Ped deficits and interventions

Visual-motor integration (VMI) deficit

Trouble coordinating what the eyes see with hand movement, seen in copying, drawing, and handwriting.

Assessments to test Visual-motor integration (VMI) deficit

Beery VMI, DTVP-3, BOT-2 (precision subtests)

interventions for VMI deficit

tracing and copying shapes from simple to complex, mazes, and dot-to-dot, plus modified worksheets and a slant board.

Visual perception deficit

Trouble interpreting what the eyes see, without needing a motor response (discrimination, figure-ground, closure, form constancy, spatial relations, visual memory).

Assessments to test visual perception

TVPS-4, MVPT-4, DTVP-3.

interventions for visual perception deficit

matching and sorting games, hidden-picture tasks, and reduced visual clutter on worksheets.

Fine motor deficit

Weak dexterity, hand strength, or finger isolation, causing trouble with buttons, scissors, and utensils.

Assessments that test fine motor

BOT-2, PDMS-3 (birth to 5), Jebsen-Taylor, Purdue Pegboard, Nine-Hole Peg Test.

fine motor interventions

putty and tongs, bead stringing, tearing and cutting activities, and adapted tools.

In-hand manipulation deficit

Trouble moving objects within one hand (translation, shift, rotation), such as moving coins to the palm or turning a pencil.

In hand manipulation assessments

observation, plus the BOT-2 and Jebsen-Taylor.

in hand manipulation interventions

coin and bead games, picking up several small items and storing them in the palm, and rotating small objects.

Immature pencil grasp

Grasp progression runs palmar supinate, digital pronate, static tripod, then dynamic tripod.

interventions for immature pencil grasp

short pencils or crayons, pencil grips, and vertical surfaces to build wrist and shoulder stability.

Handwriting deficit

Poor legibility, speed, spacing, or letter formation.

assessments for handwriting deficits

ETCH, Test of Handwriting Skills-Revised, Minnesota Handwriting Assessment

interventions for handwriting deficits

multisensory letter practice, Handwriting Without Tears, lined paper with visual cues, a slant board, extra time, and keyboarding as an alternative.

Gross motor deficit

Trouble with running, jumping, balance, and ball skills.

assessments for gross motor deficits

BOT-2, PDMS-3, Movement ABC-2, TGMD.

gross motor interventions

obstacle courses, ball games, balance activities, and often a PT referral for collaboration.

Bilateral coordination deficit

Trouble using both hands together, as in cutting, stabilizing paper while writing, or lacing.

Assessment for Bilateral coordination deficit

BOT-2, SIPT.

interventions for bilateral coordination deficits

stabilize-and-manipulate tasks, bimanual play like stringing beads, and cutting paper while the other hand holds and turns it.

Postural control or core instability

Slumping, leaning on the desk, W-sitting, or fatigue during seated tasks

Assessments for postural control or core stability

observation and the BOT-2 strength subtests.

interventions for postural control or core stability

proper desk and chair fit with feet supported, core strengthening, wobble cushion trial, and movement breaks.

Low muscle tone (hypotonia)

Reduced resting muscle tension, causing poor stability, fatigue, and loose joints.

assessment for low muscle tone hypotonia

observation and the BOT-2.

interventions for hypotonia

proximal stability and strengthening activities, positioning supports, and pacing and rest breaks.

Motor planning deficit (dyspraxia)

Trouble planning and sequencing unfamiliar motor tasks, even with adequate strength.

assessments for motor planning deficits

SIPT, DCDQ, Movement ABC-2.

interventions for motor planning dyspraxia deficit

task analysis, practice with repetition, verbal and visual cues, and the CO-OP approach.

Developmental coordination disorder (DCD)

Motor skills well below age expectation that interfere with daily function, with no other medical explanation.

assessments for DCD

Movement ABC-2, DCDQ, BOT-2.

interventions for DCD

CO-OP (a goal-plan-do-check strategy approach), task-specific practice, and environmental adaptations.

Sensory processing difficulty

Atypical responses to sensory input (over-responsive, under-responsive, or seeking), affecting attention, behavior, and participation.

sensory processing assessments

Sensory Profile 2, Sensory Processing Measure (SPM-2), SIPT.

sensory processing interventions

sensory diet, sensory-friendly environment modifications, Ayres Sensory Integration therapy, and teacher and parent education.

Sensory modulation problem

Over- or under-reacting to sensory input, which can look like avoidance, distractibility, or constant movement.

sensory modulation assessments

Sensory Profile 2, SPM-2.

interventions for sensory modulation

movement breaks, calming or alerting strategies, seating options, and adjusting the environment, such as noise and lighting.

Attention and executive function deficit

Trouble with organization, planning, task initiation, working memory, and time management.

attention and executive functioning deficit interventions

visual schedules, checklists, task breakdown, timers, and organized workspaces, with adolescents also using planners and time-management routines.

Self-care or ADL deficit

Difficulty with dressing, feeding, grooming, or toileting.

assessments for self care or adl deficit

PEDI-CAT, WeeFIM, School Function Assessment (SFA).

interventions for self care or adl deficit

task analysis, backward chaining, adaptive equipment, and visual supports.