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Presenter study handout

The VPA™: Assessment & Clinical Reasoning

4 contact hours · 0.4 AOTA CEUs · Module 5 · 15 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 5

5.1 — Administering the Full VPA™: level progression, basal and ceiling rules, validity flags

Transition

Module 5

Administering the Full VPA™: level progression, basal and ceiling rules, validity flags

1:55 – 2:35

The VPA™: Assessment & Clinical Reasoning
1 / 15

Say this

Transition: "Administering the Full VPA™: level progression, basal and ceiling rules, validity flags."

My notes

5.2 — Administering the Full VPA™

Title

Module 5

Administering the Full VPA™

Level progression, basal and ceiling rules, and the five validity threats.

The VPA™: Assessment & Clinical Reasoning
2 / 15

Say this

Open here. "Administering the Full VPA™." Level progression, basal and ceiling rules, and the five validity threats.

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

My notes

5.3 — Stopping rules

Poll

Poll

Stopping rules

What most often makes you unsure when to stop testing?

Select one.

The VPA™: Assessment & Clinical Reasoning
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Say this

Ask the poll: "What most often makes you unsure when to stop testing?"

Options:

• Deciding the basal

My notes

5.4 — Progression, basal, ceiling

Teaching slide

Rules

Progression, basal, ceiling

  • Every skill runs sequentially L1 → L5; no adaptive skipping.
  • Basal: the highest level performed cleanly without prompting.
  • Ceiling: the level at which performance breaks down and stays broken.
  • Record the achieved level per skill — that number, not a raw total, drives the profile.
Item 1 — difficulty 1Item 2 — difficulty 2Item 3 — difficulty 3Item 4 — difficulty 4Item 5 — difficulty 5Item 6 — difficulty 6Item 7 — difficulty 7Item 8 — difficulty 8BASALTESTCEILING
Basal establishes a floor of secure performance; ceiling stops testing once the demand exceeds capacity. Items outside the window are inferred, not administered.
The VPA™: Assessment & Clinical Reasoning
4 / 15

Say this

Frame the slide: "Progression, basal, ceiling."

Walk each point, one sentence each:

• Every skill runs sequentially L1 → L5; no adaptive skipping.

My notes

5.5 — The five validity threats

Teaching slide

Validity

The five validity threats

  • Setup drift — distance, lighting, or positioning changed mid-session.
  • Fatigue or state — illness, hunger, medication timing, time of day.
  • Attention and effort inconsistency across comparable items.
  • Language or instruction comprehension confounding the visual demand.
  • Uncorrected refractive status or missing habitual correction.
1

Fatigue

Performance decays across the session, not across difficulty.

2

Attention

Errors scatter randomly instead of clustering by demand.

3

Comprehension

The student fails the instruction, not the visual task.

4

Motor confound

Hand control limits the response before vision does.

5

Environment

Glare, distance, clutter, or noise changed the demand.

Five threats that make a low score mean something other than a visual performance deficit. Name the threat in the record before you interpret the profile.

An unaddressed validity threat invalidates interpretation — document and re-probe.

The VPA™: Assessment & Clinical Reasoning
5 / 15

Say this

Frame the slide: "The five validity threats."

Walk each point, one sentence each:

• Setup drift — distance, lighting, or positioning changed mid-session.

My notes

5.6 — The 15 skills sit on the five levels

Teaching slide

Structure

The 15 skills sit on the five levels

  • Level 1 · Access — near acuity, intermediate/distance acuity, contrast tolerance. Nothing above this level is interpretable if it fails.
  • Level 2 · Efficiency — fixation, pursuits, saccades with near point of convergence and endurance.
  • Level 3 · Processing — discrimination and closure, figure-ground, visual memory and spatial relations.
  • Level 4 · Visual-motor integration — form reproduction, copy accuracy, timed written output.
  • Level 5 · Functional integration — sustained reading, generative writing, classroom-task simulation.
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.

Each of the 15 skills runs its own L1–L5 task ladder. The level of the domain tells you where in the framework the skill lives; the level achieved within the skill tells you how far up that skill’s ladder the student got.

The VPA™: Assessment & Clinical Reasoning
6 / 15

Say this

Frame the slide: "The 15 skills sit on the five levels."

Walk each point, one sentence each:

• Level 1 · Access — near acuity, intermediate/distance acuity, contrast tolerance. Nothing above this level is interpretable if it fails.

My notes

5.7 — What a full battery looks like, level by level

Five-Level Framework

Walkthrough

What a full battery looks like, level by level

1

Visual Acuity & Sensory Foundation

Measure both distances with habitual correction on. Fail here and you stop, refer, and re-assess after the eye examination.

2

Visual Efficiency

Three skills, each timed and observed. This is where NPC and near endurance are measured — the same probe you ran in the Mini, now with the full ladder.

3

Visual Processing

Processing tasks the student can do slowly are still passes; record the latency in the observation column.

4

Visual-Motor Integration

Copy and reproduction. Watch model-rechecking — intact processing with unreliable output is the signature of a Level 4 limiter.

5

Functional Integration

Sustained reading and generative writing. Score the time course, not just the end product.

