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Dealing with the Reversal Problem - June 2008

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Dealing with the Reversal Problem

Compiled By: Melanie Lambert, OTR/L

Reversals are among the most common characteristics seen in children with learning disabilities. Many children reverse letters in the early years because they lack familiarity with letter and/or number symbols. Visual reversals should not be present beyond seven years of age. This usually indicates some form of delayed neurological maturation. Students who reverse letters, especially b's, d's, p's and q's, experience difficulty with position-in-space. The student's confusion is in what position the parts of the letter occupy in relation to one another (Is the circle to the left or to the right of the straight line?) or the position the symbol occupies in the overall space of the paper (With b and p confusion, is the straight line above or below the blue line on the paper?).

There is no magic cure for children who display reversals in their reading or writing. These aids will, however, be helpful for the classroom teacher seeking strategies to teach correct letter formation or to correct poor learning as well as for the specialist seeking to stimulate neurological development. Remediation should be carried out with an overall program strategy guided by a professional or group of professionals trained to work with children with learning disabilities. It is important that a child masters right-left orientation on their own body before progressing to analyzing symbols (letters and numbers).

The following is a plan for b/d reversals but a great deal of it can be adapted for other reversals too (numbers as well as letters). This list is certainly not exhaustive and will hopefully stimulate some ideas of your own. Select what is appropriate for each individual child depending on their chronological age, actual academic performance level and interest. Try to concentrate on the letter "b" and leave the letter "d" for later especially when dealing with a preschool child. Use as much color and variety as you possibly can.

Reinforce the actions or movements used in these activities with verbal prompts. Here are some ideas for verbal prompts:
  • The letter "b" is: down up around, that makes a "b"
  • The letter "d" is: around up high and down that makes a "d"
  • The letter "b" is associated with a "baseball" which begins with the "b" sound. When a child writes the letter "b", talk about how to play baseball. First you swing the bat (draw the straight line down, that's the bat), then you hit the ball (draw the round part, that's the ball). As a child practices writing the letter "b" they should whisper, "First the bat and then the ball". For the letter "d", talk about the word "door" which begins with the d sound, so when a child writes the letter "d", they think about opening the door. To open the door you first turn the knob (draw the round knob), then open the door (draw the straight down stroke, that's the door). As a child practices the writing the letter "d" they whisper to themselves, "First the doorknob then the door".

Activity ideas:
  • Walk out the shape of a large letter placed on the floor with masking tape. Upgrade the activity by getting the child to walk the shape of the letter with his eyes closed.
  • Ride over the shape of a large letter on a scooter board.
  • Have the child make the letter with string on the floor and walk over it afterwards (first with eyes open then with eyes closed).
  • Make a "b" and let the child trace it, color it in, cut it out and paste it onto a bright background.
  • Cut out a letter "b", cut it into a couple of pieces to make a puzzle, put it together again and paste it down onto a bright background.
  • Make a letter "b" in sandpaper, felt, silk, with pipe cleaners etc. and have the child trace it with their fingers (first with eyes open, then with eyes closed).
  • Let the child make a roll out of clay or play dough and form the letter over a cardboard template. Make the letter out of cookie dough as an alternative and bake it.
  • Make the letters b, d, p, q out of lollipop sticks and bottle top rings.
  • Spread finger paint onto a large sheet of paper or tray and finger paint the letter.
  • Cut out a stencil of the letter or make a potato stamp and stamp a pattern for some wrapping paper.
  • Let the child draw letters in a sandbox.
  • Let the child draw letters in shaving cream on a mirror.
  • Let the child draw letters in the air with his whole arm (big movement) then fingers (small movement) while verbalizing the direction.
  • Get two children to partner each other in drawing letters on each others backs with their fingers. Have them identify the letter and state whether it was drawn correctly.
  • Place a number of letter cards in a box. Have the child find all the cards with letter "b". Use different fonts or different letter sizing to make it more interesting.
  • Have letters cut out of cardboard. Have the child match the letters to the letter shape it was cut out from (find the correct "house" for the letter).
  • Picture match, present the child with a few mixed letters, they must sort them out to make a word and match it to the correct picture. Start with small words using the letters that are often reversed.
  • Complete dot to dot pictures that join up to make the letters.
  • Picture letters, match the picture with the correct letter it starts with.
  • Give the child a newspaper or magazine article. Have them find all the letter "b's" and circle them. Encourage the child to track from left to right starting at the top of the page and working to the bottom. Score the older child's work and get him to try improve on his score.
  • Fill in the missing "b" or "d" in words in sentences.
  • Spelling darts, have a number of letters stuck on a suitable board. Give each child 3 darts to throw at a time. Each letter that a dart lands on can be used to make a word. Each letter used in a word scores a point. Problem letters have a higher score.
  • Make the letters b, d, p and q by drawing lines on a page and have the child print a circle next to the lines to make the letter you ask for. Use colored circle stickers as an alternative.
  • Make a domino game with letters. Match the letters as you would in a regular domino game.
  • Make a lotto game with letters instead of pictures.
  • Play memory game with letters on the cards instead of pictures

This Month's Featured Vendor: Skills For Learning

Special Thanks to Melanie Lambert and Summerdale Educational Services for providing an article for this issue's Therapy Corner.

Ms. Lambert is the designer of the Visual Perceptual Skills Builder CD Program. She ran a pediatric private practice based at a remedial school in South Africa for a number of years. During this time she was involved in assessing and treating children with learning difficulties and developmental delays. She was also involved in educating teaching staff with regards to visual perceptual problems and motor delays and providing teaching staff with strategies to address these problems in the classroom situation.

The practice formed a consultation base for a fairly large geographical area with a limited therapy infrastructure. She received a number of referrals from children who had to travel from further afield and were unable to attend regular weekly therapy sessions to address their particular learning needs. It was during this time that the idea for the Visual Perceptual Skills Builder was hatched.

Melanie moved to the UK in April 2005 and has been working in a pediatric private practice in London since then.

Please support our contributing authors and vendors. Visit Skills for Learning on the web at Skills for Learning Ms. Lambert can also be reached by email at

Tags: June 2008 Newsletter OT SLP Visual Perception Article