Praxis (Motor Planning)
Each new sequence of movements requires praxis, or motor planning. Certainly, the first time a child climbs a jungle gym, threads a belt through loops, or says “Lollapalooza,” he must plan his movements with conscious effort. With practice, he can do these actions successfully because he has integrated tactile sensations, such as the feel of jungle gym rungs under his feet and hands.
The child who feels uncomfortable in his own skin may have poor motor planning, or dyspraxia. He may move awkwardly and have difficulty planning and organizing his movements. Thus, he may shun the very activities that would improve his praxis.
For instance, if he dislikes how the monkey bars feel, he won’t try to hang from them or practice the skill of traveling beneath them, one hand after the other. If touching a dandelion makes him uneasy, he won’t reach to pick it. The less he does, the less he can do. In a world where “use it or lose it” is a fact of life, this child is at a loss.
HOW PRAXIS (MOTOR PLANNING) AFFECTS A CHILD’S BEHAVIOR
A Typical Child A Child with Dyspraxia
Charley, four, arises and puts on blue jeans and a new belt, managing to buckle it all by himself. He runs downstairs. He steadies his grapefruit with one hand and spoons it with the other. Ready for school, he climbs into the car and fastens his seat belt. Arriving at school, he unsnaps his seat belt and jumps out. On the blacktop, he spots a new tricycle. It is larger than trikes he has ridden before, but he figures out how to mount it. He stretches his feet and arms to reach the pedals and handles. He takes it for a test drive, getting a feel for its new requirements. Lars, four, arises slowly. He ignores the blue jeans and belt his mother has set out; they’re too hard to put on. He struggles into his favorite sweatpants with the elasticized waist. He goes downstairs carefully: right foot first, then left, on each step. He jabs a spoon at his grapefruit, and the dish skitters across the table. When it’s time to go to school, he maneuvers himself into the car and waits for his mother to buckle him in. Arriving at school, he needs a teacher to unbuckle the seat belt. Then he inches out of the car. On the blacktop, Lars heads for an old familiar tricycle. While the other kids ride in circles around him, he sits there, dangling his feet.
GROSS-MOTOR CONTROL
Praxis is necessary for two broad categories of movement, one of which is gross-motor control. Like the super highway, this is the smooth coordination of the large, or proximal, muscles, which are closest to his body core. Gross-muscle control allows a child to bend, lift, twist, and stretch, to move his body from one place to another by creeping or running, and to maneuver his hands and feet.
The child with poor tactile (and proprioceptive) processing is out of touch with his body and with objects in his world. His gross-motor skills may be delayed, making it very difficult to learn, move, and play in meaningful ways.
HOW GROSS-MOTOR CONTROL AFFECTS A CHILD’S BEHAVIOR
A Typical Child A Child with Tactile Dysfunction
Hannah, ten, enjoys the fast-moving “Over and Under” game. One person holds a ball over her head and passes it to the next person, who takes the ball, bends forward, thrusts it through her legs, and passes it to the next. Moving is fun! For Kim, ten, playing “Over and Under” is hard. Her movements are slow and awkward. The ball feels uncomfortable in her hands, and sometimes she drops it. When she slows down or interrupts the game, the other kids get angry. Movement games are no fun at all.
FINE-MOTOR CONTROL
Praxis is necessary for another category of movement: fine-motor skills, like the byroads, which a child usually refines after establishing gross-motor skills. Fine-motor control governs the precise use of small muscles in the fingers and hands, in the toes, and in the tongue, lips, and muscles of the mouth.
Because the child with tactile dysfunction often curls his hands in loose fists or jams them in his pockets to avoid touch sensations, he has difficulty manipulating ordinary tools such as eating utensils, scissors, crayons, and pencils. So much of the school day revolves around writing and other fine-motor tasks that a problem with these skills may be extremely discouraging for the older child.
This child frequently has poor self-help skills, is a messy eater, and may also have poor articulation and immature language skills. He may use more gestures than words to communicate because the fine-motor control of his tongue and lips is inadequate.
