Visual-motor perception difficulties

Spatial awareness

Children with cerebral palsy and similar neurological impairments may have difficulty judging space. This may mean they bump into others or into objects. In the playground they may rush around getting into everyone’s way. They may also be anxious about mixing.

These problems often spill over into looking at pictures, words, maps and diagrams.

Children with mobility problems may also have these visual-motor problems. They may not show physical features as mobility is limited and controlled.

Copying from the board may be a problem. This is a complex sequence of inter-related actions.


  1. Look at the board and fix on the item to copy.
  2. Memorise the item.
  3. Look at the page and find where to transfer the item.
  4. Access memory and perform the series of movements to reproduce the item.
  5. Look back at the board for the next item.
Copying from an adjacent paper is easier. Having larger print and bigger line spaces helps. Alternatives to copying include:


  • filling the blanks on pre-printed sheets
  • joining the answer to the question by a line

Position in space

When you move, you bear weight through your joints. Messages about how you are taking weight go to the brain. The brain should relate this to other signals from ears and eyes. It interprets these to tell you where you are in relation to your surroundings. If the signals are weak, you can’t be sure you are safe. You may move constantly to get a better signal. You may misjudge spaces and situations.

Typically, the child leans against walls instead of standing straight or props head on hands getting closer and closer to the page. Children may barge into spaces that don’t exist to anyone else but them. They can become indignant when accused of pushing in. Children may be fearful when entering shadowy rooms. Young children may not be able to maintain balance when sitting on the mat and may tumble about.

These children fidget! They move constantly to reassure themselves of their position. They may be labelled hyperactive because they fail to sit or concentrate. They often sprawl or rock on the back legs of the chair. Appropriate seating and verbal reminders can help.

The child may also be easily distracted and thrown off track by stray sights and sounds that either they cannot integrate or screen out. Try to screen out these distractions to help children learn.

As a general rule, sitting with ankles, knees and hips at right angles and feet flat on the floor with the back firmly supported will give better feedback to the child. Giving extra table space to this child will prevent argument and may allow the child room to organise. Placing a small table to give an L shape can help this.

Organisation of school work

Many children with these difficulties will also find it difficult to organise their work. They may need structured guidance to take them through from start to finish. They may rely on leaving their seat to get extra feedback through their joints and reminders from staff. This may help:


  • Give the sequence of actions in picture form.
  • Give one task in a tray with all the relevant materials.
  • Call the child by name and then give one specific action to do at a time.
  • Show the child what the outcome of the task should look like.
Many children with these difficulties will not receive specific extra help. When giving instructions to the whole class, try quietly breaking these instructions down for the child or children in need. Praising each specific accomplishment will reinforce the correct sequence of actions.

Books on dyspraxia deal with these difficulties in detail and in a practical way. Children with these difficulties may not be dyspraxic but may still benefit from the physical activities recommended.

Daily movement programmes where the whole body moves through different positions in space, where limb movements are isolated and repeated when standing, sitting, on front or back are useful.

Using the position words, “up”, “down”, “under”, “over”, “by”, “through” and so on, while performing the actions can help children feel more confident about themselves.

Children who have spatial or positional perceptual problems usually lack self-confidence. If you are not sure about your movements, it’s like the first day behind the wheel of the car, in heavy traffic with, often, a disapproving driving instructor. Remember, it’s like this every day for many children. Some children become quiet and anxious. Some use speed and clowning to hide the deficits. Some children pretend they didn’t want to join in anyway.

If you think you know a child where these problems are affecting learning, contact an educational psychologist or GP and ask for an assessment from a paediatric occupational therapist.

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