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Visual Minds Learning
Administration scripts, scoring rubrics, and print-ready stimuli for the Full Visual Performance Assessment.
Visual Access
Functional concern
Reduced near acuity limits every downstream task; students strain, tilt, or avoid near work. Automatic optometry referral is indicated.
Intervention direction
Refer to developmental optometry before continuing intervention. Trial print enlargement, high-contrast copies, and lighting adjustments in the interim.
L1 · Intermediate acuity, LEFT eye — 24 in (60 cm), RIGHT eye occluded.
Position the chart at 24 in (60 cm) at eye level in good lighting. Occlude the RIGHT eye. Ask the student to read the smallest comfortable line with the LEFT eye. Watch for squint, tilt, or lean-in.
L2 · Intermediate acuity, RIGHT eye — 24 in (60 cm), LEFT eye occluded.
Keep the chart at 24 in (60 cm). Occlude the LEFT eye. Read smallest comfortable line with RIGHT eye. Compare to LEFT-eye result — ≥2-line difference is a red flag.
L3 · Intermediate acuity, BOTH eyes — 24 in (60 cm).
Chart at 24 in (60 cm), both eyes open. Read smallest comfortable line. Watch for head tilt, squint, or one-eye preference.
L4 · Near acuity, BOTH eyes — 16 in (40 cm), letters or numbers.
Move to the near acuity chart at 16 in (40 cm) at eye level, both eyes open. Read the smallest comfortable line. Note working-distance drift (holding closer than 16 in) as a red flag.
L5 · Near reading acuity — sentence ladder at 16 in (40 cm), both eyes.
Present the sentence ladder card at 16 in (40 cm), both eyes open. Student reads each line aloud, top to bottom. Record the smallest line read fluently (no regressions, squinting, or head tilt). Watch for skipped words, finger tracking, and working-distance drift.
Intermediate acuity, LEFT eye — 24 in (60 cm), RIGHT eye occluded.
Administration
Position the chart at 24 in (60 cm) at eye level in good lighting. Occlude the RIGHT eye. Ask the student to read the smallest comfortable line with the LEFT eye. Watch for squint, tilt, or lean-in.
Materials: Intermediate acuity chart · Occluder · Tape/ruler for 24 in (60 cm)
Clinical note: Unable to resolve 20/40 at intermediate → optometry referral.
Intermediate acuity, RIGHT eye — 24 in (60 cm), LEFT eye occluded.
Administration
Keep the chart at 24 in (60 cm). Occlude the LEFT eye. Read smallest comfortable line with RIGHT eye. Compare to LEFT-eye result — ≥2-line difference is a red flag.
Materials: Intermediate acuity chart · Occluder
Clinical note: ≥2-line interocular difference → automatic optometry referral.
Intermediate acuity, BOTH eyes — 24 in (60 cm).
Administration
Chart at 24 in (60 cm), both eyes open. Read smallest comfortable line. Watch for head tilt, squint, or one-eye preference.
Materials: Intermediate acuity chart
Near acuity, BOTH eyes — 16 in (40 cm), letters or numbers.
Administration
Move to the near acuity chart at 16 in (40 cm) at eye level, both eyes open. Read the smallest comfortable line. Note working-distance drift (holding closer than 16 in) as a red flag.
Materials: Near acuity chart (letters/numbers) · 16 in (40 cm) distance
Near reading acuity — sentence ladder at 16 in (40 cm), both eyes.
Administration
Present the sentence ladder card at 16 in (40 cm), both eyes open. Student reads each line aloud, top to bottom. Record the smallest line read fluently (no regressions, squinting, or head tilt). Watch for skipped words, finger tracking, and working-distance drift.
Materials: Near reading acuity card — sentence ladder · 16 in (40 cm) distance
Clinical note: Reading acuity worse than distance/near letter acuity by ≥2 lines suggests oculomotor or accommodative involvement — proceed with Domain 2 tasks.
Visual Access
Functional concern
Poor contrast sensitivity causes fatigue with faded print, whiteboards, and low-contrast worksheets — often mistaken for inattention.
Intervention direction
Refer to optometry / neuro-visual assessment. Interim accommodations: high-contrast print, matte paper, glare control, tinted overlays.
L1 · Intermediate contrast, LEFT eye — 24 in (60 cm), RIGHT eye occluded.
Seat the student at 24 in (60 cm). Occlude the RIGHT eye. Present the intermediate contrast strip (100% → step-down). Ask the student to name the direction of each E until they miss two in a row. Record the lowest contrast step correctly identified.
L2 · Intermediate contrast, RIGHT eye — 24 in (60 cm), LEFT eye occluded.
Same distance, occlude the LEFT eye. Repeat the intermediate contrast strip. Flag interocular difference ≥ 2 steps as a referral trigger.
L3 · Intermediate contrast, BOTH eyes — 24 in (60 cm).
Both eyes open at 24 in (60 cm). Repeat the intermediate contrast strip. This mimics whiteboard / projected-slide viewing.
L4 · Near contrast, BOTH eyes — 16 in (40 cm), letters.
Move to the near contrast strip at 16 in (40 cm), both eyes open. Have the student identify the direction/letter at each step. Note working-distance drift as a red flag.
L5 · Near reading contrast — low-contrast sentence ladder at 16 in (40 cm).
Present the low-contrast sentence ladder at 16 in (40 cm), both eyes open. Ask the student to read each row aloud until they miss two words on a row or refuse. Record the lowest contrast row read fluently.
Intermediate contrast, LEFT eye — 24 in (60 cm), RIGHT eye occluded.
Administration
Seat the student at 24 in (60 cm). Occlude the RIGHT eye. Present the intermediate contrast strip (100% → step-down). Ask the student to name the direction of each E until they miss two in a row. Record the lowest contrast step correctly identified.
Materials: Intermediate contrast strip · Occluder · Tape/ruler for 24 in (60 cm)
Intermediate contrast, RIGHT eye — 24 in (60 cm), LEFT eye occluded.
Administration
Same distance, occlude the LEFT eye. Repeat the intermediate contrast strip. Flag interocular difference ≥ 2 steps as a referral trigger.
Materials: Intermediate contrast strip · Occluder
Intermediate contrast, BOTH eyes — 24 in (60 cm).
Administration
Both eyes open at 24 in (60 cm). Repeat the intermediate contrast strip. This mimics whiteboard / projected-slide viewing.
Materials: Intermediate contrast strip
Near contrast, BOTH eyes — 16 in (40 cm), letters.
Administration
Move to the near contrast strip at 16 in (40 cm), both eyes open. Have the student identify the direction/letter at each step. Note working-distance drift as a red flag.
Materials: Near contrast strip · 16 in (40 cm) distance
Near reading contrast — low-contrast sentence ladder at 16 in (40 cm).
Administration
Present the low-contrast sentence ladder at 16 in (40 cm), both eyes open. Ask the student to read each row aloud until they miss two words on a row or refuse. Record the lowest contrast row read fluently.
