Evaluation and Treatment of Dyspraxia Flashcards
Main feature of Development Motor Disorder
- Impaired motor coordination not due to intellectual disability, congenital, or acquired neurological disorder
- Sensory processing disorder with proprioceptive, vestibular, & tactile dysfunction
- Prevalent in Down syndrome & Autism
Possible etiologies
- parietal lobe damag
- dysgenesis of corpus callosum
- cerebellar dysfunction
- environment (sensory deprivation)
- prenatal (VLBW, preemie)
Characteristics of dyspraxia
- poor motor planning
- low muscle tone
- clumsy
- poor body awareness,
- inefficient movement
- low self esteem
- emotionally labile
- auditory processing problems
- poor organization
- poor fine motor skills
- poor postural maintenance
- decreased rotation
Dyspraxia in gait can appear as
- Toe walking
- Foot slapping
- Stomping
- High stepping
- Shuffling
What are the 3 P’s of proprioception and posture (poor proprioception/hypotonia)
- Pop up
- Plop down
- Prop on
Assessment tools for dyspraxia
- Sensory Profile 2
- Sensory Processing Measure
- Quick Neuro Screen
- Peabody
- BOT 2
- COMPS (Clinical Observations of Motor and Postural Skills 2000)
- TSFI (Test of Sensory Function in Infants)
- PEDI- CAT, School Function Assessment
What are the 2 approaches to treatment of dyspraxia
- Bottom up: process or deficit orientated; frequently used with children with significant cognitive deficits
- Top down: functional skill approaches; body impairments are addressed only if they interfere with completing the task
Describe the CO-OP (cognitive oriented occupational performance)
- Focuses on activities child needs or wants to do
- Child is actively engaged in choosing goals & using executive problem solving strategy
- Child guides himself through problem solving task by talking aloud
Strategies used in cognitive approaches
- Comparative discussion (which sentence is written he neatest)
- Self rating eval: child rates own performance
- Question & answer
- Therapist eval: positive reinforcement of child’s performance
For cognitive approaches the child must
- Be able to set goals for themselves
- Have sufficient cognitive ability & language skills to benefit from the approach
- Be receptive to react & respond to the intervention
Characteristics of treatment for dyspraxia
- Requires active participation of the child
- Child directed
- Individualized to child’s needs
- Prioritizes purposeful activity
- Need for adaptive response
What are the 6 levels of adaptive response (NOT TESTED ON THIS)
1) Normal response to passive stimuli
2) Hold and stay
3) Alternating contraction & relaxation of muscle groups
4) Move independently through the environment in a familiar way
5) Move independently through the environment in an unfamiliar way
6) Complete a complicated activity requiring an unfamiliar way, difficult timing or multiple adaptations
What are the therapist responsibilities in treatment for dyspraxia
- Choose the activity & modify the environment
- Use the Premack principle: variable free time intersperse desirable with undesirable activities
- Protect child’s self-esteem
- Provide consistent positive & negative consequences to motivate
- Identify the end product
Ways to alter alertness and arousal based on the system effected
- Vestibular: rolling, rocking, swinging
- Proprioceptive: weights, pressure, resistance, chewing
- Visual: lighting
- Auditory: music/headphones
- Gustatory: sweet/sour
- Olfactory: perfumes/food
Describe process deficit approach versus cognitive/functional skill approach
- Process deficit: therapist & caregivers provide sensory input
- Cognitive/functional Skill: child makes decisions about sensory input needed