HOW FINE-MOTOR CONTROL AFFECTS A CHILD’S BEHAVIOR
A Typical Child A Child with Tactile Dysfunction
Today is woodworking day for Alex’s preschool class. Alex sorts through the woodbin, chooses two pieces, and hammers them together to make an airplane. He takes it outside and experiments with different ways to hold and throw it. At dinner, he explains in detail how he constructed his lovely airplane, and how well it flies. Alex has good praxis. Josh, four, wants to construct an airplane. He isn’t sure how to begin, so the teacher hands him two wood pieces. He has trouble holding the hammer, so the teacher helps him. His airplane looks pretty good. Outside, he throws it to see if it will fly. It falls at his feet. Then he stands and holds it until it is time to go home. At dinner, his father asks what he did at school. Unable to express his thoughts, Josh holds up his lovely airplane for his father to see. Josh is dyspraxic.
Visual Discrimination
The tactile system plays an important part in the development of visual discrimination—the way the brain interprets what the eyes see. By touching objects, a child stores memories of their characteristics and relationships to one another. Looking at a rain puddle, for instance, he perceives that it is wet, cool, and fun to splash in, even without touching it, because he has touched puddles before.
Normally, a young child touches what he looks at and looks at what he touches. Many experiences touching objects and people are the basis for visual discrimination.
When a child’s brain mismanages touch stimuli, however, he cannot integrate tactile and visual messages. Basic information eludes him about how things appear to feel. He looks but does not understand what he sees.
HOW TACTILE PROCESSING AFFECTS A CHILD’S VISUAL DISCRIMINATION
A Child with Tactile Dysfunction A Typical Child
The teacher hands each kindergartner a plastic shape. Each shape has different attributes. It is big or small; red, yellow, or blue; round, square, or rectangular. Then, the teacher lays a series of similar shapes on the rug and asks the children to tell her which shape on the floor matches the one in their hands. Tiffany knows the answer right away because she has handled many objects in her five years. She places her small red square next to its mate. The teacher hands Chrissy, five, a big yellow rectangle, and Chrissy drops it into her lap. When her turn comes to match her shape with one on the floor, Chrissy is uncertain about its size and shape. She knows her colors, though. She makes a guess and puts her big yellow rectangle next to a small yellow square. A classmate points out her error, and the teacher asks him to show Chrissy how to make a correct match.
Language
The tactile sense, in a way, leads us to language. Babies depend on touch to make contact with the world. Expanding their contacts as they move around and touch things, young children absorb others’ commentaries about what they are doing.
“That’s a daisy. Touch it gently.”
“Pull hard on that wagon. Pull, pull!”
“Give me your foot and I’ll put on your shoe.”
“Where’s the ball? It’s under the couch. Get the ball. Throw the ball to Daddy.”
“Whoops! You fell down, head over heels! That was scary. Come here; I’ll brush you off and make it all better.”
Words become associated with actions, body parts, objects, places, people, and feelings. Thus, children learn verbs, nouns, names, prepositions, adjectives, adverbs, and labels for emotions.
HOW TACTILE PROCESSING AFFECTS A CHILD’S LANGUAGE
A Typical Child A Child with Tactile Dysfunction
Jeff’s eighth-grade cooking class made delic
ious tacos last week. Today the teacher asks the students to write down the recipe to test their memory about the various steps and processes involved. Jeff writes, “Warm taco shells in preheated oven. Grate cheese. Shred lettuce. Mince chipotle chilies. Chop cilantro. Dice tomatoes and peppers. Sauté ground beef or turkey. Drain fat. Peel and slice onion, and sauté. Spread mixture on taco shells. Arrange condiments in bowls so guests can choose what they like.” Etcetera. Gavin, thirteen, enjoys eating and thought taking a cooking class as an elective would be easy, but preparing the food is hard. Dyspraxia and tactile discrimination problems cause him to fumble with the taco ingredients, measuring spoons and knives. He jumbles everything together. Now he is supposed to write down the recipe but is vague about the manual tasks involved and the words to describe them. He wishes he could prove to the teacher that his motivation to do well is high…but how? He writes, “Cook meat. Cut vegetables. Serve.”
