Wednesday, June 23, 2010

Activities to Improve Visual Perception

For more information on vision, read my other post on the topic, It's a Vision Thing.

Most, if not all, of the children who come for occupational therapy have an undiagnosed visual problem.  This is because the low muscle tone in the neck and trunk of children with sensory processing issues does not give the eyes a stable base of support from which to operate.  As a result, the fine motor coordination in the eye muscles is compromised, which in turn affects the brain's ability to process and interpret visual information correctly.  This makes tasks like reading and writing, copying from the blackboard, navigating the playground, and participating in team sports an extra challenge.  Because the child has to work extra hard to coordinate the muscular activity of his eyes, his mental and physical energy for the actual task he is using them for is less.   His endurance and performance are going to suffer as a result.

Since the strength and coordination in the eyes is so dependent on the strength and stability of the spine and neck, the child should be given ample opportunity to play outside, and provided with gross motor activities regularly.  This can be a team sport or martial arts class, swimming, tennis, volleyball, bike riding, dance, or anything that the child enjoys and will participate in willingly and happily.  Take the child outside and play catch, shoot some hoops, shag some flies, have him practice running and kicking a soccer ball.  Do sit ups and push ups together, and have the child wheelbarrow walk.

Read to your child every day, and have him sit with you and look at the book while you read.

If your child is continually resistant to close work, has a poor attention span for reading or tabletop activities, rubs his eyes, loses his place while he's reading, doesn't copy well from the board, misses part of the page when using a workbook, or complains of headaches or double vision, he is undoubtedly struggling with weak eye muscles.  If your child is working with an OT in a sensory gym, give it a year.  If his vision doesn't improve after a year of  working on suspended equipment, it's time to see a neurobehavioral optometrist, who can prescribe vision therapy if it is warranted.

Meanwhile, here are some things to do at  home.

To improve convergence and the ability to do close work:

1.  Give the child a drinking straw in one hand and a strand of uncooked spaghetti in the other.  Tell the child to look straight ahead as he brings his hands up in front of his face and slowly slides the spaghetti into the straw.  Repeat ten times.  Do this once or twice a day.

2.  Provide the child with whistles and bubble toys that have moving parts when blown.  They encourage the child to pull the eyes in together to watch.  {If you can even find breath powered bubble toys anymore.  Except for old fashioned bubble wands, these seem to have disappeared off the face of the earth and have been replaced by battery operated versions.}

3.  Give the child a lollypop to suck on while doing close work.  The vacuum created while sucking will pull the eyes in together.  Give the child all of his drinks through a straw, and provide opportunities for resistive sucking, such as smoothies, juice boxes or drinkable yogurt.

4.  Provide craft projects that challenge and motivate the child.  Find lots of fun ideas here and here.

5. Play marbles, jacks, and other eye hand skill games.

To improve pursuit fixation, or the ability of the eyes to track and maintain attention on stable and moving objects:

1. Have the child race a car on a lazy eight {sideways} speedway track on a chalk board or on the floor.

2. Play balloon tennis, either with rackets or hands.

3. Have the child jump on a bosu or mini trampoline while catching small beanbags and tossing them at targets around the room.

4.  Play "I spy" or other visual games, like finding as many out of state license plates as you can, etc, while traveling in the car.

5. Blow some bubbles.  Have the child chase  and pop them.  I  give them a little claw toy or a pair of zoosticks to pop them with so that they are also working on fine motor skills.

6.  Dim the lights and have the child chase the beam from a laser or a flashlight.   This might be a fun activity on a summer evening at twilight with other children from the neighborhood.  Or give the child his own flashlight and play tag with the beams.

To improve visual memory:

1.  Play concentration, where the child has to turn over cards and find matches.  You can either do this with regular playing cards or buy a set.  This teaches the child to develop good strategies for visual memory.  If you type "memory games" into your search engine, you'll find quite a few sites that have games suitable for children.

2.  Play "What's different?".  Put three things on the table, have the child close his eyes, and then change one.  Have the child tell you which one is different.  Use more objects as he gets more skilled.

