Hi, I am an occupational therapist working in schools. I have a new referral for an 11 year old boy in sixth grade. He is a smart boy, but has a lot of difficulty with visual motor skills. He has the foundational skills, but not age appropriate. He exhibits the following, which makes me think he has an unidentified medical issue: double vision out of the left eye, awkward gait, low tone (tongue frequently out of mouth and mouth almost always open), writes illegibly and frequently in a downward cone shape.