Eye Hand Coordination
Also referred to as Visual Motor Integration, this is the ability
to control hand movement guided by vision.  A child who is
challenged in this area has difficulty coordinating body movements
in response to what he/she is seeing.

    The skill areas affected in this domain are vast.  Eye hand
    coordination affects our ability to color, draw basic
    strokes and pictures, solve mazes and dot-to-dot
    pictures, write by hand, catch a ball, bat a ball, create
    art, put a puzzle together, tie our shoes, build with
    blocks, thread a needle and use scissors to name a few.
Therapy Street for Kids

    Visual motor (eye-hand coordination) problems in children are often not discovered until a child is in elementary school.  Problems with
    learning to write, draw simple pictures and use classroom tools may be the first signs that there is a problem.  When visual motor
    problems are identified through testing, there is not necessarily a deficit in vision.  That is, visual acuity and visual perception may be
    intact.  There may not be a problem with motor control either.  Strength, coordination and range of motion may be sufficient.  Thus, the
    deficit is often in the mechanism that enables the visual and the motor systems to work together.  In other words, the visual and motor
    systems are not communicating well with each other.

    Visual motor skills can be enhanced through lots of practice in the activity itself.  It is also addressed by breaking down the activity
    into its component parts or building blocks.  The building blocks for developing the skill are worked on and added to as each part is
    mastered.   Thirdly, strategies can be learned that help to compensate for the deficit.  A common example of this is learning to use a
    computer for writing and do less by hand.
Skill Practice
    Drawing/prewriting activities
    Below are approximations for the developmental sequence for drawing strokes.  This varies highly as all children develop differently.
               l   ―   O   †    \   X   ∆   ◊
                                (age 2 to 3)           (age 3 to 4)           (age 5 to 6)       (age 6)

  • Children begin drawing by scribbling randomly.  Some may scribble up and down in a vertical direction, side to side, and in circles.  
    Scribbling is a healthy way to explore drawing tools.  Use all types of media: crayons, markers, pencils, paint, chalk, etc.  Scribble with
    sidewalk chalk or washable paint outdoors.
  • To teach strokes, it makes sense to draw them within context.  For example, for vertical lines draw a picture of a picket fence minus
    the pickets.  Have the child draw in the vertical lines after you've modelled a few.  Or draw train tracks without the RXR ties, or cars
    without tires, etc.  There are commercially available workbooks with "finish-the-drawing" activities for purchase.
  • Drawing within a large space, such as on a wall chalkboard, dry erase board or easel, helps children learn about the movement involved in
    the shapes and strokes they are learning.  
  • Draw shapes within square boxes for using the attributes of a square as landmarks.  For example, cut the box in half by drawing a
    vertical line through the middle of it, then a horizontal line to make a cross.  Instruct child to draw a line from one corner to the
    opposite corner for a diagonal line and do it again to draw an X.   Try a variety of shapes inside boxes.  Remember to encourage drawing
    strokes from top to bottom-- This will help when learning to write letters.
  • Drawing diagonals is the most challenging to learn.  Play games that involve diagonal relationships such as checkers, Chinese Checkers, Tic-
    Tac-Toe or Connect Four, as examples.
  • Draw shapes with a highlighter for the child to trace over
  • Make shapes with sticks (toothpicks, popsicle sticks, Wikki Stix, etc.) for child to trace beside
  • Have child use various materials (toothpicks, popsicle sticks, Wikki Stix, etc.) to make shapes
  • Trace over shapes and simple pictures with tracing paper
  • Draw around stencils of shapes and simple objects
  • Create simple drawings by putting 2 to 3 shapes together to make common objects.  As examples: a circle and stick to make a flower or
    a lollipop, a triangle and a square make a house, a small square next to a large square with 2 circles underneath make a truck, a series of
    circles make a caterpillar.  There are several commercially available books of add-on drawings available in teachers stores, book stores
    and on the internet.
  • Half-to-Whole drawings: draw half of a simple picture (pizza, house, person, tree) and child draws the other half
  • Connect-the-Dots activities
  • Mazes: trace the way out first with your finger, then with a pencil or crayon
  • Coloring books: children over age 4 should be encouraged to color inside the lines

    Non-drawing activities
  • Lacing cards: try different ways to lace around the edges
  • Stringing beads: copy bead patterns or create repeating patterns
  • Geoboards: copy shapes and letters using rubber bands on geoboards
  • Copy pegboard and Lite Brite designs
  • String macaroni, cut straws, Fruit Loops: create patterns as appropriate to medium used
  • Etch-A-Sketch: draw lines to connect several stickers; draw a maze on transparent paper and tape on the Etch-A-Sketch; diagonal lines
    are particularly challenging
  • Dress up dolls

Building Block Activities
    Large motor activities
  • Ball play: medium and large balls to catch and throw; smaller balls for older children
  • Bouncing medium and large balls
  • Beanbag toss games: go for a target such as a container or bin: large at first and then smaller as skill improves
  • Balloon volleyball; for added challenge place a marble or penny inside the balloon-- it will make more unpredictable
  • Hit a balloon with a tennis racket or paddle
  • Rolling ball with 2 hands: bowling by knocking over 2-liter soda bottles
  • Flashlight tag:  while lying on your back in a darkened room, play tag or follow the leader with your flashlight beams
  • "Speed Stacks":  a fun cup stacking game, the cups come in regular size for large grasp and small cups for finger grasp;

    Right and Left side awareness
  • Try this fun dice game: called "Left-Center-Right" at http://www.dicegames.com
  • Play the Hokey Pokey or Simon Says; emphasize the right or left side
  • Play games that incorporate movement and stamping the feet: military marching while calling out "left-right-left-right"
  • Centepede game: children crouch-sit on the floor in a line and hold the ankles of the child behind them; call out "left-right" so that each
    moves the left foot forward in unison, then right foot.  Divide the group up for Centepede races; challenging and best for older children
  • Put a sticker on the back of the right hand or a rubber band on the right wrist.  Or have child wear a wristwatch.
  • Play "I Spy" games and emphasize the right or left sides of the room, or on the page if using a book.

Compensatory Strategies
  • Coloring inside the lines: Draw (outlining) over the lines first with a crayon, then color it in (child can be taught to outline their own
    picture to color first before coloring it in with just a reminder-- "outline first")
  • Coloring inside the lines: Use Wikki Stix or glue yarn around the area to be colored in; this acts as a boundary to contain coloring
  • Difficulty stringing beads: Use plastic gimp or pipe cleaners instead of string
  • Difficulty lining up math equations: use graph paper which can be modified with enlarged squares on a copy machine
  • Hand-over-hand guidance is often needed to help a child get the feel for drawing a stroke or writing a letter.
  • Writing and drawing on a vertical or slanted surface improves viewing, head position and hand/wrist position.  Drawing can be done on an
    easel or even on paper taped to a wall.  A slant board can be placed on a desktop for writing tasks.
  • Tummy writing: helps with developing shoulder stability and an upright head.  This can be done for writing, drawing and play activities.
  • Alternatives to writing by hand for children with significant challenges:  learning computer skills, dictating to a scribe, having a peer
    note-taker or getting a copy of notes,
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