Wednesday, 19 October 2016

Praxis makes perfect? (Understanding thought processes and physical reaction)  Dyslexia Dublin  © 2016

Praxis is the ability to organise a thought/action from the brain into a pre-planned movement. In order for someone to demonstrate the appropriate movement/command, the brain extracts and uses information from all of our memory and sensory processing areas ie. touch,  auditory, smell, vision, taste plus vestibular balance/inner ear  (proprioceptive/muscle receptors) to start and finish a given task… an example is right hand knowing what the left hand is doing.  Taking this into useful terms, apraxia and dyspraxia expresses the lack of maturity in the areas required  to fully plan some coordination of movement or speech…this does not mean that we cannot carry out all processes…indeed some with DCD/Apraxia are very good at sport but lack maturity in other areas.
Before we talk about Praxis further let’s look at how we send signals from our brain to our body (movement planning and activation of those movements) -
Cognitive …what does that mean?
It is the mental/thought process of knowing, including aspects such as awareness, perception, reasoning, and judgment…everything we do for every second of our lives involves our brain in some way, shape or form…even whilst asleep (dreaming…moving, etc.)!
Sensory memory is the first tier of memory. Sensory memory retains the briefest image of a sensory stimulus…one effect of brain training is to strengthen this part of our memory…look at an object that is new to you and then close your eyes…then open them.  After the object has gone, can you still remember or visualise that object?  Rather like turning off the bedroom light and planning your journey to the bed without tripping over the bed or your shoes, we manage it sometimes but not always.
A baby learns this from around 8-10 months of age.  Up to this point it believes everything that goes out of its immediate visual range has gone forever.  This is due to lack of maturation of the short episodic and indeed long term memory.
We use this as a means to also determine body actions/movement…without signals from the brain to our body we would only move due to nerve or spasm  reactions (to coin the phrase ‘running around like a headless chicken’) having no control over movement.
Psychomotor - relating to the origination of movement in one or more (single or multi-task) conscious mental activities.  It is the transition from the thought to the planning and doing of actions, be it big or small physical activity. Psychomotor learnt skill stored in the motor cortex is portrayed by  us through physical skills such as movement, coordination, manipulation, dexterity, grace, strength, speed… actions which demonstrate the fine motor skills, such as use of precision instruments or tools, or actions which evidence gross motor skills, such as the use of the body in dance, musical or athletic performance.
We feel cold and a signal is sent from the skin surface to the brain, we then react by shivering…a part of our clothing irritates and the brain moves us to try and create a resistance to that irritation though scratching the area affected…most of these would be deemed primal reactions.
Visual motor integration is about taking all this into consideration in order to move forward with a given task and we can do this with all children and adults, but on occasions we must adapt the way we attack the learning process… this means linking coordinated visual perception skills together with gross-motor movement and fine-motor movement in a way that becomes as simple as possible in the early stages of learning new tasks, until sufficient levels of proficiency are reached… for both practical and academic outcomes to be fulfilled.
Praxis for the most part comes from learning and development (maturation) although as mentioned some would be primal (genetic).  We use several processes to complete the most basic of tasks. Some of the tasks in early infants are learnt through monkey see monkey do and others through stimulus and natural development.
These would range from the sitting up phase of a baby around 6-8 months, to coordinating limb movements to enable the child to crawl and then to stand and eventually walk…much of this progression is down to curiosity and the need to survive….keeping warm to eating and drinking.
 However we have far more complex tasks along the way and we can’t do everything by ourselves. On occasion we have to coordinate with others… this could be using one’s thoughts and another’s physical skill to complete a task.
Fine motor tasks are often harder for someone with Dyspraxia or DCD… like learning to ride a bike involves multi-tasking or tying your shoes for the first time is a very complex task and one which many take for granted.
 We don’t perceive all these components separately.  For example, as you watch a child/adult complete a task, such as tie his/her shoe laces, we don’t break it down into different actions, even though in the case of dyspraxia we should (over-learning is vital).  Also, balancing maybe to put on a sock or wash their feet.  However, when a child has apraxia, these tasks have to be broken down into singular components and then practised and built in order for the child to complete the whole task.
If you take a sequence like dressing, which becomes second nature to many, this would be an extremely complex task to someone with dyspraxia or apraxia.
In order to achieve this, as with other activities, they could benefit from visual instruction in the early days until the skill becomes second nature…pictures or even post-it notes are very handy.
Tying shoe laces is a task made easier by practising with the shoes on their lap at first, break the task down to single actions and then let them repeat it until it’s achieved with ease…my son achieved this after two hours and is now delighted to be able to wear any shoes he so chooses.  Being honest he did better than I…when I was young I remember sitting with a very tolerant girl in our village (who wasn’t aware I was dyspraxic) nearly the whole day and I finally mastered the skill!
The focus of many dyspraxics is more often than not is singular…multi-tasking is quite difficult, if you overload them with several things to accomplish be prepared for them to get this wrong or complete only part of your request and always remember rarely is this done deliberately.
“Be patient and praxis will eventually make perfect”. For those whose children bum shuffle, show them how to crawl, the increases in co-ordination are invaluable. it is so important due to slow processing ability to give long periods for practice that you would to their peers, remember demonstrate a task several times and show them piecemeal (over learning wins every-time).

Nb.The information is the work of our team and will occasionally contain the words of others…all our information is provided on a guidance basis and we always recommend that you seek professional advice. Dyslexia Dublin  © 2016

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