Motor Control and Motor Learning

Adam ambulates independently and transitions from floor to stand independently. He prefers to push up from the floor with his hands or attempts to hold onto something or someone else, indicating poor postural stability. He can run but isn't able to skip or gallop. He does not jump with 2 feet from the floor. He presents with impairments in motor planning evidenced by his tendency to have difficulty initiating a task, which leads to frustration. He has marked difficulty and anxiety with new tasks. Adam uses a palmer grasp when holding a marker and a spoon. When he engages in writing he likes to have tactile prompts when initiating copying letters but can finish on his own. Overall, he could be described as uncoordinated.

The first new concept I will incorporate from this module is a motor control concept of random trials. The Mass article identifies random order as more effective than using a block order. Specifically, this uses variable training of skills versus rote practice of the same skill. I am going to try to have Adam write letters in a random fashion and then increase to writing words. First, I will start with flashcards of letters and then change to verbal instruction to recall letters. They will not be in the same sequence as I usually use, "a,b,c...". Also, Adam enjoys various climbing activities such as climbing onto our mattress pad with assistance. Another concept that will be incorporated is decreased feedback. The Mass article reveals low-frequency feedback schedules facilitated better retention of skills. I will decrease physical assistance and feedback and then give him new challenges with climbing. For example, Adam will climb onto a large wooden box and then mattress pad or climb through tires, barrels and over other real-life obstacles such as pillows. The treatment strategies would incorporate motor control concepts of random trials and reduced feedback in a complex environment, tapping into intrinsic motivators in order to transfer skills to other environments.