Our body’s ability to conceptualise (think), plan and execute a movement in the correct sequence is called as praxis. Learning a new task and following all its sequential steps happens due to our motor planning ability. It requires person’s attention to highest level.In simple the terms, Praxis is "Doing".
Here brain first learns to hold the spoon then to put it in to the mouth and later banging. All these tasks need attention. More child learns to move his or her body in different directions, better is the motor planning which all happens during foundation years.
Planning involves conscious attention, therefore, praxis is connected to analytical and logical functions.
Different daily chores that we perform without thinking much demand
a lot of attention during childhood learning phase. Putting on clothes, holding knife or spoon, making a cup of coffee, doing laces or ties, time-telling are some of the examples of tasks which a person learns in early years with much focus, concentration and practice, however, once understood and practiced it becomes a neural memory for future times. On repeated practice, this task becomes Motor Skill.
However, a child with poor praxis will have difficulties in processing information, formulating ideas to planning, and execute any task on his own. A child with consistent poor praxis may be diagnosed as be Dyspraxic.
Features like clumsiness, avoidance of motor activities, lethargic behaviour, difficulties in learning new tasks, poor balance and postural control are prominent in children with Dyspraxia.
An occupational therapist plays a vital role in completing the full assessment and planning direct intervention strategies for the child to overcome functional difficulties in day to day activities such as self-care, handwriting, dressing, PE). Encouragement, supervision, and consistent practice are key to teach any tasks, such as tooth brushing. Following all the steps in a sequential manner is important for the child to learn this task.
I got engaged in other tasks and observed him from another corner of a room. He untied the laces with hit and trial method and then stopped.
I asked, “you okay Andrew?”
He politely responded, “what do I need to do now?”
The poor little lad did not have had the idea, to how to take off his shoe from the foot. His brain couldn’t do the planning, sequencing and execution of actions at all. The "doing part" needed for untying laces, pulling off the shoe from feet, and standing was missing.
Climbing and descending stairs needs complex motor planning and children with poor skill show anxiety to use staircase or escalators. Fear of falling or tripping makes them avoid stairway. Doing practice on climber frames is one of the ways to reduce anxiety. Making staircase of different size mattresses can be safe, appropriate and fun ways.
RELATIONSHIP BETWEEN MOTOR PLANNING AND BRAIN'S FUNCTIONING
and its relationship to each other.
In above, face wiping example, the brain sends messages to elbow so that specific muscles can contract and relax to bend elbow joint and hand can go up to face to clean the dirt. Related hand muscles also contract and relax.
This is the reason children with Dyspraxia are disorganised, forgetful and clumsy. Their brain is not able to do motor planning causing them not being able to judge speed, weight rate, the direction of any object or task.
Moreover, these maps also contain memories related to environment such as gravity. For example, while sitting on swing we know our upper body is on swing however legs are swinging. Another common example is while swimming whether our body is in deep or shallow water. In both the situations, body maps help the brain to plan the movements according to the state of the body.
In conclusion, it is essential to understand child's difficulty zone, create child-friendly strategies and provide sensory, playful opportunities which involve her imagination abilities, creativity and motor planning skills.
INTERVENTION STRATEGIES FOR DYSPRAXIA:
A. HANDWRITING STRATEGIES: -Handwriting is an important functional task for school-aged children and the primary way to express thoughts, ideas and knowledge, and emotions.
Here are some significant handwriting strategies with proprioceptive input.
B. SELF-CARE STRATEGIES:For the competent dressing skills at the age of 5-6 years onwards, a
reasonable sense of proprioception and body awareness are essential features along with an adequate sense of touch (tactile feedback).
It will be better to start with warm up exercises such as push- pull games, bouncing on the therapy ball, jumping on a trampoline, rolling on a mattress to increase sensory feedback.
Use bathroom checklists or visual checklists for ease.
C. OT APPROVED GAMES FOR MOTOR PLANNING:
D. BALANCING ACTIVITES:
- Obstacle Courses.
- Walking along a narrow beam or line marked on the ground – forwards, backward, sideways
- Walking on different surfaces such as grass, concrete, foam, mattress.
- Doing activities on balancing board or equilibrium board
- Walking in a straight line.
- Play hopscotch
- Walking on toes and on heel
- Follow a wriggly line – walk on the line or feet either side
- Tunnel Games: Crawling in the tunnel is a fun activity.
- Climbing Activities: Climbing frames, monkey bars, ladders, ropes or slopes.