Materials: Low-contrast sentence ladder · 16 in (40 cm) distance
Clinical note: Reading contrast worse than near letter contrast by ≥ 2 steps suggests visual-processing or accommodative load — proceed with Domain 2.
Visual Efficiency
Functional concern
Unsteady fixation disrupts reading, copying, and every attention-loaded near task; drift is often invisible to teachers.
Intervention direction
Fixation drills (dot targets, Marsden ball), balance-plus-fixation activities, and posture setup. Progress to fixation under cognitive load.
L1 · 5 sec × 2 trials on central dot, silent room.
Seat the student 40 cm from the screen. Point to the central black dot. Say: "Look right at this dot and keep looking at it — don't let your eyes wander until I say stop." Run 2 trials of 5 seconds each. Score each trial as steady or broke fixation. If either trial breaks, note the second in the timer where drift began.
L2 · 10 sec × 2 trials, silent room.
Same setup. Run 2 trials of 10 seconds each. Say: "Keep looking right at the dot — don't blink more than usual and don't let your eyes drift." Score each trial as steady or broke, and count refixations across both trials.
L3 · 20 sec × 2 trials, silent room.
Same setup. Run 2 trials of 20 seconds each. Note if postural sway or head tilt appears as the trial extends.
L4 · 20 sec × 2 trials with age-adaptive dual-task (verbal Q&A).
Run 2 trials of 20 seconds each while imposing an age-appropriate verbal load. Ages 5–7: ask 3 simple questions during the trial ('What is your name? / What color is your shirt? / Name an animal'). Ages 8+: name colors or letters aloud as the clinician calls them. Adult: rapid semantic naming (e.g. list animals). Loss of fixation while producing a verbal response is the clinically meaningful finding.
L5 · 30 sec × 2 trials under age-adaptive cognitive load.
Run 2 trials of 30 seconds each under age-matched cognitive load. Ages 5–7: count FORWARD to 10 aloud, then again. Ages 8–10: count forward by 2s to 20. Ages 11+ / adult: count BACKWARD from 100 by 3s ('100, 97, 94…'). Score each trial as steady or broke and count refixations. Loss of fixation during the concurrent task is the clinically meaningful finding.
5 sec × 2 trials on central dot, silent room.
Administration
Seat the student 40 cm from the screen. Point to the central black dot. Say: "Look right at this dot and keep looking at it — don't let your eyes wander until I say stop." Run 2 trials of 5 seconds each. Score each trial as steady or broke fixation. If either trial breaks, note the second in the timer where drift began.
Materials: On-screen fixation dot (interactive) · Or printed dot at 40 cm
10 sec × 2 trials, silent room.
Administration
Same setup. Run 2 trials of 10 seconds each. Say: "Keep looking right at the dot — don't blink more than usual and don't let your eyes drift." Score each trial as steady or broke, and count refixations across both trials.
Materials: On-screen fixation dot · Timer (built in)
20 sec × 2 trials, silent room.
Administration
Same setup. Run 2 trials of 20 seconds each. Note if postural sway or head tilt appears as the trial extends.
Materials: On-screen fixation dot · Timer (built in)
20 sec × 2 trials with age-adaptive dual-task (verbal Q&A).
Administration
Run 2 trials of 20 seconds each while imposing an age-appropriate verbal load. Ages 5–7: ask 3 simple questions during the trial ('What is your name? / What color is your shirt? / Name an animal'). Ages 8+: name colors or letters aloud as the clinician calls them. Adult: rapid semantic naming (e.g. list animals). Loss of fixation while producing a verbal response is the clinically meaningful finding.
Materials: On-screen fixation dot · Timer (built in)
30 sec × 2 trials under age-adaptive cognitive load.
Administration
Run 2 trials of 30 seconds each under age-matched cognitive load. Ages 5–7: count FORWARD to 10 aloud, then again. Ages 8–10: count forward by 2s to 20. Ages 11+ / adult: count BACKWARD from 100 by 3s ('100, 97, 94…'). Score each trial as steady or broke and count refixations. Loss of fixation during the concurrent task is the clinically meaningful finding.
Materials: On-screen fixation dot · Timer (built in)
Visual Efficiency
Functional concern
Jerky or head-dominant pursuits produce loss of place in reading and difficulty tracking moving targets in daily life.
Intervention direction
Pursuit drills in H/V/circular planes, Marsden ball, laser tag activities. Progress from evaluator-paced to metronome-paced, then to text-scan targets.
L1 · Slow horizontal sweep, large target, no metronome.
Turn on the on-screen pursuit at 40 cm. Say: "Watch the red dot. Follow it with your eyes only — keep your head still." Run for 3 full sweeps (about 15 sec). Score as smooth vs. jerky / head-dominant. Optional: gently steady the chin during trial to distinguish head-strategy from true tracking deficit.
L2 · Broad H + V pattern, moderate speed.
Same instruction. Run the H+V pattern for ~20 sec. Score losses and any saccadic intrusions (small catch-up jumps). Note if only one plane is affected.
L3 · Circular pursuit, both directions.
Run the circular path for ~20 sec (both rotational directions if adjustable). Watch for asymmetry between directions — one direction significantly worse is clinically meaningful.
L4 · Figure-8 pursuit + cognitive load (name a color/letter at each crossover).
Run the figure-8 pattern for ~20 sec. At each crossover point, say a color or letter the student must repeat back while still tracking. Score naming errors AND tracking losses.
L5 · Metronome-paced figure-8 at 60 bpm, 30 sec.
Turn on the built-in beep metronome (default 60 bpm — adjust per student). Say: "Every time you hear the beep, the dot should be at the far side." Run for 30 seconds. Score losses of pace, losses of fixation, and postural drift.
Slow horizontal sweep, large target, no metronome.
Administration
Turn on the on-screen pursuit at 40 cm. Say: "Watch the red dot. Follow it with your eyes only — keep your head still." Run for 3 full sweeps (about 15 sec). Score as smooth vs. jerky / head-dominant. Optional: gently steady the chin during trial to distinguish head-strategy from true tracking deficit.
Materials: On-screen pursuit target (interactive)
Broad H + V pattern, moderate speed.
Administration
Same instruction. Run the H+V pattern for ~20 sec. Score losses and any saccadic intrusions (small catch-up jumps). Note if only one plane is affected.
Materials: On-screen pursuit target
Circular pursuit, both directions.
Administration
Run the circular path for ~20 sec (both rotational directions if adjustable). Watch for asymmetry between directions — one direction significantly worse is clinically meaningful.
Materials: On-screen pursuit target
Figure-8 pursuit + cognitive load (name a color/letter at each crossover).
Administration
Run the figure-8 pattern for ~20 sec. At each crossover point, say a color or letter the student must repeat back while still tracking. Score naming errors AND tracking losses.
