Presenter study handout

1.1 — Welcome — set up before we start

Welcome

Welcome — set up before we start

The VPA™: Assessment & Clinical Reasoning · 4.0 contact hours · 0.4 AOTA CEUs

Have ready

Participation & Reflection Guide
A blank VPA™ protocol and the administration-fidelity checklist
Tape measure or ruler for working distance
A student profile you plan to assess next

Before we begin

This course is procedural — pause the video and practice as you go.
Fidelity checklist scoring happens in Module 4; have it open early.
Polls, reflections, and self-checks do not affect your exam score.
Keep your testing space at the standard working distance and lighting.

Visual Minds Learning · AOTA Approved Provider #0000001618

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Materials: Participation & Reflection Guide
Materials: A blank VPA™ protocol and the administration-fidelity checklist
Materials: Tape measure or ruler for working distance
Materials: A student profile you plan to assess next
This course is procedural — pause the video and practice as you go.
Fidelity checklist scoring happens in Module 4; have it open early.
Polls, reflections, and self-checks do not affect your exam score.
Keep your testing space at the standard working distance and lighting.

Say this

Housekeeping while people arrive.

Materials to have ready:

• Participation & Reflection Guide

My notes

1.2 — What you will be able to do

Learning outcomes

What you will be able to do

So you can administer, score, and interpret the VPA™ with fidelity — and defend every disposition you reach.

1Administer a criterion-referenced, performance-based visual assessment protocol following standardized procedure — setup, working distance, stimulus presentation, prompting limits, and observation recording — achieving at least 90% procedural fidelity, so that findings can be used to describe a client's occupational performance.
2Select developmentally and contextually appropriate assessment conditions (age band, stimulus set, environment) for a given client and state, in writing, the two client or contextual factors that drove the selection, so that assessment conditions match the client's actual occupational context (classroom, home, clinic, work).
3Apply basal and ceiling rules and a hierarchical progression of visual performance demands during performance-based assessment, correctly identifying the stopping point and the client's achieved performance level to produce a profile that guides occupation-based intervention planning.
4Score a completed performance-based visual assessment protocol and interpret the results in terms of the occupational performance breakdown they produce, naming the visual performance factor most likely accounting for the breakdown with a written rationale for each of three case vignettes.

5Translate visual assessment findings into a written occupational performance statement that names the occupation (e.g., copying from the board, sustained silent reading, legible written output), the visual performance factor limiting it, and the observed impact on participation, meeting all three elements of the provided rubric.
6Document visual assessment results in occupational therapy scope language suitable for an IEP present-levels statement or plan of care, including at least one occupation-based measurable statement of current performance, without using terminology reserved for medical eye care or optometric vision therapy.
7Apply scope-of-practice and referral decision rules, consistent with the AOTA scope of practice and the 2025 AOTA Occupational Therapy Code of Ethics, to determine for each of five completed protocols whether the client proceeds to further occupational therapy assessment, to occupation-based intervention, or to referral for medical eye care, and justify each disposition as the next occupation-based step.
8Identify validity threats to any performance-based visual assessment — incomplete basal or ceiling, environmental deviation, fatigue, attention, and unfamiliar stimulus content — and describe in writing how each is recorded and how it constrains interpretation, so that a client's participation in reading, written work, and other daily occupations is not misjudged and occupational therapy services are not misallocated.

