Praxis Flashcards
(262 cards)
1
Q
What is praxis?
A
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
2
Q
T/F: Praxis is a motor process
A
FAlse. Praxis is an organizational process, beyond motor. Focus is on using the physical body to interact with the physical world
3
Q
Other literature refers to praxis as ______
A
Other literature refers to praxis as executive functioning (setting and making a goal)
4
Q
T/F: Vestibular and prop contribute to motor plan while tactile does not
A
False. V, P, and T all contribute to body scheme which is necessary to motor plan
5
Q
T/F: Rank the following in terms of difficulty levels related to praxis:
- Body on Body
- Body to object
- Body on an object
A
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)
6
Q
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
A
Praxis
7
Q
How may a child with praxis problems appear?
A
- 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
8
Q
Which is the most essential component to praxis?
- Ideation
- Motor planning
- Execution
A
Motor planning: organizing steps to accomplish goal in head; ability to put components together
9
Q
Ability to conceptualize a new activity or a new way to perform an activity
A
Ideation–coming up with a goal
10
Q
3 Key components of praxis …
A
- 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
11
Q
Ability to organize actions needed to perform activity e.g., sequencing, and timing of action within a spatial environment
A
Motor planning
- Organizing steps to take in head to accomplish goal
- Ability to put components together
12
Q
Observable motor performance, which may be affected by issues other than praxis
A
Execution
13
Q
When testing praxis, what do you need to make sure to do when giving tasks to child?
A
Need to creative tasks that are testing motor planning above other things
14
Q
Bridge between cognition and motor function
A
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
15
Q
A kid with praxis problems may do what when attempting to conceptualize and achieve a goal?
A
-May freeze up or try same strategy over and over again even if it’s not working
16
Q
How is language related to praxis?
A
- 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
17
Q
T/F: A kid with ASD will have a lack of flexibility with motor but not language
A
False. A kid with ASD will often have a lack of flexibility with both motor and language–repeat both words and motor actions
18
Q
T/F: A child with dyspraxia always has language problems
A
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.
19
Q
T/F: Dyspraxia mostly occurs in children while apraxia is mostly used with adults
A
True. Apraxia may be used with children, however.
20
Q
What is it important to do when testing dyspraxia in children?
A
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
21
Q
A child with this problem will have difficulties with motor learning, new novel tasks, and generalizing a task to a new environment
A
Dyspraxia
22
Q
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?
A
SI clinic should look a little different each time they walk in.
23
Q
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
A
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
24
Q
Why may a child stay inside instead of going out to recess?
A
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
25
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
26
A problem grading force is related to what kind of problem?
Prop
27
A child who holds his pencil wrong--has weird position--probably has what kind of problem?
Prop
28
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
29
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)
30
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
31
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
32
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
33
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
34
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
35
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
36
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
37
T/F: A child who is underresponsive to sensory input will not benefit from experiences they had, even if in enriched environment
True
38
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
39
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.
40
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
41
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
42
T/F: Praxis is only related to the frontal lobe
False. Many parts of the CNS contribute.
43
Praxis that involves conceptualizing or planning actions of body in space; heavily dependent on body scheme
Somatopraxis
44
Praxis that involves conceptualizing or planning actions that are guided by visual perception
Visuopraxis
45
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
46
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?)
47
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.
48
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
49
Area of frontal lobe that is impacted when you have a bilateral integration and sequencing problem
Supplementary frontal lobe area
50
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
51
Area of frontal lobe that responds to primarily prop input
Supplementary
52
Area of frontal lobe that responds to visual input and somatosensory input
pre-motor
53
T/F: Children with Bilateral integration and sequencing problems only have feedforward problems
True
54
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
55
One of the 4 domains Ayres did factor analysis study; Includes tactile and prop; feedback motor planning
Somatopraxis
56
One of 4 domains Ayres did factor analysis study on; Includes vision and tactile; visual perception
Visuopraxis.
57
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
58
T/F: Somatopraxis is related to feedforward motor planning
False. Somatopraxis is related to feedback motor planning; tactile and prop
59
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.
60
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
61
Low scores in sensory tests across the board means a child has...
Generalized SI dysfunciton
62
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)
63
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
64
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
65
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
66
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
67
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
68
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
69
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)
70
```
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
71
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.”
72
The ability to generate an idea or concept for action
Ideation
73
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
74
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
75
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
76
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
77
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
78
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?"
79
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)
80
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
81
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
82
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.
83
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.
84
Ideation and motor planning are always tied to...
