By Robbyn Laufer, OTR/L
Visual-spatial skills are required for play, self-care, social interactions and academic tasks. They are the foundation for more complex skills such as problem solving and abstract reasoning.
Weaknesses in visual-spatial skills often lead to academic diffi culties in areas such as reading, handwriting, spelling, math and organizational skills. Children with visual-spatial weaknesses may struggle with coloring, assembling puzzles, building with Legos®, manipulating fasteners, tying shoes, planning, organizing, problem solving and following directions. Frequently, social skills are affected as well since children misinterpret nonverbal communication signals such as facial expressions and body language.
What is visual perception?
Visual-spatial skills can be separated into two main categories: visual perception and visual-motor integration. Visual perception is the ability to understand what is seen. It allows you to find things, notice differences between items, and remember things you have seen. The following are the major visual perceptual skills:
- Visual discrimination: the ability to notice differ ences and similarities between objects. Initially the child notices global characteristics (these toys are both white) and eventually can notice more subtle characteristics such as slight differences in size or shape.
- Visual memory/visual sequential memory: the ability to recognize and recall details of things the child has seen in the past. Visual sequential memory involves the recall of a sequence of visual information. For example, being able to recall letter sequence in a word for spelling or remembering the sequence of how to form a letter.
- Visual-spatial relationships: the ability to perceive the positions and directions of objects in relation to your own body and to other objects. This is the foundation for the emergence of directional language such as under, behind, or on top, as well as the inte gration of the concepts of left and right.
- Visual form constancy: the ability to recognize the fact that an object or shape remains the same when there are differences in detail, size, position, distance and background. For example, all books are still books even though they come in various shapes, sizes and colors.
- Visual figure ground: the ability to distinguish relevant information from “visual clutter.” For example, finding a math book in a backpack , choosing a specific toy from the toy box, or finding your place in a workbook.
- Visual closure: the ability to accurately identify an object when part of it is hidden or missing. For example, figuring out a dot-to-dot puzzle, or finding a missing shoe when all you can see is its shoelace sticking out from under the bed.
What is visual-motor integration?
Visual-motor integration is the ability to coordinate what you see with body movements. For example, controlling a pencil to start and stop a stroke with precision, or to form a letter or shape with smooth strokes. It also includes cutting or folding accurately and making sure that when writing, all the letters sit on the line. Copying text from the board or from a book is another task that requires efficient visual-motor integration since the child shifts his gaze from far to near or from the book at his side to the paper in front of him.
Though small hand (fine motor) related skills are often the focus of visual-motor integration testing and academic skills, big muscle movements (gross motor) and skills are an essential part of this developmental category. Catching, hitting, kicking and throwing a ball are all part of visual-motor integration. Accurately turning your head to look towards a sound, reaching for something without overshooting, and moving through a crowded room without bumping into anyone are also aspects of visual-motor integration and have a strong impact on day-to-day function at home and school.
| Problem |
Strategy |
| Finding book in cluttered backpack |
Color code for subjects: e.g., Blue for all math materials, green for science, etc. |
| Copying from the board |
Keep the board clean.
Use exaggerated spacing between words and sentences.
Allow student to copy from a page instead of the board.
Color code topics if more than one on the board. |
| Gets lost even in familiar environments |
Teach child to notice major landmarks and turn there (i.e., walk to the water fountain and then turn towards the window, at the window turn towards the stairs…).
Try to avoid directions including left and right which is a big source of confusion. |
| Messy playroom/ bedroom |
Use pictures or words to label where items belong on a shelf. This alleviates the pressure to remember where things go. |
| Loses place, makes errors on visually full worksheets |
Cover all but 1 or 2 lines with white sheet of paper.
Use paper with hole cut in it to see only one math problem at a time. |
| Keeping lines straight in math problem |
Use graph paper to keep numbers in their proper column or use lined paper turned sideways so the lines are vertical. |
| Spacing words when writing |
Use finger or Popsicle stick to define the space.
Teach child to draw a line at the end of each word along the baseline to “represent” the space needed before writing the next word. |
Occupational therapy for visual-spatial weaknesses
Effective evaluation and treatment of visual-spatial skills begins with the child’s level of body scheme (understanding how all the body parts fit together) and body awareness (where the body parts begin, end, and relate to other objects). A successful occupational therapy approach focuses on this strong base of body awareness to help a child experience distance, size, directionality, and the relationships between his body and objects by moving, touching, and playing. During therapy, visual-spatial skills are practiced and promoted in the context of integrating big and small movement, touch, vision and sound. As skills are stimulated and expanded within a single session or across several sessions, more sit-down tasks are integrated into the play and practiced with focus on specific goals identified for daily life (letter formation, writing on a line, tying shoes, or completing a puzzle).
The struggles experienced by children with visual spatial deficits are often frustrating and confusing. As parents and teachers, understanding this essential area of development is the first step to helping a child succeed. There are many strategies for improving, remediating and compensating for visual-spatial skill deficits to improve learning, achievement and success in daily life. Occupational therapists provide strong resources and intervention to meet this goal.
Robbyn Laufer, OTR/L is founder and director of Kids Can Pediatric Therapy Services. She has 15 years of experience helping improve the success of children with sensory integration weaknesses, learning disabilities, and general developmental challenges. She can be contacted at rlaufer@kids-can.com or 770-317-6755.
Special thanks to Emily McLaughlin, OTR/L, Susan Kronenberger, OTR/L, Emily Venable, MHS, OTR/L, and Tiffany West, OTR/L for their contribution to this article.
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