Poor Visual Motor Skills/ Visual motor integration: This is the inability to control and coordinate the movements of hands, legs and body in response to perception of eyes. This happens due to the problem in mechanism which allows visual system to work in coordination with the motor system, while strength of muscles and joints is appropriate with no deficits even in vision. Child with poor visual motor skills will have problems in kicking football, catching ball thrown in air. Skill area affected in this domain is vast and it affects the performance of child not only in school but also in various segments of daily life. Visual motor skills include a coordination of visual information that is perceived and processed with motor skills, including fine motor, gross motor, and sensory motor.
Visual motor skills can be enhanced through consistent practice in the activity itself. It can also be done by analyzing and breaking down the activities into simple steps. Lastly, 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.
Let’s take a look to all the skills involved one by one:
Eye Hand Coordination:
This is the ability to control hand movements in response to the information perceived by the vision. Eye hand coordination is one of the essential skills required to perform optimally in schools. For example child with poor eye hand coordination would be having problem in tying a shoe lace, coloring basic strokes of drawing, threading a needle, putting a puzzle, and many more…
Bilateral Coordination:
A good bilateral coordination enables to coordinate both sides of body at same time in a controlled and organized manner. For example stabilizing the jar with one hand while opening the jar by other hand or stabilizing paper with one hand while writing/cutting it by scissor with another hand. Good bilateral integration/ coordination indicate that both sides of the brain are communicating effectively and sharing information. Hands and feet movements work well together with the help of good bilateral coordination.
There are two important skills which play integral role in development of bilateral coordination.
1. Crossing the midline. 2. Proprioception
Crossing the midline:
It’s an ability to reach the opposite side of the body while finishing the functional tasks. Human body can divided into two symmetrical parts by an imaginary line which is called as midline. Being able to cross the midline to reach the space of other part of the body, while completing the task involves the good crossing to midline skill. Combing the hair in parted pattern with same hand, scratching the elbow, securing the duppatta on the opposite shoulder with safety pin while other hand is engaged in stabilizing pleats of dupatta, reading left to right and many of such activities are example of crossing midline skill. Child with poor midline crossing skill would often get stucked in midreach and switch the other hand while completing task. Or even they bent their trunk to reach other side of the body. Children with poor crossing midline skill would also face problem in tracking the moving object or even reading from left to right. Inability to establish dominant hand is direct indicator of the poor crossing the midline skill. Frequent switching of hands while writing, coloring, eating and throwing should be considered as red flags and are the indicator of the poor midline crossing skill.
Proprioception and Vestibular sense:
Propriception sense is awareness of body related to space and vestibular sense is awareness of movement. Both the senses play vital role in development of child. Children with sensory processing disorder with proprioception and vestibular sensory processing issues often noticed to have poor bilateral coordination skills.
Following are the patterns of bilateral coordination:
Symmetrical bilateral coordination:
In this movement both side of hands or legs work simultaneously, do same movements with equal amount of energy and pressure. For example rolling a clay dough with rolling pin, pushing heavy objects etc.
Red Flags: using a single hand in the activities which requires use of both the hands, bent posture.
Reciprocal Bilateral Coordination:
In this movement both the hands or legs perform the same movement alternatively in rhythmic fashion, with same force and energy. For example peddling cycle and pulling rope.
Red flags: when movements are jerky with one sided posture.
Dominant hand and supporting hand:
Both hands are important part of body but we have mechanism which enables one hand to play dominant role to perform all specialized tasks while the other one is skilled in assisting role. For example while fixing a nail against wall dominant hand plays of hammering nails while supporting hand engaged in holding the nail against wall in same position. Both the hands needed to play their role efficiently to perform the task well.
During handwriting, if a child does not stabilize the paper with the non-writing hand, then writing can be less efficient (Parush et al, 1998).
Red flags: awkward posture, use of single hand instead of both hands for example while writing by dominant hand child may not use the other hand to stabilize the paper, use of inefficient ways to complete task.
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