Are you concerned your child appear clumsy or uncoordinated? Do they find it difficult to learn new skills or often repeat the same mistakes? Do they struggle to get ready for school on time, have difficulty following multi-step instructions or just can’t seem to get their ideas written down on to paper? If you answered “yes” to any of these questions, your child may be experiencing challenges with praxis.
I recently attended a two-day course by Lisa Scott which explored DCD (Developmental Coordination Disorder), Dyspraxia and the role of Occupational Therapy.
What is praxis?
Praxis is the ability to come up with an idea, generate a motor plan (sequence of steps required to carry out the task) and then execute the movement. Put simply, it is knowing what to do and how to do it. Praxis is important as it enables a child to complete every day activities such as playing, dressing, eating, and engaging in school tasks such as writing, drawing and cutting with scissors. Difficulty with praxis is often referred to as dyspraxia.
What is Developmental Coordination Disorder (DCD)?
DCD is a motor impairment (in the absence of another diagnosis) that significantly impacts upon daily activities. The extremities of the body (our arms and legs) insufficiently process sensory input regarding movement and touch. This occurs in combination with difficulty planning, sequencing and organising motor movements. Children who have difficulties with praxis or DCD may still be able to complete every day activities, although they may present as clumsy or awkward.
How do difficulties with praxis occur?
In order to plan and sequence effectively, there are many components and underlying skills a child must have developed. These include:
- Muscle strength
- Motor control (the brain’s ability to activate the muscles in a smooth, precise way)
- Motor learning (the ability to obtain a new skill through practise)
- Postural control
- Sensory processing (the brain’s ability to correctly interpret information from our movement and touch centres)
- Body awareness
- Feedback and feed-forward skills (the ability to make small adjustments to correct movements and predict where the body needs to be positioned at a precise time)
- Problem solving
- Executive functioning skills
If any of these skills are underdeveloped, then challenges with planning and sequencing can occur, especially for more complex and multi-step activities such as using monkey bars, kicking, throwing, catching a ball, swimming or riding a bicycle.
Children with praxis difficulties are often very aware that they are not as competent as their peers and quickly learn to avoid engaging activities that challenge them. This can often lead to challenges with behaviour and may even lead to bullying from their peers.
How can I help my child develop their praxis skills?
If your child is experiencing challenges with praxis, there are many strategies that can be introduced to assist with the completion of more complex tasks. A few ideas to get you started:
- Be explicit and break down tasks into smaller steps:
- Use a “first- then” strategy (e.g. first get your lunch box and then put it in your bag).
- Count off steps on your fingers (e.g. first get dressed, 2nd clean your teeth and 3rd pack your bag).
- Use a visual picture sequence or checklist to assist your child to stay on track.
- Remind your child to remember what happened last time they attempted the task and discuss what they might do the same or differently this time. A cognitive strategy like Goal, Plan, Do, Check can assist:
- Goal- what do they want to do?
- Plan- how are they going to do it?
- Do- give it a try
- Check- see if they reached their goal, if they did keep the plan the same for next time, if not, what could they try doing instead?
- When learning new motor skills:
- It may be necessary to physically guide your child through the movement so that their muscles can feel what to do.
- Use a chant or verbal prompt to remind your child how to position their body or the sequence of movements.
- Observe others completing the task or use a mirror so they can see how their body is positioned.
- Once your child can complete the basic movement repetition is key to work towards mastery.
If you are concerned that your child is experiencing challenges with Praxis, please do not hesitate to contact myself, or one of our other therapists, to discuss their challenges further. Occupational Therapy can improve your child’s confidence in fine and gross motor skills, enhance their self esteem, develop their self care skills and enable them to demonstrate their true academic ability.