The Z axis

As therapists, we recognize the importance of mid-line crossing to help with primitive reflexes.  Reaching lateral outside of the base of support challenges balance and posture.

But to exercise convergence, the therapist must turn their favorite activity into the “Z-axis”. This axis is the near-far axis, (referred to as the Z-axis in vision) and challenges the convergence and accommodation system.  Many of our favorite activities can be modified just by turning them, to help strengthen the near vision system.

Simple convergence strengthening activities

Clothespins are a great therapy tool, strengthening pinch for writing and other tasks. Having a child reach a distance to retrieve the clothespin then hanging the clothespin on a near string can help with convergence and divergence. The proprioceptive input of the hand hanging the clothespin on the string will cue the eyes to converge to a point.

The swing adds vestibular and proprioception to the convergence and divergence in this video.

In my clinic, I also use a cup with a straw that patients then put toothpicks in. This task can be graded by moving the cup closer to the child’s face.  This is task also made more difficult by not allowing the kiddo to touch the straw, removing the proprioceptive input,  forcing the eyes to guide the hand more accurately.

Amazing creative therapists

Cheerios on a Straw

In the task, the patient puts cheerios on a small coffee stirrer. The hand working at the end of the straw does a great job cueing the eyes to converge. Just make sure the straw stays in at mid-line.

Ball in a Tube

In this task, a 4 ft florescent bulb protector ($4 at Home Depot) is cut in half with a ping pong ball put inside. I then placed stickers on top of the tube. The patient has to align the ping pong ball under the sticker. In standing? Even better. Balancing on a balance board? Even better!!!

As a bonus, the scrap end of the tube becomes a great “lightsaber” for popping bubbles to work on tracking and eye-hand coordination.

The Brock String

The classic brock string is another easy to make activity that can fit in a pocket.  

Want to learn more?

Vision Mechanic is a great website with multiple courses with great vision related activities and real science. Check them out