Occupational Therapy: A Definition Guide for Parents

Sensory, motor planning, praxis oh my! Here are various terms used in occupational therapy and what they mean. While looking at a child from a holistic view, meaning as a whole, there is a tremendous amount to observe and an even larger quantity of aspects to discuss with parents. We want to provide clear, understandable information to promote success for you and your families. The information below consists of basic knowledge of OT. Therapy requires consistency at home, but with that, it is important to know the jargon your therapist may be telling you.

Praxis is the ability to execute a motor task from beginning to end (ie. putting on a shirt, eating lunch, riding a bike). Every movement we perform requires our brain and body to connect and plan. Praxis is a four-step process that involves ideating (forming), planning, organizing, and executing a physical movement in addition to adapting to surroundings. Take a look at the obstacle course post for great examples to work on praxis at home.

Ideation focuses on forming an idea such as wanting to climb a ladder or how to order an obstacle course. Motor planning consists of the ability to plan, organize, and carry out a coordinated body movement such as, walking up stairs, balancing on one foot, or cutting fruit to eat. A key factor in motor planning is body awareness which allows a person to know where they are in space and how to move throughout their environment. The following are elements of praxis:

1. Midline Crossing: coordinates the left and right sides of the brain. This allows a person to cross the right side of their body to the left and vice versa. An example would be to have the ability to use your right hand, crossing your midline, to touch your left knee
2. Bilateral Integration: the ability to coordinate both sides of the body working together either symmetrically or asymmetrically such as, clapping hands, or holding a piece of paper with one hand while holding scissors and cutting with the other.
3. Postural stability: the ability to sit or stand while maintaining balance and stability using strength from your core and back muscles.

The areas of praxis can be further broken down into gross, fine, and visual motor skills:

1. Gross motor skills: Involve the larger muscles in the body such as the torso, legs, and arms to perform the bigger muscle movements such as jumping, climbing, running, catching a ball, and more.
2. Fine motor skills: Involve the smaller muscles in the forearm and hands to perform movements such as writing, playing with playdough, using a fork, and completing crafts. Manual Dexterity involves using the small muscles of the hand for intricate work such as folding, threading, fastening buttons etc.
3. Visual perceptual skills: The ability to comprehend and interpret what we are seeing in the world around us using visual skills such as visual attention (focusing on important information), figure foreground (finding an object when it is hidden), visual memory (recalling visual information), discrimination (matching similar items), spatial relations (relationships between objects in a given space), form constancy (similar objects that are the same even if they are a different size, color etc.), sequential memory (recalling the correct order of items), and visual closure (identifying an object even if part of it is missing). Visual motor integration encompasses these visual perceptual skills to further enhance gross and fine motor coordination development.

Primitive Reflexes contribute to our development of gross, fine, and visual motor skills as they are present at birth and build higher-level skills. The purpose of these reflexes is to assist in our development, from the birthing process through the early stages of life. After specific stages in development, the reflexes are usually re-integrated into our systems. If they are not integrated, then there are specific activities that can be performed to assist with the integration process.

Sensory processing: Similar to a computer, our brain uploads information, processes it, and gives an output. Our senses are used throughout the day in which they are “uploaded” into our brains to process and then the output is our response. An important piece of sensory processing within the brain is the amygdala which acts as a guard for the sensory information coming in or going out.

There may be times when our “guard” brings in too much or too little information. If kids are receiving too much sensory information, it is referred to as over-responsive and the output may look like challenging behaviors or becoming overwhelmed. If kids are receiving too little information, it is referred to as under-responsive and the output may look like sensory seeking and hyperactivity. In these cases, the guard is letting too much or little into their brain and their daily functions are being impaired.

Eight Senses

The first five senses (sight, hearing, smell, touch, and taste) are the more common senses. There are 3 more senses that are less commonly known. Proprioception helps us understand our body’s awareness in space and it receives information through the muscles and joints. Vestibular helps with the righting of the body and balance. Interoception helps us understand internal senses such as hunger, thirst, temperature, and bowel/bladder control.

Self-regulation is the ability to identify how you are feeling and to be able to use coping strategies to bring yourself back to a regulated state of mind and to be able to respond to situations with appropriate actions. Self-regulation is a skill set within executive functioning.

Executive Functioning is a set of skills relating to higher-level processing, meta-cognition (critical thinking), and emotional regulation that helps people to manage emotions and complete tasks. The set of skills includes:

Hopefully, this gives you a better guide and understanding of what these terms mean. These are the more common terms you may hear in OT. If there are other aspects you need clarifying, comment below and we will help guide you to a better understanding.