Ideation and motor planning are always tied to the motor performance and physical world
85
Ability to organize actions in space and time to order actualize the idea
Motor planning
86
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
87
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)
88
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
89
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)
90
T/F: Apraxia was first defined not too long ago.
True. This shows that Ayres was very ahead of her time.
91
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
92
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
93
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.
94
T/F: Apraxia = Dyspraxia
False. Apraxia (neuromotor problem) is not the same as dyspraxia
95
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
96
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.
97
T/F: Children with CP hemiplegia often have MP problems
True. Often have to teach kids with CP how to get down from bed
98
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)
99
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)
100
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
101
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
102
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
103
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
104
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.
105
How may children with dyspraxia appear in schools?
-May be good students, read instead of play sports, tend to sit more than participate in physical activity
106
T/F: Development of praxis may affect an adolescent's organization skills, but usually not social skills
False. May end up affecting social and organization skills as a teen. May affect:
- Organization of behavior in distal time and space (e.g., getting driver's license, long-term academic projects)
- Academic and social competence and self-efficacy
- Effect of self-concept on future plans
107
People with MP problems often choose what kind of careers?
Often see people with poor MP who are very bright that choose careers in academia or law--think rather than do. May do activities in which they ask others to perform certain tasks
108
```
Praxis problems in adulthood may affect which of the following areas?
A. Occupational choices
B. Work performance
C. Social networks and relationships
D. B and C
E. All of the above
```
All of the above
109
Movement which involves a simple step with a clear beginning and end:
Discrete movement
110
Task that requires repetitive steps that does not have a clear beginning and end
Continuous movement
111
Movement tasks requiring stability vs. mobility
- Stability: staying still
| - Mobility: moving through space
112
Playing violin:
- Discrete or continuous?
- stability or mobility?
- feedback (closed) or feedforward (open)?
- Requires attention?
- Requires manipulation?
- Continuous: repetitive, constantly sequencing actions
- Stability (not moving around a lot)
- feedback (can correct as you go, can go slow). But if playing very well and going fast and anticipating next notes, can be feedforward
- Requires attention
- Requires manipulation
113
Baseball catcher:
- Discrete or continuous?
- Stability or mobility
- Feedback (closed) or feedforward (open)?
- Requires attention
- Requires manipulation
- Discrete movements
- Stability
- Feedforward (anticipate when/where ball is coming from to catch, can't correct speed)
- Requires attention
- Requires manipulation
114
Playing soccer:
- Discrete or continuous?
- Stability or mobility?
- Feedback (closed) or feedforward (open)
- Requires attention
- Requires manipulation
- Continuous
- Mobility
- Feedforward (anticipating and correcting as you move through environment constantly)
- Requires attention
- No manipulation (if don't count feet)
115
Running:
- Discrete or continuous?
- Stability or mobility?
- Feedback (closed)or feedforward (open)
- Requires attention
- Requires manipulation
- No motor planning--learned task
| - Continuous task--as soon as you have continuous movement, you require sequencing
116
Working on computer as group:
- Discrete or continuous
- Stability or mobility
- Feedback (closed) or feedforward (open)
- Requires attention
- Requires manipulation
- Discrete
- Feedback if typing slow
- Attention
117
What kind of sport should you recommend to a kid with dyspraxia?
- Should do a sport that doesn't require much motor planning e.g., running
- Would recommend baseball over soccer
- Violin would be very difficult
118
T/F: Feedforward tasks are closed loop b/c you can correct while your doing the activity
False. FeedBACK tasks are closed loop, can correct while doing
119
Closed-loop/open-look theory
- Actions need external feedback
- Closed loop tasks (feedback) tasks require time and attention (e.g., threading a needle)
- Once learned the action does not require as much constant monitoring
120
T/F: Fast actions are based on feedback
False. Fast actions are based on anticipation or feedforward (e.g., soccer)
121
Tasks that require fast actions and don't require continuous external feedback
Open-loop tasks. Based on anticipation or feedforward (e.g., soccer). Not doing action based on the feedback you are receiving during the performance (only after the performance)
122
Abstract representation stored in memory developed from past experiences and used to plan future action
Schema
| -We all have schema for bicycle riding--can all get on bike and ride it
123
T/F: We are all born with schema
False. When born, haven't had experiences to learn schema. Kids need additional sensory input to develop schema.
124
The following are all four memories required for _____
1. The initial movement condition
2. The parameters used in the generalized motor plan
3. Outcome of the movement in the environment (KR)
4. Sensory consequences of the movement (KP)
Four memories required for schema
125
What is the first memory of schema, the initial movement condition, referring to?
