Praxis Flashcards
What is praxis?
The ability to conceptualize, organize, and execute new motor tasks
- Praxis is an organizational process beyond motor
- Focus is on using the physical body to interact with the physical world
T/F: Praxis is a motor process
FAlse. Praxis is an organizational process, beyond motor. Focus is on using the physical body to interact with the physical world
Other literature refers to praxis as ______
Other literature refers to praxis as executive functioning (setting and making a goal)
T/F: Vestibular and prop contribute to motor plan while tactile does not
False. V, P, and T all contribute to body scheme which is necessary to motor plan
T/F: Rank the following in terms of difficulty levels related to praxis:
- Body on Body
- Body to object
- Body on an object
From Easy to hard:
- Body on body (knowing where your body is)
- Body on an object (How do I go through door or under object without bumping)
- Body to object (How do I use a spoon to pick up something on plate)
The ability by which we figure out how to use our hands and body in skilled tasks like playing with toys, using tools, building a structure, cleaning up room
Praxis
How may a child with praxis problems appear?
- Forgets socks or backpack at school
- Always late
- Handwriting is a mess
- Problem is in organization that is not necessarily part of learning e.g., prioritizing what you need to do like keeping desk neat
- May have never transitioned out of velcro or only knows how to dress one way b/c that’s how they learned the task
Which is the most essential component to praxis?
- Ideation
- Motor planning
- Execution
Motor planning: organizing steps to accomplish goal in head; ability to put components together
Ability to conceptualize a new activity or a new way to perform an activity
Ideation–coming up with a goal
3 Key components of praxis …
- Ideation: ability to conceptualize new activity or new way to perform activity
- Motor planning: ability to organize actions needed to perform the activity e.g., sequencing, timing of action within spatial environment
- Execution: observable motor performance, which may be affected by issues other than praxis
Ability to organize actions needed to perform activity e.g., sequencing, and timing of action within a spatial environment
Motor planning
- Organizing steps to take in head to accomplish goal
- Ability to put components together
Observable motor performance, which may be affected by issues other than praxis
Execution
When testing praxis, what do you need to make sure to do when giving tasks to child?
Need to creative tasks that are testing motor planning above other things
Bridge between cognition and motor function
Praxis! (bridge between what I want to do and actually doing it)
- e.g., If task is touch door without touching feet to floor, have to come up with how to do this using praxis
- Involves conceptualizing an activity and then choosing a strategy to accomplish it
A kid with praxis problems may do what when attempting to conceptualize and achieve a goal?
-May freeze up or try same strategy over and over again even if it’s not working
How is language related to praxis?
- Both are learned
- Both enable interactions and transactions
- Both require cognitive functions and planning
- In language, you learn words and put in certain order to make a point
- Kid with ASD will have a lack of flexibility with motor and language–repeat words and motor actions
T/F: A kid with ASD will have a lack of flexibility with motor but not language
False. A kid with ASD will often have a lack of flexibility with both motor and language–repeat both words and motor actions
T/F: A child with dyspraxia always has language problems
False. The problem is with organization of actions, but not necessarily with language. Child may have oral praxis problems that look like language problems but are not.
T/F: Dyspraxia mostly occurs in children while apraxia is mostly used with adults
True. Apraxia may be used with children, however.
What is it important to do when testing dyspraxia in children?
Because difficulties are related to motor learning and new novel tasks, must do something relatively novel to test e.g., not smiling, chewing b/c automatic
A child with this problem will have difficulties with motor learning, new novel tasks, and generalizing a task to a new environment
Dyspraxia
Because children with dyspraxia have difficulties with generalizing a task to a new environment, what should we make sure to do in a clinical environment to work on this?
SI clinic should look a little different each time they walk in.
T/F: When working with children with dyspraxia, it is important that the SI clinic looks the same every time the child comes in so that he can slowly master the environment
False. The SI clinic should look a little different each time they walk in to work on motor tasks in novel environments. Playground structures are not good for this reason–always the same
Why may a child stay inside instead of going out to recess?
May have a problem with praxis and feedforward. May also be all over the place b/c don’t know what to do. We often assume b/c modulation problem
T/F: A child who has trouble initiating a movement of walking when kids are around most likely has a feedback problem.
False. This is a feedforward problem
A problem grading force is related to what kind of problem?
Prop
A child who holds his pencil wrong–has weird position–probably has what kind of problem?
Prop
A child who has trouble with fluidity of movement e.g., mechanical walking, problem clapping may have what issue?
Problem related to prop: sequencing components of movement. OR bilateral coordination problem
Kids with ______ problems often end up having some organization of behavior problems when they get older?
Kids with motor planning problems end up having some organization of behavior problems when they get older (goal-directedness from ideation)
What is organization of behavior?
Goal-directedness from ideation.
