Occupational Therapy: Building Skills and Resilience Through Motor Apraxia Challenges

Benji began occupational therapy at 6 months old to address severe low muscle tone that prevented him from holding his head up independently. He required external head support and physical assistance to maintain upright posture in his stroller. He had no fine motor control and could not grasp objects or tolerate being in a prone position while keeping his head up.

Early Therapy Goals: Benji’s First Steps in Motor Development

Initial therapy goals focused on maintaining posture in various positions. By age one,

Benji showed slight improvement in head control, and therapy expanded to include fine motor skills such as eating finger foods and placing shapes in a box, though progress was minimal. Our home filled with every recommended toy and therapeutic item.

As Benji grew older, his therapy incorporated a sensory diet to address sensory

processing challenges. This included swinging activities, weighted and compression

vests, and other sensory modalities. Despite consistent implementation for over a

decade, these traditional approaches showed minimal to no impact for Benji.

Benji was diagnosed with motor apraxia, a neurological condition that impairs the ability to plan and execute voluntary, purposeful movements such as waving, using utensils, brushing teeth, or holding a pencil. Individuals with motor apraxia understand what to do and have normal muscle strength but cannot execute the movements. Despite significant effort from Benji and his therapy team, he was unable to gain these skills, which created frustration for everyone involved.

However, recognizing that Benji understood the tasks gave us reason to believe there

must be a way for him to develop skills. Our challenge became figuring out how. The

priority shifted to managing his frustration, improving his self-esteem, building resilience, and demonstrating that we would not give up on him and that he should not give up on

himself.

Over time, the Team integrated OT principles and sought adapted equipment, including designing and 3D printing a customized fork. They practiced spearing pieces of plasticine with the fork to simulate eating. Through years of patient, repetitive practice, Benji eventually learned to eat independently with his customized fork, an accomplishment that gives him tremendous pride and independence.