Functional praxis, motor planning and visual processing are a few primary outcomes in sensory integrative intervention within pediatric occupational therapy. The visual sensory system significantly contributes to one’s ability to take in and interpret information to produce an appropriate motor response. Children who demonstrate difficulty with their visual efficiency and visual processing skills may demonstrate difficulty with tracking, focusing and coordinating their eyes to interpret essential stimuli in their environment. Some examples may include difficulty with smooth pursuits to follow along while reading, or the ability to converge/diverge their eyes while throwing and catching a ball In some cases, congenital or neurological conditions may result in convergence insufficiency, strabismus, nystagmus, amblyopia or visual field loss.

Treatment approaches to address functional vision must consider the other sensory systems (specifically vestibular and proprioceptive) that serve to provide information of one’s head and body position in space. The visual and vestibular systems work closely to stabilize vision through the vestibulo-ocular reflex (VOR). Therefore, it is important to provide enhanced vestibular input with visual tasks in intervention to promote functional vision.

Southpaw offers a great array of equipment to help provide a variety of experiences for movement and visual tracking.

Promoting Visual Fixation

Positioning a child in prone either on the Glider Bolster swing, Scooter Board or Inflatable Barrel Kit helps to activate and integrate the otoliths and semicircular canal receptors within the vestibular system.

Tasks such as “Spot it,” Southpaw’s gel pad or other common board games, such as “Perfection” or “Operation,” are great to incorporate in this position to help promote visual fixation with change in head position.

Promoting Oculomotor Skills (Saccades, Smooth pursuits, Convergence/Divergence)

Additionally, a variety of sensory equipment can be incorporated with the aim of promoting saccades, convergence and divergence, and eye teaming.

A few examples may include swinging on the Moon Swing or Frog Swing while using hands to reach for or tap a target.

One of my favorite activities to target eye teaming and body awareness involves a child using his/her feet to kick/tap targets while propelling a Frog Swing. These targets could be items that stick on a mirror surface, such as squigz, or window stickers or any figurine/toy on the ground. The Frog Swing not only provides linear input but also rotary movement, which increases the demand of sustaining ocular motor control.

Upgrades to promote tracking and oculomotor skills may include using a flashlight to shine the light on a specific color or even increasing the distance between the toys.

Promoting Depth Perception and Use of Central/Peripheral Vision

One perk of Southpaw’s suspension hardware is that it can support a variety of equipment.

Another fun idea to target body awareness, use of central/peripheral vision, depth perception and timing is to have a child navigate through a path of suspended bolsters within an obstacle course.

There are many ways to downgrade/upgrade this, including:

-Adding a postural demand of completing an animal walk or propelling a scooter board between the bolsters.
-Adding a balance demand by navigating a sequence of stepping stones or walking heel to toe on a balance beam without bumping into the bolsters.
-Changing the distance and height of the suspension to target depth perception and accommodation.
-Adding additional moving suspended objects, such as a Marsden ball, to promote smooth pursuits or saccades.

Promoting Binocularity

Aside from swings, the use of unsteady surfaces is great to incorporate with activities targeting functional vision and dynamic balance.

One of my favorite intervention ideas includes positioning a child on a balance pad or balance board with an eye teaming activity.

This could include playing a game of Zoom Ball, throwing/catching a ball, or even “fishing” for animals with a magnet rod.

Ultimately these activities all integrate thevestibular and visual systems, as they require one to maintain a stable visual field with the demand of balance from subtle weight shifts on moving equipment.

Using the principles of sensory integration, OTs can target a variety of sensory systems with equipment and adjust/adapt as needed in order to always provide the “just right challenge” for the pediatric population. With Southpaw’s equipment, the opportunities are endless to promote binocularity, efficient ocular motor skills and visual accommodation. Be on the lookout!

References:

Case-Smith, J. & O’Brien, J.C. (Eds.) (2020). Occupational therapy for children and adolescents (8th ed.). Elsevier/Mosby. Scheiman, M. (2011). Understanding and managing vision deficits: A guide for occupational therapists . SLACK.