What is visual perception? Why should I be concerned about it? What does this have to do with my child and development? This blog will answer these questions and give you an understanding of how visual perception difficulties can impact your child’s function. And, of course, we will explain what we do to help kids who have problems in this area.
First of all, it is important to understand that visual perception is not referring to visual acuity. Your child may or may not need glasses, and it is important to have acuity testing as they grow up to be sure. We do need to make sure that the eyes are healthy and any vision issues are known and corrected before determining if problems they are having are related to perception. Visual perception refers to the how the brain interprets what the eyes are seeing. The brain receives information from the eyes and interprets the information. You can imagine the problems if the information is misinterpreted.
What might you see if your child has visual perception issues? Handwriting and coloring can be a chore as well as many other fine motor tasks such as playing with construction toys, balance can be impacted and even dressing and other self-care skills. Visual perception skills include visual attention, visual memory, sequential memory, figure ground, visual discrimination, form constancy, visual closure, and spatial relations. There are a variety of standardized assessments that your OT can use to help figure out just what areas are problematic. Difficulty in one area does not mean difficulty in all areas.
I am sure you’re familiar with eye-hand coordination, something often referred in OT as Visual Motor Coordination. You need to be able to accurately judge whatever it is you are doing whether it be jumping from one place to the next, catching a ball or pouring a glass of juice. Now imagine if your sense of space is off. Try jumping, catching or pouring knowing your accuracy is poor. Would you keep trying? Some kids will, and some kids won’t, but either way, there’s sure to be frustration and extra time needed, and hopefully not a lot of bruises. Visual perception impacts nearly everything you do.
So, as mentioned above, there are a number of skills that fall under visual perception. Let’s talk about each one so you have an idea of all that the brain has to do when interpreting what the eyes are seeing.
Visual Attention – This is the ability to keep your eyes in one place for a length of time instead of momentary glances. A problem here may also be due to a general inability to pay attention for a length of time, weak musculature or low muscle tone.
Visual Memory – The ability to keep a picture in your mind of what you saw. This is related to Visual Sequential Memory in which you remember the order of several things you’ve seen such as copying a word from a whiteboard.
Figure Ground – Being able to see individual items within a busy field. Think of finding a paperclip in a full drawer or object search puzzles.
Visual Discrimination – Being able to tell the difference and the similarities between objects or pictures as related to size, shape, color, etc.
Form Constancy – Knowing that a shape or object is still the same even when its size or color has changed or if it is oriented differently such as upside down.
Visual Closure – This is the ability to know in your mind that an object is whole even if you can only see part of it. Think of an orange that is in a bowl, covered partly by an apple and a banana. You know there’s a whole orange beneath even though you cannot see it.
Spatial Relations – An understanding of the distance between things, a sense of what is in front/behind, side by side, or above/below. Children with eye muscle issues, nystagmus, or strabismus may experience difficulty with spatial relations because their eyes are not working together as they should be. In some cases, the brain is getting conflicting information, so it “ignores” information from one of the eyes to help make sense of things.
A full visual perceptual assessment will help determine which of these problems your child may be having, and your therapist can then help find the appropriate activities to help make improvements. As occupational therapists are trained in a holistic view of the body, we see the many intricate connections each system has to the others. A problem in one area often causes problems elsewhere. And so it goes with making significant changes. For example, a child being treated for sensory processing issues may experience positive changes in her visual perception because of the many links between systems.
In therapy, your OT will pay special attention to your child’s weaknesses and work to help build them up. Chances are that your child is avoiding that which is most difficult to do, so as with many therapy goals, baby steps are used to introduce him to increasing challenges. He will have the therapist there to work beside him and help him problem solve and come up with strategies to compensate for any deficits. Maybe work on pencil paper tasks such as mazes or word search puzzles will be included. Also, it is important to keep in mind that the physical activity during your child’s OT session will feed into improving visual perception. For example, a child riding the zip line has to accommodate her movements in order to clear the fast approaching pillow pit wall to be able to fall inside. Or think of your child on a tire tube swing throwing beanies into a basket. He needs to lock his eyes on his target while his body is moving and be able to time his toss just perfectly to score. These exercises will help his brain learn, and the activities can be made more difficult as his abilities grow.
Sometimes a vision specialist or a Developmental Optometrist is recommended to further assess, and vision therapy may be recommended aside from OT. It is important to note that not all optometrists or ophthalmologists are trained in vision therapy, and some even find it to be a controversial subject. As with anything else, the more you can educate yourself, the better you will be able to make a decision that is right for your family. Your therapist is always available to answer questions dealing with your child and your concerns.
Nancy E.A. Weiss, MOT, OTR/L