Apraxia an unregognised barrier to all learning

APRAXIA - AN UNRECOGNISED BARRIER TO ALL LEARNING

The writer has been deeply involved in the investigation of the learning characteristics of students with special needs and has come to the belief that apraxia is just as much a barrier to a planned learning of social behaviour as it is a barrier to learning to communicate, to read or write.

In all 40 years of studying, teaching, designing and implementing programs for the improvement of learning strategies of mildly, moderately and severely handicapped children and adults the writer had seen a consistent pattern emerging: Developmental apraxia is the common denominator for many severe learning problems.

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, but the child is able to learn splinter skills. Dressing, constructive manipulation, drawing, cutting, pasting, assembling and learning to write are difficult for an apraxic child.

There are many clues and patterns in children's performance suggesting specific dysfunctions, such as apraxia. If we can read these clues, than we will be able to use them as a basis to design and implement a program to overcome at least some of the barriers that make any learning so difficult.

Hana Jay DE Sydney, B SpEd Charles Uni Prague

© Jays' Education. IBN 1 876578 74 2 APRAXIA - AN UNRECOGNISED BARRIER TO ALL LEARNING (out of print)

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 oral-motor planning deficits. Dyspraxic children have difficulties transmitting speech messages from the brain to their mouth organs, in other words, it is affecting the 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
(htt://www.isn.net-jypsy/apraxia.htm)

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:

Apraxia - meanings in the field of medicine.

An impairment in the ability to perform voluntary skilled movements purposeful acts in a person with intact motor abilities.
A person with apraxia can still comprehend what needs to be done, has the muscular strength, coordination, sensibility to do it - yet he cannot.
People with apraxia usually do not know that they have such a problem.

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

Ideomotor apraxia is a disturbance of voluntary movement 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 they were designed for. They cannot use a tool due to a motor deficiency.

Motor movement is not lost, however the person's movement 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 tasks motor tasks.

The dysfunction is characterised by clumsiness in motor activity, a lack of knowing how to go about executing an unusual motor task, reduced sensory motor proficiency, and an inadequate extraocular control.
Dressing, constructive manipulation, drawing, cutting, pasting, assembling and learning to write are difficult for an apraxic student.
Perception input from joints, bones and muscles may contribute to sensory integration through organisation of locomotion and visual input at the stem level.

Ideomotor Apraxia or Motor Command Apraxia

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.
A type of Apraxia affecting language is Receptive aphasia, it is the inability to understand spoken language.
Expressive aphasia or Broca's aphasia is the inability to say what one desires to say. Sometimes a person with aphasia can sing or pray.
Agraphia is the inability to write what one wishes to.
Dysarthria is a slurring of speech due to paralysis or incoordination of the speech muscles; it is not apraxia.

_______________________________________________________________________

The above outline is by no means exhaustive or detailed. I have no medical qualification HOWEVER from an educators point of view I have studied apraxia for many years. I have thought a large number of students from K to 12 and improved their life as well as their school performance successfully.

To discuss any apraxia issue, answer questions send me an email.

Hana Jay DE Sydney, B SpEd Charles Uni Prague

List of signs of APRAXIA to watch for.

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

1. Speech problems. Omits or adds syllables, pronounces some sounds incorrectly and is not able to repeat the correct version of words.

2.        Language problems. 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 and run or wonder of or abuse someone or engages himself in an antisocial behaviour.
3.        Clumsiness. The child seems to be generally clumsy, cannot catch a ball, cannot use scissors, shows problems using any tools, kitchen utensils etc.
4.        The child picks up things and drops them again, misplaces things, replaces items from place to place without an apparent reason.

5. 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.

6. Cannot remember sequences of steps to carry out a task.

7.        Cannot remember more then one instruction at a time.
8.        Gets frustrated and impatient or withdrawn from listening when given an instruction or explanation.
9.        Shows often signs of withdrawal (day dreaming) during activities or lessons.
10.        Does not participate in games or starts and then wonder or runs off.
11.        Concentration span varies but is generally very short.
12.        Gets often very upset, throws things around, turns furniture over or just screams.
13.        Does not start work with the others, but has to be encouraged to do so.
14.        Does not stick at a task, seems tom lose interest quickly.
15.        Wonders often around the classroom handling things and putting them down again.
16.        Does not want to stand in lines, hates waiting and taking turns.
17.        Uses either hand for picking up things, or for manipulative tasks.
18.        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.
19.        Graphic. Cannot draw a line or a circle, just scribbles one big scribble or a little round scribble.
20.        Cannot colour in, stays on one spot and does not move or scribbles all over.
21.        Cannot join two points with a straight line, looses the direction easily.
22.        Cannot move his eyes from one spot to another and join the lines.
23.        Cannot copy a number or a letter. All attempts end in a scribble or a squiggle.
24.        Writing. Cannot form numbers or letters correctly. Matches the writing movement very fast, approximately. Does not seem to follow instructions describing how to form the letter correctly.
25.        Cannot copy a shape or a movement.

26.        Seams to learn the letters 9or numbers) but cannot produce them. Understands that they are not correct and gets upset, but cannot get them right, no matter what.
27.        Can write writes only seldom and in a clumsy manner that he comes across as if he cannot write at all.
28.        Learning Difficulties. Has difficulty to comprehend new concepts and learn new skills.
29.        Never understands what he should do or where should he put it (whatever it is).
30.        Seems to listen but does not comprehend what was said.
31.        Can read but it looks as if he cannot read well, as he does not apply the skill.
32.        Does hesitate before he starts anything.
33.        Is aware that if he does not attempt a task, he cannot be blamed that he misunderstood the instructions and done it all wrong.
34.        starts to work by the time the others have finished.
35.        Learns a skill and then he gets muddled and upset, relearns the skill and gets it few times right and then gets stuck again.
36.        Does not attempt to work unless encouraged and lead.
37.        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.
38.        Does not seem to remember what should be done, by when should it be handed in.
39.        Forgets his books and loses his pencils.
40.        Is unorganised messy forgetful, seems to be disinterested, not caring.
41.        Gets lost in time. Time means nothing to him, there are no time limits. Time lines are only for now and after.

© Jays' Education

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