Dyspraxia- Motor Planning
By Valerie Dejean,
Director, Spectrum Tomates Center and Certified Tomatis Consultant
What does Praxis look
like in my child?
three-year-old child is learning to dress herself. She puts on her
underpants and then her pants, making sure each foot goes into a
different leg and that her pocket is in the back. She next puts on her
shirt, making sure the opening is in the front. Next come the socks and
then the shoes. The same girl, a little older now, approaches a train
table in a toy store. Although she has never seen one before she knows
all about trains from her storybooks and videos. She picks up a train
and begins to push it along the tracks. She drives the train over
bridges and through tunnels, then rapidly increases the complexity of
her play by pausing at railroad crossings,
opening bridges, and parking in the "train garage."
from her past experiences to create appropriate actions at the train
A little older yet, she is
learning how to write, first in print and then in cursive. Still older
yet, she organizes six different homework assignments from six
different teachers. Still older yet, she organizes her thoughts and
time to write an end of the year term paper.
What is Praxis?
In all of the above endeavors, the girl employs praxis: the ability of
the brain to conceive, organize, and carry out a sequence of events.
Praxis is the ability to self-organize. The term praxis and motor
planning are often used interchangeably however it is more accurate to
consider praxis the broader term that encompassed motor planning. As
described above the conceiving, organizing, and executing functions of
praxis can be employed in motor events as in the case of dressing and
also can be employed in cognitive events as in organizing play,
homework, and a term paper.
Praxis is a uniquely
human quality that allows us to develop higher-level skills and to
interact purposefully with each other and the environment. An infant
innately learns to sit, stand, walk, and babble. It is when the baby
breaks from the sensory motor aspect of object use:repeatedly banging a
spoon on the table: to purposeful object use:attempting to eat with a
spoon:that he begins to utilize praxis.
Individuals with "Dyspraxia"
have difficulty executing unfamiliar tasks, even though there is
adequate motor and conceptual capacity to do so. A child with Dyspraxia
that approaches the train table at the toy store might push a train
back and forth on a section of track or open and close a bridge
repeatedly, yet typically will show little sense of purpose or
intention. In short, praxis is necessary in order for behavior to
become purposeful. If a child with Dyspraxia cannot organize the steps
in dressing he will not become independent in this skill. In other
words, praxis is necessary for behavior to be effective. Ideation.
Organization, and Execution:
In order to adapt effectively to his environment, a child must have an
idea of what he wants to do; he needs to have a plan of how he will
sequence and time his movements; and finally he needs to perform the
Praxis involves three
processes: (1) ideation, having an "idea" of what to do, (2)
organization, creating an internal plan of action, and (3) execution.
Ideation is one's ability to generate an idea of how one might interact
with an object or the environment. If an individual has no idea what to
do with an object, he cannot play or "interact" with that object.
Individuals with difficulty in ideation often wander a room full of
toys, pausing briefly to push buttons or manipulate an object, yet
never engaging in creative play:they literally have no idea what to do
with each object. Ideation is a cognitive process believed to be
largely dependent upon the brain's ability to respond properly to
sensory input. Sensory integration provides the body with a body
schema:essentially, a map of what the body can do. This map gives the
brain all the information it needs to decide what to do with the sensory
input it receives. However, if this body map is compromised
(inaccurate, incomplete or non-existent), the brain cannot respond
properly to sensory input, and ideation becomes difficult or
The organization aspect of praxis:the "how to do it" step:is an
internal plan of action that bridges ideation and execution. First, an
individual decides what to do, and then a plan of action is determined.