Materials: On-screen pursuit target
Metronome-paced figure-8 at 60 bpm, 30 sec.
Administration
Turn on the built-in beep metronome (default 60 bpm — adjust per student). Say: "Every time you hear the beep, the dot should be at the far side." Run for 30 seconds. Score losses of pace, losses of fixation, and postural drift.
Materials: On-screen pursuit target + built-in metronome
Visual Efficiency
Functional concern
Inefficient saccades cause line-skipping, place-losing, and finger-tracking on reading. Reduced fluency is the classroom signature.
Intervention direction
Saccade drills, Hart Charts, columnar reading, metronome-paced text scans. Progress from large targets to text-density stimuli.
L1 · 2-target sweep, wide separation, 5 sweeps.
Two large targets on screen, wide apart. Say: "When the red dot lights up on one side, look at it. When the other side lights up, look at that one. Keep your head still." Run 5 back-and-forth sweeps. Score over/undershoots and head-strategy.
L2 · 4-target row, 10 sweeps.
Four targets across the screen. Student saccades to whichever lights up. Run 10 activations. Score errors (skips, wrong target).
L3 · 6-target 2×3 grid, faster cadence, 14 sweeps.
Six targets in a 2×3 grid, faster flash. Student keeps up as long as possible. Score errors and any point where the student loses the sequence.
L4 · 5×8 symbol saccade grid, row-by-row.
Show the 5×8 symbol saccade grid. Say: "Call each item across the row, left to right. When you reach the end, drop to the next row and start again on the left." Score missed items, regressions, and lost place.
L5 · Dense number/letter grid, 60 sec.
Show the 6×10 number/letter saccade grid. Say: "Call each item across the row, left to right. Keep your place as you move down each row." Run for 60 seconds or to completion. Score items called, regressions, missed items, and lost place.
2-target sweep, wide separation, 5 sweeps.
Administration
Two large targets on screen, wide apart. Say: "When the red dot lights up on one side, look at it. When the other side lights up, look at that one. Keep your head still." Run 5 back-and-forth sweeps. Score over/undershoots and head-strategy.
Materials: On-screen 2-target display (interactive)
4-target row, 10 sweeps.
Administration
Four targets across the screen. Student saccades to whichever lights up. Run 10 activations. Score errors (skips, wrong target).
Materials: On-screen 4-target display
6-target 2×3 grid, faster cadence, 14 sweeps.
Administration
Six targets in a 2×3 grid, faster flash. Student keeps up as long as possible. Score errors and any point where the student loses the sequence.
Materials: On-screen 6-target grid display
5×8 symbol saccade grid, row-by-row.
Administration
Show the 5×8 symbol saccade grid. Say: "Call each item across the row, left to right. When you reach the end, drop to the next row and start again on the left." Score missed items, regressions, and lost place.
Materials: On-screen 5×8 symbol saccade grid · Timer
Dense number/letter grid, 60 sec.
Administration
Show the 6×10 number/letter saccade grid. Say: "Call each item across the row, left to right. Keep your place as you move down each row." Run for 60 seconds or to completion. Score items called, regressions, missed items, and lost place.
Materials: On-screen 6×10 number/letter saccade grid · Timer
Visual Efficiency
Functional concern
Poor convergence produces near-work fatigue, blur, doubling, and reading avoidance — often mis-labeled as motivation issues.
Intervention direction
Refer for developmental vision exam. In-clinic: pencil push-ups, Brock string, jump vergence. Pair with 20/20/20 rule and posture cues.
L1 · Gross NPC with picture target — any age, non-reader accessible.
Hold the on-screen picture target (or a printed picture on a tongue depressor) at 40 cm along the midline of the face. Say: "Watch the star. As it comes closer to your nose, keep both eyes on it and tell me if you ever see two of them." Move steadily toward the nose at ~2 cm/sec. Record break distance (cm from nose) when the student reports doubling OR you observe one eye drift outward. Then move the target back and record recovery distance (cm at which fusion returns).
L2 · Single midline NPC (medium target), 3 trials averaged — ages 8+.
Use the single midline NPC worksheet at Level 2. Hold at 40 cm along the midline. Say: "Watch the target. Keep both eyes on it and tell me the moment you see two of them." Move steadily toward the nose (~2 cm/sec) for 3 trials. Record break and recovery for each.
L3 · Single midline NPC (smaller target), 3 trials averaged — ages 11+.
Use the single midline NPC worksheet at Level 3 (smaller target). Hold at 40 cm on midline. Say: "Keep your eyes locked on the target. Tell me the moment it doubles or blurs." Run 3 slow midline trials from 40 cm toward the nose. Record break and recovery each trial.
L4 · Small single-dot NPC, 3 break/recovery trials.
Use the small single-dot NPC target. Hold at 40 cm on the midline and move slowly toward the nose. Stop at first doubling or observable eye drift, then move away until fusion returns. Record break and recovery for 3 trials.
L5 · Tiny single-dot NPC, 5 repeated break/recovery trials.
Use the tiny single-dot NPC target. Run 5 slow midline trials from 40 cm toward the nose. Record break and recovery each trial and watch for fatigue, increasing recovery distance, eye drift, blur, or doubling.
Gross NPC with picture target — any age, non-reader accessible.
Administration
Hold the on-screen picture target (or a printed picture on a tongue depressor) at 40 cm along the midline of the face. Say: "Watch the star. As it comes closer to your nose, keep both eyes on it and tell me if you ever see two of them." Move steadily toward the nose at ~2 cm/sec. Record break distance (cm from nose) when the student reports doubling OR you observe one eye drift outward. Then move the target back and record recovery distance (cm at which fusion returns).
Materials: On-screen picture target (interactive) or printed picture · Ruler · Good task lighting
Clinical note: NPC break > 6 cm or receded (> 10 cm), or unmeasurable recovery → automatic developmental optometry referral. Ages 4–7: this level only; do not attempt higher levels.
Single midline NPC (medium target), 3 trials averaged — ages 8+.
Administration
Use the single midline NPC worksheet at Level 2. Hold at 40 cm along the midline. Say: "Watch the target. Keep both eyes on it and tell me the moment you see two of them." Move steadily toward the nose (~2 cm/sec) for 3 trials. Record break and recovery for each.
Materials: NPC single-target worksheet (L2) · Ruler
Single midline NPC (smaller target), 3 trials averaged — ages 11+.
Administration
Use the single midline NPC worksheet at Level 3 (smaller target). Hold at 40 cm on midline. Say: "Keep your eyes locked on the target. Tell me the moment it doubles or blurs." Run 3 slow midline trials from 40 cm toward the nose. Record break and recovery each trial.
Materials: NPC single-target worksheet (L3) · Ruler
Small single-dot NPC, 3 break/recovery trials.
Administration
Use the small single-dot NPC target. Hold at 40 cm on the midline and move slowly toward the nose. Stop at first doubling or observable eye drift, then move away until fusion returns. Record break and recovery for 3 trials.