-Praxis contributes to organization of behavior in order to act purposefully on and in the world
The child with ________ will have the following issues:
- Difficulty conceptualizing new things to do, or new ways to approach a familiar task
- Difficulty sequencing actions in order to effectively perform a task
- May have cognitive strength in cognition of language, but weakness in cognition of physical action in physical world
Dyspraxia
T/F: Both children with ASD and dyspraxia have problems with both organization of language and actions
False.
- Kid with ASD will have problems with organization of language and actions
- Kid with dyspraxia will have problems with organization of actions, but not necessarily language. The central issue is motor planning
T/F: T/F: Every child with dyspraxia or ASD has motor planning problems and ideation problems
False.
-Every kid with dyspraxia has a motor planning problem but not necessarily ideation problem. They may or may not have an ideation problem while almost every child with ASD will have ideation problems and problems coming up with a goal. Motor planning is not always bad in children with ASD–can usually figure out how to move body in environment to get what they want
What is the difference between a child with ASD and dyspraxia?
ASD:
-Will have problems with organization of language and actions
-99% have ideation problem
-Problem coming up with goals for action
-Motor planning is not always bad–can usually figure out how to move body in environment to get what they want
Dyspraxia:
-Will have problems with organization of actions, not necessarily language.
-Central issue is motor planning
-Not necessarily ideation problem–some do, some don’t
Dyspraxia vs Apraxia
(usage of these terms have changed over years)
Current usage:
Apraxia: loss of praxis ability due to brain trauma or disease; praxis had developed normally in infancy or childhood but became impaired due to damage
Dyspraxia: Significant delay or difference in the development of praxis ability in infancy and childhood, with no evidence of structural brain abnormality
T/F: Ayres contributed to the understanding of praxis by finding that sensory processing is critical for ideation, but not the planning of actions
False. Found the importance of sensory processing in ideation AND planning of actions (together this is praxis)
-Also important for language too
T/F: A child who is underresponsive to sensory input will not benefit from experiences they had, even if in enriched environment
True
Complex process of integrating multiple sources of sensory info into manageable units that can be organized and sequenced with each other
Concept formation
- Involves neural networks that overlap for praxis and language functions
- Ayres proposed that overlapping neural networks involve a “somatosensory-conceptual-planning” function that links praxis with language development
T/F: it is common to see children with only bilateral sequencing and coordination problems
False, it is rare. If this is the only problem and is not identified early on, will have to pay out of pocket to get tx for. Easier to correct just this problem.
T/F: A child with a high PRN means that he is underresponsive to vestibular and has an SI problem
False. A high PRN means there is a lack of cortical inhibition. A low PRN means the child is underresponsive to vestibular and has an SI problem. A child with cortical problem will probably be very sensitive to twirling around
T/F: When using SI, the children that make the more progress are the ones that are underresponsive to vestib.
True. Their problems are milder, easier to correct
T/F: Praxis is only related to the frontal lobe
False. Many parts of the CNS contribute.
Praxis that involves conceptualizing or planning actions of body in space; heavily dependent on body scheme
Somatopraxis
Praxis that involves conceptualizing or planning actions that are guided by visual perception
Visuopraxis
When we are looking at ______ in SI, we are looking at link between motor planning and SI
When we are looking at praxis in SI, we are looking at link between motor planning and SI
If you get a child with a motor planning problem and he is all over the place, what do you need to check?
need to see if he has a somatosensory processing process (tactile, prop, anything else?)
T/F: Within the frontal lobe, the supplementary area is related to a motor planning while the pre-motor area is not
False. Both areas are related to motor planning problem. Both receive prop.
Part of the frontal lobe that tends to be more related to feedforward (anticipating), ideation and sequencing, and bilateral integration and sequencing problems
Supplementary frontal lobe area
Area of frontal lobe that is impacted when you have a bilateral integration and sequencing problem
Supplementary frontal lobe area
Area of the frontal lobe that is impacted when you have a somatodyspraxia problem
pre-motor area
-With somatodyspraxia, have feedback related problems, but also feedforward b/c of this
Area of frontal lobe that responds to primarily prop input
Supplementary
Area of frontal lobe that responds to visual input and somatosensory input
pre-motor
T/F: Children with Bilateral integration and sequencing problems only have feedforward problems
True
In order to develop ideation (e.g., know what you can do with a piece of paper), what do you need to have?
You must have experienced a certain situation? E.g., with paper, you know what to do from previous interactions with it
One of the 4 domains Ayres did factor analysis study; Includes tactile and prop; feedback motor planning
Somatopraxis
One of 4 domains Ayres did factor analysis study on; Includes vision and tactile; visual perception
Visuopraxis.
