OT Spot it game for occupational therapy

Children love Spot It games and OT professionals love to use Spot It in occupational therapy to develop skills! Today’s free resource for OT month is a fun OT Spot It type of game. This occupational therapy supplies match it activity develops visual perceptual skills and uses common OT materials and supplies. If you are working with kids, you’ll want to grab this freebie as a tool to use during OT month, but also all year long!

Amazon affiliate links are included in this blog post. As an Amazon Influencer, I earn from qualifying purchases.

OT Spot it game for occupational therapy


This therapy game is part of a larger set that you can find in our OT Materials Bundle. And, incase you missed the OT month freebie that we shared already, be sure to grab this set of OT coloring pages, too. Both are great resources to add to your toolbox.

If you have ever played the (Amazon affiliate link) Spot It card game, you will love these Occupational Therapy Supplies Match it Cards!  Spot it games come in dozens of different styles to motivate even the most resistant learner. With these occupational therapy tools matching cards, learners can practice visual perceptual skills using a familiar platform. 

Why are visual perceptual skills important?

We’ve previously shared a great post explaining the importance of visual perception on learning.  Visual perception is important for reading fluency, decoding words, scanning a page, remembering what has been seen, finding things in a drawer or closet, playing games like puzzles, recalling/recognizing correct spelling, completing math equations, and so much more.

As a related resource, this free visual perception packet covers many different visual perceptual skills.

Spot It Game for Visual Perception

If you’ve seen the Spot It game being used in therapy sessions as a tool for development, you may have wondered how this popular game supports visual perceptual skills.

What visual perceptual skills are used in the occupational therapy supplies match it game?

  • Visual Attention: The ability to focus on important visual information and filter out unimportant background information.
  • Visual Memory: The ability to recall visual traits of a form or object.
  • Visual Spatial Relationships: Understanding the relationships of objects within the environment.
  • Visual Figure Ground: The ability to locate something in a busy background.
  • Visual Form Constancy: The ability to know that a form or shape is the same, even if it has been made smaller/larger or has been turned around.

All of these skills are addressed through the use of the Spot It games, and that’s why we wanted to create an OT version to develop skills!

Use the OT Match IT Game

Because April is OT month, it is a great time to talk about the role of occupational therapy with other students, or to work with learners on understanding why they get OT. 

They may not understand why they get to see this awesome person every week.  By educating learners about the role OT plays in their lives, they can begin to explain it to other people.  When we educate other adults about occupational therapy, we are advocating for the profession, as well as teaching them how we can help.


  1. A great place to start would be by ordering the rest of this occupational therapy supplies match it cards HERE. This bundle of occupational therapy activities includes 13 printable products that can be printed off and used with students in therapy sessions to celebrate all of the therapy tools kids use. This packet is great for OT month, and all year long.
  2. An all inclusive lesson plan can easily be made by using all of the occupational therapy month themed activity freebies:
  1. Create a visual perception theme addressing several of the important visual perceptual skills.  The OT Toolbox has some brand new resources for visual perception. 
  2. Color and laminate these cards to build a reusable game set.  Make a special game set for your learners to take home and share with family
  3. Have learners research and learn more about occupational therapy and the supplies or tools we use

HOW TO DOCUMENT Spot IT Games in Therapy

If you are using these occupational therapy supplies match it cards as part of your treatment plan, you will need to accurately document your learner’s skill level. 

  • The percentage of correct cards matched
  • How long it takes to do each card
  • Attention to detail, following directions, prompts and reminders needed, level of assistance given
  • Can your learner scan the page to identify the correct items?  Are they recognizing what they are matching or merely matching shapes?
  • How many times do you need to repeat the directions so your learner can follow them?
  • How many reminders does your learner need while doing this activity?
  • First determine what goals and skills you are addressing. Are you looking strictly at visual perception and picture matching?  Or something else entirely such as executive function and behavior?
  • Focus your observations on the skills you are addressing.  It is alright to address one (or ten) skills at once, just be sure to watch for those skills during the activity.  This can take practice to watch everything all at once. Newer clinicians often videotape sessions and go back and review clinical observations they may have missed.
  • Use data to back up your documentation. Avoid or limit phrases such as min assist, fair, good, some, many, etc.  They are vague and do not contain the numbers and data critical to proficient documentation.  Instead use percentages, number of trials, number of errors, time to do a task, number of prompts, minutes of attention.  You get the idea.
  • This type of documentation may feel foreign at first if this is not what you are used to, however insurance and governing agencies are becoming more strict on accurate documentation.


