What is dyspraxia and how to identify it in children? In this article, Ana Belén Mora, occupational therapist, specialized in sensory integration and integrative health; she explains everything to us, as well as how to intervene with examples of games for the daily routine. Do not miss it!
What are praxis?
According to Jean Ayres, praxis is: «The ability of the brain to conceive, organize and carry out a sequence of unknown actions…(1979, p. 183)» and later he would say that it implies: «Planning and executing coordinated movement in three sequential steps: Ideation or conceptualization of an action, planning or choosing an action strategy and the motor execution of the action (1985).»
Motor planning and its different phases
Motor planning (praxis) occurs in new or different activities to perform. To carry out the activity, the child has had to carry out two clear processes to bring it to motor action:
- Have an idea What do I do?
- Have a plan. How do I do it?
If there is no dysfunction in any of the previous phases of the process, a third phase will be carried out.
- Having to run it; motor action.
If this process is carried out properly, you will be able to organize, plan and execute skills and abilities efficiently, impacting your daily activities. Motor planning includes both sensory, motor and cognitive skills.
What is dyspraxia?
It involves difficulty in the ability to use the hands and body in activities that involve the use of objects or resolution of novel situations. These children usually have good cognitive skills, easily solving known tasks, however, they have difficulties in learning new tasks. For example, they later learn to ride a bicycle or refuse to play with peers because of the challenge of sports games.
Difficulties with dyspraxia
They have difficulties in organizing and sequencing tasks, in solving problems, in body awareness and control. Parents often find it difficult to understand that with their high cognitive abilities they do not do simple tasks well. On the other hand, for little ones it is very difficult to organize their hands and body to carry out these activities.
The difficulties that your little one will present will be related to motor planning; ideation, sequencing, temporal-spatial organization and execution. In this way, they may present motor clumsiness, poor game skills, manipulative and visual problems, challenges in organizing their behavior and loss of autonomy in their daily activities due to the difficulty in organizing and sequencing the activity.
>> Find out more: Laterality, how does it work?
Key signs to identify child dyspraxia in their daily routine
We are going to list some of the most frequent signs in each of the areas of a child’s life:
- Shows difficulties in activities that require the use of both hands such as buttoning or fastening zippers.
- It takes longer to acquire new skills, for example in dressing: tying shoelaces.
- They tend to go more slowly and take longer in skills for their autonomy such as handling cutlery when eating.
- He gets very dirty when he eats.
- He has difficulty tidying his room.
Play and social participation:
- Has limited imaginative play.
- He prefers to watch others play and stay out of it.
- He enjoys ordering others to do it for him.
- Shows problems in proposing new ways of playing (usually repeats the same).
- Has trouble knowing how to play with materials or objects.
- It is difficult for him to establish relationships with his peers or he prefers the company of adults.
- Difficulty adapting to obstacles, moves insecurely.
- He has difficulty doing puzzles or crafts because they are fine motor tasks.
- He may have difficulty in physical education classes, is not usually good at sports, prefers to avoid them or rejects them.
- May show difficulty with motor tasks such as jumping.
- It takes longer than other children to learn to write.
- He often takes too long to do his homework or fails to finish it.
- He has difficulty organizing his backpack or his desk.
- Shows difficulty starting an activity or switching from one activity to another.
>> Download: Games to work on dyspraxia in children
How to help the child with dyspraxia?
From Occupational Therapy we use an assessment of the occupational performance of all areas of the child to identify the origin of their difficulties. They can be addressed through occupational therapy and especially with sensory integration for children with somatodyspraxia. Cognitive processes or theories from Motor Control are also often applied.
The approach to dyspraxia
The approach will be focused on graduated activities. Starting with simple movements until reaching more complex sequences. Apply activities that require the action of the whole body and offer vestibular, tactile and proprioceptive sensory information. Giving importance to the latter through push, pull or counter-resistance activities will help us a lot.