When the out-of-sync child’s tactile experiences are limited, so are his opportunities to develop language. In addition, the child with poor tactile awareness in his mouth, lips, tongue, and jaw may have a sensory-based motor problem called oral apraxia, which affects his ability to produce and sequence sounds necessary for speech.
Academic Learning
Tactile processing has a big impact on a child’s ability to learn at school. Many objects require hands-on manipulation: art and science materials, rhythm instruments, basketballs, chalk, pencils, and paper. Taking pleasure in tactile experiences leads to exploring new materials and building a base of knowledge that will continue throughout a lifetime.
A tactile disorder prevents a child from learning easily because touch sensations distract him. He may fidget when quiet is expected, complain that others are annoying him, and have trouble settling down for academic tasks.
The child misses out on learning skills requiring the purposeful use of tools such as compasses, forks, and hammers. He misses out on learning about nature, because messy, hands-on experiences are intolerable or because he can’t discriminate between an acorn and a chestnut. He misses out on learning problem-solving skills, communication skills, and “people” skills.
HOW THE TACTILE SENSE AFFECTS A CHILD’S ACADEMIC LEARNING
A Typical Child A Child with Tactile Dysfunction
Juan, six, likes science. Today, the teacher brings several caterpillars in a glass jar. Juan knows how it feels to handle caterpillars and asks, “May I hold the one that looks soft and fuzzy?” The teacher offers him the jar. He picks out the fuzzy cater-pillar and puts it on his arm. “It tickles!” Ricardo, six, dislikes science. While the other first-graders talk about the caterpillars, Ricardo averts his gaze. He rejects the teacher’s invitation to hold the jar. He squirms in his chair and sits on his hands. He hates creepy bugs.
Emotional Security
With a well-regulated nervous system, we first learn to welcome the touch of the person (usually our mother) who takes care of our basic infantile needs. Cuddling makes us feel safe.
A close physical attachment to one or two primary caregivers sets the stage for all future personal relationships. If we feel cared for and loved, our emotional base is secure, and we learn to reciprocate warm feelings. Furthermore, if we are “in touch” with our own emotions, we develop empathy for other human beings. Even if we don’t like a person, we know he feels pain when he gets a splinter and pleasure when he takes a bath.
Establishing strong attachments can be very difficult for the child with a tactile disorder. The overresponsive child may withdraw from ordinary affection, while the underresponsive child may disregard it.
Feeling empathy can also be hard. The overresponsive child feels pain or discomfort where others do not; the underresponsive child feels no pain or discomfort where others do. He cannot relate well to another person’s feelings.
HOW THE TACTILE SENSE AFFECTS A CHILD’S EMOTIONAL SECURITY
A Typical Child A Child with Tactile Dysfunction
At nine, Mike takes pleasure in going away to Boy Scout camp. He is comfortable in novel settings and likes making new friends. One night the scouts play a creative thinking game: “What Would You Need on a Desert Isle?” Mike suggests a bucket to catch rainwater, a sleeping bag, and binoculars—familiar objects that he has handled—as well as someone to talk to. Mike’s well-regulated tactile sense gives him emotional security. James, nine, is unhappy at camp. He misses his mother. He depends on her totally and exclusively for emotional support and always wants her nearby. Forming attachments to others is hard because everyone else seems unreliable. When the scouts play the Desert Isle game, he has no suggestions; all he can think is that he hates the idea of being deserted, hates being a Boy Scout, and hates being away from home.
The child may have difficulty experiencing pleasure, enthusiasm, and joy in his relationships because of his responses to touch. While he needs even more love than others, he invites less. His insecurity in the world puts his emotional well being at risk, as a child and as an adult.
Indeed, many adult relationships flounder when one partner’s tactile disorder interferes with emotional intimacy. Too little touching makes the other person feel rejected; too much makes the other feel disrespected.