3.  Place a covered tray with a dozen or so objects on a table, let the child look at it for 30 seconds, cover the tray, and have the child write down or tell you everything that he remembers.  This is a fun group activity.

To improve saccadic vision {the ability of the eyes to jump and fix, the skill required for reading}

1. Lacing, beading, coloring, and cutting activities.

2.  Mazes, dot to dot, and tracing activities.

3.  Have the child draw and paint while standing at an easel.

4. Weaving and sewing activities.

To improve visual discrimination:

1. Play the "what's different in the picture?  game.

2.  Put together jigsaw puzzles,  play Search a Word, and "Where's Waldo?"

3.  Have the child sort things for you, like socks and silverware.

4. Nesting and stacking toys promote pattern recognition, which is critical for learning shapes of letters.

5.  Play Connect Four, tic tac toe, and make a square.

For figure ground:

1.  Hide objects in an indoor sandbox:  fill a large container full of beans, rice, packing pellets, etc.  Hide little toys for the child to find.  Or move this out to the garden and hide things in the grass or among the plants.

2.  When reading a picture book together, play "I Spy" with the drawings.  Describe something to the child and have him try to find it in the picture based on  your description.  Then have him find something and describe it to you for you to find.

Have the child sit on a therapy ball while reading, watching television, or doing homework.  The slight postural adjustments he makes while he's sitting will help stabilize and strengthen his back and his eyes.  Or have the child lie on the floor on his belly propped up on his elbows while working for brief periods. This will strengthen the neck, which will help stabilize his eyes.


Anonymous said...

You have no idea how much better I feel after reading your board. My son was just diagnosed with a Visual Perception problem (locational/reversal). SoHe is great with sports and his hand-eye coordination is quite good. He is a very coordinated kid. Do you think OT could help?

Anonymous said...

thank you! i'm an OT and would love to use some of these ideas!

Melanie said...

Hi Laura. Thank you for posting such great ideas to help with visual perception. I am also an occupational therapist and have developed a number of worksheets to help children who encounter difficulties with visual perceptual processing. Feel free to visit if you would like to check it out. Melanie

Anonymous said...

I want to say, THANK YOU for posting this!!!! My baby girl, who is in the 2nd grade has been diagnosed with a visual perception learning disability. We live in a very rural area, and a lot is not known about this particular issue. I think it is being "written off" as something different. She is struggling so very much! She has started OT and visual therapy. I appreciate you!!!

Tara Alexander said...

Thank you so much for this post. I am a first year COTA working in schools. I am going to use this information today!

Thanks, Tara

Unknown said...

I am a OTAS doing my level II practicum with our local school district. I'm trying to find ideas to work with a student who seems to have some visual perceptual issues that greatly effect her handwriting. She cannot differentiate between a poorly drawn letter and a correctly drawn letter, even when the poorly drawn letter is composed of random lines that aren't touching. I have to place her pencil on the top line for her to start a letter, otherwise she will start her letter in the middle of a page and seems to not understand what 'top line' means. I've tried HWT tactile strategies, copying, letter recognition games and gross motor obstacle courses incorporating searching and scanning for hidden letters around the room. I'm at a loss as to where to go next. Any suggestions?

Loren Shlaes said...

Please read this:

Doc Edwards said...

This came up ranked pretty high on my Google search for visual OT exercises toddler. I'm a chiropractor who works primarily with children, and I screen for retained primitive/postural reflexes. You've created a wealth of information with this blog, and I'm very thankful. I will share these with my patients and credit you fully!

Anonymous said...

I am a certified provider for Integrated Listening Systems and, while I'm including many of these activities in my sessions already, I can't wait to add some of these other great ideas. As we all know, the internet can quickly lead to info overload, but you've done a wonderful job of presenting material in a way that's both thorough and yet easily readable, and easy to implement! This will be a great resource to share with my parents for their additional reinforcement at home. THANKS!!!

Anonymous said...

Thankyou for these really brilliant ideas. I am myself an occupational therapist and i found these activities very useful.