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visual motor integration

Visual Motor Integration Deep Dive – Part 2

By | NESCA Notes 2020

 

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

Last week’s blog taught us the nuts and bolts of Visual Motor Integration. Let’s jump into the what VMI really means for students who struggle with VMI.

Research has shown a statistically significant correlation between performance on visual motor integration assessments and teachers’ assessments of early elementary school students’ reading, mathematics, writing and spelling ability (Optometry and Vision Science, 1999; Pereira, D., Araujo, R., & Braccialli, L., 2011). Now that we understand what visual motor integration is as a concept and that it is a foundational skill for academics, let’s look at some areas of education that may be difficult for children with visual motor dysfunction.

  • Written Output – Beginning in preschool, children start to learn how to draw vertical, horizontal and diagonal lines. They practice circles, squares, crosses and drawing an X. All of these are considered pre-handwriting practice. As a child moves along in their academic career, they start incorporating these movements into letters and eventually words. Children who struggle with VMI have particular difficulty recreating the images that they see. This often manifests itself in letter reversals, illegible written output and inability to judge whether their copy looks like the model or not. As children get into later grades, visual motor dysfunction may include difficulty copying information from a whiteboard, trouble staying on the line or within the space provided, and a simple lack of fluidity when writing. Tasks, such as filling out graphic organizers and brainstorming, feel tedious and tiring, as opposed to helpful.
  • Math – While math is not typically thought of as a motor-based task, substantial portions of current math curriculums rely on visual motor integration. For younger students, drawing shapes, writing equations and recognizing patterns may be particularly tough. As students get older, geometry requires them to write out proofs and draw shapes, while calculus requires graphing and drawing lines based on complex equations. Building on VMI helps students to access more than simple written output.
  • Using Classroom Tools – While this may not seem as academically focused as the other areas that are affected by VMI, classroom tools are frequently used throughout the school day. Scissors, a stapler, a hole puncher and a mouse/keyboard all require some level of visual motor function.

It’s difficult to briefly sum up all of the ways that students are incorporating their visual motor integration skills into a typical school day, or realistically a day in general. They use these skills without even realizing it, which means they unintentionally practice them all day. VMI is something that can continue to develop all through the lifespan. Artists pick up new tools and build mastery, adult calligraphy classes have become a new fad as people learn to modify and improve their handwriting, and even Tom Brady continues to work on perfecting that spiral. Targeted intervention can help children build on their foundation and find confidence in their abilities. If you feel that VMI might be affecting your child’s education, reach out to an occupational therapist and see if they can help you better understand your child’s individual profile.

 

References

Optometry and Vision Science: March 1999 – p 159-163. Retrieved from https://journals.lww.com/optvissci/Abstract/1999/03000/Relationship_between_Visual_Motor_Integration.15.aspx

Pereira, D., Araujo, R., & Braccialli, L. (2011) Relationship between visual-motor integration ability and academic performance. Journal of Human Growth and Development, 21(3), 808-817. Retrieved_from https://www.researchgate.net/publication/317462934_Relationship_analysis_between_visual-motor_integration_ability_and_academic_performance

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Visual Motor Integration Deep Dive – Part 1

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

If your child is currently receiving occupational therapy services in either a sensory clinic or a school-based setting, it is likely that you have heard the phrase “visual motor integration (VMI).” It has possibly been described as the ability to “see something and then recreate it with a pencil,” or “coordination between the eyes and the hands to create an intended outcome.” While these phrases or simple definitions do give some insight into the skill, there are layers to understanding the intricacies of VMI and how it may affect someone in a classroom setting. Why is visual motor integration important? Why does this skill affect a child’s ability to successfully access their curriculum? And really, why do occupational therapists seem to be so focused on this foundational skill?

Let’s start by dissecting the phrase visual motor integration, as each word truly highlights an important aspect.

Visual.

In this sense, “visual” refers to the functional visual skills and visual perception. Functional visual skills include being able to follow along a horizontal, vertical or diagonal line with one’s eyes, as well as being able to account for depth by focusing on objects that are both close to the face (a book) and far away (the whiteboard). Clinically, these skills are referred to as visual tracking and convergence respectively. Visual perception is the brain’s ability to interpret the data that the eyes are seeing and turn it into meaningful information. This is not simply the ability to clearly see something, a skill that is often assessed by school nurses or optometrist. It is the ability to understand it. Visual perception is complex in its own right, but the specific details are for another time, or potentially another blog.

Motor.

