Many children that pediatric occupational therapists treat have challenges with motor planning, or praxis. These terms are often used interchangeably, but motor planning is actually one of three steps comprising praxis. So, what is praxis?
The term praxis refers to the ability to approach and master novel motor actions. Originally coined by A. Jean Ayres, the founder of Ayres Sensory Integration Therapy, praxis is an intricate process intertwining motor, sensory, and cognitive skills. A person with A+ praxis is able to see a new task and learn how to perform it appropriately. Although they may require practice to build skill, the initial understanding of what to do comes relatively easily.
For example, when taking a hike on a new trail, it may require more attention to the landscape. There are more obstacles in the woods, such as tree roots, uneven ground, and twists and turns on the trail, that require hikers to move in unusual positions. Hikers have to perceive sensory information, such as visual trail markers to make sure not to get lost and environmental noises from wildlife to maintain safety. This new task requires more cognitive attention, sensory awareness, and postural (or body) adjustments to navigate safely and effectively.
Praxis consists of three steps:
Ideation - WHAT are we going to do
Motor Planning - HOW are we going to do it
Execution - we DID it!
Read on for a further breakdown of this process...
Step 1. Ideation
The first step to any action is to come up with an idea: WHAT do we want to do? A great way to challenge ideation is to simply present a variety of items and come up with a list of ideas for how we could use them.
Try it out
Here are the materials:
5 rubber bands
2 paper clips
3 pieces of construction paper: red, green, yellow
a roll of tape
Think about 3 activities you could perform with at least 3 of these simple household items. They do not have to be fancy...
When we think of ideation in this way, it can be tricky! This challenge represents what it may feel like for children who are not sure how to come up with ideas for play, even when toys are provided. (Comment below if you're wondering about my activity ideas!)
Ideation relies on cognitive processes and visual processing to take in the world through observation. A great deal of learning is achieved initially through motor imitation, borrowing ideas from others as a foundational skill for coming up with novel ideas. Once children develop joint attention, in which they pay attention to the actions of another person, they build skills for reciprocal (or back-and-forth) play. Examples of reciprocal play include peek-a-boo, imitating facial expressions, and rolling a ball back-and-forth. As kids get older, they become more independent in choosing their activities. A child with good ideation skills may choose to play with Legos and have a mental image of the castle he wants to build.
Step 2. Motor Planning
Once we know what to do, a plan is needed for HOW to do it. Combining the cognitive mental image, previous memories informing physical abilities, and executive functioning (a set of skills consisting of planning, assessing risk, inhibiting impulsivity, initiating tasks, and sequencing steps), this step can be overwhelming when these processes are not automatic. When tasks are new, individuals have to learn them and form step-by-step motor plans. As the activity is repeated, the motor plans become increasingly automatic, requiring less cognitive attention and allowing people to focus on building physical skill.
Motor Planning is the intersection of cognition, motor skills, and sensory processing. In particular, tactile and proprioceptive processing are the foundation of body awareness, or the understanding of where the body is in space. Kiddos with sensory processing challenges are likely to have difficulty with motor planning, as well.
Remember the little buddy with the idea to build a Lego castle? His motor plan involves gathering the materials and planning how to stack the blocks to bring his idea to life.
My Own Experience
Last year, I learned how to ski...and it did not come easy! Children are blessed with a level of fearlessness that enables them to quite literally fall and get back up, which helps them learn how to move their bodies. As an adult, I was afraid of falling! I found myself very stiff, unable to trust my body as my skis wanted to pick up speed.
Through a number of ski lessons, I asked my instructors to break down the positioning and motor sequences step-by-step for me to observe, and then perform. Over time, I learned I had to keep my knees bent, my shoulders squared off, and my eyes looking down the mountain (even though I wanted to keep staring at my feet!)
I'm definitely still learning, but my movements are now more fluid and my confidence is building slowly. And I keep that perspective--the memory of that pit in my stomach right before my first ski run--in mind as I challenge kids with new motor tasks in the OT gym.
Step 3. Execution
Okay, there is an idea, then there is a plan...so it is time for ACTION! This final step is the actual movement that is performed. Adequate motor execution relies on coordination, strength, endurance in addition to the aforementioned skills of steps 1 and 2.
The sweet spot of motor planning lies in reflection, following execution. When an action is performed, our mind is working hard to determine what went well and what should be improved for next time. This subconscious consideration is what keeps us moving and grooving on future attempts!
Finally, our Lego friend is executing the castle beautifully! She is able to coordinate her eye and hand muscles to align the Lego blocks and has adequate strength to connect the pieces. At one point, the tower falls. With the help of her dad, she learns that she needs to create a wider base to hold the castle as it becomes taller.
When Praxis Goes Awry
Individuals who face challenges with the steps outlined above may appear clumsy, uncoordinated, and even afraid. They are often unsure how to move their bodies, especially when faced with a new environment or task. As a result, kids facing difficulty with praxis tend to prefer playing with same toy and repeating the same activity over and over again. While having play preferences is okay, restricting the play repertoire too much limits the opportunities for learning and development.
OT Can Help!
Occupational therapy addresses each of the performance skills contributing to praxis, including cognition, motor, and sensory processing. By delivering targeted sensory experiences and the "just-right challenge," children are able to learn WHAT and HOW to play. With therapy disguised as play, children do not even know their brains and bodies are hard at work. They can become confident little explorers before your very eyes!
Don't forget to subscribe to our newsletter today for the full infographic detailing the 3 steps of praxis. If your child has motor planning challenges, contact an occupational therapist to learn more.