Functional Vision Skills:



Vision Therapy Activities for PreschoolersBoulder Valley Vision TherapyJen Simonson, OD, FCOVDCourse Objectives:Learn about normal vision development in Preschoolers (ages 3-6)Identify delayed visual skills developmentBecome familiar with the Wachs Analysis of Cognitive Structures (WACS) assessmentWork-shop on Age-appropriate Vision Therapy ProceduresVisually-guided MotorTrackingAccommodationBinocularityVisual-PerceptualLearn how to adapt common vision therapy activities to the appropriate level for this age groupVision in Preschoolers Research Study (VIP)Early detection increases the likelihood of effective treatmentFewer than 15 percent of all preschool children receive an eye examination. Fewer than 22 percent of preschool children receive some type of vision screening. Prevalence of Vision Disorders: Amblyopia (2-5%)Strabismus (3-4%)Significant refractive error (10-15%) Motor LEADS Vision Development: From Birth until Six Months, motor development drives visual developmentA child at one month can follow moving lightsAccidental touch of objects leads to visual reach at 3 monthsA four month old can focus as an object is moved as close as 16 inchesThe Emergence of VisionObject Permanence develops between 9-12 months. The child will search for a covered object because they know that it still exists. First concept that an object isn’t gone if it isn’t seen.At the age of 9 months to 1 year, vision plays a key role in LEADING motor developmentFunctional Vision Skills:FixateFollowFocusFuseFigure-OutAge 3 Able to switch attention from near to farShows good spatial orientationAble to scan smoothlyCan team the two eyes at near and intermediate distances (up to 7-10 feet)Ability to plan ahead and predict movements in space (better able to catch a ball)Able to name more objects seenAble to describe experience of space – over, under, back, bigger, moreAble to turn eyes without moving headSigns of Developmental Lags (25% below Average)OculomotorUnable to follow a moving object without moving the headHas to move the head to shift attentionUnable to walk and observe at the same time – has to be still to lookEye-Hand CoordinationUnable to complete a three-piece form boardCannot draw a circleUnable to fold paperSpace PerceptionFew spatial words (does not use over, from, by, on top of)Unable to place an object as directedCannot specify space details: kitchen vs. “house”Age 4Able to make eye contact at 10 to 16 feetAble to make recognizable drawingsThe child can begin to visualize and look ahead to plan motor activitiesMore peripherally awareImaginative playAble to combine horizontal and vertical movementsSigns of Developmental Lags (25% below Average)OculomotorCan only watch an object as close as 5 inchesEyes move in large jumps to follow an objectLoses track of target if keeps head stillEye-Hand CoordinationUnable to do tasks without watching handsUnable to build a bridge with blocksSpace PerceptionUnable to follow directions such as “place the toy (on, in, behind, in front, beside)”Unable to fit shapes together to make a designUnable to copy a sequence of four Age 5Acuity has now developed to see clearly at 20 feetAble to maintain eye contactCan draw circle, cross and edgesCan accurately judge where things are in spaceCan identify objects by color, size and positionImproved tracking skills (fully developed at age 7)Improved binocularity (able to fill a cup without spilling)Signs of Developmental Lags (25% below Average)OculomotorCan only watch an object to 3 inchesEyes move in small stops and startsEyes overshoot or undershoot the targetEye-Hand CoordinationSquare looks like a capital DUnable to copy a triangleUnable to complete a form boardSpace PerceptionUnable to put two triangles together to make a rectangleDoes not know his left or right sideCannot follow directions when drawing to place a mark under, above, behind, or in front of a printed shape.WACS – Wach’s Analysis of Cognitive Structures: Identification of ObjectsShape MatchingColor MatchingShape IdentificationColor IdentificationTactile – Visual MatchVisual Identification ActivitiesRequire fixation, accommodation, visual perceptionVisual Thinking HierarchyAge 1-2 same – differentAge 2-3 direct matching Age 3-4 side-by-side matchingAge 