Materials: Small single-dot NPC target · Ruler
Tiny single-dot NPC, 5 repeated break/recovery trials.
Administration
Use the tiny single-dot NPC target. Run 5 slow midline trials from 40 cm toward the nose. Record break and recovery each trial and watch for fatigue, increasing recovery distance, eye drift, blur, or doubling.
Materials: Tiny single-dot NPC target · Ruler
Visual Processing
Functional concern
Weak discrimination causes letter/number confusion (b/d, p/q, 6/9) past age 7 and inefficiency scanning similar visual arrays.
Intervention direction
Sorting/matching drills with graded similarity, targeted letter-pair discrimination, tactile letter formation to strengthen visual memory.
L1 · Shape matching — 3 items, 4 choices each.
Purpose: baseline exact-detail matching with whole shapes. Present the L1 Visual Discrimination worksheet (or interactive screen). Each item shows one TARGET shape above a row of 4 choices. Say: "Look at the shape on top. Point to the ONE below that is exactly the same." 3 items, 4 choices each. Score correct of 3. Pitfall: if the student scans only the first one or two choices, cue "look at all four" once, then withdraw the cue.
L2 · Confusable letters / numbers — 4 items, 4 choices each.
Purpose: detect reversal and orientation confusion (b/d/p/q, 6/9, 2/Z, rn/m depending on age band). Each item shows one TARGET character above 4 choices that differ only by orientation or fine detail. Say: "Look at the letter on top. Point to the ONE below that is exactly the same." 4 items, 4 choices each. Score correct of 4 and tally how many errors were mirror/rotation picks. Pitfall: past age 7, repeated mirror picks here should be reported with the Spatial Relations mirror data as one reversal pattern, not two separate deficits.
L3 · Word-level detail matching — 4 items, 4 choices each.
Purpose: exact-detail matching at word level (sequencing and internal-letter detail). Each item shows one TARGET word above 4 similar words (e.g. was/saw, form/from, trial/trail). Say: "Look at the word on top. Point to the ONE below that is exactly the same. Some are very close — check every letter." 4 items, 4 choices each. Score correct of 4. Pitfall: sequence errors (saw for was) implicate scanning direction; internal-letter errors implicate fine discrimination — note which pattern dominates.
L4 · Sentence-level detail matching — 3 items, 4 choices each.
Purpose: carry exact-detail matching into connected text. Each item shows one TARGET sentence above 4 sentences that differ by a single word, letter, or function word. Say: "Read the sentence on top. Point to the ONE below that matches it exactly, word for word." 3 items, 4 choices each. Score correct of 3 and note time if the student is unusually slow. Pitfall: this is not a reading comprehension task — allow the student to re-check the target as often as needed.
L5 · Complex sentence detail matching — 3 items, 4 choices each.
Purpose: highest detail load — long, grade/age-appropriate sentences whose distractors differ by one embedded word or morpheme. Each item shows one TARGET sentence above 4 choices. Say: "Read the sentence on top. Point to the ONE below that matches it exactly. The differences are very small — one word or one ending." 3 items, 4 choices each. Score correct of 3. Font-recognition demand belongs to Form Constancy L5, not here. Pitfall: errors at L5 with clean L3–L4 performance indicate a load/endurance limit rather than a discrimination limit — cross-check Reading Endurance.
Shape matching — 3 items, 4 choices each.
Administration
Purpose: baseline exact-detail matching with whole shapes. Present the L1 Visual Discrimination worksheet (or interactive screen). Each item shows one TARGET shape above a row of 4 choices. Say: "Look at the shape on top. Point to the ONE below that is exactly the same." 3 items, 4 choices each. Score correct of 3. Pitfall: if the student scans only the first one or two choices, cue "look at all four" once, then withdraw the cue.
Materials: Visual Discrimination worksheet — L1 (shapes)
Confusable letters / numbers — 4 items, 4 choices each.
Administration
Purpose: detect reversal and orientation confusion (b/d/p/q, 6/9, 2/Z, rn/m depending on age band). Each item shows one TARGET character above 4 choices that differ only by orientation or fine detail. Say: "Look at the letter on top. Point to the ONE below that is exactly the same." 4 items, 4 choices each. Score correct of 4 and tally how many errors were mirror/rotation picks. Pitfall: past age 7, repeated mirror picks here should be reported with the Spatial Relations mirror data as one reversal pattern, not two separate deficits.
Materials: Visual Discrimination worksheet — L2 (letters / numbers)
Word-level detail matching — 4 items, 4 choices each.
Administration
Purpose: exact-detail matching at word level (sequencing and internal-letter detail). Each item shows one TARGET word above 4 similar words (e.g. was/saw, form/from, trial/trail). Say: "Look at the word on top. Point to the ONE below that is exactly the same. Some are very close — check every letter." 4 items, 4 choices each. Score correct of 4. Pitfall: sequence errors (saw for was) implicate scanning direction; internal-letter errors implicate fine discrimination — note which pattern dominates.
Materials: Visual Discrimination worksheet — L3 (words)
Sentence-level detail matching — 3 items, 4 choices each.
Administration
Purpose: carry exact-detail matching into connected text. Each item shows one TARGET sentence above 4 sentences that differ by a single word, letter, or function word. Say: "Read the sentence on top. Point to the ONE below that matches it exactly, word for word." 3 items, 4 choices each. Score correct of 3 and note time if the student is unusually slow. Pitfall: this is not a reading comprehension task — allow the student to re-check the target as often as needed.
Materials: Visual Discrimination worksheet — L4 (sentences)
Complex sentence detail matching — 3 items, 4 choices each.
Administration
Purpose: highest detail load — long, grade/age-appropriate sentences whose distractors differ by one embedded word or morpheme. Each item shows one TARGET sentence above 4 choices. Say: "Read the sentence on top. Point to the ONE below that matches it exactly. The differences are very small — one word or one ending." 3 items, 4 choices each. Score correct of 3. Font-recognition demand belongs to Form Constancy L5, not here. Pitfall: errors at L5 with clean L3–L4 performance indicate a load/endurance limit rather than a discrimination limit — cross-check Reading Endurance.
Materials: Visual Discrimination worksheet — L5 (complex sentences)
Visual Processing
Functional concern
Figure–ground difficulty makes cluttered worksheets, textbooks, and word searches overwhelming; student appears distractible or slow.
Intervention direction
Hidden-picture puzzles, letter/shape searches on graded backgrounds, contrast manipulation, worksheet-density modification.
L1 · Find 3 stars hidden among ~20 filled circles.
Present the L1 Figure-Ground worksheet. Say: "Find and mark every star in this picture." Score targets found and time.
L2 · Find 4 stars hidden among ~32 filled circles.
Present the L2 Figure-Ground worksheet. Say: "Find and mark every star." Score targets found and time.
L3 · Find all 5 letter T's hidden among ~48 competing letters (60 sec).
