Sensory Integration Vocabulary
Sensory Systems Clinic
St. Clair Shores, MI 48082
Praxis: Praxis is the process of getting the idea, initiating, and completing new motor tasks. It is an end product of input from all the necessary systems and the brain. Integrated information from the sense of touch, balance and movement, vestibular, vision and hearing, may be necessary for good motor planning. Dyspraxis means disordered motor planning. Apraxia means that motor planning is almost absent. Individuals with motor planning problems have to think harder to complete a new motor task that other people because of poor information from the sensory systems. They might appear stubborn or lazy, because they can complete a more difficult task, but cannot generalize the skill to an easier task. These are called “splinter skills.” Some may get very tired. Others may have difficulty stopping motor tasks, and may be labeled as perseverative. Below are listed several definitions of specific areas of praxis.
Praxis on Verbal Command: This is the ability to integrate a verbal command and motor response. For example, if a child is given a direction to “sit down and pick up your pencil,” they have to hear two steps (auditory) and complete two motor acts. Difficulty following directions is often misinterpreted as deliberate misbehavior in children. Sometimes you can easily spot the young child who had trouble with following verbal directions in the classroom. They are the last ones to respond and look around the class to see what the rest of the children are doing. With adults, it may be seen as problems following verbal directions at the workplace. They seem confused because they thought the direction was followed and may become defensive.
Postural Praxis: The ability to imitate body position is called postural praxis. Individuals with this difficulty are often poor at sports or games. If the instructor says, “Hold the bat like this,” they may have a greater difficulty than average in grasping how to place the body or move. An infant may become “stuck” under a table when crawling, being unable to figure out how to move their body to get out. Individuals with postural praxis problems may appear wooden in their movement. Even their personality may be described as inflexible.
Sequencing Praxis: Sequencing tasks is the ability to know how to get things done in order. Some children have dressing problems because they can’t sequence whether to put the undershirt or the shirt on first. Most motor tasks have some sequencing to them, so sequencing praxis is considered to be central to all praxis. It helps start us on our way to being organized.
Oral Praxis: This is the ability to organize sequenced movements in the area of the mouth. Naturally, it is often a problem area for children with speech problems. Drooling, feeding problems and difficulty in blowing bubbles, whistles, etc. may be observed. An older child or adult may have difficulty with reading that is associated with oral praxis. They may be unable to sequence sounds, and be unable to sound out the word properly. Information from the sense of touch is especially important for good oral praxis.
Constructional Praxis: This is a task which requires three dimensional manipulation. Difficulty in these areas may be seen in early childhood with frustration playing with blocks or difficulty with breaking toys. Toys just don’t move the way they expect and frustration may occur. Difficulty dressing dolls may be observed. Older children may have problems with art projects. Adults may prefer to attempt to assemble things that come “Assembly Required” using guesswork or give it to someone else to put together. Constructional praxis is much harder to transfer from a two dimensional design to three dimensional project.
Design Copying: Design copying is the ability to see a two- dimensional form and copy it onto a paper. A practical application of this is the ability to copy from the board or from one page to another. This is very important in the career of any student from 1st of 2nd grade to a doctoral candidate.
VISUAL SPATIAL PERCEPTION: Visual spatial perception is how one perceives objects in relationship to space and to one’s self. Below are described some specific perception problems.
Figure Ground: Figure ground perception is the ability to separate the foreground from the background. Individuals with this problem may look for an object in a drawer, around a room, or on a shelf and be unable to find the desired object even if in plain sight. They constantly lose things against the background and frustrate those around them who find things easily.
Spatial Relationships: Spatial relationship problems are frequently associated with reading problems or, if severe, dyslexia. Spelling and math may also be affected. The individual may confuse w,m; b,d: and p,q or reverse entire words. Math may suffer due to numerical reversals or an inability to align numbers in columns.
Directional Perception: Directional confusion can be observed in a few different ways. Sometimes an individual finds it difficult to follow directions because they have never learned to relate easily to spatial words, such as, underneath, before, after, etc. Another type of problem may stem from difficulty remembering a general orientation in space. These people may get lost easily because things look a little different each time they see them. Visual perception problems may be seen in infancy if the child swipes or reaches for objects and often misjudges distance. The preschool child may have an unusual difficulty in identifying shapes or assembling puzzles. Mentioned earlier are the problems commonly associated with the school age child or adults.
VISUAL MOTOR INTEGRATION: Visual motor integration is the ability to smoothly coordinate the movement of the eyes with each other, the head, neck, hands and body.
Eyes: Difficulty coordinating the eyes is observed while the individual is following a slowly moving object. An infant may have eyes that just do not move well together, jerking, or avoidance may be seen. If this happens for an older child while reading, the words may appear to jump around the page. Fatigue and concentration problems often result. A sign of avoidance may be someone who is irritated or shows an increased amount of activity around blinking or bright lights.
