What’s So Fine About Fine Motor Coordination?

Posted on

Do you remember back when you first learned to zip up your own jacket? How about tie your shoes? Write your name for the first time? Color carefully to stay inside the lines? You may not have known it then, but as a child you built many of the fine motor coordination skills you still use every day. When you think of “coordination” you might think of playing sports or swimming, and you would be right! However, when we talk about fine motor skills, we also use the word “coordination” to describe how many different muscles in your hands are working together to accomplish the smallest of movements.

Fine motor coordination involves learning many different skills simultaneously in order to have more control and precision over tools or objects in order to be accurate. These skills include having strength in the small muscles within your hand and fingers, developing a good grasp on tools, moving items around your hand without dropping them, and developing precise targeting. As your child practices these skills, he/she will refine these skills to help learn the foundational skills in many different areas of development. In general, large motor skills (stability of the head, core, controlled limb movements), become more consistently accurate before fine motor skills.

What skills should my child have now?

  • Around 12 months: Pulling off socks, starts to finger feed self with small table foods, can use a spoon to dip, grasps objects of different sizes, uses their whole hand to grasp around writing utensils, places and releases small objects down on a flat surface
  • Around 24 months: Pulling off untied shoes, can use a fork to pierce food, and a spoon efficiently to transfer food, shows an interest in scissors but may not be able to open and close them with one hand, may use a pronated (thumb side of hand down) grasp on writing utensils, they are starting to pick up small items and tuck them into their palm, they are starting to place items from the inside of their palm down by passing them to the finger tips, they consistently rotate items 90 degrees using just their finger pads (such as when taking the top off a small twist top jar)
  • Around 36 months: Unbuttoning large buttons on a jacket, pulling on socks with some help, can open and close scissors, and snip through paper, may continue to use a pronated (thumb side of hand down) grasp on writing utensils
  • Around 3rd birthday: Putting shoes with Velcro fasteners, putting on socks, zipping and unzipping a jacket (help putting both sides together at bottom), buttons large buttons on a jacket, starts to use scissors to cut through paper, over the next year practices pushing scissors forward to cut on a line, starts using a three-finger grasp that is looser and their arms and shoulder move lots when coloring
  • Around 4th birthday: Able to put together jackets that have a snap or hook fastener, some snaps on pants, zipping jacket independently, puts on shoes (needs help with tying laces), can put a belt through loops, pushes scissors to cut out simple shapes, over the next year starts cutting curved lines and circles, your child continues to get more efficient and accurate with drawing with their three-finger grasp, they are able to separate two pieces of paper by rubbing their fingers together
  • Around 5th birthday: Can tie knots, improved accuracy with scissors, the child uses a dynamic grasp (three fingers on utensil near the tip, their shoulder/arm are stable, their fingers and wrist are controlling movements, they are more accurate and efficient with this grasp, they can adjust their grasp on a pencil by moving it between their fingers
  • Around 6th birthday: Can tie a bow, independently manage shoes, other clothing fasteners, can cut more complex figures, they can flip a pencil around to reach the eraser without picking up and moving the pencil, they can pick up small items sequentially while holding other small items in their hands

My child isn’t ready to tie their shoes or write yet; why do these skills matter now?

Fine motor coordination skills are built over a long period of time, and gradually get more complex as a child gets older. Foundational skills in this area, such as grasping tools and moving small items from the palm to tips of the fingers, are key for later important skills such as writing, typing, cutting, money management, using utensils to eat, tying shoes, and managing fasteners on clothing. A child may become successful and efficient with navigating these skills as they continue to develop other skills through play and participation in daily routines.

Why do occupational therapists work on these skills?

Occupational therapists focus on these skills because they are a part of our daily living skills, from putting toothpaste on our toothbrush, to getting dressed, to participating in school, and feeding ourselves! Children use their fine motor coordination skills during daily living activities, in education, and in play, all areas which are covered by the domain of occupational therapy! During an occupational therapy evaluation, a therapist would look more in depth at your child’s fine motor coordination skills for their age.

What can I do?