5-6 recallAge 7-8 more difficult patternsAge 9-10 Transpose (flip & rotate)Age 11-12Tilted figuresAge 13-14Adult level skillsAttribute SortingMatrixObject-Picture-Symbol-WordPattern MatchingWACS – Wach’s Analysis of Cognitive Structures: Object ConstructionBlock StackingBlock PatternsStick PatternsPeg PatternsWACS – Wach’s Analysis of Cognitive Structures: General MovementBalanceHopping and SkippingBody LiftsLine WalkingBall CatchingVisually Guided Gross Motor ActivitiesEye/Body CoordinationVestibular systemAuditory systemTactile perceptionEye-foot coordinationEye-body coordinationDoll’s Eyes reflexTrampoline BallMarble TrapBowlingMarble catchOKN BallFoam PuzzlesVolleyball BalloonRollingOptokinetic Nystagmus (OKN)Bubble PoppingMovements that activate both hemispheres of the brain: Cross CrawlsPatty Cake MarchingVestibular Prep activitiesSwingsBalance BallsBalance BoardsRotationsHead TurnsBody TurnsCars and TracksPool Cue Knock - offBean Bag TossCross WalkingFishingFeel and FindWACS – Wach’s Analysis of Cognitive Structures: Graphic DesignShape Drawing and Tunnel DrawingLine Tracing and Dot ConnectingTemplate DrawingVisually Guided Fine Motor ActivitiesDrawing, Writing, Grasping, StackingPenny DropShape SorterFine MotorChopsticks/Tongs/TweezersGiant Peg BoardRotating Peg BoardMarbles on PegsCheerios on PointerBeading (string/shoe lace)Lacing CardsGraphic MilestonesScribbles15 monthsImitates vertical stroke2 yearsImitates a circle 2 yearsImitates a cross 3 yearsCopies a circle 3 yearsCopies a cross4 yearsCopies a square4.5 yearsImitates oblique lines 4 yr., 9 mo.Copies a triangle5 yearsCopies 2 pictures 5.5 yearsCopies oblique lines5 yr., 9 mo.Copies divided rectangle6 yearsChalkboard: Circles/Lines Tracking: Fixations, Pursuits, SaccadesOptokinetic Nystagmus (OKN)Training using reflexesPaint Stick SaccadesMarsden BallTai ChiBall TapFlashlight ActivitiesTagFollow the leaderLight PursuitsTarget PracticeSaccadic FixatorGaze StabilizationStimulate visual-vestibular pathwaysFinger PuppetsDr. Selwyn Super Eye Stretch4 Corner Fixations Focusing ActivitiesGlow in the Dark BoardNear-Far activities modified for age, example: Disney FocusLens Focus activitiesAmblyopia TrainingEqualizing monocular skills and Developing Sensory FusionTap-n-See NowRed/Green ActivitiesRed light / Red mazeMagnetic playsets (red/green toy box)Sherman CardsRed/Green pom pomsOpto “Alien Tracing” AppBinocular Activities: Motor alignment, sensory fusion, depth perceptionFish MatchingFrog Brock StringFlashlight TagSpoon and Ping Pong BallStraw and Cotton BallsBlowingSuction3D PicturesAlphabet Fusion CardsKeystone CardsTranaglyphsBC Training Cards3D Picture BooksComputer ActivitiesVTSAmblyopia Treatment ProgramPress LightsOptoPrism BarFusion ActivitiesStereoscopesRed Lens TherapyiPad ActivitiesRed/Green ActivitiesRed light / Red mazeMagnetic playsets (red/green toy box)Sherman CardsRed/Green pom pomsRed/Green ActivitiesOpto “Alien Tracing” AppFish MatchingFlashlight TagPress Lights3D PicturesAlphabet Fusion CardsKeystone CardsTranaglyphsBC Training Cards3D Picture BooksFrog Brock StringSpoon and Ping Pong BallStraw and Cotton BallsBlowingSuctionComputer ActivitiesVTSAmblyopia Treatment ProgramOptoVectogramsPrismHome activities for ages 3-4Play games of matching pictures. When you read aloud to your child, have them point to pictures that illustrate what you are reading.Play a game of hide and describe. See what the child can remember about the objects.Play with blocksHave the child make a pattern and then describe to you how you can make a matching pattern.Play catchRoll objects off of a table and see if they can catch it after it falls off the edge.See if the child can identify a partially covered toyHome activities for ages 4-5Identify landmarks and describe them in the order they were seen on the tripDemonstrate how to do activities in a certain sequenceDescribe photographsPlay card games and board gamesConstruction toys (Legos, blocks)PuzzlesReferences and Resources:The Journal of Pediatrics, December 2010 Volume 157, Issue 6, pgs. 889-893Journal of Head Trauma Rehabilitation: September/October 2006 - Volume 21 - Issue 5 - p 375–378 visit , News and Events for more information. ................
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