Visual Minds Learning · AOTA Approved Provider #0000001618

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So you can administer, score, and interpret the VPA™ with fidelity — and defend every disposition you reach.
Administer a criterion-referenced, performance-based visual assessment protocol following standardized procedure — setup, working distance, stimulus presentation, prompting limits, and observation recording — achieving at least 90% procedural fidelity, so that findings can be used to describe a client's occupational performance.
Select developmentally and contextually appropriate assessment conditions (age band, stimulus set, environment) for a given client and state, in writing, the two client or contextual factors that drove the selection, so that assessment conditions match the client's actual occupational context (classroom, home, clinic, work).
Apply basal and ceiling rules and a hierarchical progression of visual performance demands during performance-based assessment, correctly identifying the stopping point and the client's achieved performance level to produce a profile that guides occupation-based intervention planning.
Score a completed performance-based visual assessment protocol and interpret the results in terms of the occupational performance breakdown they produce, naming the visual performance factor most likely accounting for the breakdown with a written rationale for each of three case vignettes.
Translate visual assessment findings into a written occupational performance statement that names the occupation (e.g., copying from the board, sustained silent reading, legible written output), the visual performance factor limiting it, and the observed impact on participation, meeting all three elements of the provided rubric.
Document visual assessment results in occupational therapy scope language suitable for an IEP present-levels statement or plan of care, including at least one occupation-based measurable statement of current performance, without using terminology reserved for medical eye care or optometric vision therapy.
Apply scope-of-practice and referral decision rules, consistent with the AOTA scope of practice and the 2025 AOTA Occupational Therapy Code of Ethics, to determine for each of five completed protocols whether the client proceeds to further occupational therapy assessment, to occupation-based intervention, or to referral for medical eye care, and justify each disposition as the next occupation-based step.
Identify validity threats to any performance-based visual assessment — incomplete basal or ceiling, environmental deviation, fatigue, attention, and unfamiliar stimulus content — and describe in writing how each is recorded and how it constrains interpretation, so that a client's participation in reading, written work, and other daily occupations is not misjudged and occupational therapy services are not misallocated.

Say this

Read the filed learning objectives verbatim — this is the AOTA-approved wording.

Objectives:

• Administer a criterion-referenced, performance-based visual assessment protocol following standardized procedure — setup, working distance, stimulus presentation, prompting limits, and observation recording — achieving at least 90% procedural fidelity, so that findings can be used to describe a client's occupational performance.

My notes

1.3 — How this session runs

How the session runs

Your learning experience

How this session runs

Session schedule

Eight modules, 4.0 contact hours total
Procedure → demonstration → practice → self-check
Scored fidelity checklist and scenario sets
Post-course exam, evaluation, certificate

Participation & Reflection Guide

Record your fidelity scores and scenario answers
Note every validity flag you observe
Entries save and print with your handout

Discussion & engagement

Opening poll in every module
Think / Process / Share after each procedure block
Three full clinical reasoning walkthroughs
One knowledge check per module

Visual Minds Learning · AOTA Approved Provider #0000001618

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Eight modules, 4.0 contact hours total
Procedure → demonstration → practice → self-check
Scored fidelity checklist and scenario sets
Post-course exam, evaluation, certificate
Record your fidelity scores and scenario answers
Note every validity flag you observe
Entries save and print with your handout
Opening poll in every module
Think / Process / Share after each procedure block
Three full clinical reasoning walkthroughs
One knowledge check per module

Say this

Explain how the session runs.

Schedule:

• Eight modules, 4.0 contact hours total

My notes

1.4 — Why performance-based visual assessment: what norm-referenced batteries miss

Transition

Module 1

Why performance-based visual assessment: what norm-referenced batteries miss

0:00 – 0:20

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0:00 – 0:20

Say this

Transition: "Why performance-based visual assessment: what norm-referenced batteries miss."

My notes

1.5 — Why Performance-Based Visual Assessment

Title

Module 1

Why Performance-Based Visual Assessment

What norm-referenced perceptual batteries do not tell you about the school day.

Visual Minds Learning · AOTA Approved Provider

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What norm-referenced perceptual batteries do not tell you about the school day.
Visual Minds Learning · AOTA Approved Provider

Say this

Open here. "Why Performance-Based Visual Assessment." What norm-referenced perceptual batteries do not tell you about the school day.

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

My notes

1.6 — What are you using now?

Poll

What are you using now?

Which tool do you currently reach for when vision is the referral question?

Select one.

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Which tool do you currently reach for when vision is the referral question?
– A norm-referenced visual perception battery
– Clinical observation only
– A checklist I built myself
– Nothing consistent yet

Say this

Ask the poll: "Which tool do you currently reach for when vision is the referral question?"

Options:

• A norm-referenced visual perception battery

My notes

1.7 — What a standard score misses

Teaching slide

The gap

What a standard score misses

A single accuracy score cannot show endurance decay across a work period.
Item-level batteries rarely sample the occupation the referral was written about.
Pass/fail cut scores hide the level at which performance actually breaks down.
Observation of strategy, prompting, and error type carries the clinical signal.

