Do you have a clumsy child?

Do you have a clumsy kiddo?  Do they fall down more than peers? Do they seem to get lost when they are supposed to be getting dressed?  Do they seem to struggle to achieve motor milestones like riding a bike later than peers?

If you answered yes your child might have a praxis problem.

I found myself getting frustrated when my daughter would get lost on her way to get her shoes on.  How hard could it be??!  Eventually, my pediatric OT brain kicked in over my frustrated mom brain and I figured out she was struggling with praxis.  She got stuck in the planning part-she could think of what she was supposed to do but could make a plan that would successfully carry out the action in a timely manner.

If you’ve searched the web for ideas about how to help you may have run across the term dyspraxia, poor body awareness, difficulty with motor planning. What all of this means is that your child has a hard time coordinating their body for action.  Praxis is how thought (cognition) directs movement (Ayres, 1985).  Praxis is a latin work that means “doing or action”.  This is a simple definition for a complex set of events that have to happen in order for the successful movement to take place.
The steps of praxis:

  • Ideation-thinking of what to do
  • Planning-planning how you are going to do the action
    • success is based on knowledge of body in space
  • Execution-performing the action
  • ​​Motor Organization/Sequencing-organizing body to move through space
  • Evaluation/Feedback-reflecting on how successful movement was and making changes

So as you can see coordination of movements from start to finish is a VERY COMPLEX process!  It’s not as simple as “go get dressed”.  That involves knowing what that means, figuring out how you will get the dirty clothes off your body, get clean clothes out of the drawer, orient them correctly on your body and maneuver your body so clothes will go on and then decide-do my clothes match, am I wearing clothes that will be appropriate for the weather and are my clothes on my body correctly.  Many kids struggle with knowing where their body is in space.  When they are asked to get dressed they get lost with their own body. Clothes end up being backward, wrong season or the child just won’t get dressed because the job is too hard.

Imagine how stressful it is living in a body that is so lost?  Self-esteem issues are common as children get older and cannot seem to coordinate their bodies like their friends.  They start to be made fun of because they can’t keep up.

​ But how would I know if my children are having difficulties with praxis?​ 

  • Slow to achieve developmental milestones
  • Avoid tasks requiring good manual dexterity (eg. puzzles, intricate construction, or fine motor tasks such as writing and cutting)
  • Clumsiness (eg. constantly bumping into things or falling over)
  • Messy eaters (may not be aware of food around the face and continues to feed with fingers)
  • Difficulty riding a bike
  • Lack of or limited imaginative play
  • Difficulties coordinating both hands together (eg. managing fastenings)
  • Difficulties during physical education
  • HIgh levels of movement, limited concentration
  • Slow to complete classwork
  • Problems with self-help skills such as using cutlery, dressing, or tying shoelaces
  • Difficulty forming relationships with peers, sometimes preferring the company of adults

Great news-help is near!
Pediatric occupational therapists are a great asset in working with your child to help with praxis difficulties.  Find a pediatric OT in your area that can help provide intervention and home program activities that can help your child develop a better awareness of their body and improved ability to move through their world with success.

If you have questions, need additional resources or want to schedule an appointment in Lincoln, NE please call Dr. Kristen or email at

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