Take time this month not only to advocate for occupational therapy, but to celebrate each other for the fabulous work we do!  Share stories of success, funny moments, learning opportunities, and resounding failures.  Every time I think I have heard or seen it all in my thirty years practicing, a new surprise or hilarious moment comes my way!  Someone should publish a book or page about all of the funny things people say during a therapy session. 

This profession is rewarding but also very tough.  Burnout is common among health professionals. In fact, caregiver stress and burnout applies to many therapy professionals! If you can’t find a moment of levity, it will break you.  

While this post is highlighting the occupational therapy match it cards, take time to reflect about what great work you are doing, spread the word about OT, and practice your own self care.

Free Match IT Game for OTs

Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

Level 1 members gain instant access to all of the downloads available on the site, without enter your email each time PLUS exclusive new resources each month.

Level 2 members get access to all of our downloads, exclusive new resources each month, PLUS additional, premium content each month: therapy kits, screening tools, games, therapy packets, and much more. AND, level 2 members get ad-free content across the entire OT Toolbox website.

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Free Occupational Therapy Spot It Game

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    Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

    9 Hole Peg Test

    9 hole peg test

    The 9 hole peg test is a common fine motor test used in occupational therapy assessments to collect a baseline on fine motor skills, dexterity, hand-eye coordination, motor planning, and more. When an occupational therapist uses a nine hole peg test in OT evaluations, several areas of data are collected to support and drive therapy progression. Let’s take a closer look at this fine motor assessment and the skills developed using pegboard activities like the nine hole peg test.

    9 hole peg test

    This blog post on the 9 hole peg test contains affiliate links.

    Amazon affiliate links are included in this blog post. As an Amazon Influencer, I earn from qualifying purchases.

    9 Hole Peg Test

    Continuing in the series of posts related to grasping, grip strength, and standardized testing measures, the (Amazon referral) 9 Hole Peg Test is another classic test used to measure and track fine motor dexterity.  In this post we will review the nine hole peg test, norms, correct testing protocol, and testing options.

    The Nine-hole Peg Test typically is used in the adult clinical settings such as outpatient hand therapy, rehabilitation settings, or in assessment of adults with coordination and dexterity needs, typically seen with neurologically impaired or cognitive, sensory, or motor impaired patients.

    However, we know that in children, especially in the 5-9 range, much of the day revolves around motor skills, particularly fine motor contributions. We’ve covered in a previous blog post, the vast amount of school and learning tasks that involve fine motor work. Read about fine motor skills needed at school for more information.

    • In this test, participants are asked to place pegs into the holes one at a time, then remove them one at a time, and place them back in the container as fast as they can
    • Participants may only use one hand at a time, but the opposite hand can stabilize the board
    • Alternative testing method: record the number of pegs placed in the peg holes in 30, 50, or 100 seconds.  Record the data as number of pegs/second.
    • Another alternate testing method: record the number of peg placed in the peg holes and seconds before the child loses interest. First, record the number of pegs.  Second, record the number of pegs placed/second.
    • The timer starts the second the hand touches the first peg, and ends when the last peg is placed into the container.

    Versions of 9 hole peg test:

    There are different varieties of the 9 hole peg test available for purchase, from a basic board (affiliate link) to the gold standard  Jamar 9 Hole Peg Test

    The Jamar test is reported to be worth the hefty price tag because:  “The placement of the dish and pegboard allows for an easy, consistent reach, which ensures proper results during the evaluation procedure. Thanks to the design and materials, the kit is also easy to clean and maintain, allowing for quick and easy disinfection to prevent any contamination”. 

    How to Administer the 9 Hole Peg Test

    The nine hole peg test is a convenient testing instrument.  It requires the test kit, a pencil and paper, and a stopwatch or other timing device.

