Children’s Occupational Therapy
Position in space, Spatial relations, Sequencing.
Visual spatial relations are the ability to perceive the position of objects in
relation to oneself and other objects. A child with spatial perception
difficulties may be clumsy and hesitant in his movement and may have difficulty
understanding what is meant by words such as in, out, up, down, before, behind,
left and right. A child may confuse letters such as d/b/p f/t/j s/z n/m as well
as numbers and whole words. These letters have similar forms and must be
distinguished in their spatial positioning. The child may reverse letters,
numbers and whole words. They may also have difficulty with arts and crafts
activities setting out work and drawing maps and diagrams. Writing may show
poor spacing between words, poor sizing of letters and difficulty staying on the
line. A child may have difficulty staying within personal boundaries and their
belongings may be scattered and disorganised. Judgement of distance and
height may be inadequate, for example-negotiating stairs and curbs, pouring
from containers. Finding the way from one place to another may be difficult
without getting lost. The older child may have difficulty reading plans, diagrams
and maps to 3D constructions and concepts e.g. in Geography and Design and
Technology.
Activity ideas.

Standing in front of a full- length mirror, ask you child ‘Is your head
above or below your tummy?’ ‘Is your chin above or below your legs/

Body puzzles- name parts of the body using spatial concepts such as
above, at the side, below, in front, behind. e.g. your arms are at the side
of your body.

Have the child put themselves in different positions in relation to an
object e.g. under the table, and then another person e.g. stand in front
of another child.

Make and use obstacle courses- moving over, under, in and out of items.

Looking at pictures and asking questions such as ‘where is the cat?’ e.g. on
the table/ next to the bowl.

Copying designs such as pegboards. From one pegboard to another.

Pattern copying using cubes/bead sequences/ shape and letter sequences.
Build a block design and let your child copy it.
Draw a block design and let your child copy it.

Constructional toys e.g. Lego, macanno, k-nex
Build from a diagram
Build from a model.

Puzzles.

Mosaic shape puzzles.

Positioning object games e.g. ‘put the ball in the box’ or ‘where is the
ball?’

Make pattern puzzles for the child to copy e.g.

Copy patterns made with straws.

Draw a cross on a board, paper or magnet board. Describe the location of
each quadrant on the cross i.e. top left, bottom right, top right, bottom
left. Ask the child to draw a cross or place an item in the quadrant as
they are called out.

Relating objects to one another in the garden/house e.g. Roses are at the
top of the stems; leaves are above the tree trunk.

Line up a number of toys e.g. cars or draw pictures of the same objects
with one doing in a different direction. Ask the child which one is facing
a different way.

Using a chalkboard, write a row of letters, some of which are reversed.
The child has to rub out the incorrect letters.

Worksheets with letters written both the correct and reversed. The
child has to cross out the incorrect letters or ring the correct ones.

Posting letter/number cards with only the letter b, if the child has b, d, p
reversals.

Flash cards of known words e.g. find/finb- ask the child which one looks
right.

Worksheets of similar words e.g. ball, ball, dall, ball/ from, from, from,
form/ on, no, on, on. Again the child has to identify which words are
correct.

Provide directional cues to help your child to remember difficult letters;

Make a cue card of the difficult letters or number to keep on the table.

Write sentences that involve the reversed letter/number.
Strategies
 To assist the child to develop left to right progression for writing
a. Use coloured tape on desk/ page- green on left for start, red on
right to stop
b. Use highlighted margins.

Use a strip of card or finger to help mark a pace between words.

Give worksheets rather than have the child copy from the blackboard or
book.

Use windows or blocks to isolate units of work to assist with organisation.