Vision in OT Practice

Transition: "Case Walkthroughs: Three Common Occupational Performance Patterns."

Open here. "Case Walkthroughs." Four real student profiles, worked through together — then one on your own.

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

Ask the poll: "Which of these three presentations shows up most on your caseload?"

Options:

• Board copying breaks down, near work is fine

Read the scenario aloud, slowly:

Maya, age 8, has glasses worn consistently and a current eye exam. She copies the first two lines from her worksheet accurately, then loses her place, skips lines, and stops after 5 minutes. Her teacher says the first problems on a math page are always her best work.

Then put these questions to the room:

Read the scenario aloud, slowly:

Elijah, age 7, tracks smoothly, keeps his place while reading, and has 20/20 corrected acuity. His letters vary in size, drift above and below the line, and spacing collapses when he copies from the board.

Then put these questions to the room:

Read the scenario aloud, slowly:

Aiden, age 10, scores low on every task you present. He was up late, has no eye exam on file, and his teacher reports he "gives up on everything," not just visual work.

Then put these questions to the room:

Read the scenario aloud, slowly:

Sofia, age 14, reads at grade rate with clean acuity and efficiency. She cannot find a labeled part on a diagram, loses items in a full locker, and misreads graphs in science.

Then put these questions to the room:

Read the scenario aloud, slowly:

Noah, age 5, holds books about 4 inches from his face, squints at the whiteboard, and has a documented diagnosis of albinism with reduced acuity managed by his ophthalmologist. He engages well and works hard for 15 minutes at a time.

Then put these questions to the room:

Frame the slide: "How to read any profile in four steps."

Walk each point, one sentence each:

• Rule out validity threats: setup, state, effort, correction.

Contrast the two columns: OT acts versus OT routes out.

OT acts:

• Direct service on the unstable floor

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

Describe what belongs here: Profile chart from a completed VPA™ showing the shape you are discussing..

Describe what belongs here: De-identified handwriting or copy sample that illustrates the case..

Land the "so what": Three patterns cover most school referrals — near endurance, page navigation, and visual-motor output. Recognizing the pattern gets you to the right first probe in minutes.

Explain the mechanism plainly: Each pattern has a different latency signature: minutes to fatigue, loss across lines, or breakdown as motor precision rises.

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

Two-minute case. Read it aloud:

A Grade 4 student starts written work strongly, then within six minutes his letter size grows, spacing collapses, and he asks to take a break.

Put the question to them: "Which pattern is this, and what is your first probe?" Give 60 seconds, no talking.

Reflection prompt: "For the vignette we just worked, what would you have done differently before today, and what will you do now?"

Offer the sentence starter: "Before today I would have... Now I will..."

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

Knowledge check: "Reading endurance collapses after four minutes but single-word accuracy is intact. What does that pattern point to first?"

Options:

• Visual processing (Level 3)