Discover effective goals for occupational therapy with examples, activities, and tips to improve outcomes, independence and patient progress.

<p>
  As a school-based occupational therapist, you have the opportunity to help
  students struggling with tasks that require visual motor skills – activities
  like copying from the board, tying their shoes, throwing or catching. Visual
  motor skills are critical for everyday functioning, and strengthen them can
  help kids thrive in the school setting and beyond. Here’s a refresher on
  visual motor skills, along with visual motor integration activities, IEP goals
  and resources for school OTs.
</p>
<h2>Visual Perceptual Skills</h2>
<p>
  Visual perception is multi-faceted and complex and requires various skills
  including (<a href="https://www.cincinnatichildrens.org/service/o/ot-pt/visual-motor-perception" target="_blank">Cincinnati Children’s</a>):
</p>
<ul>
  <li>
    <strong> Figure ground discrimination –</strong> Ability to find an object
    in a grouping or against a background
  </li>
  <li>
    <strong>Form constancy –</strong> Ability to identify similar objects even
    if they are of different size, color, etc.
  </li>
  <li>
    <strong>Visual discrimination –</strong> Ability to match objects that are
    the same
  </li>
  <li>
    <strong>Visual closure –</strong> Ability to identify similar objects even
    if a part of one is missing
  </li>
  <li><strong>Visual memory –</strong> Ability to recall visual information</li>
</ul>
<h2>Visual Motor Skills</h2>
<p>
  Visual motor skills (or visual motor integration) involve the eyes, brain and
  body. The skills needed for visual motor integration include:
</p>
<ul>
  <li>
    <strong>Visual perception –</strong> The ability to interpret the
    surrounding environment through vision (see components above)
  </li>
  <li><strong>Motor control –</strong> The ability to regulate movement</li>
  <li>
    <strong>Eye-hand coordination –</strong> The ability to move eyes and hands
    together to perform tasks
  </li>
</ul>
<h2>Signs of Visual Motor Deficit</h2>
<p>
  School-based occupational therapists and others who work with children can be
  vigilant for several different signs that may hint at possible visual motor
  deficits. Children with visual motor integration challenges may struggle with:
</p>
<ul>
  <li>Handwriting</li>
  <li>Completing mazes</li>
  <li>Copying from the board</li>
  <li>Coloring within the lines</li>
  <li>Catching or kicking a ball</li>
  <li>Lining up math problems</li>
  <li>Recognizing patterns</li>
  <li>Reading</li>
  <li>Reversing letters</li>
  <li>Drawing, copying shapes</li>
  <li>Bumping into objects</li>
</ul>
<h2>Visual Motor Integration Activities</h2>
<p>
  The great news for school-based OTs is research shows “intervention, including
  occupational therapy, can effectively improve visual-motor skills in
  preschool-aged children (<a
    href="https://research.aota.org/ajot/article-abstract/57/5/542/8616/Occupational-Therapy-Effects-on-Visual-Motor?redirectedFrom=fulltext"
    rel="noopener noreferrer" target="_blank">The American Journal of Occupational Therapy</a>). Here are some of our
  team’s favorite resources chock full of visual motor
  integration activities.
</p>
<h3>The OT Toolbox</h3>
<p>
  <a href="https://www.theottoolbox.com/visual-motor-skills/" target="_blank">The OT Toolbox</a>, a go-to resource for occupational therapists, features an
  extensive list of visual motor integration activities broken down by topic,
  like eye-hand coordination, visual scanning, figure ground, visual closure,
  visual discrimination and more. Examples include:
</p>
<ul>
  <li>
    <strong>Tracing letters with chalk and rainbow writing –</strong> Create a
    box for the child to form the letter in, give verbal clues. Activity helps
    with planning, dexterity, and hand-eye coordination.
  </li>
  <li>
    <strong>Sight word sensory bin –</strong> Put large printed sight words into
    a box of shredded paper. The child pulls out sight words, sorting them from
