When it comes to handwriting, we have found that vision is one of the most overlooked and underestimated systems in children. We’ve been taught that if a child has 20/20 vision, they do not have a visual issue that will affect their academic performance. But in truth, children who have difficulties processing and perceiving what they see still quietly struggle in school.
Visual perception is the total process responsible for receiving and interpreting what we see. This allows us to make accurate judgments within our environment such as size, configuration, and spatial relationships of objects.
To do this, our visual-receptive components and visual-cognitive components must work efficiently. If one of these areas is compromised, it will affect how a child understands and responds to visual information.
What are the visual-receptive components?
Driven by how our eyes move and work together, these skills permit us to locate and identify things visually:
Visual Fixation – a prerequisite skill where the eyes are positioned in relation to the head when focusing on an object, like a baby looking at their mother’s face.
Visual Pursuits – when the eyes follow a moving object first with head movement, like watching a rolling ball. When children age, they should use only eye movements, and not need head movement.
Saccadic (Scanning) Movements– when the eyes rapidly and precisely change focus from one point to another, like when reading a book.
Acuity – the ability to discriminate fine details at a certain distance, like when reading an eye chart.
Accommodation – the ability to adjust our eyes to obtain clear vision at varying distances, like shifting focus from the chalkboard to paper.
Eye Teaming (Binocular Fusion) – when both eyes focus on a single object to form a single image, like determining how many fingers someone is holding up.
Stereopsis (Depth Perception) – when both eyes have the ability to determine objects in the foreground from background, like gauging out how fast a ball is being thrown at you.
Convergence/Divergence – the ability to move eyes inward and outward, like when looking down at your nose.
What are the visual-cognitive components?
These elements mentally interpret visual information and help provide meaning:
Visual Attention – the ability to maintain focus on relevant visual information, such as a child playing with a toy while other distractions are present
Visual Memory – the ability to recall and retrieve visual information, such as recalling how to spell a word
Visual Discrimination – the ability to detect features of a visual image and relate them to memory, like noting differences and similarities between a house cat and a tiger
Visual Imagery (Visualization) – the ability to picture people, objects, or ideas when they are not physically present, as seen when a child is drawing castles, dragons, aliens, or spaceships
What about visual motor skills? Visual motor skills (or visual motor integration) is the coordination of motor movements while interpreting visual information.
This can be seen in handwriting as it requires the ability to incorporate the visual image of letters or shapes with an appropriate motor response. This skill is the best predictor of handwriting. In fact, research has found correlations between students’ visual motor skills and their ability to legibly copy letters.

What can I do to help my child?
Believe in a multisensory approach – To help learn shapes, letters, and numbers, incorporating other sensory systems such as touch can be very helpful. Writing letters in paint, forming letters with Play-Doh, or writing letters on surfaces that provide friction can support learning of such concepts. For more activities, check out The Quick Long List of Handwriting Activities.
Move the whole body – Activities such as Simon Says can help with body/spatial concepts to help with letter formation. Asking them tasks to make their bodies as “tall as a house” or “small as a mouse” can help them understand the difference between uppercase and lowercase letters. Going to the playground and moving their bodies–like staying on a balance beam, climbing on top of the jungle gym, or sliding to the bottom of a slide–also help spatial and motor planning. (Bonus: Movement helps expel energy, allowing the attention necessary for writing afterwards.)
Play ball– Games like catch can assist with visual motor skills. Do it indoors by tossing clothes into the laundry basket or catching stuffed animals.
Adapt Your Environment– If their eyes fatigue, try using a slant board to reduce the amount of effort when copying from the board to paper. If they are having trouble seeing the board, move them closer. If they are using their whole head to read along with a book while sitting, have them read on the floor while propped up on elbows.
Learn their learning styles – If a child has visual issues, they have compensated by learning information in other ways. Find out what their strength is and work with it. Perhaps they are auditory learners who can recall 75% of what is heard in a 40-minute period. Maybe they learn best when they interact or participate in the task via touching, manipulating, or handling objects. They may need to move around when they receive information such as wiggling in their seat, doodling on their paper, or even tapping their feet.
If you think the issue runs deeper, an occupational therapist can determine what visual perceptual difficulties may be affecting your child with various assessments and create a treatment plan. If necessary, they can refer an optometrist who may prescribe glasses, or they can recommend an optometric vision therapy program to enhance basic visual skills and perception.
Sources:
Case-Smith, J. (2005). Occupational Therapy for Children, 5th ed, pg. 412-441.
Cook, D. (2004). When Your Child Struggles: The Myths of 20/20 Vision, What Every Parent Needs to Know.
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