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Bearfoot OT

Handwriting Skills Part 3: Visual Perception and Visual Motor

Written by Noémie von Kaenel, OTS and Bearfoot OT


We rely on our eyes and what we see a lot in everyday life. We use our visual sense for seeing colors, seeing how close or far objects are, recognizing faces, reading, and writing........just to name a few!



But why is our visual sense so important for handwriting?


It sure helps to see what you are writing but visual perception and visual motor skills go past just “seeing.” More developed visual perceptual and visual motor skills including visual closure, visual discrimination, and in-hand manipulation (covered in our fine motor blog post) are good predictors of appropriate writing speed/efficiency and legibility/quality of handwriting ² ⁵ ⁸. Children with ASDs are more likely to have difficulty with fine motor skills and visual motor integration, which makes letter writing a more difficult task compared to neurotypical peers ⁷.


Challenges with visual perceptual or visual motor skills may look like:

  • Your child not noticing their letters are reversed or oddly spaced

  • Difficulty copying from the board at school

  • Struggles with letter formation or letter recognition


What is visual perception?

It’s an umbrella term describing skills that involve how we understand what we see with our eyes. This skill helps us know that we wrote an “L” when we see a line down and a line across or notice if we have written a reversed letter.


Some visual perceptual skills include:

  • Visual discrimination

  • Position in space/spatial relations

  • Figure ground

  • Visual closure

  • Form constancy

  • Visual memory

All of these skills don’t work in isolation. They instead combine to help our brains understand what we are seeing.


What are visual motor skills?

Visual motor skills use both your eyes/visual sense and your motor sense/muscles/movement to coordinate a task. For example, to catch a moving ball you need to see where it is and coordinate your body to catch it at the same time. Visual motor skills are essential for handwriting, for example when copying from the board, writing letters, and writing on the line.


If your child struggles with visual motor skills they may have messy handwriting, letters of different sizes that are all over the page, and/or difficulty with grasping the writing tool. You can work on visual motor skills by building puzzles, playing this game with marbles maze, or playing ball games.


Just like we’ve talked about before, there is a LOT going on with writing. Below we break down some of the visual perceptual and visual motor skills needed.


Visual Discrimination

Visual discrimination is seeing the differences or changes in visual information like how long a line is, colors, patterns, size, and position. This is important to notice how letters may look similar but are different. For example, discriminating the difference between “n” and “h” or “b” and “d.” If your child struggles with visual discrimination they may reverse their letters or confuse letters that look similar like “p”/”q” or “b”/”d”.


Here are some activities to try at home:

  • Have your child identify what they see in a landscape. Do they see an animal? What kind? What shapes do they see?

  • Go on a scavenger hunt in nature looking for the alphabet. What natural materials look like letters?

  • Have your child match a letter or shape to a sample of multiple letters and shapes where 1 does match

    • This can be a simple sequence of 10 letters where 2 letters are the same and the rest are not, or where there’s only one letter that does not match

    • Example - Find the q: ppppqpp or Circle the letter b: ddbdbddbdbddbd

  • Find the difference puzzles

  • Matching uppercase to lowercase letters

  • Practice differentiating what letters look like for example “b” and “d”

    • A trick we like to teach to differentiate “b” and “d” is to make two thumbs-ups with your hands and bring your knuckles together. Imagine something is resting on top of your index fingers like a bed. This “looks” like a bed that starts with the letter b and ends with the letter d. If you look at your hand, you can copy the letter off of the shape of your hand.



Position in Space/Spatial Relations

Positioning in space/spatial relations is understanding of directionality and position of the things you see. You need this skill to know right from left, and up from down. If your child struggles with the position in space/spatial relations they may write letters all over the page but not necessarily next to each other. You also use this skill to write the size of letters (especially lowercase) where some letters are tall, some are small and some fall below the line. You can help your kid with sizing by using highlighted/adapted paper or help them with spacing with some tricks from the list below.