  • Play games while picking up small items with kitchen tongs, chopsticks attached at the top with a rubber band and paper, or a straw bent in half to form tongs
  • Snap/button art boards
  • Puzzles with different snaps, buckles, locks to open
  • Read books with flaps to lift up to reveal pictures below
  • Practice tearing paper with your child, crumpling it up between your fingers, and using it in an art project, such as gluing it onto a snowman outline to make it 3-D.
  • Make a paper cup lantern by pushing a paper clip through the side of the cup and place an LED tea light inside
  • String beads or pasta on spaghetti noodles, string, or pipe cleaners
  • Make PlayDoh with salt, flour, and cream of tartar. Roll it into snakes, small balls, build tiny snowmen
  • Let your child practice opening items in the house for food consumption, such as bags of chips, twist off applesauce pouches/water bottles,
  • Tape small animals to a baking sheet and practice pulling the small pieces of tape off
  • Cut a slot in the top of an oats container. Have your child practice placing popsicle sticks in the slot; recreate this activity with Q-tips and a plastic lid with a straw hole, sort coins into different piggy banks
  • Stretch rubber bands around the outside of a small jar
  • Pull pom poms or other small items out of a kitchen whisk
  • Decorate cookies and allow your child to pick up the small sprinkles and push them into the dough
  • Let your child have as much practice as possible with fasteners (snaps, buttons, zippers, and shoe tying)
  • Cut through different layers/thicknesses of paper (tissue paper, paper, paper plates, cardboard)
  • Increase your child’s opportunities to practice writing outside of school by having the child write the score of a game, write letters to family members, write the list of items needed at the store
  • Use a stylus if your child plays games on a device. There are apps to practice coordination while using a stylus such as: iTrace, LetterSchool, Dexteria Jr, Writing Wizard, Trace it/Try it
  • Paint using the ends of Q-tips to make small dots on paper to draw fireworks
  • When recycling boxes, have your child cut the box instead of breaking it down for extra scissor practice
  • Allow your child to practice peeling fruit, picking the stems off the ends of beans, etc.
  • Hide toys in small jars and bottles, and have the child practice getting them out by twisting open the top

Questions or concerns?

If you have questions or concerns about your child’s fine motor coordination, please contact us at info@playworkschicago.com of 773-332-9439

Caroline Stevens, MS, OTR/L
Occupational Therapist

References: Fleming-Castaldy, Rita. (2019). National occupational therapy certification exam review and study guide. 8thedition. Therapyed.

Photo Credit: Markus Spiske via unsplash.com

Valentine’s Craft Ideas!

Posted on

Valentine’s day is approaching, and love is in the air! Here are a few fun craft ideas for you to make with your littles while working on their language development!

Heart Man:

Supplies:

Red paper, white cardboard, black marker, googly eyes, scissors, glue

Instructions:

  1. Cut out one large heart and four small hearts from the red paper.
  2. Fold the white strips of paper like an accordion. Glue two strips for arms and two strips for legs.
  3. Create a face for your heart man! Glue two googly eyes and draw a mouth!

How to target language?

  1. Expressive language: Talk about body parts when making/gluing the eyes, mouth, legs, and arms.
  2. Receptive language: Following multi-step directions (e.g., “First, put on eyes, then draw mouth”).

Valentine Mailbox

Supplies:

Tissue box, wrapping paper, stickers, markers, candy and/or envelopes

Instructions:

  1. Cover the empty tissue box with wrapping paper.
  2. Decorate your tissue box with stickers, markers, pom poms, etc. Get creative!
  3. Deliver candy and/or Valentine’s cards to other mailboxes!

How to target language?

  1. Expressive language: practice “mail”-related vocabulary, such as card, send, mailman, mailbox, write, letter, and stamp
  2. Receptive language: understanding pronouns (e.g., “put the candy in her mailbox” or “put a card in theirmailbox”)
  3. Pragmatic language: role play social exchanges as you deliver letters to loved ones

Friendship Necklaces:

Supplies:

Craft foam, yarn, scissors, hole punch, beads

Instructions:

  1. Cut a small heart out of the craft foam.
  2. Punch a small hole into the top center of the heart.
  3. Thread a 2-3-foot piece of yarn through the hole.
  4. Add the beads of your choice and tie a knot on the top!

How to target language?