A child with ______ will have decreased scores in lots of tests that require visual perception, copying and imitating
Visuopraxis
- May have visual perception problem or visual processing that affects motor planning
- Tests include motor accuracy, constructional praxis–requires you to visually transform something
T/F: Somatopraxis is related to feedforward motor planning
False. Somatopraxis is related to feedback motor planning; tactile and prop
T/F: Bilateral integration and sequencing problems are related to feedforward problems
True. When both sides of the body are moving, have to time something, moving fast.
T/F: Bilateral integration and sequencing, one of four of Ayres factor analysis categories, include Tactile and prop
False. Include vestibular and prop. Also called (VP) Bilateral integration and sequencing
Low scores in sensory tests across the board means a child has…
Generalized SI dysfunciton
Children with dyspraxia on verbal command generally have low scores with which SIPT test?
Low scores on test of praxis on verbal command–tests auditory processing (like simon says)
If a child only shows low scores on auditory processing and high scores on PRN, will an OT treat him?
NOPE. Refer to speech and language therapist. Probably has more of L hemisphere function. High PRN scores mean higher level cortical issue. We don’t treat
What does “low average SI and praxis” category of Ayre’s cluster analysis of 293 children with and without SI problems or learning disabilities mean?
Kid is borderline
What does “High average SI and praxis” category of Ayre’s cluster analysis of 293 children with and without SI problems or learning disabilities mean?
Kid is normal
T/F: From over 2 decades of research and praxis, Ayres concluded that ideation in praxis is related to tactile perception, language development, but not visual perception
False. She concluded that ideation in praxis is related to tactile perception, language development, and perhaps also visual perception
From over two decades of research and practice, ayres concluded that tactile perception is strongly associated with motor planning that requires imitation of body positions and actions. What concept is she describing?
Somatopraxis
From over two decades of research and practice, Ayres concluded that visual perception is strongly associated with planning of fine motor actions to copy 2- and 3-dimensional designs. What concept is she describing?
Visuopraxis
T/F: Ayres’ factor analysis findings have not been able to be replicated in subsequent years
False.
- Mulligan replicated Ayres’s findings via a generalized factor
- Mailloux et al., replicated findings via factor analysis of SIPT and sensory processing measure (SPM) (she added sensory processing measure)
- She saw that prop was also part of bilateral integration and sequencing (why we say prop/vestib bilateral integration and sequencing)
Ayres research related to dyspraxia included factor analysis of which of the following domains: A. Somatopraxis B. Visuopraxis C. Bilateral integration and sequencing D. Praxis on verbal command E. A and C F. All of the above
F. All of the above
One of Ayres four factor analysis categories that tests auditory processing
Praxis on verbal command. Praxis on Verbal Command in the SIPT assesses the ability to interpret verbally given instructions to assume certain positions and to then assume them. A typical test item might be “Put your hands on top of your head.”
The ability to generate an idea or concept for action
Ideation
Ability to conceptualize a purposeful interaction with the environment
Ideation:
- A cognitive process
- Dependent on previous interactions
- Ayres postulated that ideation serves organization of behavior
- Visualization may be involved
T/F: Praxis can only be demonstrated with a skill that is already learned
False. Anything that is already learned is a skill e.g., a gymnast on monkey bars. It is not praxis–doesn’t require motor planning. If learning monkey bars for the first time, then would be praxis: have to time it, anticipate, bilateral coordination, use momentum
T/F: Going on the monkey bars requires more feedforward while climbing a ladder is more feedback
True. With monkey bars, have to anticipate actions and use momentum while with a ladder, you can go as slow as you want without changing performance. If you go slow on monkey bars, won’t be able to do it
T/F: Teaching a child to pump on a swing for the first time requires more feedforward than feedback
True. Has a little motor planning and feedback motor planning at the beginning. Once they need to learn to time it, requires more feedforward
T/F: Teaching a child to jump on a trampoline for the first time requires a sense of feedforward
True. Cannot do this slow. Have to anticipate when to jump and land
With a child with ASD, how can you test his ideation?
By stopping him and asking “what are we doing?” “How should we do this?”
What does bad/good ideation look like in a child doing an obstacle course?
Bad ideation: always sets it up in same way; puts similar pieces again and again
Good ideation: Is the goal of the task. often missing the goal of a task (especially with kids with ASD)
How can you work on ideation with a kid who lacks the ability to come up with a plan/goal?
- Give them the first goal
- Can still offer choices
T/F: When asking a child to copy/imitate something e.g., model of blocks, you are looking at ideation
FALSE. Looking at motor planning–he is not coming up with the idea/plan on his own
T/F: Ideation is the same as creativity
False. A child can be creative without moving e.g., language, social demands. Can come up with stories but have trouble transferring it to real world. Ideation involves creativity, but not all creativity involves ideation in praxis. Ideation is used in relationship to movement–coming up with interactions with physical world.
