Your infant’s eyes: “Hey, brain, you should see this new object (rattle). I haven’t seen anything like this before.”WHEN WE THINK about gross motor skills, we usually think of walking, running, and jumping. What many people do not realize is that there is more to gross motor skills than the simple act of moving. Gross motor skills rely on effective sensory processing of a number of different skills and systems, especially the body senses: tactile, proprioceptive, and vestibular processing. They also require an understanding of the properties of our physical world. Coordinated gross motor actions also call for sufficient muscle tone, trunk control, and muscle strength. If all of this is present, then the key to “good” gross motor skills is effective motor planning.
Praxis (referred to as motor planning) is the bridge between brain processing and motor control—it’s the process where the brain tells the body to do something, which results in the body actually doing it. There are three stages of praxis: ideation, motor planning, and execution. The communication between the brain and body allows us to accomplish new tasks as well as familiar tasks in new environments confidently. For example, the simple act of picking up a rattle is quite complicated. When you watch a baby learning to reach for an object, you are privy to a conversation between the brain and the body that goes something like this:
Your infant’s eyes: “Hey, brain, you should see this new object (rattle). I haven’t seen anything like this before.”
Brain: “Let’s check it out and get a little more information from the hands. You guys up for it?”
Hands: “Let’s do it, but how?”
The brain: “You, me, and the eyes up there need to work together. Trunk muscles, wake up! We need you to help us stay upright.”
The eyes: “Hey, brain, tell the hand to move forward.”
The brain transfers information to the hand. The hand reaches and misses. The eyes tell the brain that the hand reached too far.
The hand: “Hey, bad coordination, you two.”
The brain: “OK, arm, it’s a little closer to us, so tighten your muscles and bend your elbow.”
If there’s a glitch in the wiring of the motor planning system, new skills do not easily move from conscious control to automatic control. The child whose brain and body do not plan and execute together, in essence struggling with praxis, must expend much cognitive energy trying to figure out how to physically interact in his or her environment. You will often hear therapists refer to a child’s struggles with praxis as dyspraxia.
Furthermore, many children who have praxis difficulties do not readily generate ideas that would spur them to interact in their world. The motor planning system stores a library of basic skills that it can rely on as a foundation comprising the entire middle shelf of your child’s Brain Library. This allows the body and brain to learn more complex skills without having to attend to the basic stored skills. For example, the child whose motor planning system shelves are well stacked with bilateral skill experiences will look through a play yard, see his friend at the top of the playscape, run full-steam ahead, wind around the girls playing jump rope, continue to run under the football being tossed between two older boys, slow down just enough to put his right foot on the first step of the playscape, and join his friend at the top with their secret handshake. The child with praxis difficulties may want to get to the top of the playscape but would not have any idea of how to plan to navigate around the obstacles on the play yard, people, or objects. When he makes the attempt, he may find himself running into things or people and requiring much more time to get to his goal. One of the sure signs that a child is struggling with praxis is when the child always moves to the back of the line as children are lining up for a physical activity. Another example is the child who obviously wants to play, but because of these difficulties, he will walk the perimeter of the playground because he does not know how to enter into a game.
Dyspraxia, or difficulties with motor planning, can be seen in difficulties with gross motor, fine motor, and speech skills since they all rely on intact sensory processing and motor control. Thus it is not uncommon for a child with motor-planning difficulties to struggle with gross and fine motor skills as well as the motor control required for smooth speech. Motor planning references the base sensory systems while pulling the cognitive and motor system together; it lays the foundation for higher-level academic skills. This is one reason engaging your child in activities geared to learning gross motor skills is a powerful starting point for the development of other skills.
Jumpin’ Bears Indoor, but can be outdoor
Mini-trampoline
Container of small rubber, multicolored bears or a couple of small stuffed animals
Place a small number of same-colored bears on the trampoline.
Be sure your child has her shoes on for this activity.
Then hold your child’s hands and say, “Show the bears how to jump.” You may need to physically cue your child to jump.
Once she is jumping, encourage her to keep jumping until all the bears have “jumped off.”
Put two different-colored bears on the trampoline, and have your child yell out the color of the bear that is jumping off, such as “Yellow bear!” or “Red bear!” Some children will simply jump up and down, watching the bears fly off the trampoline. After they hear you say, “Yellow bear is jumping off!” or “Red bear is jumping off!” over and over, they will start to identify the color of the bear jumping off the trampoline.
