Packing the car so the cases fit. Following the picture that came with a new shelf. Setting the table the way it looked last time, or finding the way back to a hospital ward along corridors that all look alike. Each of these leans on visual spatial skill: judging where things are in relation to each other, how shapes fit together, and how something will look once it is turned. After a stroke, a brain injury, or another neurological change, these everyday jobs can become slow and effortful, even when eyesight itself is fine.
This page is a practical guide to visual spatial activities for adults, and it starts with block design, the hands-on task that brings most of those skills together in one activity. Download a free printable set of block tiles and four pattern cards below, no email required. Then find ten ways to use block design at home or in a session, how to make a set of blocks without buying any, and other visual spatial activities, from mental rotation to figure-ground, each with a free page to try.
Download the free printable blocks and pattern cards
Download the PDFWant more pages like this? Kohs Block Design Pattern Cards (50) $5.49 See the full set
Page 1 is a sheet of 30 cut-out block tiles, each 1.4 inches square: 10 red, 10 white, and 10 split corner to corner into a red and a white triangle. Page 2 has cards A-01 and A-02 (level 1, 2x2 designs) and B-01 and B-02 (level 2, 3x3 designs with the block edges drawn in) from the Kohs Block Design Pattern Cards set, on one US Letter sheet in landscape. Free for personal, classroom, and session use.
- Tiles: 30, enough for any 3x3 design
- Designs: 4, two 2x2 and two 3x3
- Levels: 1 and 2 of 3
- Timing: untimed
- Paper: US Letter, card stock for the tiles
What are visual spatial activities?
Visual spatial activities ask a person to work out where things are and how they fit: the position of one shape against another, the way parts join into a whole, or how an object will look after a turn. The word visuospatial means the same thing and turns up in therapy notes and research. The activities can be hands-on, like building a pattern, or on paper, like choosing which figure has been rotated. Most of them draw on four related skills:
Spatial relations
Judging where one part sits against another: above, beside, a quarter turn to the left. In block design, every block has to land in the right square of the grid.
Mental rotation
Picturing how a shape will look after it turns. A half red, half white face can sit four ways, and only one matches the card.
Seeing parts in a whole
Breaking a picture into the pieces it is made from. Two half faces on neighboring blocks join into one bigger triangle, so the picture has to be split back into blocks.
Visual construction
Building something with the hands to match a model. Look, choose, turn, place, check: the copy grows one block at a time.
Why start with block design?
Block design puts all four of those skills into one short, concrete task. The person copies a printed pattern with identical blocks, each face red, white, or split corner to corner. The goal is plain to see, and so is the result: the copy either matches the card or it does not, so the person can check their own work without anyone marking it.
It also grades easily. A 2x2 design needs four blocks and a 3x3 design needs nine. Guide lines drawn where the blocks meet make a design easier to split up, and taking them away makes it harder. Because the person builds rather than talks, the task needs very little language. The format has a long history, too: the psychologist Samuel C. Kohs published his block design test in 1920, and block design still appears in standardized testing today. Our guide to the free block design pattern cards covers that history and how the full card set is organized.
Ten ways to use block design
- Copy a pattern card. The classic version: prop the card beside a tray, build the copy next to it, and compare. Start with the 2x2 cards, where four blocks make the whole design.
- Copy a model instead of a picture. Build a design yourself and ask the person to copy it beside yours. Every block edge is visible in a model, so it makes a gentle start for a first session or a hard day.
- Fade the guide lines. Level 2 cards draw the block edges in; level 3 cards leave them out. Moving from one to the other is the clearest step up, because finding the edges becomes part of the task.
- Look, cover, then build. Show a 2x2 card for a slow count of ten, turn it face down, and build from memory. Turn the card back over to check. The same materials now ask for visual memory as well.
- Describe and build. One person holds a card the other cannot see and describes it (“top left, half red, with the red in the bottom corner”). The builder copies it, then the two compare. Swap roles. It practices spatial words as much as spatial skill.
- Build, then draw. After building a design, draw it on a blank grid of squares, shading the red parts. Moving from blocks to pencil shows whether the layout carries over to paper.
- Invent a design to swap. The person makes up a 2x2 or 3x3 pattern and a partner copies it. Talking about why one invented design is harder than another is a natural way into what makes these tasks hard.
- Copy it turned. Once ordinary copies are easy, ask for the design as it would look after a quarter turn to the right, without moving the card. This adds mental rotation and is a real step up, so start with 2x2 designs.
- Use the screen as a pattern generator. The free Block Design tool on our tools site deals new designs every round. Show them on the screen and build them with real blocks or the printable tiles, so the patterns never run out.
- Make it a table game. In a group, give everyone the same card and the same blocks, then set the copies side by side. Differences become something to talk about rather than mistakes to correct.
No blocks? Make a set
The free download starts with a sheet of 30 printable tiles: 10 red, 10 white, and 10 split corner to corner. A 3x3 design never needs more than nine of one kind, so one sheet covers every design in the free cards and in the full set. Print it on card stock if you can, cut along the dashed lines, and keep the printed side up, since the backs are blank. A split tile can be turned to put its red triangle in any of the four corners.
