I’ll be honest: I was a little nervous to share these results. Not because they were bad — but because they were really good, and I didn’t want anyone to think I was overclaiming.

But the principal said it herself: these numbers are impressive. So here we go.

A Little Backstory

If you’ve been following me for a while, you know I teach a vision course with Robert Constantine for school OTPs. Vision is one of those areas I get genuinely fired up about — because undiagnosed vision issues are constantly getting misread as ADHD, dyslexia, behavior problems, or just a kid who doesn’t care.

Last fall, one of the principals in my district heard I wanted to start an Ocular Motor Group as a multi-tiered support for kids struggling with reading. We got the green light from Special Ed. And then things moved fast.

I had a few days to create the program outline and design all the activities. We ran two groups of four students, seen every other day, rotating through stations every two weeks. Total of about 12 weeks of services (not counting winter break).

I called it the O.M.G. — Ocular Motor Group. You’re welcome.

Here are a couple of videos so that you can get a glimpse of the types of activities I used.

To be clear on what those numbers mean: I asked the school psychologist to walk me through the data because I’d never looked at diagnostic reading or math scores like this before. A score of 183% means that student hit her winter i-Ready goal and then surpassed it by 83%. It’s not just passing — it’s blowing past the expected target.

Here’s the summary:

• 3 students went up 1 grade level in reading
• 1 student went up 2 grade levels in reading
• 3 students went up 1 grade level in math
• 1 student went up 2 grade levels in math

Now — I want to be transparent. I can’t attribute all of this progress to the O.M.G. alone. These kids also had teachers, other support staff, and a lot of other variables in their lives. But I also know what I saw in those sessions. These kids were engaged, they were building skills, and something was working.

What Were We Actually Doing?

The number one question I’ve gotten: What activities did you use?

I pulled from everything I know — ocular motor exercises, brain gym, rhythmic movement, and reflex integration — and built it into playful, engaging stations. Nothing felt like “therapy” to the kids. It felt like games.

That’s intentional. When kids are having fun, you get buy-in. When you get buy-in, you get effort. When you get effort, you get results.

Keep it FUN. That’s not a throwaway tip — it’s the whole strategy.

If you want to learn more about vision and how it connects to learning, behavior, and OT practice, check out the Eyes First course I teach with Robert Constantine. The link is below.

And if you’re thinking about starting something like this in your own district — you absolutely can. You don’t need a perfect program. You need a good reason, a willing administrator, and a solid foundation of knowledge to back up your clinical decisions.

Start there.

Want to learn more about vision and school-based OT? Check out Eyes First → Eyes First Vision

Tips for Success

• Adapt activities based on skill level by pre-cutting materials or providing hand-over-hand assistance
• Create visual guides for color sequencing
• Take breaks between steps for sensory regulation
• Celebrate effort and creativity over perfection

Conclusion

These St. Patrick’s Day crafts offer more than just festive fun – they’re carefully designed to build essential developmental skills while keeping children engaged and motivated. From simple rainbow reveals to detailed heart displays, each activity provides meaningful therapeutic benefits wrapped in creative play.

Remember, the true pot of gold in these activities isn’t just the finished product – it’s the valuable skills your little ones develop along the way!

As an occupational therapist working in schools, I’ve discovered that the best interventions often feel like play. That’s why I’m excited to share a free Thanksgiving-themed cryptogram with our wonderful community of therapists, teachers, and parents.

Why Cryptograms?

These decode-the-message puzzles are more than just fun – they’re powerful tools for developing essential skills:

1. Visual Processing
   • Tracking left to right
   • Scanning for patterns
   • Discriminating between similar letters
2. Cognitive Skills
   • Problem-solving strategies
   • Working memory enhancement
   • Pattern recognition
3. Fine Motor Development
   • Handwriting practice
   • Precise letter formation
   • Optional cutting activities

Three Difficulty Levels

Our free cryptogram comes in three levels to ensure success for all students:

• Beginner: Letter-by-letter hints
• Intermediate: Word patterns
• Advanced: Minimal assistance

Download your free copy below and watch your students light up as they crack the code!

Need more engaging activities? Check out our full Cryptogram Activity Packet, now available at a special holiday price!