Most children will modify their jumping (jump slower, change placement of feet during landing, etc.) as they try to figure out how to make the remaining bears jump off the trampoline.
For added fun, sing the song, “Five Little Monkeys Jumping on the Bed,” but substitute bears for monkeys in the song.
Note: For a younger child, start with one small stuffed bear on the trampoline while the child is jumping and say, “Bear is jumping off the trampoline.” Once he understands the concept of the game, you can try the smaller rubber bears.
Motor planning: Since the child has to think about how to jump to get the bears to bounce off, the activity requires increased motor planning.
Visual tracking: Watching the bears jump off requires following the bears’ movements as they “jump off.”
Proprioception: Jumping on a trampoline increases deep-pressure input to the body, which has an integrating, calming impact on the nervous system.
Vestibular-visual integration: The child uses his eyes to scan while his feet are off the ground.
Preacademic skills: This activity fosters color recognition and identification.
Language: This activity builds concepts such as “off” and “jumping.”
Note: Although this activity provides much sensory-type input, I first thought of it many years ago when a speech therapist asked me to cotreat a four-year-old boy with her. She had been working with him for several months, and he was not gaining new words. She was looking for different ways to get him to talk. I did this activity with him and really overemphasized the “language” component of it. After a few sessions, the speech therapist and I couldn’t believe the verbal leaps he was making while bouncing on the trampoline.
WHY Simply jumping on a trampoline allows a child to bounce, providing proprioceptive stimulation. However, requiring the child to bounce the bears off the trampoline means the child must change his or her motor movement and plan how to jump in more strategic ways to meet the objective of the game.
Floating Balloon Either
Large balloons
Bat a balloon back and forth a few times at first until your child gets the concept of the game.
Then integrate peers. Have all participants hit the balloon to keep it afloat as long as possible.
For added challenge, the adult calls out which hand the children should use to hit the balloon.
Another possible challenge is to add a second colored balloon. The adult calls out which colored balloon should be hit.
Have the children play balloon soccer, where they use their knees and their head to keep the balloon afloat. This is geared toward older children because it requires more motor coordination and is more physically taxing as well.
The advanced activity requires and stimulates core strength and is much more motivating than sit-ups.
Trunk rotation: This activity requires trunk rotation to turn and hit the balloon.
Readying response: A key to gross motor coordination is readying the body to respond to things or people moving around it.
Visual tracking: This activity requires the eyes to track a moving object.
Eye-hand coordination: This activity promotes basic motor response to incoming visual information.
Bilateral control: This activity requires the child to use both sides of the body to hit the balloon.
Physical endurance: Keeping the shoulders and arms elevated for extended periods of time helps promote physical endurance.
Trunk stability: Keeping the arms in an extended position, as well as being fluid in responding and batting the balloon, requires and promotes trunk stability.
Socialization: This is another game that promotes interaction without requiring the child to follow specific rules. It also allows children who struggle with language skills to participate in an interactive game with a peer.
Auditory integration: The child must integrate the auditory information and translate it into motor action.
WHY Many children in this population exhibit low muscle tone, which impacts their endurance as well as motor coordination during everyday activities. This activity offers a fun way to strengthen the deep muscles of the core and promotes shoulder stability. Both are essential for sitting in the classroom and writing.
Child keeps a balloon afloat while bouncing on the trampoline.
Vestibular input: Bouncing on the trampoline challenges the vestibular system.
Proprioception: Bouncing provides cyclic deep input, which gives the body increased input to the joints about where your body is in relation to itself.
WHY The trampoline is a medium to heighten the sensory input to the body through the vestibular and proprioceptive systems. The processing of these two systems lays a basis for more effective motor planning. Although the game is harder relative to when your child is standing on the ground, it is possible to carry out this activity because the bouncing has put the vestibular and proprioceptive systems on high alert.
Lycra Ring Either
A bolt of Lycra (buy at fabric store) approximately 3 feet wide and 9 feet long, with ends sewn together creating a ring (Swimsuit Lycra works well. It is expensive but very sturdy.)
Beach ball
Spread the Lycra out into a ring so you and your child can get in the Lycra circle with the beach ball close at hand.
Have your child step in first. Pull the Lycra up so that it is wrapped around your child’s shoulders and back. Then get into the Lycra circle as well.
