NESCA has unexpected availability for Neuropsychological Evaluations and ASD Diagnostic Clinic assessments in the Plainville, MA office in the next several weeks! Our expert pediatric neuropsychologists in Plainville specialize in children ages 18 months to 26 years, with attentional, communication, learning, or developmental differences, including those with a history or signs of ADHD, ASD, Intellectual Disability, and complex medical histories. To book an evaluation or inquire about our services in Plainville (approx.45 minutes from NESCA Newton), complete our Intake Form.

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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.

 

Remote Real-life Skills Coaching: How Does it Work?

By | NESCA Notes 2020

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

What is life skills coaching?

Coaching services in general aim to target functional life skills and help our children and adolescents to slowly build the ability to independent. While some of these skills, such as taking Uber, riding the T, or ordering in a restaurant, cannot be targeted using an online platform, the majority of these skills can absolutely be built with the help of a dedicated remote coach. Currently, many of our coaches are helping students through the great task of processing a huge life change in response to the COVID19 virus.

What skills can be worked on with a remote coach?

Hard skills are often thought of as specific, functional abilities that one can develop and perform. (In employment, these are often thought of as technical skills.) Options that can be worked on with a remote coach include cooking based on a specific recipe, ordering groceries on-line, calling to refill prescription, setting up a medication management system, typing, using Google classroom or Microsoft suite, electronic calendar management, etc.

Soft Skills include more abstract and broad abilities that are necessary for employment, academic success, and community independence. NESCA coaches work on executive function, social communication, and self-determination skills necessary for long-term independence at home, in school, and at work. Example skills taught include creating daily schedules, goal setting, preparing for interviews, organizing the home environment in order to be productive, reading and understanding IEPs and assessments, using technology to support memory, customer service skills, research skills, and more.

With the current pace and routine of life changing dramatically, NESCA coaches are working to help our clients establish healthy routines and habits. Coaches are available to help develop functional morning and evening routines, set up weekly to-do lists, develop a system to meet deadlines, use online resources for virtual learning, etc.

Who can benefit from this service?

Almost all adolescents and young adults could benefit from building life (and career or college readiness) skills, increasing independence, and practicing executive function; however, our neurodiverse population often has particular difficulty with changes in routine and greatly benefits from having a relational support to build structure and navigate change. All of our coaches have extensive experience working with adolescents and young adults with a wide range of learning, developmental, physical and social-emotional needs. NESCA is committed to helping young people who are struggling with this transition as well as families who are eager to use this unique situational opportunity to focus on skill building at home that is often difficult to fit in simultaneous to normal school demands.

What is a recommended coaching schedule?

Due to the individualized natural of coaching, the schedule and frequency can be incredibly personalized for each individual client. All of our coaching sessions begin with an intake process that includes input from both the adolescent and their family. Schedules are often developed in collaboration with the teen or young adult, the family, and the coach to best meet the client’s needs. Some example schedules that are used by current NESCA clients include:

  • Weekly Skill Building. Clients who are looking to target specific skills often choose to do a weekly session focus on learning and repetition.
  • Monday, Wednesday, Friday 30 Minute Check-ins. This model allows for a student to receive some guidance creating their own scheduling, while simultaneously holding them accountable.
  • Monday Motivation/Friday Follow-up! These sessions range from 1-2 hours and include weekly goal setting, check-ins regarding a weekly to-do list, and personal scheduling. For many clients a Friday follow-up session is an important opportunity to practice self-monitoring and review the previous week.

As somebody who coaches students in person and remotely, what differences do you notice?

I find that the main difference when coaching students remotely is when and how skills are targeted. In person, much of my coaching focuses on community integration, using our transit systems, and navigating the complex social interactions that are necessary when out in the community. Remote coaching can still target pieces of each of these skill areas but the process is in many ways more intrinsic. We may focus on learning to use the internet to find community opportunities, learning to create schedules for travel or complete applications for para-transit, using video learning to “try out” travel, employment, and community activities, and bolstering social media skills. We focused on building global skills in new ways that will help in the future, across environments. For instance, social communication by phone and video conferencing is a skill that will support social and employment success in the future.

In terms of the personal connection and opportunity to build rapport, I find that some teenagers are incredibly adept at communicating over a digital medium. Those who are not, tend to learn quickly. I am continually impressed by their ability to focus, discuss real-life topics, and build skills remotely.

 

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, Transition Services, or Virtual Coaching 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.

 

School-based Occupational Therapy at Home

By | NESCA Notes 2020

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

While school districts and government officials work to plan for the current “new normal,” no concrete decisions have been made about the delivery of special education and provider services. As parents take on the huge task of educating within the home, it is important to consider how we can bolster some of the skills that are continuously targeted in the school setting. As an occupational therapist, I have provided direct services and worked with teachers who are adeptly teaching a class of 20, while simultaneously making sure that their two students with OT needs are being provided appropriate accommodations and motor practice. Here are some activities that can be done in the home to keep the development and learning going!

If your child’s occupational therapy (OT) evaluation mentions difficulty with fine motor coordination, consider incorporating these activities into your day.

  • Sort marbles, pompom or coins. Using fingers to pinch and pick up small objects helps to build strength and solidify grasp and grip patterns. Increase the difficulty of this activity by having kids push pompom and marbles through small holes or manipulate coins through slits in a tub or box.
  • Play with playdough or putty. Make shapes using cookie cutters, push beads into putty and pull them all out, roll playdough into a snake and use different pinches to create patterns from head to tail. Pinches to consider include: thumb and index finger, thumb and index+middle finger and thumb against the side of the index finger (lateral pinch).
  • String beads, cheerios or pasta with holes. This activity promotes bilateral coordination, fine motor control and grasp patterns. Scaffold this activity by starting with threading on pipe cleaners, moving to dry spaghetti and finally working to thread onto string.
  • Practice using tweezers to pick up small objects.

