APRAXIA in Children - An Unrecognised Barrier to Learning

What is Apraxia?

"The terms Apraxia and Dyspraxia are used interchangeably. Both terms refer to disturbances of praxis, known as motor planning. They are usually referring to oralmotor planning deficits. Dyspraxic children have difficulties with expressive side of language. It is the output from the brain that causes the dysfunction. Most cases of Dyspraxia are idiopathic, of unknown origin."
Lucker - Lazerson, MA, CCC – SLP (http://www.isn.net-jypsy/apraxia.htm - link no longer active)

The word Apraxia comes from a Greek word "a" which means "to do without" and Greek word "pratto" which means "to do".

Thus Apraxia roughly translates into "without being able to do". (Source: http://www.medfriendly.com/ideationalapraxia.html)

Scientists recognise many forms and kinds of Apraxia. The way scientists describe and characterise apraxia differs according to the scientist's field and personal experience.

The main types of Apraxia are listed below:

Motor Apraxia - disturbance of voluntary movements in which one cannot use objects for the purposes for which they were designed.

Ideomotor Apraxia is a disturbance of voluntary movements in which a person cannot translate an idea of thought into the performance of simple motor acts.

Ideational Apraxia is a disturbance of voluntary movement in which one cannot use objects for the purposes for which they were designed. He cannot use a tool due to a motor deficiency. Motor movement is not lost, however the person's movements appear confused because he cannot form a plan how to sequence those movements when using an object.

Developmental Apraxia is defined as a disorder of sensory integration interfering with the ability to plan and execute skilled or non-habitual motor tasks. The dysfunction is characterised by clumsiness in motor activity, a lack of knowing how to go about executing a specific motor task, reduced sensory motor proficiency, and an inadequate extra ocular control. Dressing, constructive manipulation, drawing, cutting, pasting, assembling and learning to write are difficult for an Apraxic person.

Ideomotor Apraxia or Motor Command Apraxia is defined as inability to carry out a previously learned motor task. It is a disorder of planning, timing and spatial organisation. It is usually the cause of learning difficulties manifesting itself in poor learning habits, disruptive behaviour, underperforming in all subjects.

Dressing Apraxia is an inability to dress himself properly. The person with dressing Apraxia will place their clothing upside down, backward and will be unable to self correct. The inability to change even after demonstration is typical of an Apraxic person.

Constructional Apraxia is the inability to copy, draw or construct. Constructional Apraxia limits the person's ability to manipulate the environment effectively.

Expressive Apraxia is a type of Apraxia affecting language.

The above outline is by no means exhaustive or detailed. To discuss any Apraxia issue, please fill out the enquiry form to your left or call us on Phone/Fax: (07) 3822 1813 or Skype: Jays Education (please, state the reason of your call, we do not accept casual “chat”).

Hana Jay DE Sydney, B SpEd Charles Uni Prague

List of signs of APRAXIA to watch for

These signs are often misinterpreted, and insufficient methods of remedial programs are applied. It usually treats the symptoms not the cause. If only the symptoms are targeted, some improvement is possible but generally in time the progress slows down again and a different approach is looked for.

• Omits or adds syllables, pronounces some sounds incorrectly and is not able to repeat the correct version of words.
• The language might be delayed, or might be very immature for the age. The child may have problems to form sentences, cannot find the words to express himself. The child might be impatient to express himself altogether.
• Seems to be generally clumsy, cannot catch a ball, cannot use scissors, shows problems using any tools, kitchen utensils etc.
• Picks up things and drops them again, misplaces things, replaces items from place to place without an apparent reason.

• Wonders often around the room handling things and putting them down again.

• Problems with dressing himself. Does not do his buttons up. Has problems putting socks on (does not know how to go about it). Cannot zip up his jumper etc.
• Cannot remember sequences of steps to carry out a task.
• Cannot remember more than one instruction at a time.
• Gets frustrated and impatient or withdrawn from listening when given an instruction or explanation.
• Shows often signs of withdrawal (day dreaming) during activities or lessons.
• Does not participate in games or starts and then wonders or runs off.
• Concentration span varies but is generally very short.
• Is overly sensitive, his feelings are often hurt.

• Does not start work with the others, but has to be encouraged to do so.
• Does not stick at a task, seems to lose interest quickly.
• Does not want to stand in lines, hates waiting and taking turns.
• Uses either hand for picking up things, or for manipulative tasks.
• Though he is using either hand he cannot freely put both hands together in a synchronised way. Often he has one hand hanging down and uses one hand only, even if the task requires two hands. When reminded of other hand, he switches hands, and one is again hanging down.
• Cannot draw a line or a circle, just scribbles one big scribble or a little round scribble.
• Cannot colour in, stays on one spot and does not move or scribbles all over.
• Cannot join two points with a straight line, looses the direction easily.
• Cannot move his eyes from one spot to another and join the lines.
• Cannot copy a shape or a movement.
• Cannot copy a number or a letter. Does not seem to follow instructions describing how to form the letter correctly.
• Seams to learn the letters or numbers but cannot produce them.
• Has difficulty to comprehend new concepts and learn new skills.
• Never understands what he should do or where should he put it.
• Seems to listen but does not comprehend what was said.
• Can read but it looks as if he cannot read well, as he does not apply the skill.
• Does hesitate before he starts anything.
• Is aware that if he does not attempt a task, he cannot be blamed that he misunderstood the instructions and done it all wrong.
• Starts to work by the time the others have finished.
• Learns a skill and then he gets muddled and upset, relearns the skill and gets it few times right and then gets stuck again.
• Does not attempt to work unless encouraged and lead.
• Cannot “think” of anything to write about, does not know how to start, where to get information, or what is important and what is irrelevant.
• Does not seem to remember what should be done and by when it should be handed in.
• Forgets his books and loses his pencils.
• Is disorganised, messy, and forgetful.
• Seems to be disinterested, not caring.
• Gets lost in time. Time means nothing to him, there are no time limits. Understands only now and not after. Has limited idea when events will take place, can not anticipate or plan.
• Is all the time on the move, getting from one thing to another.
• Lack of order makes it difficult to keep his possessions to be organised and tidy, his homework done.
• When interrupted, forgets what he is doing, and usually does not continue in that activity.

Developmental Apraxia is defined as a disorder of sensory integration and central organisation interfering with the ability to plan and execute skilled or non-habitual motor tasks. Although the person may have adequate comprehension, sensory and motor function, he may demonstrate difficulty in performance. The dysfunction is characterized by clumsiness in motor activity tasks, reduced quality of oral motor proficiency, inadequate extra ocular control. Skill development is slower than age expectation, resulting in learning difficulties.

Hana Jay DE Sydney, B SpEd Charles Uni Prague
© Jays' Education. IBN 1 876578 74 2 APRAXIA - AN UNRECOGNISED BARRIER TO ALL LEARNING.

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