You and your child should back away from each other until the Lycra is pushing against each of your bodies. The idea is to keep pressure against the Lycra.
Encourage your child to gently kick the ball to you while still pressing back against the Lycra.
Note: This game can include a few children. For younger children who do not have kicking skills yet, have one child sit at one end of the Lycra circle and the other child at the other end so the Lycra is stretched tight around their shoulders and backs. They will need to sit with their legs in an open V. Then have them push a ball back and forth to each other. This is a less scary way of playing ball activities, the ball is in the same plane as the child’s eyes.
Spatial awareness: The Lycra ring acts a physical boundary, decreasing the space in which your child can operate his body.
Proprioceptive/touch input: The entire time the child is engaged in the activity, he is giving himself physical input and helping draw his attention inward. The Lycra acts as a nonthreatening boundary. It is akin to touching a child on the shoulder to let him know that the ball is heading his way.
Bilateral control: By requiring your child to stabilize and balance on one foot while kicking the ball with the other, this activity requires bilateral coordination of the lower extremities.
Visual scanning: Your child must visually track the ball as it rolls across the floor.
Visual-motor skills: Your child must coordinate his body’s timing and response to make successful contact and kick the ball.
WHY Due to their multisensory nature, ball activities are something that many children with autism, Asperger’s, or sensory processing disorder find too difficult to do. This is because such games require visual tracking, a motor response, and attention. Using the Lycra ring as a stabilizer and boundary helps provide support to the trunk and the pelvic girdle while the child is standing and to the entire trunk area while the child is sitting because many children with neurological difficulties have low muscle tone. Low muscle tone refers to lack of tension in the muscles, which is linked to low muscle strength.
Scooter Safari Indoor
Square scooter board
Small toy jungle animals (or laminated pictures or picture cards of animals)
Cardboard box (The size of the box can vary depending on what you have available; however, you want to make sure it is big enough to accommodate all the animals coming to the zoo.)
Place the small toy animals (or laminated pictures or picture cards) around the room. Place the animals under, on, in, in front of, or behind objects in the room.
You and your child should set up the cardboard box together and talk about how all the animals are going to come live in the zoo.
Tell your child that she has to find all the animals and bring them to their new home.
Have your child lie on the scooter board with her upper body extended off the scooter board. The edge of the scooter board should be just below the armpits, allowing the arms the freedom to move.
Show your child how to propel herself on the board by physically by moving her arms in an alternating motion and thus pulling herself along on the scooter board. By using physical assistance to teach her how to move her arms, you are helping her motor plan her body. This will help increase the speed at which she is able to learn this new motor skill.
As soon as the child reaches an animal, prompt the child to announce the animal, such as saying, “Tiger,” or you can announce, “Tiger, you found the Tiger.” Then, depending upon the child’s level of language, prompt your child by saying, “Where was the tiger?” or say two to three times, “The tiger was under the table.”
Upon retrieving the animal, have your child bring it to the cardboard box (zoo) where the animals can live. She can walk back to the zoo and then go back to the scooter board.
Then have your child get back on her scooter board to retrieve the next animal and bring it to its new home.
Infuse language into the game by having your child identify the animal and make the animal sound. You may have to demonstrate the animal-and-sound combination a few times.
Motor planning: Encourage a child to decide how to move her arms so that she can navigate the room to get to the next object. This develops the child’s thought process.
Strengthening: This activity builds upper-extremity strength, specifically shoulder and arm strengthening.
Bilateral coordination: Moving both hands together to propel the scooter board promotes bilateral coordination.
Vestibular input: Changing the plane of the child’s head in space from vertical to horizontal excites the vestibular system.
Direction following: This activity is helpful for gaining command of multistep directions.
Proprioception: This activity provides increased deep-pressure input to the upper extremities.
Visual-motor skills: Visual skills (visual-perceptual and ocular-motor) are used to scan the environment room, perceive the animal of interest, and then fix on the animal as the child moves toward it.
Language: This activity introduces the concepts of on, under, behind, in front of, and in. These concepts help increase the child’s understanding when following directions and expand the child’s vocabulary (animal names).
WHY One of the significant benefits of crawling is the deep pressure provided to the palmar surface of the hands, which facilitates the arch formation of the hand. This is key to fine motor skills. However, many children with developmental delays do not spend enough time crawling, thus missing this intense input to the palmar surface of the hands and upper extremities. This activity mimics the benefits gained from crawling, including shoulder strength and stability.