Tactile disorder also limits a child’s imagination. Fantasy and make-believe may be beyond his scope, and the differences between real and pretend may be vague. He may be a rigid, inflexible thinker.
Social Skills
A well-regulated tactile sense is fundamental for getting along well with others. Building on the primary mother-child bond, we begin to reach out to others, gladly and comfortably touching and being touched. When we enjoy being near people, we learn how to play, one of the unique characteristics of being human. Thus, it becomes possible to develop meaningful human relationships.
When the child responds to physical contact in ways that are incomprehensible to most people, he may turn them away. The sensory disregarder who doesn’t notice touch will have difficulty in social situations, as will the sensory craver or “bad boy” who tackles others because he seeks deep-touch pressure, and the sensory jumbler, slumper, or fumbler who cannot use touch messages effectively.
The sensory avoider or “sissy” who withdraws from touch has particular problems with socialization. Standoffish behavior sends signals that he is unfriendly and prefers to be left alone. Seeming to reject others, he is rejected in turn. He has difficulty dealing with the give-and-take, rough-and-tumble world of “playground politics.”
Children with tactile defensiveness frequently mature into adults who are “cool characters.” They may be cautious, controlled, and often inflexible people. They may seem distrustful or judgmental. Their behavior may be considered “touchy”—a funny word for people who avoid touch! Of course, they can develop social relationships with a select group, but the relationships are often built on shared interests that do not involve physical interaction.
HOW THE TACTILE SENSE AFFECTS A CHILD’S SOCIAL SKILLS
A Typical Child A Child with Tactile Dysfunction
Standing in line to go to the lunchroom, Jake, eight, playfully bumps into Lewis. Lewis bumps him back. Laughing, they collide a few more times until all the third-graders are lined up and ready to go. When the teacher turns her attention to them and raises her eyebrow, the boys regain control and walk peacefully down the hall. Jake’s positive reaction to tactile sensations is the foundation of his good social skills. Curtis, eight, always tries to be last in line so no one is behind him. But today, Eli brings up the rear and grazes him as they go down the hall. Overresponding, Curtis punches Eli. Eli punches back. The boys begin to argue, and the teacher pulls them apart. Curtis complains, “Eli started it. It’s his fault.” Eli says, “I touched him accidentally! He’s such a baby.” Relating to his peers is hard because Curtis is uneasy when they get near.
CHARACTERISTICS OF TACTILE DYSFUNCTION
The following checklists will help you gauge whether your child has tactile dysfunction. A
s you check recognizable characteristics, you will begin to see emerging patterns that help to explain your child’s out-of-sync behavior. Not all characteristics will apply, but many checked boxes suggest that SPD affects your child.
The sensory avoider with overresponsivity (tactile defensiveness) has difficulties with passive touch (being touched). He may:
Respond negatively and emotionally to light-touch sensations, exhibiting anxiety, hostility, or aggression. He may withdraw from light touch, scratching or rubbing the place that has been touched. As an infant, he may have rejected cuddling as a source of pleasure or calming.
Respond negatively and emotionally to the possibility of light touch. He may appear irritable or fearful when others are close, as when lining up.
Respond negatively and emotionally when approached from the rear, or when touch is out of his field of vision, such as when someone’s foot grazes his under a blanket or table.
Show fight-or-flight response when touched on the face, such as having his face washed.
Respond negatively when hairs on his body (arms, legs, neck, face, back, etc.) are displaced and “rubbed the wrong way.” A high wind or even a breeze can raise his hairs, literally “ruffling his feathers.”
Show fight-or-flight response to hair displacement, such as having his hair brushed, or receiving a haircut, shampoo, or pat on the head.
Become upset in weather with rain, wind, or gnats.
Be excessively ticklish.
Overrespond to physically painful experiences, making a “big deal” over a minor scrape or a splinter. The child may remember and talk about such experiences for days. He may be a hypochondriac.
Respond similarly to dissimilar touch sensations. A raindrop on his skin may cause as adverse a response as a thorn.
Strongly resist being touched by a barber, dentist, nurse, or pediatrician.
The Out-of-Sync Child Page 11