Visual Minds Learning

Clinical Governance

VPA™ Scope & Limitations

An honest statement of what the Visual Performance Assessment is designed to do — and what it is not.

Treatment plan templates →

Positioning statement

The VPA™ is a structured clinical observation system for licensed occupational therapists, teachers of students with visual impairments (TVIs), and other qualified professionals. It helps clinicians identify visual performance patterns that affect occupational performance, guide intervention planning within their scope of practice, and monitor progress over time.

1. Intended users

  • Licensed occupational therapists (OT / OTR/L / COTA under supervision)
  • Teachers of students with visual impairments (TVIs)
  • School-based multidisciplinary teams working within their scope
  • Developmental optometrists using the VPA™ as an OT-facing communication tool

The VPA™ is not designed for lay use, for use by unlicensed aides, or for self-administration by families.

2. Intended use

The VPA™ IS designed to
  • Structure observation of visual performance across 5 levels and 15 sections
  • Identify functional impact of vision on school occupations
  • Guide OT intervention planning within scope
  • Support goal writing and service justification
  • Provide repeatable pre / post progress monitoring
  • Trigger appropriate referrals when red flags appear
  • Give teams a shared clinical vocabulary
The VPA™ is NOT
  • A standardized, norm-referenced psychometric test
  • A diagnostic instrument for ocular or neurological pathology
  • A substitute for a comprehensive medical eye examination
  • A replacement for MVPT-4, Beery VMI, TVPS-4, or DEM
  • An FDA-cleared medical device
  • A tool for diagnosing learning disabilities
  • Valid for use outside the clinician's licensed scope

3. Evidence stage

The VPA™ is currently a pilot-stage clinical framework. Descriptive statistics and internal reliability data are reported publicly with sample sizes (n ≥ 30 per age band unless otherwise noted). We do not claim published sensitivity, specificity, or multi-site validation. Ongoing reliability and criterion-validity work is disclosed on the Research page.

4. Scope of practice

The VPA™ is administered by licensed professionals within their own scope. For occupational therapists, this means observing how visual performance affects client factors and occupational performance — reading, writing, ADLs, classroom participation — and delivering intervention within the OT scope. The VPA™ does not extend a clinician's scope; it structures observation within it.

5. Red flags — refer to medical eye care first

Stop the VPA™ and refer to a developmental optometrist, ophthalmologist, or primary care provider (as appropriate) when any of the following are present:

  • Reduced acuity that has never been evaluated (no eye exam within 12 months)
  • Visible strabismus, nystagmus, or lid asymmetry
  • Reported diplopia, transient vision loss, or new-onset visual complaint
  • Head-injury / concussion history without visual follow-up
  • New photophobia, eye pain, headaches with visual triggers
  • Suspected amblyopia, refractive error, or accommodative dysfunction
  • Progressive neurological signs, sudden regression, or asymmetry between eyes

Referral language: "Consider evaluation by a developmental optometrist for accommodative, vergence, and ocular health assessment." Never diagnose.

6. Recommended use pattern

  1. Fast Screen (free, 3–5 min) — teacher / parent triage to decide whether OT observation is warranted.
  2. Mini VPA™ (10–15 min) — 5 probes, one per level, flags which levels warrant deeper look. Not sufficient for treatment planning alone.
  3. Full VPA™ (30–60 min adaptive) — 15 sections × 5 levels. Anchor for OT intervention planning, IEP goal writing, and progress monitoring.
  4. External Assessments section — attach MVPT-4, Beery VMI, TVPS-4, or DEM scores from your own licensed kits when standardized data are required. These scores add documentation weight and support criterion validity; they do not replace VPA-driven treatment planning.
  5. Re-administer at 8–12 week intervals for progress monitoring.

7. Documentation & privacy

  • Enter student initials or a non-identifying code — never full names, DOB, MRN, or SSN.
  • PHI is not accepted by the platform. See the Privacy Notice and DPA.
  • Clinician retains professional responsibility for interpretation and treatment decisions.

Author: Jeff Foster, MS, OTR/L, EdD(ABD). NBCOT-registered occupational therapist licensed in Mississippi and California. Pediatric vision and school-based practice.

Questions or clinical feedback: visualmindslearning.com/contact.