Present the L3 Figure-Ground worksheet. Say: "Find and mark every letter T. Ignore the others." Score targets found in 60 sec; note scanning pattern.
L4 · Find all 6 letter R's in a cluttered field of ~70 similar letters.
Present the L4 Figure-Ground worksheet. Say: "Find and mark every letter R. Ignore all the others." Score time to completion and misses.
L5 · Find all 7 lowercase e's in a high-density field of ~100 confusable letters.
Present the L5 Figure-Ground worksheet. Say: "Find and mark every lowercase e. Ignore c, o, a, s, n, u, r." Time to locate all 7. Note frustration or abandonment.
Find 3 stars hidden among ~20 filled circles.
Administration
Present the L1 Figure-Ground worksheet. Say: "Find and mark every star in this picture." Score targets found and time.
Materials: Figure-Ground worksheet (L1 — 3 stars in ~20 circles) · Timer
Find 4 stars hidden among ~32 filled circles.
Administration
Present the L2 Figure-Ground worksheet. Say: "Find and mark every star." Score targets found and time.
Materials: Figure-Ground worksheet (L2 — 4 stars in ~32 circles) · Timer
Find all 5 letter T's hidden among ~48 competing letters (60 sec).
Administration
Present the L3 Figure-Ground worksheet. Say: "Find and mark every letter T. Ignore the others." Score targets found in 60 sec; note scanning pattern.
Materials: Figure-Ground worksheet (L3 — 5 T's in F/I/L/H/E field) · Timer
Find all 6 letter R's in a cluttered field of ~70 similar letters.
Administration
Present the L4 Figure-Ground worksheet. Say: "Find and mark every letter R. Ignore all the others." Score time to completion and misses.
Materials: Figure-Ground worksheet (L4 — 6 R's in P/B/K/D/H/N field) · Timer
Find all 7 lowercase e's in a high-density field of ~100 confusable letters.
Administration
Present the L5 Figure-Ground worksheet. Say: "Find and mark every lowercase e. Ignore c, o, a, s, n, u, r." Time to locate all 7. Note frustration or abandonment.
Materials: Figure-Ground worksheet (L5 — 7 lowercase e's in c/o/a/s/n/u/r field) · Timer
Visual Processing
Functional concern
Difficulty completing partial forms slows word recognition, math symbol reading, and inferential visual reasoning.
Intervention direction
Partial-picture completion, dot-to-dot with missing segments, occluded word reading, guessing games with progressive reveal.
L1 · Identify a basic shape from ~55% visible broken contour.
Show a basic broken-contour shape with about 55% of the outline visible. Student points to or taps the matching complete shape from the answer choices.
L2 · Identify shape from ~50% visible outline (5 items).
Show broken-contour shapes with about 42% of the outline visible. Student picks the completed shape from the answer bank.
L3 · Identify a letter from ~33% visible broken contour.
Show broken-contour letters with about 33% of the outline visible. Student picks the matching letter from the answer choices.
L4 · Identify shape from 30% visible with distractors.
Show broken-contour letters/numbers with about 25% visible and close distractors. Student picks the true completed form.
L5 · Identify an object from ~17% visible broken contour.
Show a real-world object contour with about 17% visible and close distractors. Student picks the completed object.
Identify a basic shape from ~55% visible broken contour.
Administration
Show a basic broken-contour shape with about 55% of the outline visible. Student points to or taps the matching complete shape from the answer choices.
Materials: Visual Closure worksheet
Identify shape from ~50% visible outline (5 items).
Administration
Show broken-contour shapes with about 42% of the outline visible. Student picks the completed shape from the answer bank.
Materials: VPA™ Visual Closure worksheet
Identify a letter from ~33% visible broken contour.
Administration
Show broken-contour letters with about 33% of the outline visible. Student picks the matching letter from the answer choices.
Materials: Visual Closure letter worksheet
Identify shape from 30% visible with distractors.
Administration
Show broken-contour letters/numbers with about 25% visible and close distractors. Student picks the true completed form.
Materials: Visual Closure worksheet — hard set
Identify an object from ~17% visible broken contour.
Administration
Show a real-world object contour with about 17% visible and close distractors. Student picks the completed object.
Materials: Visual Closure object worksheet
Visual Processing
Functional concern
Spatial relations weakness affects reversals, math column alignment, map / diagram reading, and multi-step directions.
Intervention direction
Directional-language work (left/right, above/below), rotation matching, block-design copies, mapping activities.
L1 · Direction match — point to the arrow that goes the same way (3 items).
Purpose: baseline directional matching. The arrow on the LEFT is the target. Say: 'This arrow points this way. Point to the ONE arrow in the row that points the SAME way.' Setup: 3 items, 3 choices each; no time limit. Pitfall: finger-tracing is allowed — score the item but record the strategy.
L2 · Mirror discrimination — flipped vs. identical (4 items).
Purpose: detect mirror-image confusion that underlies b/d and reversal errors. One choice is the target flipped like a mirror image. Say: 'Point to the arrow that is EXACTLY the same as this one. One of them is flipped like in a mirror — do not pick that one.' Setup: demonstrate item 1 once, then withdraw help. 4 items, 4 choices each. Pitfall: mirror errors here plus b/d errors in discrimination = report as a single reversal pattern, not two deficits.
L3 · Rotation match — quarter turn clockwise (4 items).
Purpose: mental rotation without motor output. Say: 'Turn this arrow one quarter turn to the RIGHT in your head — the way clock hands move. Point to the arrow that shows where it ends up.' Setup: model the turn with your hand on item 1 only; 4 items, 4 choices each; do not let the student physically rotate the page. Pitfall: page-turning is a compensation — score the item but record the strategy.
L4 · Route / map direction relations (4 items).
Purpose: apply directional relations to a route, the way a student navigates a hallway or a map in class. The target arrow shows the direction the student is FACING at the start. Say: 'You are walking and facing this way. Make the turns I read to you in your head, then point to the arrow showing which way you are facing at the END.' Turns are from the student's own point of view. Setup: read each caption aloud once; 4 items, 4 choices each. Pitfall: this is spatial, not memory — reread the caption on request.
L5 · Quarter turn clockwise with mirror decoys (4 items, 5 choices).
Purpose: hardest combination — the Level 3 quarter turn plus mirror discrimination. The rule is the SAME every item: rotate the target 90° clockwise, and reject any arrow that is flipped. Say: 'Turn this arrow one quarter turn to the RIGHT in your head — the way clock hands move. Some of these are turned the wrong way and some are flipped like in a mirror. Point to the ONE that is only turned, and turned the right way.' Setup: read the caption aloud on each item; 4 items, 5 choices each; no page rotation. Each row contains exactly one correct answer (target +90° clockwise, not flipped), its mirrored twin, a counter-clockwise turn, and two other flipped traps. Pitfall: tally error type — mirror picks indicate a mirror-discrimination limit; the counter-clockwise pick indicates a rotation-direction limit.
