Defining Visual Motor Skills and Visual Perceptual Skills
By Sarah Koppenhoefer-Little, OTR/L
Kids Place Central Pediatric Occupational Therapist

Visual motor integration skills are integral to a child’s development. Visual motor skills are more commonly referred to as eye-hand coordination. They involve the use of both vision and the hands to complete tasks. Some examples are writing, coloring, and tying shoes.

Visual perception refers to how the brain understands what is being seen, including color, size, shape, and direction of objects. These skills enable the child to interpret and make sense of what they are seeing. These skills include:

Form constancy: the ability to identify forms that are the same even if they are different in color, size, orientation, or texture

Figure ground: the ability to find and distinguish an object from a busy surrounding background

Visual closure: the ability to identify an object even if part of it is missing or is not visible

Visual discrimination: the ability to perceive differences and similarities in forms and match objects that are the same

Visual memory: the ability to remember what one sees

Spatial relations/Position in space: the ability to understand the position of objects in relation to each other and in relation to one’s self

When these abilities are compromised, many different skills can be affected. Some individuals only experience issues with the visual element. Others only experience problems with the motor element or find the integration of both to be problematic. Skill areas that can be affected include, but are not limited to, the ability to color, draw, catch or bat a ball, complete mazes or puzzles, build with blocks, tie shoes, as well as handwriting and scissor skills. Visual motor skills develop in a sequence. Listed below are the typical ages that certain skills develop. Please keep in mind that ages are approximate, and that variations occur depending on the individual child’s developmental process.

12-16 months: Able to scribble on paper

16-20 months: Imitates vertical and horizontal scribbles

20-24 months: Imitates circular scribbles, as well as singular vertical and horizontal lines

2-3 years: Imitates single circle, and can copy vertical and horizontal lines

3-4 years: Imitates cross, square, and diagonal lines

4-5 years: Copies cross, square, and oblique lines; Imitates and copies an “X”; Imitates some letters and numbers; May begin imitating and copying name

5-6 years: Copies a triangle and most letters; Writes name and some letters from memory

Signs and Symptoms of Dysfunction

  • May reverse letters either vertically or horizontally
  • Confusion of similar looking words
  • Does not recognize a word or object if only part of it is shown
  • Difficulty reading or writing letters and words
  • Frequent loss of place while reading or writing
  • Difficulty with reading comprehension
  • Difficulty copying from the board or up close
  • Misaligns letters or numbers with irregular spacing and letters or numbers not on the line
  • Head tilting or closing one eye
  • Turns head when reading or may hold paper at odd angles
  • Complains of eyes hurting or itching or blurred print while reading
  • Headaches or nausea after reading
  • Excessive squinting or blinking
  • Holds pencil too tightly, often breaks pencil and crayons
  • Struggles to cut or paste
  • Inconsistent or poor sports performance
  • Navigation difficulties

Now What?

If you suspect your child may be experiencing difficulty in any of these skill areas as a result of dysfunction in visual motor integration or visual perception, a referral for occupational therapy services should be obtained from your child’s physician. Occupational therapists are trained to evaluate and treat children experiencing deficits in visual skills. Participating in occupational therapy will address individual needs depending on the specific deficit, and will provide the child with the skills to confidently perform daily activities.

Please call Kids Place Central or Kids Place West at (623) 242-6908 if you feel your child can benefit from an occupational therapy evaluation.

Read Part 2: Improving Your Child’s Visual Skills