Purpose: To develop awareness of peripheral visual information, to become aware of the periphery during movement, to develop fixation/localization/targeting skills, to deliberately alternate between central and peripheral visual awareness, and to improve eye teaming (binocular movement) skills. As an extended/loaded skill, this is also helpful in developing accommodative facility (ability to focus near then far then near again).
Procedure:
1. Assistant attaches origami figure to one end of yardstick with a piece of string so that it hangs about eight inches below the yardstick.
2. Patient is to balance the yardstick on his head with the origami figure in front. A cloth pad may be used to help balance the yardstick, if needed.
3. He is to keep looking at the origami figure but be aware of the rest of the room.
4. Patient walks about while looking at the origami figure with the yardstick balanced on head.
5. He is to try to walk backwards, still looking at the origami figure.
6. The assistant then calls out different objects in the room, within the patient’s field of view, and has him look from origami to the object and back. He is to locate the object with his side (peripheral) vision first, before looking at it. There should be no searching eye movements.
7. Have him stop opposite various objects, while holding fixation on the origami target.
8. Have him walk to the beat of the metronome.
Aspects to be emphasized:
1. Ability to balance yardstick on head while moving about.
2. Ability to walk normally, without tightness or tension.
3. Ability to maintain ocular fixation on origami target and peripheral awareness of the surrounds simulaneously while walking.
4. Ability to walk in time with a beat.
Other notes:
This is one of my favorite activities as it covers many visual training elements but it’s also fun and interesting. It has great variability in what it actually trains depending on whether the child is moving, or objects/targets in the room are moving (see below), what the target is that is hung from the yardstick, and how far the target is positioned from the child’s face. Best of all, this is a terrific exercise for developing general gross-body awareness and balance, while also helping with focusing attention.
Whether you have a yardstick or not is inconsequential as there are many other suitable substitutes. A yardstick, (or meter stick) is an ideal choice as it is light, thin, and long. As such, it can easily be weighted down by a heavy towel to keep it in place on a child’s head without being overly uncomfortable.
The target used can vary. Origami is nice as it it light weight. Targets, ideally, should not be too large or heavy. An excellent target is a small 6-sided die; you can have the child call out the numbers she sees when she returns her gaze to the stick target after looking at a room target. The best targets have some words, letters, or number to read and fixate upon.
Try placing the target further away from the child at first. There will be more movement in the target, but it is easier to see. Later, over successive trials/sessions, slowly bring the target in closer to the child’s face so that it is eventually within a just a few inches; this makes it harder to focus on and to track.