Direction match — point to the arrow that goes the same way (3 items).
Administration
Purpose: baseline directional matching. The arrow on the LEFT is the target. Say: 'This arrow points this way. Point to the ONE arrow in the row that points the SAME way.' Setup: 3 items, 3 choices each; no time limit. Pitfall: finger-tracing is allowed — score the item but record the strategy.
Materials: Spatial relations worksheet
Mirror discrimination — flipped vs. identical (4 items).
Administration
Purpose: detect mirror-image confusion that underlies b/d and reversal errors. One choice is the target flipped like a mirror image. Say: 'Point to the arrow that is EXACTLY the same as this one. One of them is flipped like in a mirror — do not pick that one.' Setup: demonstrate item 1 once, then withdraw help. 4 items, 4 choices each. Pitfall: mirror errors here plus b/d errors in discrimination = report as a single reversal pattern, not two deficits.
Materials: Spatial relations worksheet
Rotation match — quarter turn clockwise (4 items).
Administration
Purpose: mental rotation without motor output. Say: 'Turn this arrow one quarter turn to the RIGHT in your head — the way clock hands move. Point to the arrow that shows where it ends up.' Setup: model the turn with your hand on item 1 only; 4 items, 4 choices each; do not let the student physically rotate the page. Pitfall: page-turning is a compensation — score the item but record the strategy.
Materials: Spatial relations worksheet
Route / map direction relations (4 items).
Administration
Purpose: apply directional relations to a route, the way a student navigates a hallway or a map in class. The target arrow shows the direction the student is FACING at the start. Say: 'You are walking and facing this way. Make the turns I read to you in your head, then point to the arrow showing which way you are facing at the END.' Turns are from the student's own point of view. Setup: read each caption aloud once; 4 items, 4 choices each. Pitfall: this is spatial, not memory — reread the caption on request.
Materials: Spatial relations worksheet
Quarter turn clockwise with mirror decoys (4 items, 5 choices).
Administration
Purpose: hardest combination — the Level 3 quarter turn plus mirror discrimination. The rule is the SAME every item: rotate the target 90° clockwise, and reject any arrow that is flipped. Say: 'Turn this arrow one quarter turn to the RIGHT in your head — the way clock hands move. Some of these are turned the wrong way and some are flipped like in a mirror. Point to the ONE that is only turned, and turned the right way.' Setup: read the caption aloud on each item; 4 items, 5 choices each; no page rotation. Each row contains exactly one correct answer (target +90° clockwise, not flipped), its mirrored twin, a counter-clockwise turn, and two other flipped traps. Pitfall: tally error type — mirror picks indicate a mirror-discrimination limit; the counter-clockwise pick indicates a rotation-direction limit.
Materials: Spatial relations worksheet
Visual Processing
Functional concern
Weak visual memory reduces sight-word retention, math-fact recall, and copying accuracy; impact grows sharply from 2nd grade on.
Intervention direction
Look-cover-write drills, memory matrices, flashcard chaining, dictated-then-drawn sequences. Add auditory pairing for cross-modal recall.
L1 · 2 shapes shown 5 sec, then 4-choice recognition.
Show the 2-shape row for 5 seconds, hide it, then ask the student to pick the matching row from 4 choices.
L2 · 3 shapes shown 4 sec, then 4-choice recognition.
Show the 3-shape row for 4 seconds, hide it, then ask the student to pick the matching row from 4 choices.
L3 · 4 shapes shown 3 sec, then 4-choice recognition.
Show the 4-shape row for 3 seconds, hide it, then ask the student to pick the matching row from 4 choices.
L4 · 5 shapes shown 2.5 sec, then 4-choice recognition.
Show the 5-shape row for 2.5 seconds, hide it, then ask the student to pick the matching row from 4 choices.
L5 · 6 shapes shown 2 sec, then 4-choice recognition.
Show the 6-shape row for 2 seconds, hide it, then ask the student to pick the matching row from 4 choices.
2 shapes shown 5 sec, then 4-choice recognition.
Administration
Show the 2-shape row for 5 seconds, hide it, then ask the student to pick the matching row from 4 choices.
Materials: Sequential memory worksheet
3 shapes shown 4 sec, then 4-choice recognition.
Administration
Show the 3-shape row for 4 seconds, hide it, then ask the student to pick the matching row from 4 choices.
Materials: Sequential memory worksheet
4 shapes shown 3 sec, then 4-choice recognition.
Administration
Show the 4-shape row for 3 seconds, hide it, then ask the student to pick the matching row from 4 choices.
Materials: Sequential memory worksheet
5 shapes shown 2.5 sec, then 4-choice recognition.
Administration
Show the 5-shape row for 2.5 seconds, hide it, then ask the student to pick the matching row from 4 choices.
Materials: Sequential memory worksheet
6 shapes shown 2 sec, then 4-choice recognition.
Administration
Show the 6-shape row for 2 seconds, hide it, then ask the student to pick the matching row from 4 choices.
Materials: Sequential memory worksheet
Visual Processing
Functional concern
Poor form constancy causes letter/number reversals past age 7 and difficulty generalizing shapes across fonts, sizes, and rotations.
Intervention direction
Multi-font letter sorting, rotated shape matching, tactile letter formation, mirror/reversal discrimination games.
L1 · Match identical shapes among 3 choices.
Form constancy — identical shape match among 3 choices.
L2 · Match shapes across 2 rotations.
Match target shape when candidate is rotated 45° or 90°.
L3 · Match across size + rotation (5 items).
VPA™ Form Constancy set — 5 items with size and rotation distractors.
L4 · b/d/p/q constancy with partial occlusion (8 items).
Present 8 items using b, d, p, q with the top or bottom third of each letter physically occluded by a solid bar. Student must identify each letter from its remaining features and mark rotation/reversal errors. Partial-occlusion overlay is embedded in the L4 worksheet.
L5 · Geometric forms + font-recognition constancy (8 items).
Present 8 items: 4 geometric forms across rotation and scale, plus 4 letters shown across 4 fonts (serif, sans, italic, script). Student groups by IDENTITY, not by font or rotation. This absorbs the multi-font demand formerly on Discrimination L5.
Match identical shapes among 3 choices.
Administration
Form constancy — identical shape match among 3 choices.
Materials: Form Constancy worksheet (easy)
Match shapes across 2 rotations.
Administration
Match target shape when candidate is rotated 45° or 90°.
Materials: Form Constancy worksheet
Match across size + rotation (5 items).
Administration
VPA™ Form Constancy set — 5 items with size and rotation distractors.
Materials: VPA™ Form Constancy worksheet
b/d/p/q constancy with partial occlusion (8 items).
Administration
Present 8 items using b, d, p, q with the top or bottom third of each letter physically occluded by a solid bar. Student must identify each letter from its remaining features and mark rotation/reversal errors. Partial-occlusion overlay is embedded in the L4 worksheet.
