Pediatric Visual Perception Difficulties

What is visual perception?

Visual perception is the ability to make sense of what the eyes see. It involves processing, interpreting, organizing and using the information that the eyes take in.

Visual perception is different from visual acuity, which describes how clearly someone can see, such as 20/20 vision. Visual perception includes seven skills:

• Form constancy: Recognizing objects even when they’re in different contexts or environments

• Visual discrimination: Noticing slight differences between objects and paying attention to detail

• Visual closure: Identifying an object even when parts of it are hidden

• Visual memory: Storing visual details in short-term memory and recalling them later

• Sequential memory: Remembering a series of visual details in a specific order

• Spatial relations: Understanding and identifying the position of objects in space

• Visual figure ground: Picking out objects within busy backgrounds or environments

Why is visual perception important?

Strong visual perception skills enhance your child’s overall growth, development, confidence and self-esteem. They support your child’s ability to develop learning, motor and social skills and do their everyday activities. For example, visual perception skills help a child:

• Learn to read, write, spell and do math

• Draw pictures from memory and trace shapes and images

• Find a specific object in a cluttered drawer

• Filter out visual distractions to focus on tasks at hand

• Match socks, shoes and other clothing as they get dressed

• Cut lines or shapes with scissors

• Organize their personal belongings

What are the signs and symptoms of visual perception difficulties in children?

The signs and symptoms vary from child to child based on the specific visual perception skills they’re having trouble with. Some signs and symptoms related to each of the seven skills include:

• Form constancy: Difficulty completing worksheets, reading different handwriting or reading in general

• Visual discrimination: Difficulty sorting similar items, reading maps or completing puzzles

• Visual closure: Difficulty with puzzles, connect-the-dots drawings or reading

• Visual memory: Difficulty recalling sight words, reading fluidly or remembering how items should look from past experience

• Sequential memory: Difficulty copying or remembering a series of numbers, remembering phone numbers or addresses, or following multi-step directions

• Spatial relations: Difficulty remembering left and right, staying inside the lines or forming letters correctly

• Visual figure ground: Difficulty remembering their place when reading or finding items in a pile

How are pediatric visual perception difficulties diagnosed?

If your child’s pediatrician or eye doctor suspects that your child may have trouble with visual perception, they may refer you to our occupational therapists. We evaluate children to understand the difficulties they’re experiencing and use occupational therapy to improve their skills.

At Children's Health, our occupational therapists begin with a thorough evaluation to assess your child’s visual perception skills. We will:

• Ask you about what your child is having trouble with

• Ask about specific challenges that you, your child’s teachers or their health care providers have noticed

• Do standardized tests to assess your child’s visual perception skills

Using these results, we work with you and your child to set specific therapy goals and create a personalized care plan.

What causes visual perception difficulties in children?

The causes of visual perception difficulties aren’t fully known. Certain factors may increase the risk of developing visual perception difficulties, including:

• Developmental delays

• ADHD

• Learning disabilities

• Brain injuries, such as a concussion or stroke

How are visual perception difficulties treated?

At Children’s Health, our occupational therapists work with children in one-on-one sessions to improve their visual perception skills. Each session lasts about one hour, and our therapists sometimes invite parents to join in therapy activities.

During our sessions, we use structured games and creative play in fun activities that engage children[1] , such as:

• Puzzles and mazes

• Memory card games such as Go Fish

• Drawing activities such as connecting the dots and completing partially drawn pictures

• “Spot the difference” activities and hidden picture books such as Where’s Wally

• Matching, sorting and patterning activities

• Board games that focus on letters

• Sensory activities to create arts and crafts using a variety of textures, shapes and colors

• Construction activities using Legos or other building blocks

At the end of each session, our therapists will explain what skills your child worked on. We also review materials and instructions for you and your child to practice those skills at home. We usually recommend practicing 20 to 30 minutes a day, four to five times a week.

Sometimes, children with visual perceptual difficulties need additional treatment from other specialists. Our multidisciplinary team can help coordinate your child’s care with:

• Physical therapists

• Speech-language pathologists

• Optometrists and ophthalmologists