Purpose: To integrate the visual skills of focusing (accommodation), tracking (saccades), and visualization with balanced and rhythmic bilateral movement.

Materials: Trampoline (if none available, jump on floor) Whiteboard

Procedure:

As the patient becomes comfortable with each level, move on to the next.

1. Have the patient begin jumping. Ask them to draw circles in the air with their hands (palms down, fingers together) that are about the size of a basketball and are circling out from the center of their body toward each side. The patient should work of keeping these circles smooth and of consistent size as they jump.

2. While maintaining the circles the patient should a. Spell their name forward with one letter per jump. b. Spell their name backward with one letter per jump. c. Spell their name backward with one letter every other jump.

3. Write the sentence “the train went down the track” on the whiteboard. Have the patient a. Spell forward while looking. Seat drop on spaces. b. Turn around and spell again from memory. c. Spell the sentence backward while looking. d. Turn around and spell backward from memory. e. Spell sentence outside in (alternating from first letter to last letter, second letter to second from last, etc.) f. Spell outside in without looking. g. Spell with 90 degree turns or turn on each vowel. h. Substitute vowels for an object (e.g. “dog”) i. Spell with seat drop on spaces and knee drop on vowels. j. Spell sentence outside in with seat drop on spaces and knee drop on vowels.

4. Have the patient spell a word (e.g. “School”) forward and backward while jumping (S-C-H-O-O-L, then L-O-O-H-C-S). Follow this with a. Spelling with 90 degree turns between each letter. b. Self-directed reversal (Patient turns on each letter and decides when to begin turning in the other direction. For example, turning clockwise with S-C-H, then changing to counter-clockwise with H-C-S.)