Monday, January 13, 2014


Come On, It Can’t Be That Hard

By Kate LeFebvre, OTR
A Communication in Motion

        A few months back, I stayed at a ski condo with some family members.  It had a fairly typical set-up for such rentals, with bunk rooms designed to cram in as many people as possible. Each top bunk was accessible via a ladder, something like this:
Photo credit:

        There were three rungs – one in the middle, one a normal distance above it, and one a normal distance below.  But a standard bunk bed ladder has four or five rungs and thus there was quite a distance from the floor to the bottom rung and from the top rung to the mattress.  Another notable feature is that these bunks, unlike the one pictured above, lacked railings.
Now imagine trying to climb that ladder and coming back down again.  Difficult for a young child with short legs, right?  But surely a twenty-something adult who has slept on numerous top bunks, some without ladders at all, in her lifetime can navigate this simple task without a problem?  Not so, it turns out.

        My sister claimed one of the bunks in mention.  She climbed up to check out her sleeping arrangements, hoisting herself from the top ladder rung onto the mattress, noting a lack of leverage due to the distance and lack of handholds.  But after a slight struggle she was up.  Nothing too taxing.  Coming down, it turns out, was another matter.
She turned around, felt for the first rung, and took another step down.  Before she knew it, she was out of rungs.  She was standing there, her upper body still lying across the bed as she gripped wherever she could reach, one leg dangling down unable to locate another foothold.  She flailed a bit, tried to reposition to see how far she still needed to descend… and got stuck.  The rest of us, of course, laughed copiously at her expense.  Stuck on a bunk bed ladder with her bottom sticking out in the air?  How absurd.  Her husband had to pick her up and place her back on the ground.

        Well, I apparently don’t watch and learn from others’ predicaments.  I thought I’d try this for myself, show my sister how easy a task it really was.  Oops.  I ran into exactly the same thing (rescued by my brother-in-law and all).  Who designed that thing anyway?
The reason I’m telling you this story is that how my sister and I felt stranded on that ladder, unable to navigate our way down to the ground, is how I imagine my students who struggle with praxis feel when confronted with a novel task.  Developmental dyspraxia occurs when a child is unable to create motor plans for new actions.  His muscles and joints work fine, but his brain can’t figure out how to move them in the correct order.  He may intellectually know exactly what needs to be done to participate in an activity, yet the neurons won’t fire to tell his limbs how to move.  Children with dyspraxia do eventually learn new motor tasks with increased support and opportunities to practice.  I likewise could have conquered that ladder if I had scaled it a few more times.  In the meantime, it was frustrating, embarrassing, and a bit scary.

        This is how it can feel every time a child with poor praxis (motor planning) skills faces a new task.  This could be playing soccer, tying shoelaces, cutting with a knife and fork, climbing on playground equipment, stepping over an obstacle, catching a ball, holding a pencil, completing jumping jacks, anything.  He’s helpless in controlling his own body.  This child appears clumsy, uncoordinated, even lazy or obstinate in his refusal to try new things.
Luckily, treatment is available.  In occupational therapy, we break down complex activities into their component steps, use forward and backward chaining techniques so children can be successful at part of a task before doing the whole thing, design sensory-rich obstacle courses and games, and teach new skills through play.  Speech and language pathologists likewise work with children whose motor planning difficulties interfere with forming words. These kids can and do learn to move their bodies.  Given appropriate support, they are able to participate in recess, physical education, rec sports leagues, and play of all sorts alongside their peers.

Interested in increasing your understanding of what it’s like to live with this condition?  Try snowboarding, water skiing, or roller-blading for the first time.  Attempt a gymnastics or martial arts move you've never done before.  Try to keep up with an unfamiliar line dance. Or find that ski condo in Vermont and dare to venture up onto the top bunk.  It’s harder than you think.

Read-aloud version of this post:

Edited, Recorded, and Posted by Noah Morse

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