Materials: Form Constancy L4 worksheet — b/d/p/q with partial occlusion
Geometric forms + font-recognition constancy (8 items).
Administration
Present 8 items: 4 geometric forms across rotation and scale, plus 4 letters shown across 4 fonts (serif, sans, italic, script). Student groups by IDENTITY, not by font or rotation. This absorbs the multi-font demand formerly on Discrimination L5.
Materials: Form Constancy L5 worksheet — geometric + multi-font
Visual-Motor Integration
Functional concern
Weak visual-motor integration is the visual foundation under handwriting breakdown — poor alignment, spacing, sizing, board-to-paper copy errors, and inefficient worksheet output. This is the ocular-motor / perceptual-motor contribution to written output, distinct from grasp mechanics or letter-formation curriculum.
Intervention direction
Curriculum-neutral graded work: shape and symbol copying, spatial-relations tracing, spacing / sizing frames, vertical-to-horizontal transfer (chalkboard/whiteboard to paper), rulered-grid copying, and visual-motor warm-ups before writing tasks. Pair with postural setup and Harmon working distance.
L1 · Copy circle, cross, square (3 shapes).
Student copies 3 preschool shapes beside each model. Do not demonstrate. Score recognizable of 3.
L2 · Copy 6 age-appropriate shapes with orientation cues.
Student copies 6 shapes. Score recognizable, closure, orientation.
L3 · Copy 8 shapes incl. diamond, oblique cross, overlapping triangles.
Full VPA™ shape copy set — 8 shapes. Score recognizable + line quality.
L4 · Sentence copying — near copy from printed model.
Copy 3 sentences to lined paper. Score legibility, spacing, alignment, and visual place-keeping.
L5 · Board-to-paper copying (far-to-near transfer), 3 sentences.
Copy 3 sentences from a distance display to lined paper. Note near-far speed/error gap.
Copy circle, cross, square (3 shapes).
Administration
Student copies 3 preschool shapes beside each model. Do not demonstrate. Score recognizable of 3.
Materials: Shape copy worksheet (early) · Pencil
Copy 6 age-appropriate shapes with orientation cues.
Administration
Student copies 6 shapes. Score recognizable, closure, orientation.
Materials: Shape copy worksheet (elementary) · Pencil
Copy 8 shapes incl. diamond, oblique cross, overlapping triangles.
Administration
Full VPA™ shape copy set — 8 shapes. Score recognizable + line quality.
Materials: Shape copy worksheet (Full set) · Pencil
Sentence copying — near copy from printed model.
Administration
Copy 3 sentences to lined paper. Score legibility, spacing, alignment, and visual place-keeping.
Materials: Sentence copy sheet (near) · Lined paper · Pencil
Board-to-paper copying (far-to-near transfer), 3 sentences.
Administration
Copy 3 sentences from a distance display to lined paper. Note near-far speed/error gap.
Materials: Distance display · Lined paper · Pencil
Clinical note: Large near > far gap may signal accommodative or copy-integration involvement worth coordinating with optometry.
Visual-Motor Integration
Functional concern
Errors on clock-drawing tasks signal visual-spatial planning or executive-organization limits — worth flagging in the referral note.
Intervention direction
Guided sequencing tasks, drawing to verbal instruction, executive-strategy coaching (plan-do-check). Pair with neuropsych referral if severe.
L1 · Draw a plain clock face — numbers only.
Purpose: baseline organization of a familiar circular layout. Say: 'Draw a clock face and write all 12 numbers in the right places. Do not draw the hands.' Setup: blank paper, pencil, no model in view, no demonstration. Score contour + number placement. Pitfall: do not correct spacing mid-task — spacing IS the measure.
L2 · Layout copy — weekly planner grid (non-clock).
Purpose: constructional layout outside the over-learned clock format. Say: 'Copy this planner grid exactly — same rows, same columns, same day labels across the top, about the same size.' Setup: place the printed model grid directly above the student's blank paper; no ruler. Score row/column count, intersecting lines, proportional cells, and correct label placement. Pitfall: a student who counts aloud is planning — note it, it is not an error.
L3 · Clock showing 3 o'clock.
Purpose: add hand placement to the layout demand. Say: 'Draw a clock face with all 12 numbers, then draw the hands to show 3 o'clock.' Setup: blank paper, no model, no demonstration. Score contour, numbers, hour hand. Pitfall: accept any legible number style.
L4 · Clock showing 10 past 11 (VPA™ CDT).
Purpose: full command-drawing probe with a time that cannot be solved by number-matching. Say: 'Draw the face of a clock, put in all the numbers, and set the hands to ten past eleven.' Setup: blank paper, no model, do not demonstrate or repeat more than once. Score the 5-point VPA™ CDT rubric. Pitfall: '10 past 11' is failed when the minute hand is drawn to 10 instead of 2 — that is a stimulus-bound error, score it 0 for minute hand.
L5 · Command drawing (3:40) followed by a copy condition.
Purpose: separate planning/retrieval from constructional skill. Setup: BOX 1 — keep the printed model covered and say 'Draw a clock showing twenty to four (3:40).' Then uncover the model and say for BOX 2, 'Now copy this clock exactly as it looks.' Score both boxes on the 5-point CDT rubric. Interpretation: a copy that is markedly better than the command drawing points to planning/retrieval demand, not visual-motor skill. Pitfall: never let the student see the model during Box 1.
Draw a plain clock face — numbers only.
Administration
Purpose: baseline organization of a familiar circular layout. Say: 'Draw a clock face and write all 12 numbers in the right places. Do not draw the hands.' Setup: blank paper, pencil, no model in view, no demonstration. Score contour + number placement. Pitfall: do not correct spacing mid-task — spacing IS the measure.
Materials: Blank paper · Pencil
Layout copy — weekly planner grid (non-clock).
Administration
Purpose: constructional layout outside the over-learned clock format. Say: 'Copy this planner grid exactly — same rows, same columns, same day labels across the top, about the same size.' Setup: place the printed model grid directly above the student's blank paper; no ruler. Score row/column count, intersecting lines, proportional cells, and correct label placement. Pitfall: a student who counts aloud is planning — note it, it is not an error.
Materials: Printed planner-grid model (worksheet) · Blank paper · Pencil
Clock showing 3 o'clock.
Administration
Purpose: add hand placement to the layout demand. Say: 'Draw a clock face with all 12 numbers, then draw the hands to show 3 o'clock.' Setup: blank paper, no model, no demonstration. Score contour, numbers, hour hand. Pitfall: accept any legible number style.
Materials: Blank paper · Pencil
Clock showing 10 past 11 (VPA™ CDT).
Administration
Purpose: full command-drawing probe with a time that cannot be solved by number-matching. Say: 'Draw the face of a clock, put in all the numbers, and set the hands to ten past eleven.' Setup: blank paper, no model, do not demonstrate or repeat more than once. Score the 5-point VPA™ CDT rubric. Pitfall: '10 past 11' is failed when the minute hand is drawn to 10 instead of 2 — that is a stimulus-bound error, score it 0 for minute hand.