Things to help visual spatial relations include:

  • Play the Hokey Pokey or Simon Says to work on differentiating the right and left sides

  • Play tic tac toe but with commonly reversed letters or arrows for direction

  • Use a finger space while writing (using the visual of your finger as a space between words)

  • Spaceman with a popsicle stick just like this one

  • Teach "spaghetti and meatball" spaces

    • This is a technique of describing the thin space between letters (1 spaghetti) and the larger space between words (1 meatball)

  • Try writing on graph paper with one letter per box and leaving one box between words


Figure Ground

Figure ground is seeing objects or shapes in a busy background.


You can work on this by:

  • Find the differences in two similar pictures/scenes

  • Play I Spy when on a walk with your child

  • Have your child describe what they see while on a walk together or on an outing. Do you notice anything different? What’s close by, what’s far away?

  • Having your child find something in the “junk drawer”


Visual Closure

Visual closure is the visual perceptual skill that allows us to see part of a word, picture, object or shape and know how it would end or be completed.


Activities that work on visual closure skills include:

  • Fill in the other side of the image: cover some leaves half way onto with your hand, have your child guess what shape the other side (the side you are hiding) looks like

  • Play with puzzles

  • Word shapes (make your own here)


Form Constancy

Form constancy is being able to recognize a shape/word/letter when seen big, small, upside down, reversed, in different colors or fonts.

  • Draw letters in the sand or dirt or with rice on a tray and have your child look at it upside down, or make the different sizes

  • Play Tetris

  • Play with puzzles

  • Click here for worksheets, if you're into that sort of thing


Visual Memory

Visual memory is remembering what something “looks like.” If a child doesn’t remember what a “W” looks like in their brain, they are going to struggle with writing it or reading it. If this continues to be difficult your child may rely more heavily on their auditory learning.

  • Letter naming can be a difficult skill, so try to teach your child in their own learning style,

    • If they remember best by moving, try building the shapes out of legos or clay

    • If your child remembers best by hearing the sound or using a rhyme then use that! A good resource for this is this packet by TeachMama: https://teachingmama.org/alphabet-formation-rhymes/

    • If they are a visual learner, you can notice what the letter looks like (ie. “M” looks like two mountains)

  • The game of memory

  • Showing an image or letters/words for only 1 min, then hide it and have your child tell you as much as they can of what they saw


Love research? SO DO WE! Below are our references.


  1. Beck, C., Chuan, C., Cooley, T., Drobnjak, L., Greutman, H., Geffron, C., Kiley, C., Meadows, An., Rice, M., Spencer, J., (2017) The Handwriting Book. OT Toolkit’s The Functional Skills for Kids Pediatric Therapist Team.

  2. Brown, T., & Link, J. (2016). The association between measures of visual perception, visual-motor integration, and in-hand manipulation skills of school-age children and their manuscript handwriting speed. The British Journal of Occupational Therapy, 79(3), 163–171. https://doi.org/10.1177/0308022615600179

  3. Case-Smith, J. & O’Brien, J.C. (2015). Occupational Therapy For Children And Adolescents. 7th Ed. Elsevier and Mosby Publishing.

  4. Chanu, H. L., Vig, D., & Saini, S. (2018). Impact of intervention in remediating visual perception skills of urban school children with poor handwriting. Indian Journal of Health & Wellbeing, 9(7), 953–959.

  5. Grewal, R. K., Vig, D., & Saini, S. (2014). Role of visual perception in improving quality of handwriting. Indian Journal of Health & Wellbeing, 5(5), 591–595.

  6. Handwriting without Tears Website and free resources, Retrieved from<https://www.lwtears.com/programs/distance-learning/families/packets>

  7. Kushki, A., Chau, T., & Anagnostou, E. (2011). Handwriting Difficulties in Children with Autism Spectrum Disorders: A Scoping Review. Journal of Autism and Developmental Disorders, 41(12), 1706–1716. DOI 10.1007/s10803-011-1206-0

  8. Uysal, S. A., & Aki, E. (2012). Relationship between writing skills and visual-motor control in low-vision students. Perceptual and Motor Skills, 115(1), 111–119. https://doi.org/10.2466/24.27.25.PMS.115.4.111-119

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