Learning to use a keyboard and to type isn’t easy! It is a false assumption that children with handwriting difficulties will learn to type easily. It will certainly help these children in the long run, however, it is important to remember that children with motor and planning difficulties (e.g., bilateral coordination, eye-hand coordination, motor planning, visual perceptual and fine motor difficulties) in handwriting will also have these difficulties when initially learning to use a keyboard to type. Accommodations for these difficulties may need to be considered when teaching keyboarding and typing skills.

How do YOU type?

Hands up if you are a ‘2 finger’ typer. Do you use your two index fingers to stab at the keyboard? While there are a lot of proficient ‘2 fingers’ typers out there, I think it is important to teach kids proper finger positioning when learning how to use the keyboard!

If you have a keyboard in front of you, look down at it for a moment. What do you see?

• letters, numbers, symbols
• whole words
• a series of rows
• diagonal columns and straight columns of keys
• function keys
• a trackpad or a mouse nearby
• keys split into different sections
• lights
• white on black, black on white, something else?​

Did you notice what I asked you to do? Looking up at a screen then looking down at the keyboard. Did you easily find your place back up on the screen to read my suggestions? For children with visual perceptual difficulties, this is one of the main issues they may have difficulty with as they look up and down and up again. They may also have to move their hands completely off the keyboard so they can see the keys. One of the main benefits of touch typing is eliminating the need to look up and down so often.

Recommendations and Accommodations for Visual Perceptual Difficulties

1.Use stickers on the keyboard. There are many stickers on the market to help children learn to type. Some of the features that stickers can help with include lowercase to cover capital letters, both lower and capital letters on the one sticker, and color coding so that the same finger strikes a certain color. You may also like to buy two sets of stickers so that you can place the ‘home key’ stickers on the child’s fingers.

2.Change the computer font to reflect a familiar handwriting font that the child is familiar with.

3.Teach proper finger positioning and touch typing. This will mean that over time, the child will not need to look at their hands when typing and they can concentrate their visual attention to the screen and what is being produced.

4.Change the mouse or cursor options on the screen. On a PC, this may be done through the control panel. You may want to experiment with options such as choosing a scheme with a large cursor (for easier visibility). Another recommendation is selecting the ‘Show location of pointer when I press CTRL key’. This is helpful for those children who have trouble locating their cursor/pointer on the screen within the confusing information that may be presented on the screen. Other options include downloading animated pointers. The cursor blink rate may also be changed so that it provides the appropriate visual prompt for the child so that it is not too fast to be noticed.

5.Provide a vertical easel document holder so that the child can see work to be copied in the same plane as it will be produced on screen. Some of these holders also include a highlighting line guide to help keep track of where the child is up to on the document to be copied.

• Position in Space or Visual Spatial Relationships 

It involves the ability to process information about oneself in relation to their environment in space, orientation and position. It may involve the ability to understand directional language concepts such as up/down, next to, left/right, over/under, etc.

As mentioned previously, as typing and keyboarding skills develop there is less reliance on visual guidance to find the right keys on the keyboard. Over time touch typers can understand where their fingers are ‘in space’ and in relationship with other keys to be struck without looking. This is also true for the use of the mouse and trackball.

• Figure-Ground and Visual Memory

Figure-Ground is the ability to see an object or form when presented in a complex background. Visual Memory is the ability to remember and recall objects, shapes, symbols or movements in short-term memory. Visual memory requires visualization of what to remember.

In keyboarding and typing skills, both figure-ground and visual memory skills are required to learn the layout of the keyboard. They need to have a map (i.e. visualization) of the keyboard in one’s mind so that finding the keys becomes automatic. Difficulties with figure-ground and visual memory may lead to more reliance on the visual skills of looking and scanning (i.e. hunting) for the correct keys on the keyboard. This will slow down the typist and can often be observed with ‘2 finger typists’.

Both figure-ground and visual memory skills are also needed to enable a child to maintain their place on the screen when looking down and then up again to keep track of what they are writing on the screen. This is further complicated if the child is copying text to type onto the screen as they are looking at the stimulus, looking at the screen, looking back at the stimulus, looking at the screen, looking at their hands and so forth.

Locating the cursor/pointer may also be difficult for children who have difficulty with figure-ground skills. The pointer may look like a large capital ‘I’ when typing text and be confused with the print on the screen.

