHARE
Vision in OT Practice
16 / 17

Say this

Reflection prompt: "Write the decision rule you will use to move a student from screening to full assessment. Be specific enough that a colleague could apply it."

Offer the sentence starter: "I move to a full assessment when... The threshold is... The evidence I need is..."

Think for one minute, write, then take two shares.

My notes

3.17 — Knowledge check — the two-step

Self-check

Knowledge check

Knowledge check — the two-step

What is the job of a screen?

Self-check only — it does not affect your post-course quiz score.

Vision in OT Practice
17 / 17

Say this

Knowledge check: "What is the job of a screen?"

Options:

• To measure the size of the deficit

My notes