Jenny Clark

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More Than Meets the Eye: Sensory Integration and Visual Processing

Vision is a complex neurological process involving the integration of multiple sensory systems. Therapeutic activities that integrate visual, vestibular, and proprioception input are effective interventions to help alleviate visual processing challenges. Listen to Jenny’s audio podcast as she talks about engaging therapy activities that address visual integration in children with sensory processing disorder.

The visual pathway is a neural pathway where visual input travels from the eyes to the central nervous system and integrates in the cerebellum. The cerebellum plays an especially important role in this process as it is the grand central train station where sensory signals from visual, vestibular, proprioceptive and auditory input communicate with each other.  There are many symptoms that a child may demonstrate which could indicate a visual processing deficit. Some of these may surprise you. These can include idiopathic toe walking, motion sickness, balance issues, eye-hand coordination delays, ocular tracking problems, and learning difficulties such as reading, math and handwriting. Therapeutic activities that integrate visual, vestibular, and proprioception input are effective interventions to help alleviate visual processing challenges. Here are some engaging therapy activities I have incorporated in my OT practice over the years to address visual processing in children.

  • Trampoline Activities
    • Coordinate vis.-vest.-prop. in graded sequence, such as:
    • Have child visually fixate on you while they bounce
    • Have child visually track your moving hand while bouncing
    • Play catch with child using large ball while they bounce
    • Draw visual targets on trampoline with chalk, such as clock face or square grid with numbers, then jump in a pattern
    • Have child toss and catch bean bag to self while bouncing
  • Swing Activities
    • Rescue the animals: while prone on a swing, reach to pick up a plush animal on mat and place it in a box
    • Prone in swing, assemble puzzle on mat
    • Prone in swing, engage in ring toss activity
    • Sit on swing and pick up a bean bag with feet (supine flexion)
    • Sit and swing while tracking a light-up toy
  • Alphabet Twister Games
    • Jump and spell
    • Upper-and lowercase letter discrimination
    • Right-left directionality – e.g., right hand on letter Z
    • Balance one foot on a letter
    • Visual perceptual skills – VSR, VM, VSM, VFG
    • Ocular tracking skills – Find the…
    • Midline crossing – Traditional Twister with hands/feet
  • Ball Pit Activities
    • Jump into (vestibular) and catch a plush animal
    • Climb out for proprioception and motor planning – Add VP and set up puzzle pieces to assemble
    • Throw the balls at stationary and moving targets
    • Toss and catch a beanbag
    • Pop bubbles while in ball pit
    • Look at light-up toys while in ball pit
    • Search for hidden objects in balls
  • Ocular Motor Activities
    • Catch bubbles on wand
    • Balloon volley: write letters/numbers on balloon; choose a letter/number to track while bopping the balloon
    • Zoom ball (ocular convergence): spell words
    • Beanbag toss while on balance board
    • Scoop Ball: name ice cream flavors
    • Hasbro Elefun game: catch pretend butterflies with net
    • Velcro ball game
    • Juggling with scarves
    • Dribbling a playground ball

The Many Adventures of Telehealth in Pediatric Therapy

Telehealth is an adventure in which therapists encounter many new opportunities and challenges. It requires flexibility, creativity, and open-mindedness. In this podcast, Jenny offers some ready-to-implement activity ideas from her experience in telehealth to help make the telehealth adventure easier to navigate.

I know it is very scary to tackle teletherapy for the first time. I was nervous when I started practicing teletherapy 3 years ago. I needed confidence that I could navigate the technology pieces. I needed reassurance that I could be creative with limited resources. I learned a lot about how to effectively implement teletherapy, but it took courage and a sense of adventure.

So I ask you, what would Winnie The Pooh do during this time of COVID-19? Pooh bear is a simple bear with a childlike personality, full of wonder and exploration. He takes things as they come and lives life in a fun and spontaneous manner. And when he lives his life this way, it always turns out just fine. Remember to be like Winnie the Pooh so you don’t get stuck in the mud like Eeyore!