Eye, Neck and Head Integration: If the head, neck and eyes don’t move together well, this contributes to an unsteady head. This has much to do with forming our idea about where we are in space and can also contribute to reading problems. This will also cause complaints of being tired while reading.
Eye and Hand Coordination: Sometimes the eyes have a difficult time directing the hands where to go. This may result in poor eye hand coordination. Coloring, handwriting or other tasks requiring the eyes to direct the hands may be affected.
Eye and Body Movement: How our body moves in space is directed by our eyes. A visual motor problem may be suspected in the individual who bumps into things frequently when walking.
THE VESTIBULAR SYSTEM: Just as the eyes are the sensory organs for sight, and the nose is the sensory organ for smell, and the inner ear is the sensory organ for balance, the inner ear is part of a larger system called the vestibular system. The vestibular system has a great influence in balance, and eye movements, as well as an influence over muscle tone. Balance can affect behavior by causing an individual to be withdrawn in a group situation. It may also cause a person to be fearful due to insecurity brought on by postural insecurity. It may also create the appearance of restlessness. Indirectly vestibular problems are thought to have a marked influence on learning, in part because of the vestibular system’s profound control over the neck and eyes.
Clumsiness: There are many ways that problems in balance can be seen. The clumsy child is perhaps the first type that comes to mind. These children will often trip over their own feet, and may experience frequent falls. While sitting they may squirm in the seats, or even fall off their chairs onto the floor, evoking frequent comments to “sit still.” Although not as easily identified, children who run, or are constantly on the move, may also have a balance problem. Running actually requires less balance than walking slowly. Occasionally, children race along and then slide onto the ground as if sliding into home plate, because they cannot balance themselves to stop.
Postural Insecurity: Posturally insecure individuals are abnormally fearful of falling. As infants they may be slow to roll over and may startle frequently to movement. Generally as young children they will not climb, and avoid large groups of children, being fearful of being pushed over. School-aged children may be loners and may be insecure. If you can’t trust gravity, what can you trust? Adults are typically not very athletic, and may be fearful of heights. Posturally insecure individuals may have balance that is adequate, but are so fearful of falling that they won’t attempt activities.
Gravitational Insecurity: An irrational fear of movement. Children with gravitational insecurity may exhibit limited participation in gross motor play; avoidance or fear of escalators, elevators, or cars; or resistance to being off the ground.
Hypersensitivity to Movement: An excessive amount of movement does normally result in nausea. Hypersensitivity to movement occurs when the digestive system is upset abnormally in response to movement. Car sickness would be a common problem in an individual who exhibits this.
TACTILE DEFENSIVENESS: Tactile defensiveness is an irritability to touch, especially light touch. The faulty nervous system interprets light touch as being painful, irritating, or threatening. This will generally result in undesirable behavior. Below we talk about common behaviors that may be seen in the various stages of development. Please remember that there are many behaviors that may be associated with this condition. The ones exhibited may be different than the ones discussed here.
Infancy: Touch is the main sense that the infant responds to. Tactile defensive infants often appear as irritable babies. Often they will not enjoy being carried, seeming to push away, as if very “independent.” Many of the babies will not quiet with being held, making the parent feel there is nothing they can do to make their baby happier. Some of these babies seem happier to be left alone in the crib or playpen, rather than being held. Frequently they can be described as not being cuddly.
Toddlers: In the toddler stage, the child will be very sensitive to bumps and bruises. Often these children may be thought to be “babyish” or “sissies,” as they are more sensitive to pain than other children. Occasionally, the child may be “pain insensitive,” not crying with bumps or cuts, and sometimes continuation of bed-wetting may result.
School Age Children: School age children’s behavior will be affected by increased aggressiveness, or an avoidance of playing with groups of children. Playground fights may be begun because another child bumped them lightly, and they react protectively to defend themselves from an unseen attack. Distractibility, as they are abnormally aware of wind and clothes brushing them, may also be a problem. Difficulties with fine motor control are often associated with this. Sleep problems and bed-wetting may also be due to tactile defensiveness.
Adults: Adults may also have this problem. Tactile defensiveness doesn’t just disappear; the symptoms or behavior just change. Aggressiveness may still be a problem for the adult. Irritability with the adult complaining of feeling “touchy” may be seen. Tactile defensiveness may also interfere with sexual or romantic activities, with pulling away, giggling, complains of not touching right, or tensing with touch.
Elderly: The elderly tend, in general, to suffer from lack of touch. People tend to think of the elderly as frail and fragile, and tend to limit touching them. Studies have shown that increased touch, especially in the elderly, decreases confusion and disorientation and increases socialization.
Sensory Systems Clinic, P.C.
30801 Jefferson Ave.
St. Clair Shores, MI 48082
Phone: (586) 293-7553