Wednesday, December 19, 2012

APRAXIA


There is little known about apraxia in the educational field. Apraxia is often listed as one of the cases of learning disabilities, however not explained or acted upon it.

Apraxia is acknowledged more in speech therapy as Developmental Verbal Dyspraxia, DVD as a “oral motor planning disorder”. The problem occurs when the brain tries to tell the muscles what to do, but the messages get scrambled, they are not ordered (not in sequence), they are mixed up.
Occupational therapists recognise apraxia as poor motor planning, poor coordination.

 

Apraxia (dyspraxia) is truly a hidden handicap that can lead to severe educational and social problems for the affected child. It can make the child a social outcast, provoke bullying and seriously damage the child’s self esteem.

 

Dyspraxia affects 5% to 10% of children, up to 2% severely. Some researchers put the number as high as 20%  
(Dr J. Stordy, M. J. Nicholl 2002).

 

There is now scientific evidence that the motor problems and poor planning of these children persists into adolescence. They demonstrate academic problems, low self esteem and poor social skills.

 

Awareness of this condition is still very limited. Too often apraxia (dyspraxia) is diagnosed as ADHD, mental impairment or Autistic Spectrum Disorder.

 

Apraxia (dyspraxia) is a disorder of praxis.

 

             PRAXIS     -  to know what to do and how to do it  - 

 

First we have an idea and then we have a plan how to implement the idea, and than we have to be able to carry it out (in planned steps).

 

For apraxic children the sequence of messages is broken,
lost or mixed up, jumbled. Their praxis is failing them.

 

            Early recognition means early intervention.   
            A lot of children are not identified early or not at all.  
            The doctors, the therapists, the educational
            system are not familiar with the symptoms of dyspraxia.

 

The biggest challenge for an apraxic child is starting school. Everything becomes too difficult, his clumsiness makes him stand out, and he will not be included in games, because he will “ruin everything”. He will be “bad” in ball games, in writing, in following instructions and in making friends.

 

The ongoing reprimands by peers and teachers are demoralizing. In order to avoid ridicule the child may resort to clownish or “I don’t care” behaviour. Life becomes difficult because so much revolves around motor-based activities.

 

The self esteem plummets, the child becomes hostile, aggressive and insecure. Remarks like, “I am a dumbo, there is something wrong with my brain, everyone hates me, I hate school”, are common.

 

The older the child is, the deeper the problems become, everything is frustrating. He/she can’t write well, he/she is not good at sport and not good at playing with children either.

 

This child needs help! Apraxic children can improve if they are correctly diagnosed and receive the appropriate therapy, remedial help and understanding from everybody involved in their progress.

 

Apraxic (dyspraxic) children can function normally, become well adjusted and cope with school and family life.

 

[Extract from APRAXIA Unrecognised Big Barrier to All Learning by Hana Jay]


 

I became very interested in children diagnosed with apraxia (dyspraxia) many years ago. The term apraxia has been known from the beginning of the last century, yet educationalists shy away from it. Apraxic children are still misdiagnosed. In every decade they (apraxic children) are placed in a different group. In my lifetime they were called mentally retarded, clumsy, uncoordinated, aphasic, dyslexic, hyperactive, ADD, ADHD, more modern term is Autistic Spectrum Disorder and Asperger Syndrome.

 

Apraxic children are very clever. After years of reading and working with them, I’m almost sure, that they are extremely bright. The sensory inputs into the brain are very fast, however as the brain gets bombarded with sensory inputs, it gets overstimulated (overloaded), and the balance of excitation and inhibition is hard to keep. The incoming information is well processed, classified, categorised and stored. I know that, because as I have had helped these children to overcome the original problems, the children were able to recall all that they have learned, processed and stored previously.

 


Each action that we perform could be likened to a long chain linking object to object. Every link of the chain has to be attached correctly. If one link is faulty the chain will be broken, the connection will be disrupted. If more links are faulty there will be no chain, only separate bits leading nowhere. 

 

Let’s imagine the feelings of an apraxic child. The brain is stimulated, perhaps overstimulated and the mechanism blocking out some stimuli is not functioning well or it cannot cope with too many stimuli bombarding the brain. If a brain is overstimulated it has a safety mechanism, the overstimulated brain shuts out all the stimuli, the needed with the not needed. This lasts only for a very short time but if it happens often and sporadically, the output is disrupted (like the broken links of the chain). The messages are not clear, they are not synchronised and ordered.

 

This dysfunction is characterised by clumsiness in motor activity tasks (writing), poor eye-hand coordination (writing), reduced quality of speech and extra ocular control (focusing problem).

 

Apraxic children have no linear (ordered) thinking.        
Their thinking is not based on now, before, after;  
therefore they cannot comprehend the meaning:      
“do this... and then this and after this do that”
or
what comes before
or what comes after.

They live in now.

 

They cannot plan, because they don’t understand the concept of sequential planning, they cannot transpose themselves into the future time.

 

Our expectations and explanations are for them very confusing. They don’t know how to start and what to do next. They don’t really know what we want and what we mean for them to do.

 

That is why apraxic children are not able to learn like the other kids, yet they are intelligent. They cannot do the work, because they do not know what they are expected to do. They do not know the steps to use to proceed with the task.

 

If we look at a page in a book it looks sort of organised but for an apraxic child it actually looks all muddled. We organise things in a linear fashion, they do not.

 

Apraxic children prefer nonfiction books. The facts are usually organised in a kind of sequential order. There are no tricks, no unexpected plots, no metaphors and no personifications (animals and things acting as humans).

 

An apraxic child never asks for help at school because he wouldn’t understand the linear explanation. Children tell me: “The teacher talks in gibberish.”

 

Their usual question is: “What do you want me to do?” You tell them, you explain, yet when you check a bit later, they have done nothing, explaining: “But you didn’t tell me really what you want me to do.” or they say: “Show me.” Yet they don’t look to follow the instruction, they look everywhere but to see what is being shown to them.

 
I have diagnosed, treated and taught many apraxic children successfully. If you are prepared to give it a go, I can lead you through the step by step program to improve your child’s ability to learn. Some more at http://www.jayseducation.com/APRAXIA_LearningIssues.php

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