Initiate movement: having an idea of how to start movement
126
What is the second memory of schema: the parameters used in the generalized motor plan?
- Parameters used for action
- With bike riding, pedals should be certain distance, spaced in certain way, once have this, can ride any bike. If you have bike with different pedals setup, have problem.
- Have parameters for going up stairs--if go most places, steps same size unless . a place where steps too short or long, then can't use original parameter. Then will have to motor plan whole time
127
What does outcome of movement in the environment (KR) refer to?
- 3rd memory for schema after 1. initial movement and 2. parameters used in generalized motor plan
- In tx, try not to give children knowledge of environment that isn't real
- Giving info that is appropriate so kid can change his actions
- Tell kid "it was close, but not so close. I'll move the container so you can hit it next time" "hit a little slower/faster"
- Give kid accurate info
128
T/F: Once a schema is learned, it remains the same for future use
False. We are constantly changing schemas as we learn new things.
129
Theory that posits that learning consists of the constant updating motor and sensory schemas with each movement that is made
Schema theory. Practice gradually builds up the motor program and develop a more appropriate representation of the action
130
What is Imitation as Motor Planning?
Imitation of unfamiliar body positions and movement sequences
131
T/F: Ayres found that accuracy and speed of body imitation is strongly associated with visual perception
False. Ayres found that accuracy and speed of body imitation is strongly associated with tactile perception, but not so much visual perception
132
Ayres theorized that _____ perception is critical for imitation of novel body positions
somatosensory perception is critical for imitation of novel body positions. Coined the term "somatopraxis"
133
Copying, imitation, sequencing, and feedforward are all part of ____________?
Motor planning
134
If a child has low tone and doesn't realize his body is crooked, he has problems with...
Prop. Not getting enough feedback from positions so crooked.
135
Difficulty with copying/imitating, and low prop indicates what problem?
MP problem that is FB and prop related
136
T/F: All motor problems are results of poor praxis
False. Need to consider alternative explanations for a child's movement difficulties
137
Assessment that is a gold standard for evaluating motor planning problems
SIPT. Additional assessment tools are used to evaluate specific aspects of praxis.
138
In order to evaluate motor planning/praxis problems, what kind of behavior is critical to observe?
Observation of spontaneous behavior is critical. Parent and/or teacher questionnaires may also provide valuable information. SIPT is gold standard for evaluating motor planning problems. Additional assessment tools used to evaluate specific aspects of praxis.
139
T/F: When evaluating praxis, standardized tests will give you a full picture for the diagnosis
False. Select multiple evaluation methods for comprehensive sensory integration assessment of praxis, including ideation and various aspects of motor planning:
- standardized tests
- clinical observations
- observation of spontaneous behavior
- parent questionnaires and/or interviews
140
Why is it important to consider the age of the child when evaluating praxis?
Consider typical developmental expectations for praxis at different ages when observing spontaneous behavior.
-Also consider whether child meets diagnostic criteria for medical conditions that are, or re not, consistent with a sensory integration problem
141
Difficulty conceptualizing what to do
Ideation
142
T/F: A child with ideation problems will always have motor planning problems.
False. Ideation often accompanied by poor motor planning, but not always. If not, don't consider it a dyspraxia problem.
143
What assessment may be helpful to use when assessing ideation?
May-Benson Test of Ideation may be helpful: looks at interaction of child with task e.g., piece of paper and ask what to do with it
144
The following observations are indicative of what problem?
- Child does not know what to do, so must observe others or follow commands
- May wonder, touch surfaces or objects, pick up or throw objects, stack objects rotely (mechanical/unthinking/repetitive), or do the same motor action repeatedly
Problems with ideation. Usually accompanied by poor motor planning, but not always
145
How can you evaluate somatodyspraxia (includes tactile and prop) ?
- Example tactile perception and kinesthesia
| - Examine relevant somatopraxis scores
146
How can we evaluate visuodyspraxia?
- Need to look at visual perception scores
| - Examine relevant visuopraxis scores
147
How can we evaluate motor planning?
SIPT tests
- Specifically evaluate somatodyspraxia (examine tactile perception and kinenesthesia; examine relevant somatopraxis)
- Specifically evaluate visuodyspraxia (examine visual perception scores; examine relevant visuopraxis)
- Use clinical observations--structured and unstructured
148
Somatopraxis test in which child imitates unfamiliar static postures
Postural praxis. Will have problems if can't do.
149
Somatopraxis tests in which child imitates face, lips, and jaw movements.