Hey there!

I’ve grown accustomed to seeing terrible handwriting in all the classrooms since COVID. The other day I went to do a consult in a general ed first-grade classroom expecting “the usual.”

But this classroom was different. The work samples in the hallway were neat, with good spacing and letter formations.

In the classroom, I observed the children all started working at their desks with their Chromebooks. It was obvious that they were used to the activity.

It was a YouTube Channel called:

“Art for Kids”

…and the children were all drawing holiday pictures. I couldn’t believe how good they were! From reindeer to the Grinch, each picture was better than the next—all created by 6-year-olds!

I asked the teacher about it—I know there isn’t extra time in their day to do fun things like this. She agreed, but said, “We just do a few minutes each day. It has made a HUGE difference in their motor skills!”

Their visual perceptual skills, too!

Truthfully there are a lot of skills involved in copying a picture. Here are just a few:

• Executive functioning to follow directions
• Speech and Spatial Language processing
• Visual tracking/accommodation from the computer to the paper
• Visual motor skills to copy the shapes, lines, and forms that the artist demonstrates
• Fine motor skills to manipulate the pencil, marker, or crayon
• Visual perception skills (discrimination) to recognize the shapes and spatial orientation of the forms
• Visual perception skills (visual memory and visualization) to remember what the artist did and then plan it on your page
• Visual Perception (bilateral integration) to hold the paper while drawing
• Visual-Spatial Skills (Directionality to follow the left/right directions)
• Visual Closure to mentally fill in the rest of the picture

Isn’t this amazing? So this simple, calming, and FUN activity was helping her students with all of these skills. What a game-changer. I couldn’t believe that I’d never heard of it.

I am always looking for activities that target multiple skills at once—and this one hits the mark! I hope you’ll check it out.

AND, for the first time ever, I’m offering a teacher’s version, so school OTs who want to educate staff can present on this important topic without doing the work—because I’ve done it for you.

Coming July, 2024

Hey there, fellow occupational therapists and curious readers!

Let’s talk about something super important in our field – vision! Understanding how vision works and spotting any potential deficits can make a huge difference in the therapy we provide. After all, vision plays a vital role in our daily activities and occupation. When a child experiences visual impairments, it can really impact their educational performance.

In this blog post, we’re going to dive deep into the world of vision within occupational therapy. We’ll explore the key terms related to vision care and why they matter. Plus, we’ll shine a light on the signs and potential misdiagnosis of vision difficulties in children.

So, get ready to gain some valuable insights and tips that can help us make a positive impact on the lives of the kids we work with. Let’s join hands to enhance our understanding of vision in occupational therapy! Stay tuned for more exciting content coming your way.

The Scope of Vision in Occupational Therapy

According to the Individuals with Disabilities Education Act (IDEA), visual impairment is “any impairment in vision that adversely affects a child’s educational performance.” (IDEA; Pub.L. 108-446)

This broad definition encompasses various conditions, including ocular pathology, brain injury, and ocular motor issues, making vision a significant aspect within occupational therapy (Office of Special Education and Rehabilitation Services, 2017).

Understanding Key Terms

Let’s unravel the mystery behind vision care professionals – the optician, optometrist, and ophthalmologist. Understanding their unique roles is key to getting the best eye care possible.

School Professionals that Look at Vision

In a school setting, we have a bunch of fantastic professionals working together to evaluate and tackle any vision issues. So, if you’ve ever wondered about the team behind your child’s vision care at school, we’re here to shed light on their amazing contributions and the magic they bring to the table.

• School Physician: Conducts medical assessments and may refer students for further vision evaluations.
• School Nurse: Assists in identifying visual concerns and may facilitate vision screenings.
• School Occupational Therapist: A vital member of the team responsible for identifying and addressing vision-related challenges that affect a child’s occupation and education.
• Teacher of Visually Impaired children (TVI): Provides specialized instruction and support for students with visual impairments.

Vision Difficulties

may look like something else

Vision difficulties can often manifest in unexpected ways, leading to misdiagnosis. 

   May Look Like

• • ADHD
  • Autism
  • Behavior
  • Reading disabilities
  • Motor delays

Recognizing vision difficulties and how they can sometimes be mistaken for other conditions is essential. It’s essential to be aware of this because misdiagnoses can happen, and we want to make sure every child gets the right help and support they need.

