Praxis Emma Wijnberg Occupational Therapy and Speaker Introduction - - PowerPoint PPT Presentation
Praxis Emma Wijnberg Occupational Therapy and Speaker Introduction In Sensory Integration theory, praxis refers to the ability to plan new movements (Bundy, et al., 2002, p. 6). Three Processes (Ayres, 2005) - Ideation- Planning-
Emma Wijnberg Occupational Therapy and Speaker
Three Processes (Ayres, 2005)
Dependant on Sensory Integration Motor Pathways Clumsy, Awkward and Accident Prone Struggle with novel tasks Avoidance, Anxiety and Frustration
“In Sensory Integration theory, praxis refers to the ability to plan new movements” (Bundy, et al., 2002, p. 6).
Ideation is a cortical function of having an idea, and the ability to conceptualise a goal (Bundy, et al., 2002, p. 71)
Motor planning is the ability to determine the sequential steps or the series of movements that need to occur in order for the action to happen. (Bundy, et al., 2002)
Sensory information regarding the external environment, the position of the body, the degree of muscle contraction is all vital for the efficient adjustments and grading needed for the accurate execution of movement (Bundy, et al., 2002, p. 84).
Discrimination is the ability to interpret information. It allows you to filter various sensory input, sorting relevant detail from irrelevant input. (Bialer & Miller., 2011)
Tactile input is detected by receptors the skin. Dysfunction of the tactile system, therefore, affects a wide array of functional areas, including body scheme and awareness, motor planning abilities, visual perception, academic learning and social skills. Dorsal Column Medial Leminiscal Pathway
Information about where our body parts are in relation to one another and the external environment. Detected by receptors in the muscles, tendons and ligaments around joints. Dysfunction results in clumsiness, easily and frequently breaks things, exhibits low functional muscle tone, may fixate during movements, and present with mass movement patterns (Bundy, et al., 2002).
“Somatodyspraxia is a type
dyspraxia in which there is evidence of poor processing
information. ” (Bundy, et al., 2002, pp. 71-72). Impaired tactile and proprioceptive discrimination
Vestibular input provides us with information regarding head position in relation to gravity. Motor responses play a role in balance, postural control, eye movements. Receptors: Semi-Circular Canals and Otolith Organs.
Coordination of both sides of the body and the ability to perform sequences of
Subtle, mild practic difficulty
“Bilateral integration and sequencing disorder is a type of sensory integrative-based dyspraxia in which there is evidence of deficits in vestibular and proprioceptive processing” (Bundy, et al., 2002, p. 72).
Most important sense for our daily functioning (Bundy 2002). NB for learning new motor skills. Initially, vision guides the body’ s movements, until the skill is learnt, and becomes automatic.
“The relationship between visual perception and visually directed praxis” (Parham, 2010, p.350) Difficulties using vision to coordinate movement, copy drawings and find objects in a busy background (Schaaf 2010, p. 272).
“Posture is that motor response which reflects an individual’ s relationship to the earth’ s surface and gravitational force. ” (Ayres, 2000, p. 75). Postural Control is the
and control the quality of postural movements (Bundy, et al., 2002, p. 7).
Postural-Occular Control is reliant on the integration
vestibular (specifically receptors on the semi- circular canals), and visual systems, to ensure smooth, coordinated eye movements and gaze stability during movement.
Auditory discrimination is the ability to recognise differences between sounds.
Praxis on verbal command refers to the child’ s ability to assume unfamiliar body positions, following a verbal command. Praxis on Verbal Command relies purely on verbal directions and not visual demonstration (Mailloux, 1990,
Consider postural and linguistic ability before diagnosis.
Developmental Delay Poor gross motor skills, avoidant Social difficulties Poor spatial awareness Slow and hesitant in most actions Appears not to be able to learn anything instinctively but must be taught skills Falls over frequently Poor pencil grip Cannot do jigsaws or shape sorting games Often anxious and easily distracted Does badly in class but significantly better on a one-to -one basis Reacts to all stimuli without discrimination and attention span is poor
Experiences great difficulty in copying from the blackboard Writes laboriously and immaturely Difficulty remembering and /or following instructions Disorganised
Low Self-Esteem Compensation Avoidance Delays Anxiety Disorganised
History Taking (Parent Interview) Classroom Observation Clinical Observations (structured and unstructured) Sensory Integration and Praxis Tests (SIPT), Ayres 1989 Bruininks-Oseretsky Test of Motor Proficiency, 1978 Miller Assessment for Preschoolers, Miller 1988 Movement Assessment Battery for children (Henderson & Sugden) Developmental Test of visual-motor integration (Beery) Test of Visual Perceptual Skills (Gardner) Sensory Profile (Winnie Dunn) Sensory Processing Measure (Lucy Miller)
American Psychiatric Association Diagnostic and Statistical Manual V classifies dyspraxia under umbrella term of Developmental Co-
Billable Diagnostic Code: R27.8 (Other lack of coordination) OR F82 (DCD)
Ayres Sensory Integration Perceptual Motor Approach Sensorimotor Approach A cognitive goal directed approach (Older children) Teach Coping Skills Family support and education Concessions
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