This plan must be sequenced and timed correctly in order to be
successful. In most individuals, this process is automatic:an idea
occurs followed rapidly by an action, with no awareness of the
organizational plan that formed in that split second to orchestrate the
Dyspraxia, however, tend to organize themselves cognitively:they must
think through how to accomplish the desired action before they execute
Execution is the motor part of praxis:the physical manifestation of the
desired action. While it is not necessarily the major source of
difficulty in developmental Dyspraxia, it is the only part that can be
observed. The Dyspraxic child at the train table demonstrates
difficulty executing purposeful play, but it is likely that her true
difficulty is in determining what to do (ideation) or how to do it
Individuals with Dyspraxia have
difficulty imitating actions, sequencing activities, and executing
Does Praxis Relate to My Child? Or What Does Praxis Have to Do with My
Many children with
developmental challenges have motor planning difficulties. Difficulties
with motor planning are often at the heart of these children's
frustrations. As children grow, they move away from simply experiencing
the world and are instead called upon to master it. Toys, tools and
self-care activities become more complex, requiring more intricate and
sequenced motor planning behavior. Motor planning problems make it
difficult for these children to master the use of objects, which leads
to an increasing sense of frustration. Academic tasks become
increasingly complex and the self-organization required at the level of
Junior High School can be daunting.
These individuals often require
repeated exposure to an activity in order to master it:they are
essentially organizing their actions consciously, since the body is
less able to automatically determine the necessary steps for execution.
They aren't able to generalize their experiences to other situations
because they have learned behaviors in a very "splintered off" fashion.
Learning becomes exhausting, as
essentially these individuals are working much harder than their peers
to accomplish the same thing, all of which places an enormous tax on
the nervous system.
Learning can be challenging for
these children as motor planning problems decrease a child's ability to
imitate the actions of others.
Some Dyspraxic children find it
easier to develop their own way
of doing something as opposed to attempting to learn someone else's way
or "the right way." These children can then be described as
unconventional or less kindly as oppositional, all of which can make
social interaction more difficult. The children end up feeling
misunderstood and the adults are scratching their heads as to why this
bright child isn't performing at their potential.
Dyspraxia can affect
speech and language development in some subtle as well as some not so
subtle ways. As a child develops, language becomes increasingly
complex, requiring rapidly sequenced movements of the tongue and jaw,
all of which must be coordinated with breathing. A motor planning
disorder can effect articulation and compromise intelligibility.
Dyspraxia can compromise language development, as phonemes must be
organized into words, words into sentences, and words into paragraphs
in order for an individual to express his thoughts and feelings. For
the child with Dyspraxia, ideating and organizing language can be a
Dyspraxia has a
tremendous negative impact on a child's sense of self-esteem. Children
with Dyspraxia have very few feelings of mastery. Learning is not
intrinsically rewarding. They never have the sense of effortless
Since this is a hidden
disorder - they don't look different on the outside from their friends
- they're left to feel that something is wrong with them. They feel
"stupid" and it is difficult to talk them out of this, as that's what
their experience feels like. They are often labeled as lazy by
misunderstanding adults and this can become a self-fulfilling prophecy
as these children start to "give up" in light of repeated failure.
How can the Spectrum
Tomates Center Help?
At the Spectrum Tomates Center we have been using the Tomatis Method of
"listening training" since 1992. The Spectrum Tomates Center pioneered
using Tomatis's developmental theories in conjunction with the sensory
integration theories of Dr. A. Jean Ayres, in what we have called the
Spectrum Center Method. Through this unique perspective we create an
individualized program for each client that enable him or her to
overcome communication, behavioral, organizational or learning
difficulties. Dyspraxia is secondary to an underlying sensory
integration disorder and the Spectrum Tomates Center Listening Training
programs increases an individual's motor planning ability by improving
his overall sensory processing.
processing provides the brain with a better body schema (map of
abilities) and a clearer sense of self (one must have a sense of "self"
and "other" in order to interact), which in turn gives our brains the
tools it needs to conceive of an idea, organize a plan, and execute an
action. If you feel your child has dyspraxia or motor planning issues,
contact the Spectrum Tomates Center at (845) 915-3288 to discuss your
situation or to schedule an initial evaluation. Or mail us at Spectrum
Tomates Center, 233 Route 17, Suite 4, Tuxedo Park, NY 10987-0698
Valerie Dejean with Alfred A. Tomatis
at his Villa in Spain, location of the legendary "Last Seminar"