How is creativity linked to ideation in praxis?
Ideation in praxis is creativity in coming up with new ways to move or use the physical body in the physical world.
Ideation and motor planning are always tied to…
Ideation and motor planning are always tied to the motor performance and physical world
Ability to organize actions in space and time to order actualize the idea
Motor planning
Motor planning requires which of the following:
A. Requires managing the location and position of body parts in relation to each other
B. Requires managing the location of the whole body in relation to the physical environment
C. Requires sequencing actions to achieve the goal
D. Requires timing actions to achieve the goal
E. B and C
F. All of the above
F. All of the above
T/F: Praxis is the same as motor skill
FALSE.
- Praxis is the ability to conceptualize and plan NOVEL actions or action sequencings; requires focused attention
- Motor skill is a familiar learned motor pattern that is programmed; it has been practiced and stored in memory, and is performed automatically (but may be modified by perception of immediate conditions)
T/F: Praxis is the same as motor learning
False.
- Praxis is the ability to conceptualize and plan novel actions or action sequencings
- Motor learning is the process of acquiring a specific motor skill; involves practice of movement pattern that becomes stored in the CNS (i.e., programmed) and can be activated for performance in a predictable way
- Sensory integration and praxis contribute to efficiency in the process of motor learning, and enable rapid creation of a new motor program, but is not the same as motor learning or executing a motor program
T/F: When a skill is learned and is new longer new, motor planning is now required
False. Praxis is required to learn new skills which requires motor planning. But, once learned something, doesn’t require MP anymore. Only actions that continue to require MP are skills in which you have to be organizing space and time continuously e.g., karate, soccer (constantly adjusting to what happens around you)
T/F: Apraxia was first defined not too long ago.
True. This shows that Ayres was very ahead of her time.
T/F: Early views of apraxia stressed the importance of conceptualization while later views stressed a motor execution deficit.
False. Early views stressed a motor execution deficit while later views stressed the importance of conceptualization
Type of adult apraxis that refers to difficulty in planning action
Ideomotor.
- Names object but doesn’t program an action, evaluated using imitation and pantomime tests (meaningful gestures)
- Ideation is intact but the planning action has broken down
- Possible disconnection between planning and execution
- Other types of apraxias: constructional, dressing, postural apraxia
- Ideomotor apraxia may occur without ideational apraxis
T/F: When identifying types of adult apraxia, we ask if the problem is related to ideation, motor planning or both. Generally, the problem is affected more by ideation
False. Generally, child is affected by both ideation and motor planning.
T/F: Apraxia = Dyspraxia
False. Apraxia (neuromotor problem) is not the same as dyspraxia
T/F: If a child has a neuromotor problem, he will also have dyspraxia
False. Neuromotor problems are not the same as dyspraxia. A child with a neuromotor problem (e.g., CP, dystonia, tremors) will affect execution of a motor plan by interfering with muscle control, but execution of problems will not necessarily mean problems with motor planning (Can plan, but just not execute b/c muscles) May have very good praxis–e.g., intelligent in figuring out ways to compensate for motor control impairment
-Execution is only the final step in praxis (ideation, MP, execution) which is the expression of MP an other things
A child on top of a swing that does not know how to get down is an example of what kind of problem?
Motor planning problem.
T/F: Children with CP hemiplegia often have MP problems
True. Often have to teach kids with CP how to get down from bed
T/F: Apraxia or dyspraxia is manifested only in the context of a simple task
False. Apraxia or Dyspraxia is manifested only in the context of a complex task because MP requires sequencing
- Inability to activate the correct pattern of muscles during movement (Apraxia)
- Inability to activate the correct pattern of muscles to accomplish task (apraxia and developmental dyspraxia)
How is sensory processing important for the development of praxis?
Sensory processing influences development of a sensory-motor map (scheme) of the body, which is essential in interactions with the environment
(Sensation –> Processing –> Actions)
How are basic motor skills important for development of praxis?
Basic motor skills emerge as a result of praxis, and provide a foundation for more complex praxis capabilities
Include intention, anticipation, cause and effect, object relations, and basic ideation. These skills appear during the first year of life and lead to the development of “orchestrated patterns” of organized behavior and meaningful occupations
Cognitive skills
T/F: It is difficult to see problems with motor planning until the ages of 5-6 years old
False. Can already see MP issues in 2nd or 3rd year
At what age does ideation begin to drive one’s actions?
In the second year:
- Simple organization of behavior
- Ability to imitate simple actions
- Enhanced timing of gross motor skills
- Late in the second year, child starts combining actions into coordinated behavior sequences
At what age is a child generally able to orchestrate multiple units of actions into a meaningful pattern –> Complex organization of behavior
Third year and later. Ideational ability expands.