    the shredded paper and makes sentences by organizing the words.
  </li>
  <li>
    <strong>Figure ground sight word hunt –</strong> Hide printed sight words in
    a room or in nature and have students look for the words. This helps them
    discriminate the word from a background.
  </li>
</ul>
<h3>Your Therapy Source</h3>
<p>
  <a href="https://www.yourtherapysource.com/blog1/2019/07/31/visual-motor-activities/" rel="noopener noreferrer"
    target="_blank">Your Therapy Source</a>
  has free and paid resources for OTs and has a page with 10 free worksheets to
  print and play. The activities include:
</p>
<ul>
  <li>
    <strong>Visual-motor exercise –</strong> Downloadable maze with directions
    for kids to complete
  </li>
  <li>
    <strong>Visual-motor workbook –</strong> 2 free pages from their complete
    Visual Motor Workbook
  </li>
  <li>
    <strong>Follow the path –</strong> Dot to dot diagrams to practice visual
    motor and visual-spatial skills
  </li>
</ul>
<h3>OT Closet</h3>
<p>
  <a href="https://www.youtube.com/watch?v=7yvQGXRaQIQ" rel="noopener noreferrer" target="_blank">OT Closet</a>
  has a 5-minute YouTube video demonstrating 8 fun games with a ball for fine
  motor and visual skills. This video can be shown directly to a student to run
  through the exercises or can be used to instruct the OT. Activities include:
</p>
<ul>
  <li>Transferring ball from cup to cup</li>
  <li>Building bridge with cups and pencil and rolling bridge under it</li>
  <li>Bowling to knock the cups down using the ball</li>
</ul>
<h2>Visual Motor Integration Goals</h2>
<p>
  When writing visual motor integration IEP goals, there are a few things to
  remember:
</p>
<ol>
  <li>
    It’s critical to write the best possible goals for your students.
    Researchers have found that “poorly written IEP goals are negatively related
    to growth and progress in the curriculum” (<a href="https://pubs.asha.org/doi/10.1044/persp2.SIG16.34"
      rel="noopener noreferrer" target="_blank">ASHA</a>).
  </li>
  <li>
    Strive to write SMART goals. SMART goals are Specific, Measurable,
    Attainable, Relevant and Time-Limited. Using the SMART acronym can help you
    write much more effective goals. See our resource on writing
    <a href="https://www.crosscountryeducation.com/blogs/goal-writing" rel="noopener noreferrer" target="_blank">SMART
      goals</a>
    for more.
  </li>
  <li>
    Use a template for writing IEP goals, like this one: By [date] in order to
    [educational/OT need], student will [functional skill] with [measurement]
    with [level of assistance], as measured by [person]. For example, by October
    2023, in order to legibly complete classroom writing tasks, student will
    self-generate two sentences with 75% legibility with adapted tools as needed
    for 3 out of 5 opportunities as measured by teacher and OT.
  </li>
</ol>
<h2>Visual Motor Developmental Milestones</h2>
<p>
  <a href="https://www.choc.org/userfiles/file/Rehab-Developmental Milestones final.pdf" rel="noopener noreferrer"
    target="_blank">CHOC Children’s</a>
  has a chart adapted from the Peabody Developmental Motor Scales‐ 2nd edition
  and Occupational Therapy for Children‐ 3rd edition OTs can use as a rough
  guideline for visual motor development.
</p>
<p><br /></p>
<table>
  <tbody style="font-weight:bold;">
    <tr>
      <td> 1 month </td>
      <td>
        <ul>
          <li>Eyes can follow (track) an object towards the middle (midline) or starting at midline to either side
          </li>
          <li>Tightly grasp objects placed child’s hands </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>1-3 months</td>
      <td>
        <ul>
          <li> Infant attempts to swipe or hit objects</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>2 months</td>
      <td>
        <ul>
          <li> Eyes can follow (track) an object to right and left sides, past the midline</li>
          <li> Can briefly hold small toys placed in child’s hands</li>
          <li> May begin to notice their own hands </li>
        </ul>
      </td>
    </tr>


