Motor Planning

1. What is Praxis?

“To relate one’s body to the environment we must both know one’s own body and how it can move, and know the nature of the environment and the nature of its demand or invitation.” (A. Jean Ayres)

 

Motor planning (or praxis) is a neurological process where cognition (the whole brain) directs motor action or action planning.  Ayres also describes that praxis is the ability of the brain to conceive of, organize and carry out a sequence of unfamiliar actions.  Sequencing is at the root of all praxis difficulties.  From a young age, children need many opportunities to experiment and play in various settings, in order to develop and integrate the tactile, visual, movement and proprioceptive senses, which would in turn develop a well-integrated body schema, needed for sufficient motor planning.  Children with motor planning challenges have difficulty establishing new motor plans or maps (i.e. engrams), as well as difficulty with adapting already attained motor plans or maps (i.e. engrams) to  accomplish a new skill.

 

2. What is Ideation?

Ideation is not just the ability to generate a goal, it involves the ability to have an idea of how to reach that desired goal.  To be able to achieve any action or motor task (with or without an object/tool/equipment), the child must have some idea of how to accomplish the goal, they should have a certain amount of knowledge about the capabilities of their own body (this involves a well-developed body schema) and knowledge of the affordances or properties of the object/tool/equipment that they intend on using.  

 

Representational thought is our internal reference.  It develops through exploratory play and multi-sensory experiences, through play and adaptive responses.  If children have representational thought they experience embodied cognition, meaning that they must feel, sense, and OWN the experience.  Children with sensory processing difficulties, who lack tactile processing for example, would lack experiences and therefore struggle to develop representational thought, which is a vital building block for ideation.  

 

The ability to recognise the affordances of objects is related to our knowledge of actions (e.g. jump, roll, swing, slide, run, hop) and objects (e.g. a ball can bounce, roll, etc) and this facilitates our ability to “KNOW” what to do with an object.  In order to get to this point, the child needs to have the sensory foundation of the tactile, vestibular and proprioceptive systems in place and they should truly be able to embody the experiences and actions that they have tried out in the past so that they can visualize similar actions in future.  It is thus important to assist children with ideational difficulties to:

• • Mentally visualize what it is that they are doing
• • Understand the affordances or properties of the objects or tools that they are using
• • Have the knowledge of various actions that they would engage in
• • Build representational thought.

 

3. Strategies to facilitate memory

• • It is important that we provide visual representations or pictures for the child. Most children benefit greatly from a visual calendar at home with their week visually set out and pictures of school, ballet, OT session and play date afternoon.  This will also make it easier for them when asked to think back what their week was like when there is a visual picture of the week.  
• • In general, when planning things with your child, use lists to help with their planning, e.g. when packing your bags for the weekend away, pack your things and then after packing take 10 minutes and let your child recall what he packed into his bag and write it down or draw pictures of what he packed. The quality of the writing or drawing is not important here, you want to facilitate that memory (and visualize) the items in the bag.  This can also be done when packing a picnic basket, making a sandwich, packing schoolbags or lunchbox for school.
• • Rehearse “what just happened”, “what will happen next” and “what happened last week”. You can do this after an extra-mural, their OT session, play date or weekend away. 

 

4. Strategies to facilitate language

• • Children who struggle with ideation difficulties can often be very serious and struggle to grasp humour. It would be important to help them by being more silly or goofy when engaging with them e.g. when doing homework.  You can tease and say “OK get your cutlery ready before we start writing!” and they might look at you and then you can pretend that you don’t know what you said wrong… joke around for a bit and ask “what did I say incorrectly? What must you get out before we write? Oh sorry – your knife and fork!!” until they tell you “it’s stationery!!””
• • Use word games and rhymes e.g. “See you later alligator” or “In a while crocodile!”
• • Encourage symbolic representational use of objects and actions e.g. when they are playing make the links for them, e.g. “That swing looks like the vine in the forest”.

 

5. Strategies to facilitate awareness of objects/ environmental/ action affordances

• • Give your child precise feedback and labelling “that bat is really hard and will hurt someone when you hit them with it” or “that slide is so slippery today”.
• • When describing objects with your child, be aware of the size, colour, number, shape, where it is (over, under, through), the movement it makes (action words), the mood (if referring to people), background or sound it makes.
• • Be aware that this must be done while they are moving!! We want to give them the sensory-motor embodiment while they are playing and experiencing.
• • Label your child’s action and their impact on the environment or on objects e.g. “you threw the ball so hard and it knocked over the skittles.” Many children truly do not get the link between the action and outcome and we have to point that out for them.  
• • Label the affordances in the environment and what possible actions can be taken on them e.g. “sometimes children like to climb on those rocks and then jump off”.
• • Facilitate the language while playing/doing, e.g. while rolling down the hill, ask your child “what are you doing!?”, you want him to say “I am rolling!” while doing the action.

 

6. Strategies for cognitive learning:

• • Develop the use of a consistent global strategy, e.g. when doing homework always:
  • Set a goal (“Ok, our goal is to write down five of your spelling words”)
  • Plan (What do we need before we can start writing? Get all the stationery ready e.g. pencil, eraser, book, ruler).
  • Complete the task (Sit down and do it)
  • Check yourself (Our goal was to write five spelling words, let’s count if we did this)
• • Use verbal motor mnemonics whenever you can, for example use little stories and rhymes that will help children to remember actions, for example the story of the bunny ears and the hole when tying shoelaces, or when writing the number 5, say the story “first you make the neck, then the big belly and then put his hat on last”.
• • Encourage verbal self-instruction when doing actions “I am going under!”, or “I am jumping” or “jump jump sugar lump!” while on the trampoline.

 

(Home programme and strategies based on the work presented by Theresa A. May-Benson, ScD, OTR/L – Workshop attended in June 2015, Cape Town, South Africa).