  1. Expressive language: using prepositions (e.g., “on the string,” “in the heart”)
  2. Receptive language: following directions to put different beads on the string

Jill Teitelbaum, MS, CCC-SLP
Speech-Language Pathologist

Activities for All: December Family-Friendly Events

Posted on

Sensitive Santa

Time: Sunday, December 8 from 9:00am-11:00am.

Location: Lincolnwood Town Center

Cost: Free

About: Visiting Santa is a winter tradition for many families. However, if your child has sensory sensitivities, it can be a difficult experience. Opening before regularly scheduled activities begin, Sensitive Santa allows for a sensory-friendly environment so that all can enjoy meeting Santa.

Play for All

Time: Saturday, December 14th from 9:00am to 10:00am

Location: Chicago Children’s Museum

Cost: Free to the first 100 visitors to register

About: On the second Saturday of every month, the Chicago Children’s Museum opens one hour early and invites children and families with disabilities to come explore the museum in a quieter, less stimulating environment.

Sensory Friendly Beatrix Potter Tea

Time: Sunday, December 15th at 11:30am and 2:30pm

Location: The Station, 100 S. Racine Ave. Chicago, IL. 60607

Cost: $45

About: This puppet show, staring Peter Rabbit and his animal friends, is performed in a sensory-friendly environment. Guests are encouraged to dress in their holiday best, or wear whatever is most comfortable for them. Cookies and hot cocoa will be served following the show.

Sensory Friendly Performance of A Christmas Carol

Time: Monday, December 23rd at 2:00pm

Location: Goodman Theatre

Cost: Tickets start at $15

About: The Goodman Theater is putting on a sensory-friendly performance of A Christmas Carol. The sensory-friendly accommodations include lower sound level, lower lighting level, small crowds, designated quiet areas, and a space for movement breaks.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Cooper Le on Unsplash

A Set Routine + Family Meals = First Steps to Mealtime Success

Posted on

 

 

 

 

 

 

 

Mealtime can be stressful, often with your child challenging your attempts to have them try new foods. Some days, your child may not go to the table or sit in their chair long enough to even offer new foods! However, establishing a set routine and regular meals may be the first steps to mealtime success.

What can a mealtime routine look like?

Why is mealtime so challenging for my child? And why is a routine and family meals so important?

Eating is one of the most challenging sensory activities for children. When we eat, all eight senses are working and integrating eight new pieces of information. The properties of the food change as we eat, for instance, as part of our five senses, the taste and smell changes as we chew. Additionally, our sense for self-movement and body position is working to use different amounts of jaw pressure. Our sense for balance and spatial orientation is working to re-adjust our balance as we chew. Lastly, our sense of the internal state of the body is being put to the test by requiring that we track the changes to our stretch receptors (on the stomach) to the changes to our appetite. Processing each of those sensory changes can be and is difficult for many children. Furthermore, eating is a multisensory experience; therefore, we need to help children’s sensory systems to be regulated before, during, and after meals to increase their feeding skills and sensory tolerance for new foods.

What can I do?

If your child is demonstrating some behaviors before or during mealtime and/or is a picky eater/problem feeder, consider contacting one of our speech-language pathologist or occupational therapists, who can provide your family with helpful tips and tricks to make mealtime less stressful and more fun!

Questions or concerns?

If you have questions or concerns about your child’s mealtime routine or feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Jaclyn Donahue MS, CCC-SLP
Speech-Language Pathologist

Reference: Toomey, Kay A.. 2008/2010. Family Meals.

Kay A. Toomey, Ph.D. & Lindsay Beckerman, OTR/L., 2016. Explanation of The Role of Sensory Therapy In Advancing Feeding Goas.

Photo Credit: Jennifer Murray and amsw photography via pexels.com

Blankets, Vests, and Lap Pads…Oh My! A Guide to Weighted Objects

Posted on

What are weighted objects, and how do they work?

In the context of pediatric therapy, a “weighted object” refers to any object or item that is worn, placed on, or carried by the body to elicit a desired sensory response. These objects work by providing deep pressure, or distributed weight over parts of the body through cuddling, hugging, squeezing, and holding, to regulate the nervous system and calm the body. Additional input is processed by the proprioceptive system, which provides information about the position and movements of our muscles and joints, to increase understanding and awareness of where our body is in space.