Imagine this: eye movement issues, which can be found in 8% of kids, might look a lot like symptoms of ADHD. That’s why it’s crucial to dig deeper and properly understand what’s going on. And did you know that children with autism may face challenges with accommodation and processing visual information? Understanding these nuances can make a big difference in providing the best care for our kids.

So, let’s keep our eyes wide open and be mindful of the possibilities. Together, we can ensure every child gets the right diagnosis and the support they deserve.

Two Different Models of Vision

For many individuals, vision concerns are commonly addressed through traditional eye exams, focusing on visual acuity, refractive disorders, and eye health. However, a more comprehensive approach, known as the Three-Component Model of Vision Examination, goes beyond the basics to assess additional aspects of visual function.

Traditional Eye Exam

The traditional eye exam is a standard evaluation performed by optometrists and ophthalmologists. It primarily centers around three key aspects of Visual Integrity:

1. Visual Acuity: This test measures a person’s ability to see at a specific distance. It involves reading letters or symbols from an eye chart to determine the clarity of vision.

2. Refractive Disorders: The evaluation of refractive errors, such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism, or presbyopia. Corrective lenses, such as glasses or contact lenses, are prescribed to address these conditions.

3. Eye Health: A thorough examination of the external and internal structures of the eye to detect any signs of eye diseases, such as cataracts, glaucoma, or macular degeneration.

While the traditional eye exam provides essential information about visual acuity and basic eye health, it may not fully capture other important aspects of visual function that can impact daily activities and performance.

Three-Component Model of Vision Examination

The Three-Component Model of Vision Examination offers a more comprehensive assessment, recognizing that vision encompasses various interconnected elements. It consists of three main components:

1. Visual Integrity (Visual Acuity, Refractive Disorders, Eye Health): This component aligns with the traditional eye exam, evaluating visual acuity, refractive errors, and overall eye health.

2. Visual Information Processing: This aspect explores how the brain processes visual information. It includes:

• • • Visual Motor Integration: Assessing how well visual information is coordinated with motor skills, such as eye-hand coordination and spatial awareness.
    • Visual Analysis: Evaluating the ability to recognize and interpret visual stimuli, such as shapes, letters, and patterns.
    • Visual-Spatial Skills: Measuring the capacity to perceive and understand spatial relationships, which is crucial for tasks like reading maps or following instructions.

3. Visual Efficiency: This component investigates how effectively the eyes work together as a team. It involves:

• • • Binocular Vision: Examining the coordination of both eyes to provide a single, unified image.
    • Eye Movements: Assessing the ability to track objects smoothly, shift gaze quickly, and sustain focus as needed.
    • Accommodation: Evaluating the eye’s ability to adjust focus between near and distant objects.

The Value of Comprehensive Vision Examination

The Three-Component Model of Vision Examination recognizes that vision is more than just seeing clearly. it encompasses how the brain processes and uses visual information. Identifying and addressing issues related to visual information processing and visual efficiency can be crucial, especially in children whose visual skills are still developing.

When it comes to eye exams, going beyond the basics can be a game-changer. A comprehensive vision examination can spot potential vision difficulties that might otherwise go unnoticed. Things like issues with visual information processing or visual efficiency can actually affect our reading, writing, learning, and daily activities. But don’t worry, because addressing these concerns early on can make a world of difference. It means getting the right help and interventions to optimize our vision and overall well-being.

While regular eye exams are essential, the Three-Component Model of Vision Examination takes it up a notch. It gives us a deeper understanding of how our vision really works, allowing for early detection and intervention. And you know what that means? It’s all about enhancing the quality of life for people of all ages!

Occupational therapists also play a critical role in a child’s education and daily life. By recognizing and addressing visual deficits, they can have a huge impact on a child’s development and their ability to participate in activities.

Let’s all work together, as professionals and individuals, to embrace the value of comprehensive vision examinations. They can truly promote optimal vision and overall visual well-being. So, if you’re an occupational therapist, don’t forget the power of advocating for comprehensive eye exams – it could be the missing puzzle piece for some kids! Remember, it’s not always sensory or ADHD; sometimes, it’s all about vision. So, let’s make a positive difference together!