Does your child have difficulties coming up with a plan for what they want to do, figuring out how they are going to do it, and then carrying out the task? If so, concerns with praxis may be a contributing factor. Praxis is complex and multi-step process that we often overlook, as it typically occurs on a sub-conscious level.

What is Praxis?

Praxis refers to the neurological process through which we plan, sequence, and complete the motor tasks we want to undertake. It can be through of as the way cognition directs movement actions. The planning and sequencing required for praxis are critical for completing everyday tasks such as walking, learning new routines, dressing, and even eating. For children experiencing difficulties with praxis, learning new movement patterns can be especially tricky. Challenges with praxis are referred to as apraxia or dyspraxia. These terms are often used interchangeably; however, dyspraxia is typically used to describe difficulties with planning and sequencing that are largely considered developmental.

The Four Elements of Praxis:

Learning new movement patterns is complex and involves many steps. The four elements of praxis are as follows:

• Ideation: This involves your child generating an idea for what they want to do. For example, your child may see a bike and decide that his or her plan is to get on the bike to go for a ride.
• Motor Planning: Motor planning involves your child figuring out how his or her body is going to carry out the plan. For example, your child may plan to stand on one foot, lift one leg, and swing it over the bike in order to mount it.
• Execution: This refers to the body successfully or unsuccessfully carrying out the movement plan. For example, was your child able to successfully get on the bike, fall over, or get on backwards?
• Feedback/Adaptation: This element of praxis involves your child reflecting on the feedback from the attempt in order to make changes in subsequent trials. For example, if your child got on the bike backwards, feedback/adaptation would involve your child facing the other way before attempting to mount the bike during his or her next try.

What Do Difficulties with Praxis Look Like?

Children with dyspraxia may:

• Appear to struggle with coordination or look clumsy.
• Require more practice than their peers to learn new movement tasks.
• Seem to struggle with sports.
• Demonstrate difficulty following multi-step directions.
• Experience low self-confidence when comparing themselves to peers.
• Benefit from frequent hand-over-hand assistance when learning new tasks.
• Appear to be disorganized.
• Seem to demonstrate difficulty initiating tasks or knowing what to do with novel objects.
• Demonstrate delays in developmental milestones such as crawling or walking.

What Is Required for Successful Motor Learning?

A variety of building blocks are required for successful planning, sequencing, and execution of motor tasks. Muscular strength, coordination, postural control, and body awareness all play a role in learning non-habitual movements. Moreover, sensory processing, or the ability to register, interpret, and respond to environmental stimuli affects praxis. Executive functioning, or the higher-level reasoning and organizational skills, additionally affect your child’s ability to plan for and problem-solve issues that may arise during trial and error. A skilled occupational therapist can help target where in the process your child may be struggling and implement a treatment plan for improved motor planning and sequencing skills.

Questions or concerns?

If you have questions or concerns about your child’s planning and sequencing of movements, please contact us at info@playworkschicago.com or 773-332-9439.

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

Biel, L., & Peske, N. (2009). Raising a sensory smart child: The definitive handbook for helping your child with sensory processing issues. London, England: Penguin Books, Ltd.

Case-Smith, J., & Clifford O’Brien, J. (2015). Occupational therapy for children and adolescents (7th ed.). Canada: Mosby, Inc.

Photo credit: Photo by Jordan Sanchez on Unsplash.