PRAXIS/DYSPRAXIA SYNDROME AND BENEFITS OF PROPRIOCEPTIVE AND DEEP TACTILE PRESSURE INPUT
What is Praxis?
A complex multi-step neurological process, which directs motor action and happens automatically or subconsciously. This involves planning the movement and how to carry it out.
These complex series of events include: 1. Ideation or conceiving the idea, 2. Organizing or Motor Planning (Motor planning is the sensory process that enables a child to adapt to an unfamiliar task and learn how to do that task automatically). The key to motor planning is having a body perceive accurate tactile, visual, auditory, proprioceptive and vestibular sensory information to form appropriate internal representation or internal models, 3. Execution or performing the perceived movement, and 4. Receiving feedback from our performance and adapting for future performance.
To accomplish this we need to have good sensory awareness of where our body is in space in addition to the well organized cognitive ability, coordination, and ability to adapt our movements.
Dyspraxia and DCD (Developmental Coordination Disorder)
A neurological disorder characterized by loss of the ability to carry out learned purposeful movements, despite having the physical ability and desire to do so. These terms are used to describe a range of motor planning difficulties (6-8% of children experience) with posture, movement and coordination, without there being a specific medical reason for these difficulties. These children have difficulty with Ideation, forming internal representation, motor planning, executing and adapting. This difficulty is not caused from brain damage or clinical neurological abnormality. The two hemispheres of the brain do not seem to work together harmoniously to produce an effective desired response.
SYMPTOMS (can include but not limited to):
marked impairment in motor coordination
difficulty with dressing
difficulty with self regulation
difficulty coordinating both sides of the body
difficulty with attention
difficulty with writing
difficulty with academic performance
significant speech difficulties
difficulty with concepts (in, up, over etc)
falls frequently
immature pencil and paper tasks
difficulty learning new skills such as bike riding
difficulty with balance and agility activities
difficulty with ball skills
difficulty with core strength
tires easily
difficulty using utensils
as a baby, may have feeding difficulties
temper tantrums
messy eater
difficulty with imaginative play
may be sensory sensitive
may have hypermobile joints
may have muscle weakness
may have low muscle tone
difficulty with organizing
difficulty with building
struggles in PE
You can imagine the physical, emotional, and mental effort that a child with Dyspraxia or DCD must exert for activities that their peers seem to master automatically. Therefore they may demonstrate frustration and avoidance further affecting their ability to learn and master new skills.
TREATMENT
Children are often referred for Occupational Therapy to access and determine the difficulties and how they impact the child's daily activities at play, school, and home. In dyspraxia syndrome, there is a decreased ability to carry out new or unfamiliar actions, even though there is conceptual and motor capacity to do so. Tactile, proprioceptive, and vestibular sensory information are organized, when registered from the body, into forming internal representation or internal models. This would allow effective programming of the proper organized sequence of movement steps required to perform proper motor behavior. Problems of the vestibular, tactile, or proprioceptive system are difficult to identify, however, disorders in their functioning are profound. The use of Sensory Integration techniques focus on the underlying neurologic sensory processing which cause difficulties in the child's daily life. If the sensations are processed from the child's body and environment inaccurately the child demonstrates a motor planning problem. In treatment, each child would be given an individualized treatment plan.
PROPRIOCEPTION
This is the input from our own bodies and our environment to our muscles and joints which tells us where our body is in space. The proprioceptive sense gives us feedback that tells us about movement and body position. With Proprioceptive Dysfunction a child is clumsy, uncoordinated, and has difficulty performing activities of daily living their peers seem to perform easily automatically. Without proper proprioceptive sensory integration the child has difficulty motor planning including ideation and performing a task in proper sequence and effectively. They may have difficulty grading their movement (how much pressure to is needed for a particular task i.e. how much pressure to hold a paper cup versus a mug), and difficulty with safe effective postural stability. This child will have significant difficulty moving and using their body effectively. This child tends to have frustration and may quit easily therefore adding difficulty learning new skills.
PROPRIOCEPTIVE INPUT
There are many examples of how to use proprioceptive sensory input to help a child organize, attend, and calm their sensory system. Just remember it should be incorporated into a "fun" environment where a child "learns" best. Children also benefit from proprioceptive activities that focus on posture and strengthening the muscles. It is a good idea to provide extra proprioceptive sensory input when learning a new motor skill. Here are some sites that suggest how to incorporate proprioceptive sensory activities:
HOW TO INPUT THROUGH CLOTHING AND WEIGHTED PRODUCTS
Deep pressure, weighted vests and weighted blankets, and sensory compression clothing can be highly beneficial to many children with neurological disorders. Based on the sensory integration technique, the added weight or pressure provides the special needs child with unconscious proprioceptive and deep tactile pressure information from their muscles and joints. As a result, they may better integrate sensory information and remain calmer. They may become more organized and improve their ability to concentrate, learn, and better engage in activities of daily living.
Until now, most sensory weighted and compression clothing have been stigmatizing and basically not stylish. Kozie Clothes aims to provide high quality attractive clothing possessing the therapeutic qualities to help children with special needs.
When a garment is being constructed to address children who suffer sensory processing difficulties, specific consideration should be made to address ease of function, tactile sensitivity, relevant design, safety, consistency in design for spatial orientation, and proprioceptive input (the unconscious awareness of sensations coming from receptor's in one's joints, muscles, tendons and ligaments). This helps promote independence as well as organization, alertness, and simplicity where quickness of dressing is often expected throughout the child's day.
Susan Donohoe OTR SI and SIPT Certified
Owner, KozieCare LLC, Kozie Clothes