Introduction to Learning and Vision Therapy: Principles Part X

Part X: Sequencing Therapy

Complement to Clinically Speaking Part VI.

This lesson is under construction. Please consult with your doctor to establish appropriate programming and sequencing for your own circumstances. Reach us by email for immediate assistance.

Planned Content: The general sequence of events over a session and over 3 mo for a general case scenario. Also, notes on group therapy design. (Will describe session on day one and how training evolves over time. NB, what is done depends on what needs to be addressed visually, it is not cookie cutter.)

 Practical Planning

Get a minimum 1.5-inch binder. Pocketed dividers and a a sturdy construction are recommended – it should allow you to use it as a writing tablet. Divide the binder into sections divided into parts of the lesson. For example, you might include the following sections to the binder, in order of the tabs.

  1. Long Term Plan – Three month arc. See Clinically Speaking Part VI. Include a calendar page for each month to write out your intended sequencing. Write in pencil and don’t be afraid to modify as yo go along.
  2. Daily Plans. For this section of the binder, throw in 5o pages of lined sheets for making notes. You have one entry for each lesson. Write the date, then list out the activities you will do in sequence for that date.
    1. It is most practical to do this while you are working an activity. When the activity is completed for the day, simply write out the activity name on the daily plan for the next lesson. Do not include notes regarding the specifics of the activity in the daily plan.
    2. When finished an activity for the day, consult with the child regarding their intended targets for the next session – consider how many of an item might be attempted, how long the activity is sustained for, what difficulty might be attempted, and so on. Again, don’t spend too much time discussing the details, simply offer reasonable options and let the child choose. Write the notes on the activity sheet itself. Include the activity sheet in the appropriate section in the binder.
    3. Make it a point to review plans with the child at every occasion, especially
      • review goals as determined at the last session for a particular activity before you begin the activity anew,
      • review plans for ‘next time’ at the end of a therapy session, that is, what activities will you do,
      • review these plans again immediately before you begin the next session.
  3.  ‘Set-up‘ – Binder Section. ‘Mood setting’ activities. Begin your lessons with these activities. These are going to be self-awareness activities, either yoga or meditation.
  4. Fine Visual Motor Integration (Fine VMI)‘ – Binder Section. These activities require visually guided fine motor control. Gross VMI skills are considered later. Fine VMI implies the child is quietly sitting at a table working with the hands drawing, building, doing puzzles, tracing, and so on.
  5. 3R’s Reading / Writing / Math‘ – Binder Section. These activities will be clearly labeled in the library, or certainly include your own preferred activities. eLVT activities tend to take a visual functional approach to these concerns and to not generally adhere to phonics methodology.
  6. Gross VMI‘ – Binder Section. In these activities, the child is engaging in motor movements involving primarily the hands and arms, but not ambulating. They might be, for example, tracing door frames using a laser pointer. This section might include activities where the child moves the feet or legs while in a seated position.These activities allow the child to move from the more contemplative and cerebral activities towards more physical tasks, preparing them for the next section.
  7. ‘Gross-Motor / Balance‘ – Binder Section. Activities requiring the child focus primarily on motility and ambulation, balance, bilateral integration, directionality, and laterality / laterality awareness.
  8. ‘VSA’ (Visual Signal Acquisition) – Binder Section. These activities are designed to strengthen the motor elements of vision including accommodation, vergence, alignment (strabismus, excessive phoria, convergence insufficiency).
  9. ‘VSP’ (Visual Signal Processing, Perception) – Binder Section. These activities stimulate visually-oriented cognitive processes and help to build skills with printed language, spatial orientation and manipulation, and visual targeting.
  10. Cognitive/Academic – Binder Section. These activities look more like traditional school activities, but are more likely to target certain skill areas as opposed to teaching content.


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