In addition, it will be important to look for new activities where the steps are different, always offering the right challenge to reduce frustration. We will avoid advancing the next step, being better to opt for the feedback option so that they perceive the action. It will be helpful to give information and verbal cues but avoid talking too much.
Finally, the most important thing of all will be that the little one enjoys and works according to their intrinsic motivation.
Practical case of intervention with dyspraxia
Martina is a 6-year-old girl, very happy, participative with adults although not so much with her peers at school and more specifically in sports activities. Her parents mention that she finds it difficult to learn new skills such as the dance classes she has signed up for.
After an exhaustive evaluation of all areas of Martina’s performance and her participation in the different contexts, we can observe that she presents difficulties in praxis. She has a hard time devising, organizing and sequencing the activities to carry them out. She doesn’t know how to use her body for her performance.
Objective of the intervention
The main objective for the intervention is to come up with new games that will help her put them into practice at school, as well as organize, sequence and execute the activity in a functional way, allowing Martina to participate in her school physical education activities and her classes. dance.
Sessions with Martina
In the sessions with Martina the first thing will be to ask What do you want to play? In this way we are inciting to have to devise a game. Meanwhile, we look at what motivates you to use it in interventions. In this case, it is a set of geoforms/) and little geoman case because its pieces attract his attention. Now we just have to think about how we introduce the game, Do you think Martina if we use this game that you like so much within a circuit?
Making a circuit will allow us to devise each activity, order and sequence. To do this, we will use a giant blackboard-type mirror to point out / draw the steps of our circuit to advance in motor planning. In addition, the circuit will allow us to use material that provides vestibular (swing), tactile (sensory sac) and proprioceptive (ladder to climb) information, helping us a lot to feel and know your body to use it in the game.
Giant spinning top: Laughs guaranteed with the giant spinning top. Develops balance, coordination, strength but in a fun way. Rotate with the help of the body weight. Usable in the water. Ultra resistant red plastic.
Whizzy Dizzy: Extremely solid and stable, the Whizzy Dizzy stimulates the vestibular sense. Kids love to sit on it and spin it like a merry-go-round thanks to the large, ultra-maneuverable central handle. Made of resistant plastic. Maximum weight: 54 kg. diam. 55cm Tall. 30cm From 3 years.
In this way, together we have created a circuit:
- Get on the swing and jump on the bean bag.
- So we reached the ladder to climb and get the briefcase with the game that he had liked so much.
- We get into the sensory bag to get the pieces that we need to complete the figure of the game.
- We left the bag to put the missing pieces and complete it.
Verbal feedback will be given to help organize and sequence the game. Writing/Drawing it will help her organize her ideas. Feedback on her own body will be important in the most motor actions, as well as making her feel safe to continue. We will always put the right challenge to get the appropriate adaptive response. In this way you will be motivated to continue improving and we have achieved the proposed objectives. And what better way than through play and enjoyment?
My name is Ana Belén Mora, I am an occupational therapist specialized in sensory integration and integrative health. My main job is to build health from a young age and accompany the little ones and their families to enhance their development so that they are autonomous.
I work both offline (in the child’s own environment) and online. I also collaborate with different centers where children and their families can benefit from my services. You can follow her work at www.anabelenmora.com and on Instagram @anabelen.mora. To get to know her a little more: https://bit.ly/3Kt6N0R
Chumbita G. Somatodyspraxia. [Internet]. 2003; Available in: http://www.terapia-occupacional.com/articulos/Somatodispraxia.shtml
Matesanz Garcia B, Moya Rosendo D. The Sensory Integration Theory.
Moral Orro G, Pastor Montaño MA, Sanz Valer P. From the theoretical framework of sensory integration to the clinical intervention model. TOG (A Coruna) [revista en Internet]. 2013; 10(17): [25 p.]. Available in: http://www.revistatog.com/num17/pdfs/historia2.pdf
Serrano P. Sensory integration in child development and learning. Lisbon: Narcea; 2019