Telehealth truly is an adventure! You will encounter many new opportunities when using telehealth service delivery model for pediatric therapy. You will develop resiliency, just as the children with multiple challenges do in their lives daily. Be flexible, creative, open-minded and expect the unexpected.

Here are some ready-to-implement activity ideas to help make your telehealth adventure a little easier to navigate.

Ready-to-Implement-Activity Ideas

Activity ideas using a paper bag and crayons

  • Tear edges of bag to make fringe
  • Go on a scavenger hunt with paper bag
  • Locomotor actions – pick up a crayon and move across room to place in bag
  • Trace hand on paper bag with crayon
  • Identify objects inside bag without looking

Activity ideas using a couch, pillows, chairs

Good for proprioception input, motor planning and following directions.

  • Hop over a pillow
  • Jump & stop activity on couch
  • Bear walk, crab walk over pillows
  • Pretend turtle with pillow on back while crawling
  • Imitate Ninja moves with pillow

Activity ideas using pipe cleaners

  • String cereal
  • Twist together and jump over
  • Copy design for visual perception
  • Wrap around finger
  • Minute to win it, how many can you pick up in 1 minute

Activity ideas using a playground ball

  • Roll over bowling pins (could be empty plastic bottles)
  • Ball wall walk, don’t let it fall
  • Crab kick
  • Spell words for each catch
  • Over under game with adult assistant

Activity ideas using cotton balls

  • Draw a sheep or cloud on paper and glue cotton balls
  • Sponge painting with cotton balls
  • Pretend feed cotton balls to plush animal
  • While supine, pick up cotton ball with toes and bring to hands
  • Throw and catch cotton ball

Tools to Help Children Develop Visual Perception

In this audio-cast, Jenny discusses tools that can be used by teachers, therapists, and parents to help children develop visual perception.

Jenny offers presentations, webinars, and workshops for teachers, occupational therapists, speech therapists, and physical therapists. If you are planning a conference and you are looking for a speaker on SPD, please contact Jenny today.

Visual perceptual skills are the foundation skills necessary for reading, writing, and math. There are seven visual perceptual skills that impact learning. A student can have deficits in one or more of these subskills. I would like to share with you a description of these visual perceptual skills, how they might impact children in school, and activities to help improve each area of visual perception to enrich learning ability.  

Visual Discrimination: The ability to discern slight differences between letter shapes, sizes and fonts. This can affect reading comprehension.

Activities: Matching game such as Old Maid, Go Fish, scrabble.

Visual Memory: Important skill for copying from the chalkboard or spelling.

Activities: Memory card game, practice spelling words using a scented marker, then smell the marker just before the test. The olfactory system is linked to memory.

Visual Spatial Relationship: Enables discerning between b-d-p-q. It is important in preventing letter reversals and manipulating columns of numbers.

Activities: Puzzles, parquetry, tanograms.

Visual Form Constancy: It is important in discriminating similar font styles when reading. Can lead to poor reading comprehension and recall.

Activities: Find and circle all of the letter “a’s”  on a magazine or newspaper page. Then find all of the letter “b’s” etc.

Visual Sequential Memory: Affects reading comprehension and spelling. It is important in written organizational skills for creative writing. VSM difficulties may mean that class performance exceeds exam responses.

Activities: Use a hand-held electronic speller. Spell words using magnetic letters. Spell words in modeling clay.

Visual Figure-Ground: Difficult to focus on tasks without being distracted by extraneous input. May lose things easily in desk and would therefore benefit from organizational aids. May lose place on page when reading.

Activities: Use a window guide when reading. Here is one example (Reading Helper 954-752-3692). Hidden picture activity pages such as Highlights magazine, Where’s Waldo or I-Spy books.

Visual Closure: Difficulties may affect word identification, seeing words “spl-it”, or omitting letters when reading.

Activities: Finish the picture activity books, dot-to-dot (ask child what the picture is before completing it).