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line, but instead moves his pencil across the paper. You can draw anything you want that may go together and interests your student. Mazes, word searches, and tracing are other paper/pencil activities you can try.

      • Using a large whiteboard or chalk board, draw a figure eight lying on its side (like the infinity sign). Draw a rainbow with many colors. Have your student stand in the middle of the shape and trace the shape back and forth. Encourage him to cross his arm across his body while completing the activity.

      • Use colorful pieces of fabric to write numbers or letters in the air and across their bodies.

      What Is Bilateral Integration?

      Bilateral means both sides and integration means working together. Bilateral integration is when both sides of the body work together to complete a task. Often, the hands are completing different tasks to accomplish a common goal. There is awareness of sides, right and left. Generally, one side is dominant and the other is used as a stabilizer. When a student has difficulty in this area, she may avoid crossing her midline. This means that she may not be able to coordinate her hands together to complete a task. She may have difficulty with scissoring since it requires one hand to cut while the other stabilizes the paper. A student with poor bilateral integration may also have trouble with lacing shoes, jumping jacks, bicycle riding, and threading beads. Sometimes a student may appear “clumsy” and may have a great deal of frustration. Many of my clients have difficulty cutting meats with a fork and knife. This task requires both hands to work together.

      Children with bilateral integration difficulty should be given motivating tasks that are specifically planned to be fun. Encourage wording such as “use both hands” or “use your helper hand.”

      • Cut worksheets into halves or quarters and ask students to crawl around the room to find the pieces.

      • Set up a bakery center and use the hands together to roll, pat, and create pastries out of real or play dough.

      • Complete jumping jacks, skip, or do “scissors” by crossing legs over each other when lying on the back.

      • Scooter activities in the gym use the entire body.

      • Shuffle cards and play card games which require the student to hold the cards in one hand and pick up with the other.

      • Provide containers of different sizes to practice opening and closing, place a treat in each one for a fun surprise!

      • String beads of different shapes and sizes.

      • Use different veggies to stamp onto paper. The dominant hand is the primary one, but the helper hand is needed to stabilize the paper and ink container.

      • Squeeze sponges of different shapes. Use colored water for more fun.

      • Play hide and seek with various shaped items in putty or dough.

      • Tearing paper is a fun activity. Use paper to make a craft.

      • Origami uses both hands and is fun.

      • Set up a t-ball area at recess or gym and encourage use of both arms to swing at the ball.

      • Work on classroom exercises prior to longer lessons. Encourage students to clasp fingers on both hands and move arms across the body in circles—big and small; diagonally; etc. Move to music for relaxation. (Neck rolls are an extra way to relax!)

      What Is Vision?

      Vision is the ability to see with our eyes. However, we need to make sense of what we’ve seen. We don’t usually consider that our eyes must work together to focus: they must move to see what’s around us; help us to see objects near and far; and they must be able to determine details of what we are looking at. When we have processed all of those things, we can then use our hands together with the information from our eyes to complete a task. Most children have an evaluation of their eyesight performed by an ophthalmologist to rule out problems with vision or have a screening at school. The doctor will use charts with either pictures or letters, examine the eyes with various ophthalmic instruments, and complete tests to look at the structures of the eye. It is at this time glasses may be recommended. Additionally, when a child has headaches, developmental delays, and difficulty in school; I always recommend a functional vision assessment by a developmental (sometimes called a behavioral) optometrist. There can be difficulties not only with visual acuity, but also in the processing of the information we receive via our eyes.

      See “Visual Supports” section for more details and for visual accommodations.

      What Is Hand-Eye Coordination?

      Hand-eye coordination is when the visual system and brain give information to the hands to complete movements necessary to successfully complete tasks such as painting, writing, and catching a ball. Additionally, this skill is used in gross motor movements. When a student plays baseball, he must be able to see the ball coming toward him to either hit or catch it. The eyes and body need to work together so functional activities can be done. It is important to remember that the eyes, hands, and arms make constant small adjustments to ensure that the activity is done successfully. Here are some activities that you can do to work on hand-eye coordination:

      • Hang a Koosh or tennis ball from a string on a small hook either in the garage, ceiling, or a doorjamb and have your student use arms individually and then together to hit the ball.

      • Encourage your student to lie on his back as you hold the ball on the string. Ask him to hit the ball with the arm(s) you name (left, right, and together).

      • While lying on his back, your student can toss the ball up into the air. Therapy catalogues or even discount stores offer balls with many different textures and colors for more variety. Beach balls are slower moving and larger for beginners.

      • Build a small tower with blocks and then knock it down for fun!

      • Sit on the ground facing each other and roll balls of various sizes to each other.

      • Copy shapes or trace them using differently sized puzzle pieces or blocks.

      • Pour water with different sized cups.

      • Play balloon volleyball.

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