    • Set up the pegboard on a flat surface in front of the learner.  Add a grip or non-slip surface to insure the board does not move.  The peg side of the board is placed toward the dominant hand (when testing the non-dominant side, this will be reversed).  
    • Instruct the learner to:  “Pick up the pegs one at a time, using your right (or left) hand only and put them into the holes in any order until the holes are all filled. Then remove the pegs one at a time and return them to the container. Stabilize the peg board with your left (or right) hand. This is a practice test. See how fast you can put all the pegs in and take them out again. Are you ready? Go!” 
    • After the patient performs the practice trial, instruct the patient: “This will be the actual test. The instructions are the same. Work as quickly as you can. Are you ready? Go!” (Start the stop watch when the patient touches the first peg.)  While the patient is performing the test say “Faster” When the patient places the last peg on the board, instruct the patient “Out again…faster.” Stop the stop watch when the last peg hits the container. Place the container on the opposite side of the pegboard and repeat the instructions with the non-dominant hand.
    • Record the number of seconds to place and remove all nine pegs for the dominant and non dominant hand. Testing will include one practice test, one test for dominant hand, and one for the non-dominant hand. 
    • Create a tracking form to track scores over time.
    • Cross reference the scores of your learner with standardized norms.

    Fine Motor Assessments with the 9 Hole Peg Test

    There are several tests that incorporate the 9 hole peg test within their testing protocols:

    Skills Assessed with a Nine Hole Peg Test

    Once a measurement is assessed, different pegboard type activities can be used to encourage and strengthen dexterity.  While these will not be standardized with norms, they can be measured over time for improvement or decline in function.  

    Skills that the nine hole test analyzes can include:

    • In-hand manipulation
    • Precision
    • Dexterity
    • Hand-eye coordination
    • Separation of the sides of the hand
    • Force modulation
    • Cognition

    There are endless resources and activities available to address fine motor precision. This article from the OT Toolbox on Fine Motor Precision contains valuable information.

    Here is an inclusive post on Fine Motor Skills, also from the writers at the OT Toolbox.

    When Use the 9 Hole Peg Test

    You might be wondering why do we need to use measurements like the 9 hole peg test?

    Unfortunately (or fortunately depending on your perspective) therapists and practitioners are held to higher and higher standards. There is a certain amount of accountability that is being expected in practice. This is largely due to insurance regulations, however it is good practice to be able to show measurable progress.

    By using standardized methods to record and gather data, more accurate measurements can be made to document and demonstrate what is happening in therapy.  “They are doing a great job” or “we are making nice progress” was sufficient evidence at one time. 

    I personally like standardized tests. It keeps me on top of my students, helps me justify what I do, and is less likely to be questioned than a random worksheet or coloring page. With children, it is hard to make sure a test is exactly standardized to precise measurements, however, it is more measurable than “they are doing a great job”.

    If you are a new clinician, take time to study and learn various types of assessments.  If you are seasoned, brush up on your skills, dust off old assessments, or continue using the gold standard in your practice.

    9 Hole Peg Test Norms

    A clinician can use results of the 9 hole peg test to assess the skill areas above but a standardized test should be used. Norms can be used to determine needs, strengths, and skills that can be addressed in therapy sessions for functional participation in daily activities.

    Norms for the nine hole peg test vary and are separated by age, including different norms for children as opposed to adults. The norms can also be broken down by diagnoses like Parkinson’s Disease or Stroke, as well as healthy individuals.

    Use the 9 hole peg test norms to determine if dexterity, coordination, precision, in-hand manipulation, eye-hand coordination are delayed.

    Data differs between the ages of 5 though 10. During these ages, we see a huge amount of fine motor development occurring. We see this progression in ability to form smaller letters with a pencil, complete more intricate craft activities, build with more refined blocks, color with more dexterity, etc.

    This article breaks down normative data into nice charts that can be used to determine baseline levels and skill development.

    This report also breaks down norms for the 9 hole peg test.

    Variations exist with differences in dominant hand, non-dominant hand, other needs (called special education students in some reports), diagnoses, age, male/female, and other considerations.

    NOTE*The term, “learner” is used throughout this post for readability and inclusion. This information is relevant for students, patients, children and/or adults of all ages and stages or whomever could benefit from these resources. The term “they” is used instead of he/she to be inclusive.

    • References: Mathiowetz V, Weber K, Kashman N, Volland G. Adult Norms for the Nine Hole Peg Test of Finger Dexterity. The Occupational Therapy Journal of Research. 1985;5:24-33

    Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.

    Check out the seasonal Fine Motor Kits that kids love:

    Or, grab one of our themed Fine Motor Kits to target skills with fun themes:

    Want access to all of these kits…and more being added each month? Join The OT Toolbox Member’s Club!

    Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.