If your child’s OT evaluation mentions difficulty with visual perception or visual motor integration, try these!

  • Puzzles! Doing a puzzle requires multiple visual perceptual skills, as well as the fine motor precision to fit pieces together.
  • Word searches. Word searches require horizontal and vertical tracking, letter discrimination and visual figure ground ability. Consider scaffolding this activity by finding word searches that only have horizontal words, have both horizontal and vertical, or have horizontal, vertical and diagonal words.
  • Sorting activities. Objects can be sorted by color, shape, size, texture and a plethora of other characteristics. Consider using objects found in the home, such as pens, buttons, silverware or simply items in a junk drawer for sorting activities.
  • Mazes, Hidden Pictures and Spot the Difference activities can all be found online.
  • Copying activities. Draw pictures using horizontal, vertical and diagonal lines, circles, squares, triangles and crosses and have your child try to copy them exactly. This activity works on visual motor integration specifically.

If your child’s OT evaluation mentions difficulty with endurance, postural stability or core strength, try these!

  • Draw or play while lying on the ground. Tummy time is often thought of as an activity to help our newborns, but lying on your tummy and using the muscles needed to keep the upper body and head stable can be beneficial for building strength in most of our kids.
  • Yoga! Incorporate an online video or movement break into your daily routine.
  • Pretend to be different animals! Walk like a bear, slither like a snake, hop like a frog or trot like a horse. Mimicking these animals is a great activity to do while listening to music and uses all different muscles.

While it can be difficult to target our children’s specific needs without direct access to therapists and our usual resources, building in small activities throughout the day can help to maintain strength, skill development and the foundational abilities needed for academic growth.

 

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.

 

Accommodations for Computer-based Testing

By | NESCA Notes 2019

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

As a school-based occupational therapist, I found myself beginning each academic year by focusing on what my students needed to learn, the skills they needed to develop, and how I could best use my time to help them be successful in the classroom. Despite it being September, every year this inevitably led me to consider standardized testing – one of the many academic themes of springtime.

My third graders not only needed to know the foundational mathematics skills being assessed, but how to navigate the computer screen in front of them. They needed to practice the fine motor precision to move a mouse and click on small boxes or multiple-choice bubbles. My sixth graders not only needed to understand how to plot points on the x and y axes, but they needed to have the visual perceptual skills to plot these points on a computer screen that scrolls up and down.

This demand for computer literacy skills within testing was noted as early as 2003, when Thompson et. al noted the inherent disadvantage for students who lack access to computers. However, as we continue to move further and further into the digital age, it is clear that computer-based testing has become our nation’s go-to method for assessing its students’ grasp of academic content and subject mastery. Computer-based testing allows for more efficient administration, quicker result times, built-in accommodations, and other positive benefits that make commitment to this practice worthwhile. For many students, computer-based testing is hugely preferred, and the option to type an essay is far less daunting than writing pages and pages by hand.

However, the National Center on Educational Outcomes claims that, “Despite the fairly dramatic increase in attention to CBT (computer-based testing), accessibility challenges continue to have the potential to reduce the validity of the assessment results and to exclude some groups of students from assessment participation” (Thurlow, Lazarus, Albus, & Hodgson, 2010).

So, what happens when this manner of assessment is more difficult for our students with disabilities? How can we help? What can we do?

As is often noted by test creators and administrators, most computer-based tests have relatively comprehensive built-in accommodations. Options such as enlarged font, speech-to-text, and line masking are often built into the platform. Despite this, computer-based accommodations may not be enough. When it comes to being truly accessible, the assessment of skill areas, individualized accommodation, and significant practice of testing systems are all necessary to arrive at an accurate assessment of academic skills.

Consider Charles, a fourth-grade student who has been receiving occupational therapy for decreased fine motor precision, visual perception, and low visual and fine motor endurance. He has difficulty with visual memory and gets easily overwhelmed by visual clutter. As a student in the general education setting, it is initially assumed that Charles will take his standardized tests in the computer format. At his team meeting, Charles’ mother raises her concern that he will fatigue quickly due to the visual demands of staring at a computer screen for the testing period. The team offers to provide Charles with a paper-based version of the test so he can avoid having to look at a computer screen. But Charles has decreased fine motor precision and endurance! How do we accommodate his needs?

This one case displays the importance of considering the whole child, trialing different options, and working collaboratively. Charles could potentially be allowed to take the assessment on the computer with access to a paper copy. He could use a scribe to help him type or write while he takes a computer or paper version. Maybe Charles feels confident using the computer-based test and his mother’s concerns about visual fatigue were unwarranted. Realistically, the team does not know what is best for Charles until they try a few distinct options and get his input.

Computer-based testing tools are here to stay, and fortunately our children are becoming more and more comfortable with digital methods. As we continue to make this transition, it is important to maintain the commitment to be individualized. Each student has different needs, and I urge teams, related service providers, educators, and parents to consider these needs early in the school year and early in the student’s academic career.

References:

Thompson, S., Thurlow, M., & Moore, M. (2003). Using computer-based tests with students with disabilities (Policy Directions No. 15). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes. Retrieved [9/09/2019], from the World Wide Web: https://nceo.info/Resources/publications/OnlinePubs/Policy15.htm

Thurlow, M., Lazarus, S. S., Albus, D., & Hodgson, J. (2010). Computer-based testing: Practices and considerations (Synthesis Report 78). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes.

 

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.
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.