Oral praxis. Will have problems if can't do.
150
Somatopraxis test in which child imitates sequences of unfamiliar movements
Sequencing praxis. Can look at actions child has problems with
151
Somatopraxis test in which child follows verbal commands to assume unusual body position
Praxis on verbal command:
- Must come up with certain actions based on auditory input given
- If kid has MP problems, will have problems with this and other things
- If only does poorly with praxis on verbal command, will not necessarily have a MP problem
152
T/F: If a child only does poorly with praxis on verbal command, he will not necessarily have MP problems
True. With MP problems, will have problems with this as well as other things.
153
Somatopraxis test in which child imitates bilateral, rhythmic patterns of upper extremity movement
Bilateral motor coordination
| -Difficult for some b/c requires kid to organize both sides of body
154
T/F: A child with somatodyspraxia will have problems with tactile but not prop discrimination
False. Will have problems with tactile and prop discrimination.
155
Low score on sequencing praxis with no other indicators of somatodyspraxia may be due to....
Left hemisphere dysfunction
156
Low SIPT scores on postural praxis (imitate postures of examiner) or oral praxis (tongue, lip, jaw movement imitation), and possibly sequencing praxis (repeat hand and figure movements), praxis on verbal command (like simon says), and bilateral motor coordination (move both arms and feet together) probably indicates what problem?
Somatodyspraxia. Will also have low somatosensory perception test scores (e.g., manual form perception-stereognosis)
157
T/F: With somatodyspraxia, in addition to tactile and praxis problems, vestibular-proprioceptive processing also may be impaired (not always).
True
158
What is the difference between somatodyspraxia vs. somatosensory problems?
- With somatosensory: includes prop, have tactile discrimination problems (graphesthesia, finger identification, localization of tactile stimuli, manual form perception)
- With somatodyspraxia: Have tactile discrimination problems as well as praxis. In addition to assessments above, have problems with postural praxis (imitate postures) and oral praxis (imitate mouth, jaw movements). May also have vestibular processing problems
159
Why is it important to differentiate problems between subtypes of visuopraxis: visual construction (requires MP), visual perception, vs visuomotor
Need to differentiate b/c will treat differently
160
T/F: With a child with somatodyspraxia, he usually will be off on gross developmental milestones.
False. Gross developmental milestones usually within normal limits
161
T/F: A child with somatodyspraxia will have delayed ADL skills
True e.g., buttoning, zipping, opening milk cartons, putting on makeup, styling hair
162
A child who is clumsy, falls frequently, bumps into things, poor coordination, and may prefer sedentary tasks probably has what?
Somatodyspraxia
163
A child with somatodyspraxia normally does not have deficits with fine motor skills
False. Poor fine motor skills, including constructive manipulation e.g., scissors, handwriting, motor and/or spatial deficits
164
A child with somatodyspraxia may have difficulty initiating and sequencing, but not terminating serial motor acts
False. Will have difficulty initiating, sequencing, and/or terminating serial motor acts
165
T/F: Poor supine flexion, diadokikinesia, in-hand manipulation, and/or thumb-finger touching is often a clinical observation for a child with somatodyspraxia
True
166
Behavioral and emotional issues often associated with somatodyspraxia include...
- Poor self-concept (due to repeated failure and lack of mastery or poor body scheme)--know what they want to do, but can't do it
- Easily frustrated; often whiny, manipulative, or negative
- Difficulty sequencing actions together
- Poor organization of self-time, and materials
- May have emotional issues b/c low frustration tolerance
167
Design copying, constructional praxis, and motor accuracy are all ________ tests
Visuopraxis tests. With visuodyspraxia will have low scores in all : design copying, constructional praxis, and motor accuracy
168
Visuopraxis test in which child copies printed designs using pencil and paper
Design copying
169
Visuopraxis test in which child copies a 3D block structure using blocks
constructional praxis
170
Visuopraxis test in which child traces on top of a large wavy line, crossing midline
Motor accuracy
171
T/F: Visuodyspraxia is accompanied with somatodyspraxia
True.
172
When visuodyspraxia is seen with no other SI problems, deficits may be due to...
When visuodyspraxia is seen with no other SI problems, deficits may be due to cortical (i.e., right hemisphere) dysfunction
173
Poor form and space perception, poor visuomotor coordination, and poor constructional abilities are all subtypes of _________
visuodyspraxia
174
Low scores on tests that involve bilateral coordination and sequencing of movements, when seen with no other indicators of somatodyspraxia, usually reflect what kind of problems?