	Norm-referenced	Criterion-referenced
Question answered	Where does this student rank?	What can this student do, and under what conditions?
Conditions	Quiet room, fixed distance, untimed	Near/far demand, time pressure, motor load
Efficiency floor	Rarely sampled	Sampled directly
Output	Standard score / percentile	Level-and-domain performance profile
Best use	Eligibility, medical necessity	Plan of care, progress monitoring

Two legitimate instrument classes answering different questions. Eligibility needs the left column; Monday-morning planning needs the right.

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A single accuracy score cannot show endurance decay across a work period.
Item-level batteries rarely sample the occupation the referral was written about.
Pass/fail cut scores hide the level at which performance actually breaks down.
Observation of strategy, prompting, and error type carries the clinical signal.

Say this

Frame the slide: "What a standard score misses."

Walk each point, one sentence each:

• A single accuracy score cannot show endurance decay across a work period.

My notes

1.8 — Two complementary sources of evidence

Comparison

Two complementary sources of evidence

Norm-referenced batteries

Population comparison
Eligibility support in some settings
Single-session snapshot
Limited occupational context

Performance-based VPA™

Level-by-level breakdown point
Endurance and rate under demand
Error-type and strategy observation
Direct line to goals and dosage

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.

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Norm-referenced batteries: Population comparison · Eligibility support in some settings · Single-session snapshot · Limited occupational context
Performance-based VPA™: Level-by-level breakdown point · Endurance and rate under demand · Error-type and strategy observation · Direct line to goals and dosage

Say this

Contrast the two columns: Norm-referenced batteries versus Performance-based VPA™.

Norm-referenced batteries:

• Population comparison

My notes

1.9 — What an OT measures — and what we do not

Teaching slide

Scope

What an OT measures — and what we do not

We measure performance, conditions, endurance, and occupational impact.
We do not diagnose binocular vision disorders or recommend lenses.
We refer in parallel whenever an ocular trigger appears.
Every recommendation traces to a recorded score or observation.

1Systematic reviews & meta-analysesSets the default direction of practice.

2Randomized controlled trials (e.g., CITT)Supports specific dosed interventions.

3Cohort & case-control studiesDescribes patterns and associations, not cause.

4Practice guidelines & consensus (AOTA, AOA)Defines scope and role boundaries.

5Expert opinion & single-case designsFills gaps; documented as such in the plan.

Claims in this course are labeled by tier. Where the evidence is consensus or emerging, the course says so rather than overstating it.

Occupational therapists hold an independent scope; measurement discipline is what protects it.

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We measure performance, conditions, endurance, and occupational impact.
We do not diagnose binocular vision disorders or recommend lenses.
We refer in parallel whenever an ocular trigger appears.
Every recommendation traces to a recorded score or observation.

Say this

Frame the slide: "What an OT measures — and what we do not."

Walk each point, one sentence each:

• We measure performance, conditions, endurance, and occupational impact.

My notes

1.10 — Address it, refer it — or both

Comparison

The standing rule

Address it, refer it — or both

Already diagnosed and medically managed → OT addresses it

Documented low acuity: magnification, enlarged print, working distance, seating, decluttered materials.
Documented contrast loss: high-contrast materials, bold-line paper, reverse polarity, glare and lighting control.
Documented field loss: systematic scanning, anchoring, line tracking, materials placed in the intact field.
The VPA™ documents the functional limitation and the conditions under which performance breaks down.

Undiagnosed, unverified, unclear, or changing → refer

No comprehensive eye exam on file, or correction not worn, outgrown, or unverified.
Assessment performance does not match the documented diagnosis.
Anything new: new eye turn, new double vision, new field complaint, sudden change, pain.
Referral is the action for these — OT addresses acuity, contrast, or field limitations only once they are diagnosed and managed.

Finding

Diagnosed & managed → OT addresses

New / undiagnosed / changing → refer

Reduced acuity

Magnify (optical, electronic, or digital), enlarge print, increase working-distance control, reduce visual clutter, seat for viewing angle.

No comprehensive eye exam on file, correction not worn or outgrown, or a new drop in near/distance performance.

Reduced contrast sensitivity

High-contrast materials, bold line paper, dark-on-light or reverse-polarity screens, glare and lighting control, edge marking on stairs and thresholds.

