If your child struggles with following directions, coordinating their movements, or seems “clumsy” despite understanding what you’re asking, they may be dealing with something called whole-body apraxia. This lesser-known neuromotor condition is often misunderstood, overlooked, or misdiagnosed as cognitive delay or behavioral resistance among those with autism, Down syndrome, and other developmental delays. In reality, it’s a brain-body disconnect—and understanding it could change everything for your child.
In this post, we’ll break down what whole-body apraxia is, how it differs from other motor and speech delays, why it often goes unnoticed, and what you can do to better support your child.
What Is Whole-Body Apraxia?
Whole-body apraxia is the inability to carry out voluntary, purposeful movements despite having the desire and physical ability to do so. It’s not a matter of not understanding what’s being asked—it’s that the neural pathways between the brain and the body are disrupted. This makes it difficult for the brain to send accurate messages to the muscles to carry out even simple movements.
Some professionals call this a “brain-body disconnect”—because that’s exactly what it is. An individual with whole-body apraxia may fully comprehend a command but physically cannot execute the task as intended.
Why Haven’t You Heard of Whole-Body Apraxia?
You may have come across the term apraxia through a speech-language pathologist, especially if your child has been diagnosed with Childhood Apraxia of Speech (CAS). CAS refers specifically to difficulties planning and coordinating the movements needed for speech.
But whole-body apraxia is more than that. It affects the entire body, not just the muscles used for speech. And because it’s not as commonly recognized, it is significantly underdiagnosed. Even as an occupational therapist, I didn’t initially use the term “whole-body apraxia.” Instead, like many others in the field, I described my clients as having fine and gross motor delays. While technically correct, this language fails to capture the full picture—particularly in cases where a child understands a direction but can’t physically carry it out.
Presuming Competence: A Shift in Mindset
One of the biggest obstacles to diagnosing whole-body apraxia is the failure to presume competence. For example, early in my career, I would ask a child to sit beside me, and when they walked in the opposite direction, I assumed they didn’t understand. Now I understand that they likely did—they just couldn’t get their body to comply. If we presumed competence in all of our children, we would realize that with support, they can learn the movements needed to participate in their activities.
Whole-body apraxia doesn’t stem from a cognitive or intellectual disability. Rather, it’s a neuromotor issue. When we shift our mindset to presume competence, we can begin to see these behaviors through a new lens—and open the door to more effective interventions.
The Role of Motor Planning (Praxis)
To understand apraxia, we must first understand praxis, or motor planning. Praxis refers to the brain’s ability to plan, sequence, and execute motor actions. It’s how we learn to move intentionally and efficiently—from crawling and walking to writing and using tools.
Consider a toddler who sees a toy across the room. To get it, they must initiate movement, adjust their posture, crawl or walk across the room, and grasp the toy. This sequence is driven by motor planning. For children with neuromotor disabilities such as autism or Down syndrome, this motor learning process can be disrupted, leading to delays in developmental milestones like crawling, walking, and speech.
These early signs are often dismissed as developmental delays, but they could actually be early indicators of whole-body apraxia.
Does Whole-Body Apraxia Improve Over Time?
Whole-body apraxia doesn’t typically “go away,” but individuals can improve their function through targeted support. It’s also important to understand that whole body apraxia exists on a spectrum.
Some of my clients are unreliable speakers—they may speak, but their speech is limited to rote or scripted phrases. Others are nonspeaking and have more complex sensory and motor profiles. Both groups experience whole-body apraxia, just in different ways.
Multiple factors can influence a person’s ability to build new motor pathways. Two major areas to consider are:
1. Medical Issues
Pain and discomfort can seriously disrupt motor control. Many of the children I work with experience gastrointestinal issues, inflammation, or other chronic conditions that affect their ability to move intentionally. Addressing underlying medical concerns is often the first step.
2. Vision and Movement
Vision plays a critical role in motor planning. But when I say vision, I’m not just talking about visual acuity (how clearly a person sees). I mean functional vision—how well the brain processes visual input to guide movement. Poor visual processing can severely impact coordination, regulation, and attention.
(Stay tuned for a future blog post where I dive deeper into the connection between vision and apraxia.)
How to Support Someone with Whole-Body Apraxia
Understanding whole-body apraxia is the first step. Supporting someone who lives with it takes compassion, strategy, and patience. Here are some key insights for parents, therapists, and caregivers:
1. Understand That the Person Knows
Your child understands what you’re saying. They just may not be able to act on it. This is not defiance or delay—it’s a motor execution issue.
2. Initiation Is Often the Hardest Part
Getting started is one of the biggest hurdles. The movement you’re asking for might be simple to you, but for someone with apraxia, initiating that movement can be nearly impossible without help.
3. Coach the Motor
Instead of giving broad commands like “Go get in the car,” break the task into small, manageable steps. For example:
- Step 1: Look toward the door.
- Step 2: Shift weight forward.
- Step 3: Stand up.
Each step can be coached gently, allowing the person to process and follow through with physical support if needed. Also, you can schedule a virtual or in-person session with one of our Occupational Therapists at Spellers Center Tampa
Final Thoughts: Shifting our Mindset is Everything
Whole-body apraxia is a complex and often invisible challenge, but it doesn’t have to be misunderstood. When we presume competence, take time to understand each individual’s motor and sensory profile, and break tasks into achievable steps, we empower our children to succeed.
Families, teachers, and therapists all play a role in creating a supportive environment. By learning to recognize and respond to whole-body apraxia, we can reduce frustration, increase independence, and help every child feel seen, understood, and capable.