Low scores on tests that involve bilateral coordination and sequencing of movements, when seen with no other indicators of somatodyspraxia, usually reflect vestibular-bilateral problems
175
T/F: Children with vestibular-based BIS issues, and no other SI difficulties, are less severely affected than somatodyspraxic children
True
176
T/F: Children with vestibular-based BIS issues, and no other SI difficulties, tend to respond less quickly to SI intervention than children with more complex SI difficulties, such as somatodyspraxia
False. Children with vestibular-based BIS issues, and no other SI difficulties, tend to respond more quickly to SI intervention than children with more complex SI difficulties, such as somatodyspraxia
177
When treating a child with somatodyspraxia, what is the sensory experience? Challenges?
- Sensory experience: tactile discrimination and prop
- Challenges: motor planning and feedback
- Could put things in ball put and have them find certain things
178
When treating a child with bilateral integration and sequencing, what is the sensory experience? Challenges?
- Sensory experiences: vestibular and prop (generally underresponsive to vestib and prop)
- Challenges: feedforward, maybe bilateral motor control
179
What is the sensory experience of a child with somatodyspraxia vs bilateral integration and sequencing
- Somatodyspraxia: tactile discrimination, prop. Challenges with motor planning with feedback
- Bilateral integration and sequencing: vestibular and prop (generally underresponsive to vestib and prop). Challenges with feedforward, maybe bilateral motor control
180
When treating a child with tactile defensiveness, what is the sensory experience? Adaptive response/challenge?
- Sensory experience: start with prop, vestib, then deep pressure, then light touch at whole body
- Challenge: tolerance, attention
181
When treating a child with GI, what is the sensory experience? Challenge?
- Sensory experience: prop to help modulate
- AR/Challenge: Child controls vestib. input as it's slowly introduced after prop. Want child to be able to move/explore in space--tolerance to different positions. Want child to initiate own actions as move through space
182
T/F: When treating a child with GI, you can put the child in a ball put or on a swing
False. Too unpredictable. Only put on swing if he can move it own his own and his feet flat on floor
183
Which of the following will dyspraxia affect for a school-aged child?
A. Participation in playground games and activities
B. Academic skills: writing, math, reading
C. Organization of behavior to accomplish future tasks e.g., organizing homework
D. Participation in sports
E. Impact on self concept (competency, acceptive by peers)
F. Impact on social-emotional development (anxiety, self-worth, friendships)
G. All of the above
G. All of the above
184
Any repetitive tasks one after another is ________
Sequencing
185
Brushing teeth, jumping jacks, sequential finger movements are all examples of ....
sequencing
186
T/F: Feedback is part of motor planning, while feedforward is not
False. Both are part of MP. In feedforward, novel asks are anticipating actions e.g., ball play
187
T/F: When looking at fluidity of movement, you are able to see if a child has sequencing problems
True.
188
If a child has trouble with finger to nose task and often collapses, he probably has problems with...
Prop
189
Why is somatodyspraxia more difficult to treat/correct than (VP) BIS?
- BIS has feedforward problems while somatodyspraxia has feedforward AND feedback problems
- BIS has bilateral issues while somatodyspraxia has bilateral AND unilateral issues
- BIS has sequencing problems while somatodyspraxia has problems with sequencing and single actions
- BIS has problems with continuous (requires sequencing) problems while somatodyspraxia has problems with continuous AND discrete
- somatodyspraxia also has problems with imitation
190
Feedback/feedforward issues in BIS vs. somatodyspraxia
BIS: feedforward problem
Somatodyspraxia: Feedforward AND feedback problem
191
Sensory aspects in BIS vs. somatodyspraxia
BIS: vestibular and prop
Somatodyspraxia: Tactile discrimination and prop
192
Bilateral/Unilateral issues in BIS vs. somatodyspraxia
BIS: Bilateral
Somatodyspraxia: Bilateral AND Unilateral
193
Sequencing/single action problems in BIS vs. somatodyspraxia
BIS: Sequencing
Somatodyspraxia: Sequencing AND single
194
Discrete/continuous (continuous requires sequencing) problems in BIS vs. somatodyspraxia
BIS: Problems with continuous tasks
Somatodyspraxia: Problems with continuous and discrete tasks
195
Imitation ability in BIS vs. somatodyspraxia
BIS: no problems with imitation
Somatodyspraxia: Problems with imitation
196
Difficulty with smooth, precise and fast coordinated movements of independent fingers
Limb-kinetic
197
Disturbance in developing an idea
Ideational
198
The following are problems associated with ________:
- Difficulty associating sensory input with motor programs
- Difficulty carrying out a sequence of complex actions leading to impaired object use
- Difficulty knowing what to do with an object.
