Vision and Literacy

Though I've taken a few continuing education courses on combining vision and occupational therapy throughout my career, I had no idea the impact this knowledge would have on our personal family and homeschooling journey.


In January 2019, my then 7 year old was extremely frustrated with reading. He would listen to an audio book all day and could narrate the stories back yet hated reading even the simplest bob books. Since he was born at 36 weeks, I knew he may take a longer time for this skill to develop, but he was getting so frustrated and the inability to read was carrying over into other subjects. However, the real kick in the pants to evaluate and change our reading curriculum came when some boys on our block started a "club"* . However, to be in the club, you had to read the rules. My little man came home feeling excluded, frustrated, and that he was stupid. 


*Before I get a billion messages on mean kids, these are good kids, it was just a bad day. The power of prayer and communicating with/parenting with your neighbors is a wonderful thing. These boys are outside together everyday now.

We started with our local optometrist to evaluate acuity and he did need glasses. But, in my heart of hearts, I knew this wasn't the solution. He would ask me, "Mom, how do you read when the words move on the page?" Uummmm they don't!


Our next step was the developmental ophthalmologist. She did testing and confirmed my suspicions. His eye musculature was immature and his eyes were not teaming together. As a result, he could not converge (turning the two eyes toward each other to maintain single vision when looking at a close object)he had poor saccades (rapid eye movement when the eyes move together from one location to another like looking from one work or group of words when reading)and as a result had poor binocular fusion(the brain's ability to gather information from both eyes and place it into one single image). No wonder he hated reading!


Our next step was vision therapy. He went weekly for 12 weeks and had homework throughout. Much of the homework focused on visual scanning ie speed reading random letters, a brock string for convergence, and reading letters from 20 feet away and then from a sheet of paper. We were very diligent at first but then, he started complaining and we had to change it up. We began to include these tasks into our everyday rhythm more naturally.


Here are my most used, tried and true favorites for integrating vision therapy and literacy:


1) Curriculum

We switched his Language Arts curriculum to All About Spelling- This program is multi-sensory and uses the Orton- Gillingham approach. Before we even start his lesson for the day, he has to spread his tiles out independently. This is scanning at its best. This used to take him almost 20 minutes and is now less than 5. We start with reading the words to build familiarity. Then, follow the lesson plan followed up with a an activity of his choice to spell the words. Sometimes he jumps on the trampoline, sometimes he walks on his balance stilts, sometimes he spells with putty... the options are endless


We accompany All About Spelling with Handwriting Without Tears for paper. This paper is two lined to decrease busyness of the page. However, it still gives enough visual cues for him to "bump" the lines and keep his spacing correct. We also began using their cursive curriculum because writing is so much easier for him when he can flow rather than stopping and starting with each letter.


2) Incorporate visual skills into our daily activities


For scanning/saccades:  

  • We began to hang all of his shirts so he had to scan left to right to find the clothes that he wanted to wear.

  • He always comes to the grocery store with me and I give him his own list of items to find. This began with 2-3 items and now he has his own cart for 15-20 items. When he gets familiar with the location, I make his list new. Spices are my favorite because they're in alphabetical order so he's working on that as well:)

  • He loves "kits" think Egyptian dig outs, leather stamping, even cross stitching- not only are they placed on his shelf so he has to scan to find what he wants, but we purchase kits that address scanning as well.

For binocular fusion/accommodation


  • We placed a bird book by the window and a bird feeder outside. Everyone loves watching the birds and squirrels from a distance and then switching to near vision to identify them in the book

  • We made nature study and journaling a priority. He still isn't a fan of writing though he is always willing to draw. We have a nature lesson followed by a hike with drawing every week.

For convergence


  • One of our go to screen free activities; we always have a puzzle out. Full disclosure, this isn't my favorite but my husband actually loves puzzles. So, they puzzle together in the evenings. Think of how much you converge your eyes when you are holding a small puzzle piece to notice the details

3) Games


We have one night a week where everyone is home without sports practices, board meetings at work, gym time etc. So, we try to reserve Thursday nights as family game nights. Games are so good for many reasons that I'm saving for another post. Here are a few of my favorites for visual skills.


  • SequenceThis game is a mix of connect four and cards. A player places their game piece on the board corresponding to the cards in their hands. The winner has 5 game peices in a row. Its a very busy game board and the eyes must move from cards to the board itself. Its a fun way to accomplish all of the skills we were targeting.
  • Connect four- This oldie but goodie is visual scanning at its best. And, I am ruthless when I play :)
  • Spot it- There are so many versions of this fantastic game. My son is partial to the hockey version but, any will do. It is a speed game where you are searching for the one picture that matches on your card with the card on the table. My poor kiddo used to lose miserably but he is definitely competitive now.


If your child talks about words moving on the page, has a hard time tracking objects or has poor eye hand coordination, let's talk. I can provide recommendations for your homeschool as well as get you set up with your next steps for evaluations.



(updated 4/17/2021):


  • American Occupational Therapy Association. (2020). Occupational therapy practice framework (4th ed.). American Occupational Therapy.
  • College of Optometrists in Visual Development. (2021). Vital Visual Skills.

Sarah Collins

Sarah is an OT and home school mama whose zone of genius is bridging the gap between OT's and homeschool parents with resources to help them both thrive.

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