Similar to visual skills, “motor” refers to one’s overall motor skills. This includes:

  • Fine motor control – the ability to use the small muscles in the hands to make coordinated movements;
  • Gross motor – the ability to use the large muscles in the body; and
  • Postural stability – the ability to create a supported foundation when sitting or standing; a child’s postural stability is hugely affected by their core muscles and their position when sitting.

Integration.

Some students have visual motor dysfunction because of a deficit in either their visual skills or their motor skills. They find using these two skills together difficult simply because one foundational piece is already affected. Conversely, some students have trouble with VMI simply because of this integration piece. Being able to use these two skills in conjunction with intention and coordination is a skill within itself. Through standardized assessment and clinical observation, occupational therapists should be able to determine the root cause of a child’s VMI dysfunction. This helps to guide appropriate intervention and accommodation. In some ways, visual motor integration is similar to hand-eye coordination.  Being able to recreate something that a child sees, such as a square, the letter “A” or a horizontal line is truly using VMI skills.

Next week, we’ll dive further into VMI and how it serves as a foundational skill for academics, its impact on learning and the output students produce.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Visual Skill and Academic Success – Looking Past 20/20 Vision

By | NESCA Notes 2019

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Community-Based Skills Coach

When a school nurse pulls a child into his or her office to complete a basic eye screening, he or she may write, “20/20 vision in both eyes. No visual concerns.” This child has successfully looked at an eye chart and read the letters; demonstrated the ability to look straight ahead, from an appropriate distance without things becoming blurry or illegible; and demonstrated visual acuity, or the ability to see with acceptable clarity.

But does this necessarily mean there are no concerns?

Visual acuity measures whether a stimulus is being seen – not necessarily if the information is truly being understood. The visual system is a complex part of the central nervous systems that incorporates the eyes, ocular pathways and brain to produce and interpret sight. It requires consistent communication between all of these individual anatomical pieces, the vestibular system and the skeletomuscular system. Essentially, vision is complicated and messy and requires many many different skills.

Breaking It Down

In terms of visual skills needed for academic success, we often break things down into three main areas: ocular motor control, visual perception and visual motor integration.

  • Ocular motor control describes the ability to physically move the eyes using the 9 ocular muscles. It encompasses the ability to track an object across a screen or a line of text across a book, or the ability to look up at the board and then quickly refocus on a sheet on paper on the desk. Imagine trying to watch a basketball game without the ability to track the ball across the screen smoothly. It quickly becomes tiring and frustrating. Occupational therapists often refer to these specific eye movements with technical terms, such as visual saccades, pursuits, convergence/divergence and accommodation. But in essence they describe eye movement.
  • Visual perception or visual processing is in many ways more nuanced. It focuses on the brain’s ability to organize, interpret and fully understand the information it receives from the eyes. Two main skills needed at school are visual figure ground and visual closure.
    • Visual figure ground is the ability to discern relevant information from a busy or cluttered background. A student with visual figure ground difficulty may not be able to search a busy white board and find a homework assignment. These students may also be visually overwhelmed by a worksheet with 20 math problems, but successful with the same problems presented individually.
    • Visual closure is a skill that specifically helps with reading efficiency and fluency. It is the ability to identify or visualize a complete form or picture when given incomplete visual information or when only a small piece of the image is shown. Visual closure allows us to read a sentence quickly without stopping to decode each individual letter. It is aslo oen raeosn taht mnay pelope can raed setneces wtih julmbled up ltetres. We recognize the form, not simply the sequential letters.  :  )
    • Visual closure plays a role in sight words and reading partially-covered papers or street signs in the community. While there are many more important visual perception skills, these two examples have functional, measurable effects in the classroom setting and are commonly identified through occupational therapy testing.
  • Visual motor integration (VMI) describes the ability to use all of these foundational visual skills in conjunction with foundational motor skills. It is the ability to interpret visual information and produce a precise motor response. In the classroom, this affects a student’s ability to copy shapes, produce legible handwriting and use scissors to cut along a line. Not only can these things be difficult, they can be exhausting as a child tries to use all of these skills at once.

While all of these visual components have multiple layers and intricacies, it is important to simply acknowledge that there’s more than the eye can see when it comes to vision. A child who “can’t see the board,” but has 20/20 vision, may just be visually overwhelmed. A child who looks at a page full of small block text and immediately gives up may not have the visual skill to read across a line. And a child who is learning to read beautifully, but still has difficult forming the letters in his name may have poor visual motor integration. Fortunately, there are many interventions and accommodations that can help build on and develop these skills further to foster confidence and success in the class and community.

About the Author:

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. In addition to her work at NESCA, Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual skills must be taken into account to create comprehensive educational programming.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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