One of the main reasons students are referred to occupational therapy in school is dysgraphia or illegible handwriting. Occupational therapists typically perform a visual motor assessment as part of their evaluation to identify possible causes.

Difficulty catching a ball or illegible handwriting are examples of possible visual motor integration challenges. Visual-motor integration challenges are the inability of the body to generate a motor response to visual stimuli accurately. Whenever a student is being considered for a referral to occupational therapy, I find it valuable to engage in a discussion with the teacher regarding the grounds for the referral. Additionally, I find it beneficial to conduct classroom observations of the student. As part of this procedure, the teacher typically collects samples of the student’s written work and completes an occupational therapy screening tool. This collaborative approach ensures a comprehensive understanding of the situation and enables us to make well-informed decisions moving forward.

This screening tool outlines the teacher’s areas of concern regarding the student in a detailed manner. It includes information related to the student’s performance in writing, spelling, reading, and activities of daily living (ADLs), such as managing hygiene, clothing, and using utensils, among other school-related activities. In addition, it also provides information about the student’s use of eyeglasses and his or her proficiency in visual motor activities, such as coloring, drawing shapes, organizing writing on pages, taking notes, and so on.

It is a comprehensive tool, and I greatly appreciate the effort that teachers put into completing it, despite their demanding schedules and numerous obligations. This crucial information is typically collected prior to initiating a referral, serving as a substantiation for the request to conduct an occupational therapy evaluation.

Whenever I have the opportunity to sit down with the teacher to discuss the comprehensive information we’ve collected and delve into the student’s classroom performance, I make it a point to inquire about the student’s vision. Frequently, the response I receive carries an element of uncertainty, stating that the student’s vision is deemed satisfactory based on the most recent annual physical examination. However, it’s important to recognize that the standard Snellen Chart, commonly employed to gauge vision in both educational institutions and medical settings, offers only a limited evaluation of visual capability.

I take the time to clarify with teachers that this vision assessment primarily focuses on visual acuity and does not encompass the broader realm of visual processing. At this juncture, I often notice a moment of realization in their expressions—a metaphorical “light bulb” moment—as they come to understand the distinction. This realization serves as a valuable point of connection, fostering a deeper understanding of the complexity involved in assessing a student’s visual capabilities.

Typically, when we consider a child’s vision, our focus is primarily on whether they have clear eyesight. However, it’s important to remember that this is just one aspect of the bigger picture. Equally crucial is a child’s ability to effectively process and merge visual information, enabling them to respond appropriately. Let’s delve deeper into this concept as I provide some contextual and foundational insights into visual integration.

Visual motor integration, often referred to as eye-hand coordination, encompasses the intricate process of combining, harmonizing, and coordinating visual input with information from other sensory sources to generate a functional and purposeful response. When this intricate integration process encounters challenges, its effects become noticeable through difficulties in children’s handwriting, drawing shapes accurately, staying within lines while coloring, cutting along designated lines, and various related tasks.

Understanding this dynamic interplay sheds light on how a child’s visual processing influences their everyday activities and learning experiences.

“Visual-motor integration challenges are the inability of the body to generate a motor response to visual stimuli accurately. “

What are Some Examples of Visual Motor Integration Challenges

Picture your child navigating through each day, grappling with challenges like maintaining proper handwriting alignment on the page or feeling left out during a friendly game of catch due to difficulties in ball-catching. The toll this takes on them, both physically and emotionally, can be quite overwhelming. The following is a list of potential visual motor integration difficulties your child could be facing.

• Inability to stay in the line while coloring.
• Inability to write on the line.
• Inability to cut on the line with scissors.
• Difficulty copying from the board.
• Sloppy drawing or handwriting.
• Poor word spacing, letter size and shape.
• Letter reversals.
• Excessive erasing.
• Can respond orally but unable to generate written responses.
• Difficulty completing assignments or taking note in the allotted time.
• Appears to know the material but does poorly in tests.
• Inability to line up numbers in columns to solve math problems.
• Easily losing the spot while reading.
• Inability to stay within the lines while completing a maze.
• Difficulty with zipping up jackets.
• Difficulty with buttoning down shirts.
• Difficulty with tying shoes.
• Difficulty playing sports.