- Linked to left hemisphere functions
Ideational
199
T/F: Ideation is linked to R hemisphere functions
False. Linked to L hemisphere functions
200
T/F: Insufficient muscle activation is a sign of weakness
True
201
Inability to activate the correct pattern of muslces during movement
Ataxia
202
Inability to activate a specific pattern of muscles
Reduced selective motor control.
| -Ataxia: inability to activate the correct pattern of muscles during movement
203
When does a child begin to develop praxis?
At birth. From birth to 6 months:
- Develops body scheme
- Rapid development of tactile perception and prop
- early emergence of intentional action
204
The following emerge from birth to 6 months and are examples of the development of ___________
- Tactile exploration of body
- Simple movements in space
- Increased control over head and trunk musculature
- Anticipation of familiar routine
- Neonatal imitation
Development of body scheme
205
How to SI and praxis allow for flexibility in behavior?
- Detect when things aren't going well
- Anticipate what's coming next
- Create alternative plans for action, and modify as needed
206
Study of nature and cause of movement
Motor control
207
A set of processes associated with practice or experience leading to relatively permanent changes in the capability for skilled performance
Motor learning
208
Theory by Shumway-Cook, Woollacott that posits that movement emerges from the interaction of the individual, task, and environment
Systems theory. Motor control (study of nature and cause of movement) focuses on these aspects to explain the development of movement
209
What is sensation/perception
Info about the state of the body and environment
210
What does the last memory of schema, sensory consequences of the movement (KP) refer to?
The actual feedback stimuli received from eyes, ears, prop. etc
1. Initial movement condition
2. Parameters used in generalized motor plan
3. outcome of movement in environment (KR)
4. Sensory consequences of movement (KP)
211
What is the role of perception in motor learning?
Perceptual motor: combination of sensory skills (e.g., V, P, T) and motor skills (Fine, Gross) that allow a person to synchronize body movements. Example: finding right sized lid for soft drink.
- For motor learning, must understand the goal of task and movement required
- Receiving feedback to do: concurrent sensory consequences (KP) from eyes, ears, prop; outcome of movement on environment (KR) upon completion
- Searching for perceptual motor solution to task
212
Combination of sensory skills (e.g., V, P, T) and motor skills (fine, gross) that allow person to synchronize body movements
Perceptual motor.
213
Part of brain that regulates background level of arousal
Reticular Activating system
- Four A's: asleep, awake, alert, attending
- Rhythm generators modulate circadian rhythms
- -Dampens and filters unimportant stimuli and enhances stimuli critical for survival (e.g., novelty)
- Modulates neural threshold in cerebellum and cortex
- Interacts with limbic system and hypothalamus for homeostasis
214
Part of brain that:
- Receives efferent copies of motor commands from frontal lobe
- Sends messages to vestib nuclei for regulation of posture and balance
- Sends messages to frontal lobe for regulation of movement: smoothing, accuracy, and timing of action
Cerebellum
215
Structure that has multiple functional "loops" for regulating motor, emotional, social, and executive functions
Basal ganglia. Loops include:
- Motor: selection of movement and action
- Oculomotor: decisions about eye movements and spatial attention
- Executive: Goal-directed behavior, including perceptual decisions and plans in context
- Behavioral flexibility and control: self-regulation and attention in social context, selection of relevant knowledge
- Limbic: links limbic and cognitive to motor functions; reward-guided behavior, including pleasure; monitors errors in prediction
216
Part of the parietal lobe that is responsible for:
- Somatotopic organization (homunculus)
- Tactile and kinesthetic info from contralateral side of body
- Relays info to motor cortex and other parietal lobe regions for integration, interpreation, and use
Primary somatosensory cortex (SI)-areas 1,2,3a, 3b
217
Region of parietal lobe that:
- receives integrated somatosensory info from area SI
- Integrates info across areas of the body --> body scheme
- Projects info to area 7
Secondary somatosensory cortex (SII): Area 5
| --Legion in areas 5 and 7 lead to problems with learning new skills that require info about body position in space
218
Region of parietal lobe that:
- Integrates somatosensory with visual info
- Coordinates eye and limb in visually guided activities (eye-hand coordination), especially when attention is paid to movement
Association cortex: area 7.
| -Legion in areas 5 and 7 lead to problems with learning new skills that require info about body position in space
219
Region of frontal lobe that sends motor commands down to spinal cord to activate muscles
Primary motor area (Area 4).
