An OT assessment may mention that your child has poor praxis or dyspraxia. Put simply, the therapist may have told you that your child has difficulties with motor planning (planning movements) but motor planning is only the tip of the iceberg.
Praxis is latin for ‘doing, acting’ but these two simple words do not give justice to the complex series of events that one’s body must coordinate in order to produce praxis. Praxis is the neurological process by which cognition directs motor action (Ayres, 1985). Put simply, it involves planning what to do and how to do it. In order to know what to do, we must first conceive the idea of what to do (ideation), then plan how we are going to do it (motor organisation, or motor planning), perform the movement correctly (execution) and then be able to reflect on feedback so we can adapt our movements in the future (feedback and adaptation).
Each of these four areas are quite complex within themselves. For example, in order to be able to plan or organise movements, we need to have a good sense of where our body is in space (body awareness), we need to have the cognitive ability to understand our actions and objects in the environment, we need to have good bilateral coordination in order to execute movements smoothly and we need problem solving skills to help us correct/adapt our movements in the future.
So praxis is a complex, multi-step process that we often take for granted because it happens automatically (on an sub-conscious level). But how would we know if our children are having difficulties with praxis? Below are some examples: - Slow to achieve developmental milestones - Avoid tasks requiring good manual dexterity (eg. puzzles, intricate construction or fine motor tasks such as writing and cutting) - Clumsiness (eg. constantly bumping into things or falling over) - Messy eaters (may not be aware of food around face and continues to feed with fingers) - Difficulty riding a bike - Lack of or limited imaginative play - Difficulties coordinating both hands together (eg. managing fastenings) - Difficulties during physical education - HIgh levels of movement, limited concentration - Slow to complete class work - Problems with self-help skills such as using cutlery, dressing or tying shoelaces - Difficulty forming relationships with peers, sometimes preferring company of adults
Occupational Therapy For Children offers individualised treatment options that can help your child overcome praxis difficulties. If you think that your child struggles with praxis, you can contact an OT for an assessment or discuss it with your GP.