The VPA™: Assessment & Clinical Reasoning

Transition: "Administering the Mini VPA™: the seven probes, scripts, prompting limits, and observation cues."

Open here. "Administering the Mini VPA™." Five probes, verbatim scripts, prompting limits, and observation cues.

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

Ask the poll: "Which prompting error are you most at risk of during administration?"

Options:

• Repeating the item after a delay

• Adding encouragement that cues the answer

• Allowing extra time past the limit

• Rephrasing the script

Take a show of hands or the on-screen tally, then name the pattern you see before advancing.

Frame the slide: "Script discipline."

Walk each point, one sentence each:

• Read the Say line verbatim; the Do line defines your hands and the timing.

• One repetition of instructions is permitted; further prompting is recorded, not free.

• Score performance, not effort — note effort separately as an observation.

• Record the observation cues (place loss, head movement, working distance drift).

Point at the figure while you talk — name the parts before the labels.

Close with: "If you only take one of these back, take the first one."

Frame the slide: "What triggers a Full VPA™."

Walk each point, one sentence each:

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

• Any probe passed only with degraded rate, endurance, or strategy.

• Teacher/caregiver report that conflicts with a passed probe.

• Any red-flag ocular symptom — refer regardless of the screen result.

Point at the figure while you talk — name the parts before the labels.

Close with: "If you only take one of these back, take the first one."

Contrast the two columns: Pursuit: look for versus Saccade: look for.

Pursuit: look for:

• Symmetry between the two eyes as they track

• Head movement substituting for eye movement

• Target drift — eyes falling behind or leading the target

• Change in focal distance or working distance during the task

Saccade: look for:

• Accuracy of landing on the target placement

• Undershoot or overshoot of the intended fixation point

• Fatigue — accuracy degrading over repeated trials

• Loss of fixation between jumps

Ask: "Which column is your student living in right now?"

Frame the slide: "Near point of convergence — the penlight probe."

Walk each point, one sentence each:

• This belongs to the Level 2 efficiency probe. You run it here in the Mini, and again inside Domain 2 of the Full.

• Start the penlight or accommodative target at about 18 in, midline, at eye level.

• Move it slowly toward the bridge of the nose while the student holds fixation.

• Record the break — the distance at which the student reports doubling or you see an eye drift out.

• Move back out and record the recovery distance. Run three trials: a break that recedes across trials is the finding.

• Stop for any report of pain; record head movement, squinting, or an outward eye turn.

Point at the figure while you talk — name the parts before the labels.

Close with: "If you only take one of these back, take the first one."

Contrast the two columns: Levels 1–3 versus Levels 4–5.

Levels 1–3:

• L1 — acuity at the measured distance, correction worn

• L2 — oculomotor efficiency and near endurance

• L3 — a visual processing probe appropriate to the band

• Score the level achieved, not the raw item count

Levels 4–5:

• L4 — visual-motor copy accuracy

• L5 — functional reading and a writing sample

• Record rate, prompts, and place-loss events

• Any degraded pass is still a flag

Ask: "Which column is your student living in right now?"

Frame the slide: "What to watch while they work."

Walk each point, one sentence each:

• Working distance drift and head movement instead of eye movement.

• Place loss, re-reading, and finger tracking that was not there at baseline.

• Squinting, blinking bursts, eye rubbing, or turning away from the page.

• Strategy: does the student narrate a plan or guess and check?

Point at the figure while you talk — name the parts before the labels.

Close with: "If you only take one of these back, take the first one."

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

Describe what belongs here: Clinician view of a probe script with the level ladder visible..

Describe what belongs here: Positioning photo showing the clinician’s line of sight to the eyes..

Land the "so what": Every extra prompt you add turns an assessment item into a teaching trial, and the score stops meaning what the manual says it means.

Explain the mechanism plainly: The five Mini probes are standardized in wording, demonstration, and prompting limits.

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

• Read the script; do not paraphrase into encouragement.

• Stay inside the stated prompting limit and record any prompt given.

• Write observation cues as you go — they carry the clinical meaning the score cannot.

Tell them what success looks like: Yourself coaching. If you helped, note it; a scored item with an unrecorded prompt is unusable.

Ask: "Who has a student this describes right now?" Take one answer, then move.

Two-minute case. Read it aloud:

Mid-probe, a student stalls and you say "remember to start at the left." He then completes the item correctly.

Put the question to them: "How do you score and document it?" Give 60 seconds, no talking.

Model answer (reveal after they commit): Score according to the prompting rule for that probe — the item was completed with a prompt beyond the limit, so it does not count as independent. Record the exact cue and the response; that pairing is valuable intervention information even though the item is not credited.

Close with the rule: Never quietly upgrade a prompted response. Document the prompt and use it clinically.

Reflection prompt: "After scoring yourself on the fidelity checklist, which two items will you rehearse before your first real administration?"

Offer the sentence starter: "I will rehearse [item 1] and [item 2] because..."

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

Knowledge check: "A student pauses; you say "you can do it, look again at the top." What have you done?"

Options:

• Provided allowable encouragement

• Provided a cue that changes the task and must be recorded as a prompting deviation

• Nothing that affects the score

• Invalidated the entire administration

Correct answer: option 2. Rationale: Directional information is a cue. Record it as a deviation; the item score is no longer comparable to the standard condition.