Contrast difficulty never evaluated, or a functional loss that is new, worsening, or does not match the documented diagnosis.

Field loss

Teach systematic scanning, anchoring, and line-tracking; position materials and seating into the intact field; organize the workspace; travel-safety routines with the O&M specialist.

Field loss suspected but never documented, or new field complaints, bumping, or missed content on one side.

Ocular alignment, oculomotor, accommodation

Grade the visual demand of the occupation, build near-point stamina, chunk and space text, schedule visual breaks.

New eye turn, new double vision, headaches or pain with near work, or no eye care follow-up in place.

OT addresses diagnosed, medically managed limitations. A new or undiagnosed finding is a referral — the diagnosis has to come first before we treat that finding as a known visual limitation.

The standing rule: OT addresses the functional limitation only when the ocular condition is already diagnosed and medically managed. If the finding is new, undiagnosed, unclear, or changing, the appropriate OT action is referral.

Diagnosed and medically managed = OT addresses it. New, undiagnosed, or changing = refer it; diagnosis comes first.

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Already diagnosed and medically managed → OT addresses it: Documented low acuity: magnification, enlarged print, working distance, seating, decluttered materials. · Documented contrast loss: high-contrast materials, bold-line paper, reverse polarity, glare and lighting control. · Documented field loss: systematic scanning, anchoring, line tracking, materials placed in the intact field. · The VPA™ documents the functional limitation and the conditions under which performance breaks down.
Undiagnosed, unverified, unclear, or changing → refer: No comprehensive eye exam on file, or correction not worn, outgrown, or unverified. · Assessment performance does not match the documented diagnosis. · Anything new: new eye turn, new double vision, new field complaint, sudden change, pain. · Referral is the action for these — OT addresses acuity, contrast, or field limitations only once they are diagnosed and managed.

Say this

Contrast the two columns: Already diagnosed and medically managed → OT addresses it versus Undiagnosed, unverified, unclear, or changing → refer.

Already diagnosed and medically managed → OT addresses it:

• Documented low acuity: magnification, enlarged print, working distance, seating, decluttered materials.

My notes

1.11 — Why performance-based measurement holds up

Teaching slide

Evidence

Why performance-based measurement holds up

Repeated measurement of the same task documents change more defensibly than a single score.
Condition-dependent performance is the signal payers and teams act on.
Occupation-embedded probes carry the transfer argument with them.
Graded reference list with levels of evidence is published in the PD documentation.

Ocular structures

Cornea, lens, retina, extraocular muscles — image quality and eye alignment.

Looks like: Blur, fatigue, suppression, head tilt.

Pathways & processing

Optic nerve → chiasm → LGN → V1, then ventral "what" and dorsal "where" streams.

Looks like: Recognition errors, spatial disorganization, place-losing.

Visual performance

Efficiency under real demand: sustaining near work, scanning, copying, moving through space.

Looks like: Slow output, avoidance, careless-looking errors.

Occupation

Reading, writing, math layout, PE, cafeteria, hallway navigation, self-care.

Looks like: The referral you actually receive.

OT does not diagnose the first two columns; we measure the third and change the fourth. Eye care partners own structure and pathway health — our contribution is performance under occupational demand.

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Repeated measurement of the same task documents change more defensibly than a single score.
Condition-dependent performance is the signal payers and teams act on.
Occupation-embedded probes carry the transfer argument with them.
Graded reference list with levels of evidence is published in the PD documentation.

Say this

Frame the slide: "Why performance-based measurement holds up."

Walk each point, one sentence each:

• Repeated measurement of the same task documents change more defensibly than a single score.

My notes

1.12 — Module 1 video — why performance-based assessment

Video

Lecture

Module 1 video — why performance-based assessment

VIDEO SLOT

Framing lecture on the gap between scores and school-day performance.

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

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Framing lecture on the gap between scores and school-day performance.

Say this

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

My notes

1.13 — Screenshot — a standard score report vs. a VPA™ profile

Visual

Import

Screenshot — a standard score report vs. a VPA™ profile

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.

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Side-by-side comparison illustrating what each source of evidence shows.

Say this

Describe what belongs here: Side-by-side comparison illustrating what each source of evidence shows..