“Biking” Through the Maze Outdoor
Chalk
Tricycle
Using chalk, draw a zigzag path on the ground.
Have your child navigate the path on the tricycle.
Increase the difficulty over time by drawing paths with ever more turns and sharper turns.
Increase the difficulty even more by drawing arrows instead of drawing a full path.
Motor planning (praxis): First your child must learn to pedal the tricycle. Once the skill for pedaling the tricycle becomes automatic, introduce the path. This will further challenge his body and brain because he will have to think about when and how to steer the tricycle in order to keep it on the path.
Strengthening: This is an excellent activity for strengthening the pelvic region and legs.
Visual attention: You are requiring the child to focus the eyes forward to follow the chalk path.
Vestibular input: This activity is alerting to the vestibular system, since the child’s feet are away from the ground while they are in motion.
Vestibular-visual integration: By requiring the child to visually focus on the line while moving, the activity promotes the integration of the vestibular-visual systems.
WHY Pulling a child’s visual focus forward while moving is imperative for safety. When the child is moving, be it on a tricycle or simply walking, it is important that he attends visually to information in front of him so he can navigate around people and objects in the environment.
Beanbag Toss Either
Six beanbags
Bucket
Any household chair
Place the bucket about 5 feet away from the front of the chair. Have the child walk around a chair. When the child gets to the front of the chair, have the child toss the beanbags into the bucket. Progressively get farther away with successful tosses into the bucket.
Have the child walk in a straight line or figure eight about 10 feet from the bucket and attempt to toss the beanbags into the bucket, which remains in a fixed position.
The child remains in a fixed place, and someone moves the bucket around in a pattern (either straight line or figure eight). Again, toss the beanbags into the moving bucket.
Standing about 10 feet from the bucket, the child begins to move along a line, and you move the bucket along a parallel line.
Motor planning: This activity works on the execution phase of the praxis (last phase of motor planning). This is a more advanced motor activity that requires being able to throw a beanbag with graded force as well as appropriate directionality.
Visual-motor skills: The activity requires tossing the beanbag based on changing visual information (length and direction).
Visual tracking: This activity requires that the eyes track a moving object when the child is in a fixed position, as well as concentrate on the immobile object while the child is moving. Then it requires tracking an object while both the child and object are moving.
Visual fixation: The child must focus on the bucket long enough to comprehend where the target is.
WHY As previously mentioned, children with a neurological diagnosis often have difficulty with praxis and visual skills. This activity requires some basic skills such as throwing with a sense of direction. There are varying stages of difficulty, from simple through advanced, with each step offering greater challenges for motor planning and visual skills development.
Beanbag and Pillow Balance Either
Beanbag
Small couch pillow
Nonbreakable item (book, folder, towel)
Have the child keep the beanbag balanced on his or her head while walking in a straight line.
Increase the difficulty by having the child keep the pillow balanced on his or her head while walking in a straight line.
Have the child walk heel to toe while balancing the pillow on his or her head while walking in a straight line.
Have the child carry a nonbreakable item while balancing the pillow on his or her head while walking in a straight line.
Motor planning: Keeping the beanbag or pillow balanced on his head requires the child to coordinate his body while making postural adjustments to keep the pillow or beanbag in place.
Dynamic postural control: This activity requires body control around the midline, which demands that the musculoskelatal system respond to the changes in the child’s movement to keep him or her balanced. Midline is the invisible plane that separates a person’s right from left and is roughly located about where the nose is.
Vestibular input: By adding a proprioceptive input to the head (via the beanbag/pillow), the vestibular-proprioceptive-visual systems must integrate to maintain balance.
WHY Sometimes children move through their environment without thinking about their body. This activity increases sensory stimuli to the head and neck area, which elicits cognitive focus to maintain upright posture and steady movement.
Bucket Catcher Either
Beanbags
Bucket
This activity uses the same equipment as for the beanbag toss but has the opposite objective.
Someone (an adult or peer) tosses the beanbag in the child’s direction.
The child uses the bucket to catch the beanbags in it.
To make the game more challenging, increase the distance between the person tossing and the child catching.