Run bottom to top, every time. The order is the interpretation.

The VPA™: Assessment & Clinical Reasoning
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Say this

Run the five levels bottom-up.

Name each level, then say which one you assess first and why.

My notes

5.8 — Keeping a full battery clean

Teaching slide

Session management

Keeping a full battery clean

  • Order skills so fatigue-sensitive probes are not all at the end.
  • Break at fixed points, not when performance dips.
  • Re-state the setup after every break; re-measure distance.
  • Split across two sessions rather than pushing through fatigue.
1Near cards (40 cm set)
2Distance chart
3Pursuit / saccade targets
4Copy worksheet + pencil
5Timer or phone stopwatch
6Tape measure
7Scoring sheet or tablet
8Occluder / patch
Lay materials out before the student arrives, in administration order. Hunting for a target mid-probe changes pacing, and pacing changes the score.

A fatigued battery reads as a low profile — and you cannot un-ring that bell.

The VPA™: Assessment & Clinical Reasoning
8 / 15

Say this

Frame the slide: "Keeping a full battery clean."

Walk each point, one sentence each:

• Order skills so fatigue-sensitive probes are not all at the end.

My notes

5.9 — Module 5 video — administering the Full VPA™

Video

Lecture

Module 5 video — administering the Full VPA™

VIDEO SLOT

Level progression, basal/ceiling rules, and pacing.

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

The VPA™: Assessment & Clinical Reasoning
9 / 15

Say this

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

My notes

5.10 — Screenshot — Full VPA™ runner in progress

Visual

Import

Screenshot — Full VPA™ runner in progress

Full VPA™ · in progress · Skill 6 of 9
Oculomotor efficiency → Pursuits02:14 elapsed
Level 1Pass
Level 2Pass
Level 3Pass (effortful)
Level 4Not attempted
Level 5Not attempted

Running record

Basal established: L2

Ceiling rule: 2 consecutive fails

Observed: head substitution, 3 losses of place

Student report: “letters go blurry”

Achieved level: 3

The runner keeps three things on screen at once: which probe you are in, the level ladder you are scoring against, and the running record. Basal and ceiling are computed as you go so you stop at the right place.
The VPA™: Assessment & Clinical Reasoning
10 / 15

Say this

Describe what belongs here: Runner view showing the level ladder and scoring panel..

My notes

5.11 — Photo — materials laid out for a full session

Visual

Import

Photo — materials laid out for a full session

1Near cards (40 cm set)
2Distance chart
3Pursuit / saccade targets
4Copy worksheet + pencil
5Timer or phone stopwatch
6Tape measure
7Scoring sheet or tablet
8Occluder / patch
Lay materials out before the student arrives, in administration order. Hunting for a target mid-probe changes pacing, and pacing changes the score.
The VPA™: Assessment & Clinical Reasoning
11 / 15

Say this

Describe what belongs here: Bench setup: cards, worksheets, timer, measured distances..

My notes

5.12 — So what? Basal and ceiling save the student from the battery

So what?

So what?

So what? Basal and ceiling save the student from the battery

Correct basal and ceiling rules keep a student out of twenty items they were always going to fail — and keep your session inside its window.

Level progression is designed to find the boundary of performance, not to sample everything.

What you do with it

  • Establish basal before you climb; a false basal invalidates everything above it.
  • Stop at the ceiling rule even when you are curious.
  • Flag validity threats in the moment — fatigue, attention, correction not worn, setup drift.

Watch for

Frustration behavior climbing before the ceiling rule triggers — stop and note the validity flag.

The VPA™: Assessment & Clinical Reasoning
12 / 15

Say this

Land the "so what": Correct basal and ceiling rules keep a student out of twenty items they were always going to fail — and keep your session inside its window.

Explain the mechanism plainly: Level progression is designed to find the boundary of performance, not to sample everything.

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

My notes

5.13 — Two-minute case: basal was never established

Mini case

Two-minute case

Two-minute case: basal was never established

You start at the age-band entry point, the student misses two of the first three items, and you keep going upward hoping he settles.

What went wrong and what do you do?

The VPA™: Assessment & Clinical Reasoning
13 / 15

Say this

Two-minute case. Read it aloud:

You start at the age-band entry point, the student misses two of the first three items, and you keep going upward hoping he settles.

Put the question to them: "What went wrong and what do you do?" Give 60 seconds, no talking.

My notes

5.14 — Reflect and share

Reflection

Reflect and share

Reflect and share

Which of the five validity threats do you see most in your setting, and what will you change to control it?

THINKPROCESSSHARE
The VPA™: Assessment & Clinical Reasoning
14 / 15

Say this

Reflection prompt: "Which of the five validity threats do you see most in your setting, and what will you change to control it?"

Offer the sentence starter: "The validity threat I see most is... I will control it by..."

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

My notes

5.15 — Knowledge check — basal and ceiling

Self-check

Knowledge check

Knowledge check — basal and ceiling

A student fails the first two items at the entry level. What do you do?

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

The VPA™: Assessment & Clinical Reasoning
15 / 15

Say this

Knowledge check: "A student fails the first two items at the entry level. What do you do?"

Options:

• Stop and record the achieved level

My notes