Evaluation of praxis in preschoolers

This article draws from the research and clinical work of A. Jean Ayres to present a rationale and set of procedures for occupational therapy evaluation of the preschooler whose presenting problems suggest dyspraxia. The concept of praxis is briefly discussed and the problems of evaluating praxis in the preschooler are outlined. Based on the literature in this area, two major domains for evaluation are examined: sensory processing and praxis. In the domain of sensory processing, special attention is given to assessment of tactile, proprioceptive, vestibular, auditory, and visual functions. The domam of praxis is organized according to three primary processes: ideation, motor planning, and execution. Procedures for each domain are suggested, including administration of standardized test items, parent interviews, and structured observations, as well as observation of behavior in unstructured situations. Precautions in interpretation of data and suggestions for presenting evaluation findings in the clinical report are delineated. Finally, consideration is given to issues related to recommendation of occupational therapy, referral to other professionals, and setting of treatment goals for the dyspraxic child.