Visual-motor skills: For the child to catch a beanbag with a bucket, the child’s visual-motor system has to work properly. As the distance increases between the thrower and the child with the bucket, the game becomes harder because he must track the beanbag from even farther distances.
Motor planning: The child must coordinate and position his body to capture the beanbag as it flies through the air. As the distance increases between the thrower and the child with the bucket, the game becomes harder because the beanbag travels faster.
Proprioception: This activity requires muscle grading for the child to ready the body to position the bucket, as well as to respond to the force of the beanbag hitting the bucket.
WHY For many children with processing deficits, moving objects coming toward them will often elicit a fear reaction, because they cannot judge the speed of the object or its distance from them. Thus it is impossible for them to catch the object and protect themselves from being hit. By giving them a bucket and tossing a familiar object such as a beanbag from a short distance, you create a situation that the child may perceive as being safer, since the object will not be traveling fast and the child knows the beanbag will not hurt even if it hits him.
Catching on the Eight Either, but preferably outdoor
Chalk for outside, colored tape for inside
Beanbags or textured balls
Large bucket
If outside, use colored chalk to draw a figure eight about 10 feet long on the sidewalk or driveway.
If inside, use colored tape to create a figure eight about 10 feet long.
First have your child walk on the figure eight, making sure the child can actually walk the figure eight pattern (meaning walk through the middle and around)
Once the child can walk the figure eight pattern, you can tell the child to keep her eyes on you while she walks the figure eight carrying the bucket. Toss the beanbags to the child and have her catch them in the bucket.
Once the child understands the game, you can toss the beanbags faster and even two at a time to really challenge the child. You can also add a bucket at one end of the figure eight that your child can toss the beanbags into while walking.
You can make this game more complicated by drawing or taping a large X in a different color at one point on the figure eight, noting the place from where the child has to throw the beanbag back to you. Increase the difficulty even more by having your child march or cross-crawl march (i.e., while walking, alternate touching each leg with the hand from the opposite side of the body) the figure eight.
Peers can easily be integrated into this game.
For an increased level of difficulty, have music playing and instruct the child to stop walking when the music stops.
An alternative would be to have the child call out the color of the beanbag as it flies through the air.
Note: Last year a mom told me her son who had been coming to occupational therapy talked about this activity a lot. He became very motivated to get better at controlling his eyes while he moved. He did, and his teacher reported that he was better able to copy from a board, and his mother reported that he had gone from being the kid who could not hit the baseball to the kid who hit a few. But more important, he enjoyed the game because he was no longer afraid of the ball when it came toward him.
Vestibular-visual integration: Walking on the figure eight while visually tracking the tossed beanbags requires the child to simultaneously process and integrate visual and vestibular input.
Motor coordination: Catching the beanbag requires motor coordination in addition to the vestibular-visual integration.
Auditory input and integration: If you have the music playing, integrating auditory information in addition to the vestibular and visual information will challenge the nervous system further.
WHY Children with neurological difficulties often find integrating two or three systems simultaneously to be challenging. Accomplishing this activity will require the integration of several sensory systems at once.
Action Fishing Either
Cardboard fish about 3 inches in length (you can make these)
Paper clips (any size)
Computer with Internet connection and printer
Small, flat magnets
Fishing pole: cardboard tube from a paper towel roll, colored construction paper, a string about 36 inches in length
Download from the Internet cartoonlike pictures and add corresponding words underneath (as many as possible); use pictures of animals: crab walks, bear crawls, bunny hop on one foot; use pictures of people: throw ball, jump, run, do push-ups, head, shoulders, knees, toes. Print the pictures.
Tape or glue each picture to a cardboard fish. Attach a paper clip to each picture.
To make the fishing pole, wrap construction paper around the cardboard tube. Tie the string to one end of the tube; the hanging end should be about 24 to 30 inches long. Tie a magnet to the end of the string.
Place the pictures facedown on the floor.
Have the child fish by getting the magnet at the end of the fishing pole to pick up the various pictured items; then have the child roll the fishing rod to reel in the fish.
Have the child act out the picture he or she pulls.
Eye-hand coordination: Locating and picking up the fish promotes eye-hand coordination.
Wrist rotation: Reeling in the fish using the cardboard tube requires wrist rotation.
In-hand manipulation: Moving the fishing rod around requires in-hand manipulation.