Materials: Blank paper · Pencil
Clinical note: Failure of ≥4 of 5 CDT criteria → visual-spatial / executive-planning concern.
Command drawing (3:40) followed by a copy condition.
Administration
Purpose: separate planning/retrieval from constructional skill. Setup: BOX 1 — keep the printed model covered and say 'Draw a clock showing twenty to four (3:40).' Then uncover the model and say for BOX 2, 'Now copy this clock exactly as it looks.' Score both boxes on the 5-point CDT rubric. Interpretation: a copy that is markedly better than the command drawing points to planning/retrieval demand, not visual-motor skill. Pitfall: never let the student see the model during Box 1.
Materials: Worksheet with printed model clock · Blank paper · Pencil
Functional Integration
Functional concern
Even efficient sub-skills can collapse under real occupational load. Endurance failure is what teachers report as 'shuts down after 10 minutes' — and it shows up in both sustained reading and self-generated written output (the #1 school-based OT referral driver). Functional writing here is generative (name → sentence → form), distinct from Visual-Motor copying, which measures eye-hand transfer of a visible model.
Intervention direction
Timed near-task ladders that pair sustained reading with age-matched functional writing (not copying): posture/ergonomic setup, prescribed micro-breaks, graded increases in duration and linguistic load. Curriculum-neutral stimuli — child journals, teen academic prompts, adult forms/notes.
L1 · L1 · 60-sec sustained near read + name-writing baseline.
Reading: choose a stimulus matched to the student's decoding ability — (a) pre-readers → on-screen letter/number/shape grid (name each across the row); (b) emerging readers → K–2 decodable passage; (c) proficient readers → student's own grade-level text. Run 60 seconds. Then WRITING: pre-writers trace or write first name on primary lines; elementary write first + last name; secondary/adult write full name + today's date. Score reading output, postural drift, and writing legibility.
L2 · L2 · 2-min sustained near read + short functional word writing.
Reading: same tier as L1, run 2 minutes continuous. Writing: age-matched short word — young child → write one functional word from verbal prompt (color, favorite food); elementary → two functional words (day of week + weather); secondary/adult → short label or address line. Score sustained on-task time, postural drift, and writing spacing / sizing / reversals.
L3 · L3 · 3-min sustained near read + functional short-answer writing.
Reading: same tier as L1/L2, run 3 minutes. Writing: age-matched short answer — child → complete sentence stem ('I like ___ because ___'); teen → one-sentence journal answer; adult → fill 3 lines of a mock intake form. Allow 2 min for writing. Score fatigue / blur / eye-rub complaints, whether reading output rate slows across the block, and whether written output continues legibly throughout.
L4 · L4 · 5-min sustained near read with concurrent generative writing.
Reading: same tier, run 5 minutes. Concurrent generative WRITING (not copying) matched to age — pre/emerging readers → point-and-name items then write or trace a target word or draw the named shape; elementary → read and write 2 sentences about the passage; secondary → 2–3 sentence academic response; adult → 2–3 sentence note/memo/checklist. Score sustained on-task time and whether written output quality (legibility, spacing, sizing) declines across the block.
L5 · L5 · 10-min extended near read + 5-min extended functional writing.
Reading: same tier — do not raise the reading grade. Run 10 minutes with a light recall/comprehension demand appropriate to age (pre-readers → recall which items came first; emerging readers → 2 simple recall questions; proficient readers → 3 comprehension questions with note-taking). Then extended WRITING (5 min continuous) age-matched: elementary → journal entry on a familiar topic; secondary → paragraph response to an academic prompt; adult → complete a full-page functional form or paragraph note. Score off-task episodes, postural drift, spontaneous complaints, late-block written legibility, and whether recall/comprehension accuracy fades in the second half.
L1 · 60-sec sustained near read + name-writing baseline.
Administration
Reading: choose a stimulus matched to the student's decoding ability — (a) pre-readers → on-screen letter/number/shape grid (name each across the row); (b) emerging readers → K–2 decodable passage; (c) proficient readers → student's own grade-level text. Run 60 seconds. Then WRITING: pre-writers trace or write first name on primary lines; elementary write first + last name; secondary/adult write full name + today's date. Score reading output, postural drift, and writing legibility.
Materials: On-screen grid or age-matched passage · Primary-lined name worksheet · Pencil · Timer
Clinical note: Never use stimuli above the student's independent decoding/writing ability — pick the tier that matches current skill. Endurance and integration are being measured, not literacy.
L2 · 2-min sustained near read + short functional word writing.
Administration
Reading: same tier as L1, run 2 minutes continuous. Writing: age-matched short word — young child → write one functional word from verbal prompt (color, favorite food); elementary → two functional words (day of week + weather); secondary/adult → short label or address line. Score sustained on-task time, postural drift, and writing spacing / sizing / reversals.
Materials: Age-matched reading stimulus · Primary or standard-lined worksheet · Pencil · Timer
L3 · 3-min sustained near read + functional short-answer writing.
Administration
Reading: same tier as L1/L2, run 3 minutes. Writing: age-matched short answer — child → complete sentence stem ('I like ___ because ___'); teen → one-sentence journal answer; adult → fill 3 lines of a mock intake form. Allow 2 min for writing. Score fatigue / blur / eye-rub complaints, whether reading output rate slows across the block, and whether written output continues legibly throughout.
Materials: Age-matched reading stimulus · Age-matched short-answer sheet · Pencil · Timer
L4 · 5-min sustained near read with concurrent generative writing.
Administration
Reading: same tier, run 5 minutes. Concurrent generative WRITING (not copying) matched to age — pre/emerging readers → point-and-name items then write or trace a target word or draw the named shape; elementary → read and write 2 sentences about the passage; secondary → 2–3 sentence academic response; adult → 2–3 sentence note/memo/checklist. Score sustained on-task time and whether written output quality (legibility, spacing, sizing) declines across the block.
Materials: Age-matched reading stimulus · Wide-ruled or age-appropriate lined paper · Pencil · Timer
L5 · 10-min extended near read + 5-min extended functional writing.
Administration
Reading: same tier — do not raise the reading grade. Run 10 minutes with a light recall/comprehension demand appropriate to age (pre-readers → recall which items came first; emerging readers → 2 simple recall questions; proficient readers → 3 comprehension questions with note-taking). Then extended WRITING (5 min continuous) age-matched: elementary → journal entry on a familiar topic; secondary → paragraph response to an academic prompt; adult → complete a full-page functional form or paragraph note. Score off-task episodes, postural drift, spontaneous complaints, late-block written legibility, and whether recall/comprehension accuracy fades in the second half.
Materials: Age-matched reading stimulus · Recall / comprehension prompts · Age-matched extended writing task · Lined paper or form · Pencil · Timer