Flat tiles leave out one part of the cube version: finding the right face among six. For that, use red and white pattern cubes made for block design practice, or plain wooden cubes about an inch across, painted or covered with stickers so that each has red faces, white faces, and faces split corner to corner. Two of each is the usual arrangement. Keep a tray or a non-slip mat under the copy so the blocks stay together and the outline stays square.
From easy to harder
Block design steps up in a clear order. These are the stages in our pattern cards and on the screen:
2x2 designs
Four blocks. Level 1 of the card set (10 cards, A-01 to A-10) runs from simple shapes, such as the red house on A-01, to patterns where every block shows a half face.
3x3 designs with block lines
Nine blocks, with thin lines where the edges of each block fall (level 2, 10 cards, B-01 to B-10), so the design can be matched one square at a time.
3x3 designs without lines
Nine blocks and no guide lines (level 3, 30 cards, C-01 to C-30). The person finds the block edges before building, and that is most of the work.
Larger designs on the screen
The Block Design tool also deals designs of 6, 8, 12, and 16 blocks on its Pro settings, past the largest size in the card set.
| What you get | Free download | Full card set |
|---|---|---|
| Pattern designs | 4 | 50 |
| Levels | 1 and 2 | 1, 2, and 3 |
| 3x3 designs without block lines | None | 30 |
| Printable block tiles | 30 | Use the free tiles or pattern cubes |
| How-to-read page | Explained on this page | Included |
| Repeat sessions without reusing a design | One page | Weeks of practice |
More visual spatial activities for adults
Block design is one format among several. These practice the same skills in other ways, and each has a free page to try:
Mental rotation
Choose the figure that shows a shape turned, and spot the mirror image. The free visual spatial worksheets have two rotation pages, and the Mental Rotation tool times every answer.
Figure combination
Add and take away simple line figures in the head, then draw the result. Try the free figure combination worksheet, with its answer key.
Visual closure
Pick the complete picture from one with parts missing. Try the free visual closure worksheets.
Figure-ground
Find a shape hidden among overlapping outlines. Try the free figure-ground worksheets.
Everyday tasks count too, and often matter most to the person: packing a bag or a dishwasher, setting a table to match a photo, folding towels to match the pile, sorting cutlery into a tray, or following a simple floor plan of a building. They bring the same skills into real routines.
Is block design a test?
The format is best known from testing. Kohs used a series of 17 cards, copied with painted cubes, and recorded the completion time and the number of moves. The block design subtests of the Wechsler intelligence scales, the WAIS for adults and the WISC for children, use red and white blocks with their own designs, strict time limits, and norms. Those materials are given and interpreted by trained professionals as one part of a wider evaluation. The tiles and cards on this page borrow only the general idea of copying a pattern with blocks.
Worth knowing: these are practice materials, not the Kohs test, the WAIS or WISC block design subtest, or any other test. The designs are our own, there are no time limits or norms, and nothing here produces a score that can be compared with a population. They are not an assessment and not a substitute for evaluation by a qualified professional. If someone is due to have a cognitive assessment, tell the clinician about any block design practice.
Using it in a session or at home
- Set up a clear table. A tray or non-slip mat for the copy, the card propped beside it, and only the blocks or tiles that design needs within reach.
- Name the faces first. Turn a block or tile over together: solid red, solid white, half and half. Show how a quarter turn moves the red triangle to the next corner.
- Let the person check the copy. Before saying anything, ask them to compare the copy with the card one row at a time. Spotting a mismatch themselves is part of the task.
- Use the same words every time. “Top left”, “quarter turn”, and “red in the corner” are easier to follow when they never change.
- Stop on a success. A few designs that end with a match are worth more than a long session that ends in a struggle. Step back a level when a design turns into guessing.
Prefer a screen? We also offer a free interactive version, Block Design on our tools site, which deals fresh red and white designs every round, drawn like real block design cards with no lines between the blocks. Build each copy on the screen by picking a face and tapping a square, or show the designs on the screen and build them on the table with real blocks or the printable tiles. It records the designs built and the time for each one, and on the screen, the checks used and blocks placed wrong. Nothing to print, free to use.
Who uses visual spatial activities
- Occupational therapists working on visual perception and constructional skills with adults after a stroke or brain injury
- Speech-language pathologists using describe-and-build tasks for spatial language
- Hospital, outpatient, and community programs running hands-on cognitive stimulation groups
- Family members and caregivers looking for practical activities at home
- Adults who want visual spatial practice that was not made for children
The cards on page 2 are four of fifty. The full Kohs Block Design Pattern Cards set has all three levels and a how-to-read page, ready to print and laminate for use with standard red and white pattern cubes or the printable tiles. It is also part of the Entire Shop Mega Bundle. For the paper formats, the Visual Perception Worksheets Bundle collects 70 worksheets of discrimination, figure-ground, closure, and visual spatial practice, and a bound book of block design patterns is listed on our printed workbooks page. The visual perception guide explains how these formats fit together.
These materials support cognitive stimulation and structured practice. They are not medical treatment or an assessment, and no specific therapeutic outcomes are claimed.