My notes

1.14 — Photo — the referral in context

Visual

Import

Photo — the referral in context

Copy from the boardRepeated far↔near shifts, place-holding, sustained saccades

Worksheet completionNear endurance, figure-ground on a dense page, line tracking

Silent reading blockFixation stability, convergence comfort over 20+ minutes

Chromebook workContrast/glare tolerance, scrolling scan, screen-to-paper shifts

Hallway & lunch transitionsPeripheral awareness, depth on stairs, moving-crowd scanning

Referrals arrive as behavior (“loses place”, “refuses writing”). Name the occupational demand first — the demand is what you assess and what you later document as educational relevance.

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Classroom photo showing the occupational demand behind a typical referral.

Say this

Describe what belongs here: Classroom photo showing the occupational demand behind a typical referral..

My notes

1.15 — So what? A standard score does not tell you what to change

So what?

So what? A standard score does not tell you what to change

Norm-referenced batteries tell you where a student ranks. They rarely tell you which condition to change on Monday.

Performance-based assessment manipulates conditions — distance, duration, size, complexity — so the result names the demand that breaks performance.

What you do with it

Ask what decision the score will drive before you administer anything.
Record the condition under which performance changed, not only the score.
Pair any norm-referenced result with a performance observation in the same report.

Watch for

A percentile in the average range beside a student who cannot complete a page — that gap is the finding.

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Norm-referenced batteries tell you where a student ranks. They rarely tell you which condition to change on Monday.
Because: Performance-based assessment manipulates conditions — distance, duration, size, complexity — so the result names the demand that breaks performance.
Move: Ask what decision the score will drive before you administer anything.
Move: Record the condition under which performance changed, not only the score.
Move: Pair any norm-referenced result with a performance observation in the same report.
Watch for: A percentile in the average range beside a student who cannot complete a page — that gap is the finding.

Say this

Land the "so what": Norm-referenced batteries tell you where a student ranks. They rarely tell you which condition to change on Monday.

Explain the mechanism plainly: Performance-based assessment manipulates conditions — distance, duration, size, complexity — so the result names the demand that breaks performance.

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

My notes

1.16 — Two-minute case: average score, failing student

Mini case

Two-minute case

Two-minute case: average score, failing student

A Grade 3 student scores in the average range on a norm-referenced visual perception battery, yet cannot complete grade-level written work.

What did the battery miss, and what do you do next?

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A Grade 3 student scores in the average range on a norm-referenced visual perception battery, yet cannot complete grade-level written work.
Question: What did the battery miss, and what do you do next?
Model answer: The battery sampled brief, untimed, single-item processing. It never sampled sustained near performance under classroom duration and layout. Run a performance-based sample at the real distance and duration, and document completion, place-losing, and time to degradation.
Teaching point: Average capacity under ideal conditions is compatible with failure under classroom conditions.

Say this

Two-minute case. Read it aloud:

A Grade 3 student scores in the average range on a norm-referenced visual perception battery, yet cannot complete grade-level written work.

Put the question to them: "What did the battery miss, and what do you do next?" Give 60 seconds, no talking.

My notes

1.17 — Reflect and share

Reflection

Reflect and share

Recall a standard score that did not match what you saw in the classroom. What did the battery miss?

THINKPROCESSSHARE

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Recall a standard score that did not match what you saw in the classroom. What did the battery miss?
Starter: The battery score was... but in the classroom I saw... The battery missed...

Say this

Reflection prompt: "Recall a standard score that did not match what you saw in the classroom. What did the battery miss?"

Offer the sentence starter: "The battery score was... but in the classroom I saw... The battery missed..."

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

My notes

1.18 — Knowledge check — why performance-based

Self-check

Knowledge check

Knowledge check — why performance-based

What does a norm-referenced perceptual battery not tell you?

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

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What does a norm-referenced perceptual battery not tell you?
– How the student compares to same-age peers
✓ How performance holds up under real task demand and duration
– Whether the score is statistically reliable
– Which subtest was lowest
Rationale: Batteries sample brief, isolated performance. Occupational breakdown usually shows up in sustained, contextual demand.

Say this

Knowledge check: "What does a norm-referenced perceptual battery not tell you?"

Options:

• How the student compares to same-age peers

My notes