Is your child:
If your child says, ‘these pieces are too tiny!,’ they probably are. What may be happening is that your child is struggling with the fine motor skills needed to manipulate the pieces.
This struggle may show up when learning to cook, tying shoes, buttoning or zipping during dressing tasks, when trying to build a lego set, in handwriting, while using a scissors, or when trying to pick up smaller objects with tweezers or tongs.
What’s happening here is that several skills are required to work well together, and any break in the chain can render these tasks difficult. The child needs to be able to ‘see’ what the model is supposed to look like, ‘feel’ the little pieces, ‘manipulate’ the pieces with fingers, and ‘move’ the pieces where they need to go. This combination of skills is called visual-motor integration.
Children who have difficulties solving puzzles or building things may be struggling with some of the visual perception or visual-motor integration. These skills are required to follow the directions when assembling Ikea furniture or building a Lego set or a block tower. In order to effectively manipulate objects, a child has to have strong ‘visual perception skills,’
“defined as the total process responsible for the reception (sensory functions) and cognition (special mental functions) of visual stimuli .
In other words, visual perception is making sense of what you are seeing.
Many components make up visual perception
Children are using visual perception when they are see a puzzle’s completion, imagine how a model will look when done, or plan out several moves ahead on a chess board.
Taken together, the eyes have to see it, the hands have to be able to do it, and the eyes and hands have to work together to get it done right. Children with poor visual-motor integration will may struggle with writing, drawing, puzzles, and building.
If your child struggles with dexterity, an underlying visual-spatial deficit or fine motor weakness could be causing these problems. However, parents would want to consider whether or not these personal weaknesses are ‘getting in the way’ of every-day-life before they make a decision about further assessment or treatment.
For example, children with more significant struggles in these areas may have learning disabilities, particularly in writing; in that case, intervention or remediation would be required. Children with difficulties with their handwriting often respond well to occupational therapy and academic supports in the classroom. Other visual-motor challenges, such as building models and solving puzzles, may or may not be a major issue.
If not terribly troubling to your child, it may be that some ‘scaffolding’ is required in school. Scaffolding means having a teacher or parent provide supports through the task and then gradually pull away as the child becomes more independent.
In group work, in science or engineering, for example, it may be that your child’s teacher assigns a role to your child that is not as demanding in terms of motor dexterity. He could be the researcher, planner, or presenter rather than the one building the physical model. If these supports are needed, it may be helpful to consult with a school psychologist or learning specialist at your child’s school.
If, even with these supports in place, your child continues to struggle, you might consider a full evaluation and potentially occupational therapy. At home, you can use some fun strategies to help improve your child’s dexterity, visual-motor integration, and visual perception.
Activities to Help Strengthen Your Child’s Dexterity
Many fun activities can help further develop your child’s fine motor skills. Through crafts and games, it is easy for your child to work on these skills without even realizing it is ‘work.’ For example,
Activities to Help Visual-Motor Integration
Activities to Help Visual Perception
If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.
Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.
These professionals may recommend or administer the following tests for this symptom:
 Schneck, C. (2010). Visual perception. In Case-Smith, J., & O’Brien, J. (Eds.). Occupational therapy for children (373-403). St. Louis: Mosby.
 Debrabant, Julie; Vingerhoets, Guy; Van Waelvelde, Hilde; Leemans, Alexander; Taymans, Tom; Caeyenberghs, Karen. Brain Connectomics of Visual-Motor Deficits in Children with Developmental Coordination Disorder. The Journal of Pediatrics, Volume 169, 21 – 27. e2.
 Peacock, Gretchen Gimpel & Collett, Brent (2010). Collaborative home/school interventions: Evidence-based solutions for emotional, behavioral, and academic problems. https://www.amazon.com/Collaborative-Home-School-Interventions-Evidence-Based/dp/1606233459/
 Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.
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Previously Licensed on: May 13, 2017
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