| -Associated with motor homunculus
220
System that activates specific muscles, allowing for ability to isolate movements. Also has direct connections to motor neurons
Corticospinal (pyramidal) system.
| -Part of Frontal lobe motor commands
221
Tract that provides precise prop and tactile input necessary for anticipating, planning, and executing motor acts
DCML. Lesions in DCML do not result in complete loss of discriminative touch, because of some overlap with spinothalamic tract
222
Tract necessary for anticipatory action as well as initiation, readiness, and planning of movements
DCML. Lesions result in:
- Loss of tactile placement, balance, righting, and support reactions, hopping
- Disruption of planning/execution of serial motor acts requiring timing, spatial orientation, initiation, balance
- Decreased anticipatory components of sequential behavior (e.g., need to step over/around obstacles)
- Hypotonia (especially flexor)
223
T/F: Prop has a role in anticipating and planning of action sequences as well as timing of serial motor actions
True
224
T/F: Visual system contributes to feedback
False. contributes to feedforward.
- Visual analysis necessary for imitation, spatial organization for production of movement
- In depth visual perceptual processing influential in praxis
225
T/F: Vestibular system contributes to feedforward
True.
- Contributes to maintaining stable visual field
- Contributes to perception of space and time
226
T/F: all parts of the central and peripheral nervous systems are involved in praxis
True.
- Sensory input interprets present situation
- Regulation of arousal, attention, emotion
- Regulation of motor performance
- Sequencing of motor programs to create new motor plan
- Timing of action in environmental space
- Creation of new ideas for action
227
How does sensory registration play a role in praxis?
Sensory registration: process by which the central nervous system notices sensory input. CNS must register info about body and environment to imagine or plan action
228
Process by which meaning is given to incoming sensory info
Perception
229
Sensory map of the body
Body scheme
- Parietal lobe: primary, secondary, and association areas
- Integration of tactile and prop info arising from body at rest, and as it moves and makes contact with other body parts and with surface and materials in surrounding environment
230
Reference points for location of whole body in three-D space
Location of body in space
-Integration of V with prop, visual, touch pressure, and auditory info in brainstem, cerebellum, and cortical association areas
231
Ability to structure actions in time and space in order to successfully interact with the environment
Motor planning. Requires:
- Sequence of actions
- timing of actions
- dynamic positioning of body and body parts in environmental space and in relation to relevant objects, so that movements are optimal for the desired purpose
232
Motor skills vs motor programs
Motor skills: observable learned movement patterns that were acquired from past practice
Motor programs: movement plans that were learned from past practice, are stored in memory, and involved in specific sequence of actions
-Motor programs often serve as units of motor behavior during motor planning: a new sequence of existing motor programs is constructed; new sequence is time-, space-, and sensory-adjusted during execution to achieve goal
233
T/F: sequencing/ordering a series of movements is central in motor planning and programming
True.
- In SIPT, rapid transitions from one motor act to another
- Requires sequencing synergies of movement
234
Ayres found that accuracy in 2-D and 3-D copying assessments are strongly associated with ________
Visual perception.
- Coined the term "visuopraxis" for the underlying ability needed to perform these tasks
- Involves manipulation of objects in space outside the body, in contrast with somatopraxis, which involves manipulation of intrapersonal space
235
Information arising as a consequence of a response
Feedback
- Knowledge of performance: info generated by response rather than internal neuronal activity
- Knowledge of results: info arising from external environment as indirect consequence of muscular contraction
- Utilized in closed-loop tasks
236
Part of feedback involving info generated by response rather than internal neuronal activity
Knowledge of performance
237
Part of feedback involving info arising from external environment as indirect consequence of muscular contraction
KNowledge of results
238
T/F: Feedforward brain activity occurs once action can be observed
False. Feedforward brain activity occurs before action can be observed
239
Ability to begin executing the motor plan; may be related to basal ganglia, thalamus, cerebellar, or limbic system functions
Initiation of action
240
Observable movement pattern that results from motor commands arising from primary and secondary frontal lobe areas; may be affected by many factors other than praxis, for example, neuromotor control difficulties due to basal ganglia disorder
Motor execution
241
Cognitive process of predicting the results of action before or during execution, that probably involves frontal lobe use of incoming multi-sensory info; dependent on integration of internal and external sensory info; may lead to corrections in movement or changes in motor plan while action is in midstream
Anticipation of results of action
242
Integration and interpretation of internal and external sensory info during movement to make corrections, and upon completion of movement to evaluate results
Sensory feedback during and after execution
243
T/F: Motor patterns including reflexes and centrally programmed actions are praxis
False.