What are some potential benefits of using weighted objects?
Potential benefits of using weighted objects include:

1. Better attention and focus: weighted objects are often calming for children that seek opportunities for movement and deep pressure and for those that have a difficult time sitting still and attending to structured activities. As weighted objects provide the input these children are seeking, their bodies become more calm and organized, and they are better able to focus and stay on-task, especially in the classroom environment.

2. Less anxiety and improved sleep: the calming effects of weighted objects on the nervous system help to reduce sympathetic arousal, or the fight-or-flight response, and promote feelings of comfort and relaxation. For these reasons, use of weighted blankets at night has also been found to help individuals fall asleep more easily as well as improve overall quality of sleep throughout the night.

3. Smoother transitions between daily routines and activities: when children experience increased regulation and sensory organization due to the effects of weighted objects, they often feel more “in control” of their bodies and are better equipped to handle transitions and changes in their routines, leading to fewer or less intense tantrums and emotional outbursts.

What are examples of weighted objects and where can I find them?

Common examples of weighted objects include:
• Vests
• Blankets
• Lap pads
• Backpacks
• Stuffed animals

Depending on your child’s needs, weighted objects come in a variety of shapes and sizes and can be worn or held during specific activities (vest; lap pad; stuffed animal) to improve attention, carried between environments (backpack, stuffed animal) to improve smooth transitions, and placed on the body (blanket) during quiet activities, such as reading books, riding in the car, and when going to sleep, to provide comfort, reduce anxiety, and promote a calm, organized state of arousal.

Many weighted objects are available for purchase from online and in-store retailers. Weighted objects may also be created by adding weight to items already found in your home. For example, filling a long tube sock with dry rice or beans and tying off the end securely or adding these materials to one of your child’s favorite stuffed toys may work well for use as a lap pad or weighted stuffed animal. Similarly, adding books or bottles of water to your child’s backpack makes for an easy weighted adjustment during transitions to and from school. Research suggests that each object should be about 10% of the user’s body weight plus one pound to promote optimal effects, so be sure to consult with a trained therapist or doctor before trialing weighted objects with your child at home.

Do weighted objects work for every child?
While research suggests that weighted objects have several positive benefits, they may not be appropriate or suitable for every child. Objects are often most effective when implemented with other sensory strategies and should be used only as directed by your child’s occupational therapist or doctor to best target their individualized needs and ensure safe and appropriate application.

Questions or concerns?
If you have questions or concerns about whether your child may benefit from using a weighted object, please contact us at info@playworkschicago.com or 773-332-9439.

Caitlin Chociej, MS, OTR/L
Occupational Therapist

References:

Chen, H., Yang, H., Chi, H., Chen, H. (2013). Physiological Effects of Deep Touch Pressure on Anxiety Alleviation: The Weighted Blanket Approach. Journal of Medical and Biological Engineering, 33(5), 463-470. doi:10.5405/jmbe.1043

Vandenberg, N. L. (2001). The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties. American Journal of Occupational Therapy, 55(6), 621–628. doi: 10.5014/ajot.55.6.621

Photo Credit: Naomi Shi via Pexels

Employee Spotlight: Kelsey Martin, CCC-SLP

Posted on

What do you love most about working for PlayWorks Therapy?

My favorite part about working for PlayWorks Therapy is being surrounded by such an amazing support system. I truly view all of my coworkers at PlayWorks not only as colleagues, but friends as well! I have grown so much as a therapist due to the collaborative environment that this company creates, and I especially love how easy it is to bounce ideas off of one another to provide our clients with the best therapy possible.

What is your favorite children’s book?

My favorite children’s book would have to be “If You Give a Mouse a Cookie.” I adored this book as a child and appreciate it now as a therapist because the illustrations and plot allow for tons of language opportunities!

What do you enjoy most about living in Chicago?

My favorite part about living in Chicago is having so many family and friends nearby. I grew up in a suburb outside of the city and earned both of my degrees in the Midwest, so many of the people that I love most happen to be here too! I also love the fact that there is always something to do in Chicago, whether it be a sporting event, concert, outdoor activity by the lake, or a street festival to check out!

What is your favorite childhood memory?

