Occupational therapy is a health profession focused on enabling people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities, often called occupations. This field addresses a wide spectrum of functional challenges, helping individuals participate fully in life’s roles. Motor planning is a fundamental skill that underpins much of this work, acting as the cognitive bridge between an intention to move and the successful execution of that movement. It is especially involved when a person is faced with a new, complex, or multi-step task requiring the body and brain to coordinate a novel sequence of actions. OTs address difficulties in this area because a breakdown in motor planning significantly impacts independence in self-care, productivity, and leisure activities.
The Core Concept of Motor Planning (Praxis)
Motor planning, also known as praxis, is the comprehensive cognitive process that allows a person to conceive, organize, and carry out a non-habitual movement sequence. This process is the brain’s ability to formulate a plan for action, distinct from muscle strength or coordination. Praxis is typically broken down into three distinct, sequential steps that must occur for successful movement, particularly when learning a new skill.
Ideation
Ideation is the ability to conceptualize or form the idea of what to do with an object or in a situation. This involves understanding the task’s goal, such as knowing the objective is to build a tower with blocks or to get dressed.
Planning
Planning is the step where the brain organizes the sequence of movements required to achieve the idea. This involves figuring out the precise order and timing of actions, like determining which block to pick up first or which armhole to put an arm through.
Execution
Execution is the physical performance of the planned movement itself. This stage requires the body to carry out the organized sequence smoothly, coordinating muscles and joints as directed by the motor plan. After execution, the sensory system provides feedback, allowing the person to make immediate adjustments or refine the plan for future attempts.
Identifying Motor Planning Difficulties
When the motor planning system is impaired, the condition is often referred to as Developmental Coordination Disorder (DCD), or dyspraxia. This neurological condition affects how the brain plans and coordinates movement due to a disconnect in the planning process, not muscle weakness or intellectual disability. The difficulties are manifested as clumsiness, slowness, and inaccuracy in performing motor skills.
In daily life, these difficulties appear as challenges with fine motor tasks, such as struggling to button a shirt, tie shoelaces, or use scissors effectively. Gross motor skills are also affected, leading to frequent tripping, bumping into objects, or difficulty learning to ride a bicycle or catch a ball.
Motor planning impairment also impacts the sequencing of complex routines, such as following the correct multi-step process for brushing teeth or getting ready for school. Adults with dyspraxia may find it hard to learn new physical skills, manage time, or organize multi-step tasks like cooking a meal or driving. The effort required to perform these tasks can lead to increased fatigue, poor self-esteem, and avoidance of physical activities, affecting participation and independence across the entire lifespan.
The Occupational Therapy Approach to Assessment
An Occupational Therapist determines the existence and nature of a motor planning deficit through a comprehensive diagnostic process. This assessment involves both formal and informal measures to gain a full understanding of the person’s functional capabilities. Therapists rely heavily on clinical observation, watching the individual perform tasks relevant to their daily life, such as playing, self-care, or school activities. The OT uses standardized assessment tools to gather objective data, which helps to identify specific challenges in coordination and motor performance. The primary goal is to pinpoint where the breakdown occurs within the praxis sequence—ideation, planning, or execution—to guide the development of a tailored intervention plan.
Strategies Used in Motor Planning Intervention
Occupational therapy intervention for motor planning focuses on building new motor plans and improving the ability to adapt to unfamiliar tasks.
Task Analysis and Graded Activities
A core strategy is task analysis, where the OT breaks down a complex activity into smaller, more manageable steps for sequential learning. Visual aids, modeling, and consistent repetition are used in conjunction with this technique to help solidify the motor memory. The use of graded activities ensures that the person is presented with a “just right challenge,” meaning the task is difficult enough to promote learning without causing frustration.
Sensory Integration and Cognitive Strategies
Many OTs incorporate sensory integration approaches, utilizing sensory input to help the person organize their body and process information from the environment. Activities involving proprioceptive input, like heavy work or pushing and pulling, and vestibular input, such as swinging or balancing, can enhance body awareness and spatial orientation, which are foundational for effective planning.
Therapists frequently use play-based activities and meaningful tasks, such as navigating obstacle courses or playing games, to improve sequencing, timing, and coordination. They may also teach cognitive strategies, such as self-verbalization, where the person learns to talk themselves through the steps of a task. Through purposeful practice and repetition in a supportive environment, the goal is to develop automaticity, allowing the individual to perform daily routines with greater independence and fluidity.