- Reflexes are involuntary, unlearned movements that are elicited by sensory input and are independent of consciousness e.g., rooting, patellar tendon reflex
- Central programmed actions: predictable movement patterns that may occur independently of sensory input and often involve a rhythmic sequence of movements. Genetically programmed motor pattern stored in brainstem e.g., stepping or walking, swallowing, crawling
244
```
Children with dyspraxia will usually have difficulties with which of the following:
A. New motor tasks
B. Motor learning
C. Refined and adaptable motor skills
D. Generalization
E. All of the above
```
E. All of the above. May also not know what to do in new situations (ideation)
245
A child with dyspraxia may have poor gross OR fine motor coordination
True.
246
T/F: Why may a child with dyspraxia break toys and tools?
- Uses ineffective motor strategies
| - Uses inappropriate amount of force (prop)
247
If a child is "clumsy", important to evaluate whether this id due to praxis or ________
Evaluate whether due to praxis or vestibular (postural control and equilibrium) problem
248
Low scores on Praxis on Verbal Command are often accompanied with somatodyspraxia
True
249
If a child does poorly on praxis on verbal command test but his somatopraxis is okay, then the problem is likely to be ________
Language comprehension
-May also be left hemisphere problem (not an SI disorder): low scores on PrVC are associated with prolonged post-rotary nystagmus; bilateral motor coordination and sequencing test scores also may be low
250
T/F: Every motor coordination problem is a praxis problem
False. Many alternative possibilities e.g., vestibular processing difficulties, developmental delay, muscle weakness from disuse, medical condition
251
Movement disorder with prevalence estimated at 5-6% and strong overlap with SI somatopraxis disorder
Developmental Coordination Disorder (DCD)
252
The following are diagnostic criteria for ______
- Motor performance substantially below expected level given chronological age and previous opportunities for skill acquisition
- Delays in developmental motor performance outcomes: coordination problems, poor balance, clumsiness, dropping/bumping into things
- Significantly interferes with activities of daily living or academic achievement
- Not due to medical condition e.g., CP, hemiplegia, MD
Diagnostic Criteria for DVD (DSM V)
253
What does the sensory processing of children with DCD look like?
- Prop: preschool children at risk for DCD have poorer kinesthetic ability
- Somatosensation: children with DCD performed poorer on tests measuring tactile processing and visual motor skills
254
T/F: Children with DCD may also exhibit a dx of ADHD
True
255
Why is it challenging to diagnose a child with DCD?
-There is a lack of consensus across methods for identifying DCD
256
Praxis is strongly correlated with social, communicative, and behavioral impairments characteristic of _____
ASD.
| -Dyspraxia may be a core feature of autism or a marker of neurological abnormalities underlying the disorder
257
Children with ASD exhibit mean scores below avg. in SIPT tests, especially ________ when compared to children with SI problems only
Somatopraxis
258
Children with ASD often have impairments in imitation of body positions and movements, but not with actions on objects
False. Well documented impairment in overall imitation abilities: body positions and movements; oral-facial positions and movements; actions on objects
-Imitation with objects is less impaired (but still affected) than imitation of meaningful and meaningless gestures
259
When providing interventions on children with dyspraxia, it is important to address as many praxis issues into one treatment session as possible in order to see improvement quickly
False. If sensory modulation is a significant problem, focus on this initially and gradually incorporate praxis challenges
- Address postural control and motor planning issues before tackling ideation
- Analyze motor planning: when, where, and how do problems manifest: stationary vs moving activities requiring anticipation in space and time; bilateral motor vs unilateral activities
- Eventually address organization of behavior
260
When providing tx for dyspraxia, in what order should you address the following: postural control, motor planning, organization of behavior, sensory modulation, ideation
1. Sensory modulation first if it is a significant problem (then gradually incorporate praxis challenges)
2. Address postural control and motor planning
- MP: when, where, and how do problems manifest: stationary vs moving activities requiring anticipation in space and time; bilateral motor vs unilateral activities
3. Ideation
4. Organization of behavior
261
Why is it important to address cognition in action in tx sessions?
Problem solving via cognition is related to action in everyday life
262
T/F: it is important to first address the specific aspects of praxis that are affected before looking at the sensory aspects
False. Address both.
-Sensory aspects: discrimination, perception, and modulation
-Includes Tactile, Vestib, prop, visual
-Praxis concerns: body awareness, postural control, imitation and sequencing, bilateral coordination, projected action sequences, oral-motor coordination
ideation
