“Crash, bang, bump. My kid is kinda clumsy” – Understanding Dyspraxia

Toddlers are known for bumping into things, falling over and getting back up, bouncing off walls and moving onward.  Preschoolers are a little more refined.  Most preschoolers can figure out how to move their bodies to accomplish tasks after a few opportunities of practice or after they watch someone else do it. They know what they want to do, they can figure out how to do it, and they do things in a seemingly automatic manner.   As children get older, learning new movements comes with ease for many.  They have all of the components of good praxis.  

PRAXIS?  What is praxis?

Praxis is the medical term for “planning out and carrying out motor actions”; like riding a bike or parallel parking a new car for the first few times.   It takes higher level cognitive processes to perform these actions and a whole bunch of internal reactions too.

1. You have to conceptualize or come up with what you want to do. (this is called Ideation) “I want to parallel park my new car in the middle of downtown San Francisco; on a hill, in the middle of rush hour”. 

2. Now you need to plan the steps and what is needed for this task (Organization) “I need a car, a parking spot, the spot has to be the right size, it needs to be near the restaurant (insert place you are visiting) I am going to”

3. You have to carry out the steps to the plan. (Execution) “Ummm, I need to line up my car…just right next to this other car. I need to aim into the corner of my car over here; watch out for the person walking through my space.  I need to maneuver right into the spot. I need to put on the parking brake.”

4. You have to make minute adjustments to make it just right; refine the movements and attend to the little details to be successful.  (Feedback and feed forward) “In and out of the parking spot I go until I am just 18 inches from the curb.  Oops! Sorry other car owner.”

Children who have difficulty with learning new motor actions may have dyspraxia.

Copying what others are doing requires increased concentration, effort, and practice on their part. They may also have difficulty with attending to cues in their environment- for example, not walking in front of a moving swing or stopping a riding toy before it gets to the street.  They may struggle to generalize what they have learned to new situations and new activities.  Some children may have trouble with learning seemingly simple actions such as drawing or writing.  Tying shoes, learning to button, zip or manage other fasteners may be a struggle.  Sports and bike riding an all out mystery.

Here’s how you can help your child with dyspraxia!

• Ensure close supervision when performing new tasks for safety.
• Break down tasks into smaller steps.
• Offer simple directions.
• Help complete one step at a time.

Kids need many opportunities to learn a new skill, but if skills are taking much longer to achieve than expected; it’s time to talk to a specialist who has been trained in working with kids addressing praxis. 

When it comes to dyspraxia, use your senses!!

I like to think of each of the 7 senses when I am working with a kid who has dyspraxia.

Touch– 

• Give deep pressure massages to their arms, hands, legs, and feet.
• Provide “squishing” between 2 big pillows to help them “feel their bodies”.  (make sure you don’t cover their face”.

Auditory (hearing)-

• Give simple directions “get your socks.  Now find your shoes”. 
• Rehearse what he is going to do, “first you lift your leg, then you swing it over the seat”.

Visual (Eyes)

• Use a visual to do list- set out toys in a line so your child can clearly see what is first to play with, next, and last
• Lay tape down where you want your child to stand.

“Put your feet in this circle. Now throw me the ball”

Oral (Mouth)

• Chewing on chewy foods will give your child more oral input helping them to “feel their mouth better:
• Try tart apples to “wake up” their face.

Proprioception (muscle and joints)

• Push, pull, drag, lift objects to increase body awareness.
• Make an indoor obstacle course out of your couch cushions and other squishy materials for your child to crawl, jump, roll, and traverse. 

Vestibular (movement)

• Keep swings close to the ground so your child can reach the ground with their feet and propel it.
• Rhythmical jumping or linear swinging and rocking prior to movement can help your child to be calm when attempting more challenging tasks.

There is help for people with dyspraxia. Practice, multi-sensory treatment, adaptive techniques are all a part of the recipe. That’s exacty what we offer in our Bay Area Pediatric OT practice. We’ll help you understand and address the challenges that come with dyspraxia.