It’s hard to pick just one, but I hold my memories of Christmas Eve at my grandparents’ house are very close to my heart. My entire extended family is OBSESSED with the holidays and spreading Christmas cheer, so I vividly remember how excited I always was to spend time with my grandparents, aunts and uncles, cousins, and sisters singing Christmas songs, wearing matching pajamas, and of course, eating lots of cookies. It’s been pretty amazing to see how our traditions have continued over the years as new family members have been welcomed, too!

Mountain or beach vacation?

I think I’d have to say both… I would probably pick the beach in the summer and mountains in the winter, as I love soaking up the sun and being by the water, but also am a huge fan of skiing!

Share a proud “therapy moment” with one of your clients.

One of my absolute favorite parts about working with children is that every accomplishment, no matter how big or small, is celebrated and cherished. One moment that I remember specifically was when one of my clients on the autism spectrum looked me directly in the eye and said, “bye-bye Kelsey!” Not only had he never said my name before, but I was so unbelievably proud to see this little guy initiate such an awesome social interaction!

What is your hometown?

Prospect Heights, Illinois.

What do you like to do in your free time?

In my free time, I love to spend time with my friends and family, run along the lake or attend a yoga class, cross restaurants off my extensive bucket list of places to try, and support all of my favorite Chicago sports teams! I also love to sing and play guitar, as well as sing karaoke with friends on the weekend!

Fun fact about yourself?

Speaking of singing, I once sang the National Anthem to open a Bret Michaels concert in 2013! I got to hang out with Bret for a little after the show and take some pictures, too!

Favorite therapy toy?

My favorite therapy toy, without a doubt, is my sock monkey ball popper. Not only do kids of all ages find it extremely entertaining, but it’s an amazing facilitator for language, such as asking for help and more, working on directions (up vs. down), working on body parts, and more!

Kelsey Martin, MS, CCC-SLP
Speech-Language Pathologist

Fall Activities for All: November Family-Friendly Events

Posted on

Family Nature Days at Welles

Time: Saturday, Novemeber 2, 2019, from 10:00am to 12:00pm

Location: Welles Park (2333 W. Sunnyside Ave., Chicago, IL 60625)

Cost: Free

About: Family Nature day is an event for families with children of all ages. The Lincoln Park Zoo and Park District partnered up for this nature-based event which includes family scavenger hunts, bird watching, fort building, and more! In addition, the Lincoln Park Zoo staff will lead a number of educational activities.

 

Play for All

Time: Saturday, November 9, 2019 from 9:00am-10:00am

Location: Chicago Children’s Museum

Cost: Free to the first 100 visitors to register

About: On the second Saturday of every month, the Chicago Children’s Museum opens one hour early and invites children and families with disabilities to come explore the museum in a quieter, less stimulating environment.

 

A Christmas Carol: Sensory-Friendly Performance

Time: Saturday, November 23, 2019 at 2:00pm (Doors open at 1:30pm)

Location: Goodman Theatre

Cost: Tickets start at $15

About: The Goodman Theatre is putting on a sensory-friendly performance of A Christmas Carol. The sensory-friendly accommodations include lower sound level, lower lighting level, small crowds, designated quiet areas, and space for movement breaks, among others.

 

Chicago Thanksgiving Parade

Time: Thursday, November 28, 2019 at 8:00-11:00am

Location: State Street from Congress to Randolph

Cost: Free

About: Enjoy Thanksgiving morning with your family by coming out to the Chicago Thanksgiving Parade. The parade will include performances, marching bands, giant inflatable balloons, and much more!

Claire Hacker MS, CCC-SLP
Speech Language Pathologist

Photo Credit: happyedwards77 via Pixabay

Employee Spotlight: Stephanie Wroblewski, MSW, LCSW

Posted on

What do you love most about working for PlayWorks Therapy?

My favorite thing about working at PlayWorks is the welcoming environment. I love that the clinic was created in a way to promote collaboration and connection between families, staff, and therapists. Every time I walk into the clinic, I feel like I am entering the center of a special community, where everyone is focused and committed towards enhancing the lives of all children.

What is your favorite children’s book?

Instead of choosing just one book I will have to choose a series, and that is Junie B. Jones! I still remember reading my first Junie B. Jones book (when I was in early elementary school), and instantly falling in love with her character. As a child I was eager to purchase the latest book in the series, and I was constantly reading (and re-reading) each and every one.