How to Improve Your Child’s Visual Motor Integration

If your child consistently complains of eye discomfort, it’s advisable to consult your family doctor about the possibility of seeking a referral for your child to get eyeglasses. It’s important to note that prescription glasses are commonly prescribed to address issues related to visual clarity and sharpness. For example, if your child experiences blurred vision, struggles with nearsightedness (difficulty seeing things up close), or encounters challenges with farsightedness (difficulty seeing things at a distance), prescription glasses can often provide effective solutions by bringing their vision into clear focus.

Additionally, it’s essential to consider other potential visual concerns such as strabismus (ineffective eye muscle control) and diplopia (double vision) before delving into investigations of visual motor integration difficulties. By taking these steps, you can ensure a comprehensive evaluation of your child’s visual well-being and facilitate a clearer understanding of their unique needs.

Yet, when we shift our attention to potential challenges in visual processing, such as visual motor integration deficits, it becomes paramount to seek out the expertise of a developmental optometrist. These professionals are equipped with specialized training to effectively evaluate and diagnose issues related to visual processing. Through this assessment, a comprehensive treatment plan tailored to your child’s needs can be established.

In certain cases, your child may also benefit from a referral to an occupational therapist, particularly one well-versed in vision therapy. In collaboration with the developmental optometrist, the occupational therapist will create a personalized treatment plan including various activities and exercises aimed at enhancing fine motor skills and visual perceptual abilities. Below are some examples of the activities and exercises an occupational therapist might incorporate:

• Warm-up exercises

Just as any physical activity requires a warm-up, the same principle applies to visual motor exercises. My approach involves commencing with gross motor movements before transitioning to tabletop tasks and fine motor exercises. One strategy I find particularly effective is the integration of S’cool Moves into my sessions. These exercises prove invaluable for fostering self-regulation along with engaging auditory, visual and somatosensory systems for a more effective learning experience.

• Gross Motor Activities

Gross motor activities encompass a range of actions that engage a child’s arm and shoulder muscles. For example, we might involve children in a task like tossing a ball into a bucket. Initially, we would begin with a generously sized bucket and tennis size balls. As the children’s skills progress, we gradually reduce the size of the target (bucket) increasing the difficulty level while fostering refinement of the skills. Another engaging activity involves having kids replicate letters or shapes in a dimly lit room using a flashlight. By creating the shape with a flashlight, we encourage them to follow along and recreate the shape themselves.

• Fine Motor Activities

Fine motor activities encompass a range of tasks that primarily engage the muscles in a child’s arms, wrists, and hands. To delve further into the realm of fine motor skills, you can find additional information by clicking HERE. A great starting point involves creating letters using shaving cream and encouraging children to trace them using their fingertips. Alternatively, you could guide children through activities like solving paper mazes or connecting dots to form pictures. The key here is to train the little ones to have their eyes lead their hands; the hands should move in synchrony with the eyes. These exercises not only entertain but also promote the development of essential visual motor abilities.

To recap, visual motor integration challenges exert a significant impact on children’s overall development. These challenges extend to various aspects of their daily routines, affecting tasks such as buttoning a shirt, partaking in recreational activities like ball games, and even their writing legibility. Detecting visual motor integration challenges can be intricate, often involving a process of elimination to distinguish them from more conspicuous deficits.

In such instances, it’s advisable for parents to seek the expertise of a developmental optometrist to ensure accurate diagnosis. This, coupled with the implementation of effective strategies through occupational therapy, can greatly enhance a child’s functional abilities. My intention in sharing this post is to shed light on a prevalent issue among children that generally goes undiagnosed, I hope it has provided valuable insights for a better understanding of this concern.

“Always remember, empowering our children goes a long way in helping them become independent and build their self-esteem.”