Bilateral coordination: Taking the fish off the rod with one hand while holding the rod with the other promotes the use of left and right sides simultaneously.
Gross motor skills: Acting out the pictures requires gross motor involvement.
WHY Many children steer away from gross motor activities that they find too challenging. This fun activity encourages participation in varying activities, both ones they find easy and some they find more difficult.
Zoom Ball Outdoor
Zoom Ball game (Pressman)
Therapy balls
Each participant grips the handles, one in each hand so that the knuckles touch.
Have the Zoom Ball rest against one participant’s handles.
Sit on therapy balls far enough apart so that the cord is taut (about 18 feet apart). This can also be done on the knees.
The participant closest to the Zoom Ball starts by pulling his hands and arms apart, sending the ball zooming toward the other participant.
The other participant does the same, sending the ball back.
Gross motor skills: The participants must move the upper extremities to get the Zoom Ball moving back and forth.
Visual-vestibular integration: The vestibular system working in conjunction with the visual system tells your child how quickly the ball is coming toward him.
Visual-motor: Responding to the moving ball requires visual motor timing.
Visual convergence: As the ball moves toward your child, his eyes need to converge to maintain focus on the ball.
WHY Ball activities are a great way to work on visual-vestibular integration along with motor planning. However, a lot of children with neurological difficulties struggle with ball activities and can become very frustrated by them. Nonetheless, because the Zoom Ball is on a string, it ensures that the child on the other end will receive the ball, thus increasing participation in a ball activity. Altering the the children’s positions increases the motor planning challenge, while “working out” the core muscles.
Beanbag Target Game Outdoor if possible
Five hand-sized beanbags of different colors with different letters on each (available at most educational supply stores, or use a marker to write on beanbags you already have)
Five circles (12-inch diameter) made from poster board of different colors, with letters on one side of the circles and different numbers on the other side (Note: when writing the letters on the circles, take care not to exactly duplicate the letter-color scheme of the beanbags.)
This game has graduated levels of difficulty. You can increase the difficulty of this game by having ten numbered circles with letters on the opposite side (A through J).
Place the circles on the floor, and have all participants stand about 5 feet away from the circles.
Each participant throws a beanbag onto the circle that matches the color of the beanbag.
Each participant throws a beanbag onto the circle with the letter that corresponds to the letter on the beanbag.
Flip the circles over to the side with the numbers.
Each participant throws a beanbag from beanbag letter A to circle 1, from B to 2, and so on.
Eye-hand coordination: This activity has the child coordinate the appropriate grade of force and directionality to toss the beanbag to the correct spot based on the target.
Letter recognition: This activity requires letter recognition for the child to throw the beanbag to the target.
Praxis on verbal command: The directions are auditory and need to be integrated with the motor output.
WHY Since processing difficulties are well documented in these children, it is hoped that involving them in an activity that incrementally requires more mental agility will allow them to maintain focus throughout the activity. This type of activity challenges children’s attention, working memory, and visual processing.
Turtle Shell Indoor
Pillowcase
Beanbags (Start with six and add more based on child’s strength.)
Obstacle course items: household items, chairs, pillows, sofa
Different colors of tape
Put the beanbags into the pillowcase and sew the pillowcase closed to create the “turtle shell.”
Have child get on all fours, and place the pillowcase on his back.
Make an obstacle course using household items. Then have the child crawl through the course without dropping the “turtle shell.”
Using different colors of tape, create paths that cross over each other throughout the room.
Let the child choose a tape color.
Follow the preceding directions with the additional challenge of staying on the path of the chosen color (put a dot on the child’s hand for his color if necessary).
Motor planning: This activity uses visual and proprioceptive clues to aid with motor planning.
Upper-extremity strength: Crawling with the additional weight on the back helps increase shoulder girdle strength and stability.
Visual-motor coordination: Navigating through the path requires visual-motor coordination.
Hand muscle development: The deep pressure from crawling helps develop the arches of the hand.
Body awareness: Crawling provides proprioceptive input, which increases body awareness; the “turtle shell” increases the proprioceptive input.
WHY Intense proprioceptive input to the body increases body awareness, which is a prerequisite for motor planning, especially in the ideation phase of motor planning. Proprioceptive input in the form of deep pressure helps increase body awareness, which is essential for the early stages of praxis (motor planning). It is important for children to have internal references of how their bodies move so they can learn how to move in different ways.