What do you enjoy most about living in Chicago?

It is hard for me to choose just one thing I enjoy most about living in Chicago, but when I think of how much I love this city, the first thing that comes to mind is the lake. Through all seasons, I really enjoy walking/biking down the lakeshore path, waking up early to enjoy a sunrise over the water, or just taking in the beautiful waters and seemingly endless horizon.

What is your favorite childhood memory?

Again I will choose a “series” of memories instead of just choosing one: my family’s yearly vacation to Wisconsin Dells. Each summer my entire family (grandparents, aunts, uncles, cousins, etc.) drives to Wisconsin Dells to spend a week together enjoying picnics, bonfires, and all sorts of summertime activities. The tradition began a few years before I was born and continues to this day, even as our family has nearly tripled in size!

Would you rather a mountain or beach vacation?

Mountains. I will definitely choose mountains over the beach every time! I love the feel of the crisp mountain air and the panoramic views from the top of a high peak.

Share a proud “therapy moment” with one of your clients.

There are so many successes I am lucky enough to experience with my clients, both big and small, and I think it is very important to acknowledge and celebrate each and every one. A few weeks ago one of the young boys I work with was having a difficult time leaving the sensory gym in order to return to our therapy room and resume work for the day. Before I was even able to suggest some strategies he can use to calm down he stopped shouting, took a big deep breath, and told me exactly how he was feeling. This was the first time this particular child independently used a calming strategy in my presence, and I was so proud of him for doing so!

What is your hometown?

I grew up in Western Springs, Illinois.

What do you like to do in your free time?

My absolute favorite thing to do in my free time is travel! I also love to read, spend time with my family, and do just about anything outside.

What is your favorite therapy toy?

Currently my favorite therapy toy is Mr. Potato Head. I love how this toy allows for endless possibilities when it comes to creativity and expression.

Share a fun fact about yourself.

I have a goofy and energetic English bulldog named Filomena.

Stephanie Wroblewski, LCSW
Licensed Clinical Social Worker

Bilingualism: Can a child with language delays learn two languages?

Posted on

As a speech-language pathologist and Early Intervention provider, I frequently work with families who speak more than one language. While there is plenty of research on the benefits of bilingualism on children’s language development and cognitive skills, there is often confusion regarding the impact of two languages on delayed language learners. This blog aims to address frequently asked questions by bilingual families to guide language use inside and out of the home.

Question: My child has been exposed to two languages since birth. Has this caused his/her language delay?
Answer: Bilingualism itself will NOT cause a language delay. In fact, research shows that bilingualism may lead to long-term advantages, such as increasing vocabulary and problem solving skills. Birth-to-three years of age is the critical period for language acquisition, meaning that this is the easiest time in childhood for children to learn a second language.

Question: My child has a language delay. I’m afraid that a second language will confuse him/her. Should I stop speaking a second language to my child?
Answer: Definitely not! It is encouraged that bilingual families continue to speak both languages to their child and that this is carried over across settings (e.g., school, playgroups, etc.). Children with language delays can learn to speak two languages if given the appropriate supports and opportunities.

Question: My child is two years old and not yet speaking. He’s exposed to both English and our native language at home, so this is okay, right?
Answer: While children simultaneously exposed to two languages may say their first words a bit later than monolingual children, they are still expected to learn language at roughly the same rate. If your child is two years old and not yet producing words, he or she should be referred for a full speech and language evaluation.

Question: How can I support bilingual language acquisition in my child?
Answer: Some families choose to have one parent solely speak one language and have the other parent solely speak the other language. Some families decide to have parents speak both languages and use them interchangeably. Either way is fine, but it is important to consider what feels the most natural for you and your family!

What’s the takeaway?
There is NO scientific evidence that living in a bilingual household will negatively impact the language development of children. Furthermore, children with language delays CAN learn two languages with consistent, rich exposure to both languages.

Questions or concerns?
If you have questions or concerns about the impact of two languages on your child, please contact us at info@playworkschicago.com or 773-332-9439.

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

References:

Lowry, L., & Speech, H. C. (2012). Can children with language impairments learn two languages?. The Hanen Centre.

Photo Credit: 4dgraphic via unsplash.com

Planning and Sequencing for Success: A Guide to Understanding Praxis

Posted on

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.