    <tr>
      <td>2-6 months</td>
      <td>
        <ul>
          <li> Infant inspects own hands and reaches for but may not actually touch objects</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td> 3 months</td>
      <td>
        <ul>
          <li> Eyes can follow objects in a circular motion</li>
          <li> Hands are more relaxed </li>
          <li> Infant is able to look at an object and will attempt
            to reach for that object (Referred to as “visually directed reaching”)
          </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>3-7 months</td>
      <td>
        <ul>
          <li> 3-7 months • Child is able to hold a small object in each hand</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>4-5 months</td>
      <td>
        <ul>
          <li> Touches fingers together </li>
          <li> Begins reaching with both hands at the same time </li>
          <li> Able to reach and grasp a small toy using both hands</li>
          <li> Touches or bangs an object on a table or hard surface</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>6 months</td>
      <td>
        <ul>
          <li> Reaches for an object with right or left hand </li>
          <li> Shakes a rattle </li>
          <li> Uses a raking grasp (all fingers at the same time) to pick up small objects </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>7 months</td>
      <td>
        <ul>
          <li> Transfers a small object from one hand to the other</li>
          <li> Child uses an inferior pincer grasp (pads of thumb and index finger) to pick up small objects like
            Cheerios</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>8 months</td>
      <td>
        <ul>
          <li> Able to pull an item that is placed vertically in Playdoh </li>
          <li> Able to hold an object with the pad of the thumb facing the pad of the index finger</li>
          <li> Can poke objects with index finger</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>9 months</td>
      <td>
        <ul>
          <li> Uses thumb and index finger (pincer grasp) to pick up small objects like Cheerios</li>
          <li> Bangs two objects together (i.e. two blocks) </li>
          <li> Claps hands </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>10 months</td>
      <td>
        <ul>
          <li>Pull out three items that are placed vertically in Playdoh </li>
          <li>Releases an object into an adult’s hand upon request </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>11 months</td>
      <td>
        <ul>
          <li> Places small objects into a medium or large container</li>
          <li> Can place multiple medium‐sized objects (i.e. blocks) into a container
          </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>12-14 months</td>
      <td>
        <ul>
          <li> Able to let go of an object (i.e. throw a ball) and picking It up again </li>
          <li> Can turn the cover or single thick pages of a book </li>
          <li> Removes or dumps out objects from a container </li>
          <li> Is able to point finger at objects </li>
          <li> Can place a simple shape (i.e. circle or square) into a puzzle board </li>
          <li> Can place small objects into a small container </li>
          <li> Begins to make small marks on a paper</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>15-17 months</td>
      <td>
        <ul>
          <li> Can build a two‐block tower </li>
          <li> Scribbles spontaneously (without demonstration) </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>18-23 months</td>
      <td>
        <ul>
          <li> Can build a four‐ to six‐block tower</li>
          <li> Can turn a few thick pages at time in a book</li>
          <li> Can push, pull or dump things out </li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>24-29 months</td>
      <td>
        <ul>
          <li> Imitates drawing a vertical line </li>
          <li> Is able to remove a screw/twist on lid to a container </li>
          <li> Child can turn one page at a time when looking at a book </li>
          <li> Can build an eight‐block tower </li>
          <li> Imitates horizontal strokes on paper</li>
          <li> Can string four large beads onto a piece of yarn</li>
        </ul>
      </td>
    </tr>
    <tr>
      <td>30-36 months</td>
      <td>
        <ul>
          <li> Can build a 10‐block tower</li>
          <li>Copies a circle on paper</li>
          <li>Snips paper with child‐safe scissors</li>
          <li> Can cut a paper in half with child‐safe scissors</li>
        </ul>
      </td>
    </tr>
  </tbody>
</table>

<p>Thanks for reading our resource on visual motor skills for school-based OTs! We hope you find it a useful addition to
  your OT toolkit!

</p>
</br>
<p> Find out where children need your specialized OT skills in exciting locations across the nation.
  <strong>Check out our</strong> <a href="https://www.crosscountry.com/education" target="_blank">occupational therapy
    jobs here!</a>
</p>

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