An Occupational Therapist’s Tips for Helping Elementary Students Feel Ready to Read

When elementary students are physically overstimulated or emotionally dysregulated, these exercises may help them get ready for the work of reading.

February 9, 2023
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As an occupational therapist, I’ve found that the act of reading relies on many underlying developmental components connected to occupational therapy.

When elementary students between first and fifth grades are physically overstimulated or emotionally dysregulated, you may see rushed reading, difficulty visually scanning words, decreased comprehension, skipping lines, decreased visual focus, choosing books above their level and flipping through pages, decreased stamina, and work avoidance (e.g., getting up to go to the bathroom when they had recently had a bathroom break, looking for something in their backpack, going to speak to a friend, etc.). 

The strategies outlined below incorporate crossing midline (where a limb reaches across to the other side of the body, leading to cross-hemispheric integration), tactile (touch), visual input, proprioception (deep pressure to the joints to improve body awareness), and vestibular (sense of balance) input. I recommend starting from the least restrictive supports and going progressively to the most restrictive as needed: beginning with small movements, then going on to the tools, and then the big breaks.


  • Consider creating visuals of the strategies below and placing them near your classroom reading area so that students are reminded of the strategies they can utilize during the reading period to maximize sustained reading. For example, take pictures of students modeling. 
  • Create visual bookmarks of the supports for students to place in their books to use as they read.
  • Consider creating individual reading tool kits for your students with the following materials: a pencil, a reversals notebook (information below), and an I-Spy bag (information below).
  • Consider going through the tools together as a reading preparatory activity before independent reading.
  • The small-movement exercises outlined below are effective during moments of eye fatigue (e.g., eye palming) and to strengthen the muscles for reading (e.g., pencil-to-nose); students can do these during moments in the reading process.
  • The large-movement exercises outlined below can be easily integrated into reading stations and lessons to target related skills during reading.

Small-movement exercise

Eye palming: This strategy allows the eyes to rest during times they begin to feel fatigued (e.g., when reading a large amount of text from a book, looking at a screen for an extended period, looking at the board/taking notes). 


1. Students rub their hands together until the palms feel warm.

2. They then close their eyes.

3. They place warmed hands over their closed eyes and hold for at least 10 seconds. 

4. To increase focus, have students cross their arms before placing their hands over their eyes.

Pencil-to-nose: This helps to strengthen eye muscles and relates to the skill of convergence—“how your eyes work together when you look at nearby objects.”


1. Students should keep their head straight—only the eyes should move.

2. They pick up a pencil and turn it so they’re looking at an eraser.

3. They hold the pencil at arm’s-length away, pointing the eraser at the nose. 

4. Students then slowly bring the pencil toward the nose (without touching it to the nose), while staring at the eraser.


Reversals notebook: For this tool, students need a 3-inch binder. This is a binder filled with letter and number reversal worksheets (b’s, d’s, p’s, q’s, etc.), which you can find and print online. The more students practice forming the letters the right way, the easier it will be for them to put the letters into muscle memory and integrate them into their learning schema. This binder can also be placed on its side where books can be placed tilted at an improved visual angle.

I-Spy bags: This support is created out of a pencil case filled with small objects, including the target, which is magnetic fidget letters or letter beads, as well as filler such as rice, beans, barley, etc. You can also include small toys. Consider having your students create their own I Spy bags.

Students should search for specified letters or words within the beans, barley, or beads, pinching and shaking the pencil case as they search for each letter. Searching for specific letters and sight words (and even certain toys) hidden among the filler targets reading skills, specifically ocular motor skills, such as figure ground (being able to discern what they’re focusing on from what else is in view), visual perception, accommodation (adjusting focus as distance changes), and scanning abilities, which relate to the reading skill of decoding and overall stamina.  

Letters and words can be either written down or spoken by an adult. Students can also write the corresponding letters or words on paper, which adds a graphomotor/handwriting and visual motor integrative component piece, as well.

Big breaks

Note: The following two activities were created based on research highlighting the idea that visual motor integration can work to target literacy skills. 

Arrow jump: On a big sheet of paper, draw arrows going in different directions—up, down, right, left—and tape the sheet to the wall. Students should scan from left to right (similar to reading) and jump per the arrow’s directions. Next level: Put sight words or letters on top of each arrow to add an additional reading component to this activity. As students scan each arrow in turn, they state each letter or sight word as they jump in the direction of each arrow.

Square jump: For this activity, you need four tile squares or a taped box with four quadrants. On a sheet of paper, draw matching boxes with four quadrants along the paper and tape the paper to the wall. Place a sticker in one of the four quadrants—this represents the quadrant that students should jump into on the matching quadrant on the floor. 

Next level: Write sight words or letters on each sticker to add an additional reading component to this activity. As students scan each sticker in turn, they state each letter or word as they jump in the direction of each quadrant.


Have students use the small-movement exercises before (e.g., pencil-to-nose) and during (e.g., eye palming) reading exercises.

Students can utilize the tool supports on an as-needed basis (e.g., reversals notebook), in small group work, or as part of multisensory handwriting and reading activities (e.g., I-Spy bag).

Students can also use big breaks strategies on an as-needed basis (e.g., for students with more significant reading needs), for students with high levels of physical dysregulation where you may want to implement a reading or academic piece into their movement break, or as part of small group academic intervention.

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  • Literacy
  • English Language Arts
  • K-2 Primary
  • 3-5 Upper Elementary

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