The Relationship Between Narrative Language Skills and Ideational Praxis in Children

PURPOSE: Children with dyspraxia frequently demonstrate language difficulties, and current perspectives of embodied cognition support this idea that there is an underlying factor to both language and motor functions (Garbarini & Adenzato, 2004). Children with difficulties generating, organizing, and planning motor actions may also have difficulties generating, organizing, and planning linguistic functions. Difficulty generating and conceptualizing ideas for motor actions is referred to as ideational dyspraxia, and it is proposed that difficulties in this area may be related to difficulties in generating and producing narrative language. This is an area of praxis that has not yet been examined.

DESIGN: This exploratory study of secondary analysis of deidentified existing data examined the research question, What is the relationship among ideational praxis, narrative recall, and language functions among children with motor dyspraxia, those with ideational dyspraxia, and typical peers? Participants were 66 children ages 5 yr, 0 mo to 8 yr, 11 mo (41 boys, 25 girls), of whom 24 were typical peers, 21 had motor dyspraxia, 21 had ideational dyspraxia.

METHOD: The Test of Ideational Praxis (TIP; May-Benson, 2005) measured ideational praxis by asking a child to show the examiner how to do as many things as possible with a specific object. The Narrative Memory subtest of the NEPSY (Brooks, Sherman, & Strauss, 2009), recorded at time of administration and transcribed verbatim into SALT (Miller & Iglesias, 2012), measured free and prompted narrative recall by asking a child to retell a narrated story. SALT generated 30 macro- and microstructure language scores recorded in a deidentified database with TIP and other language tests completed during original study. Data were analyzed using Pearson correlations and one-way analysis of variance (ANOVA).

RESULTS: No significant differences were found among the three groups in any language function using one-way ANOVA. Typical peers had no significant relationships between TIP and Narrative Memory or language scores. Children with dyspraxia had medium to large significant correlations (r = .48 to .57) between TIP and eight language functions (e.g., mean length of utterance, number of different words, utterances with mazes). Children with ideational dyspraxia had significant relationships between TIP and free recall (r = .59, p = .005) and prompted recall (r = –.55, p = .010) on Narrative Memory. Moderate to large significant correlations (r = .47 to .73) were found between TIP and 18 language functions (e.g., total number utterances; number of different words, determiners, nouns, verbs).

CONCLUSION: Ideational skills in children with dyspraxia are most related to the ability to effectively organize and sequence language; increased pauses and less use of determiners and nouns were associated with poorer ideational skills. In children with ideational problems, poorer ideational skills were found with greater difficulty with free recall of the details of a story, more prompts needed to recall details, less use of language, fewer and shorter words, and fewer language components (e.g., nouns, verbs, adjectives, personal pronouns).

CONCLUSION: Results inform an understanding of ideation in praxis and support therapists’ clinical reports that children with ideational difficulties use less language. Preliminary findings may assist with further identification of underlying mechanisms for ideational problems and inform development of interventions for ideational problems. Also, children with dyspraxia, particularly those with ideation problems, may score within average on tests of expressive language but can demonstrate definite difficulties in language functions that may need to be addressed.

References

Brooks, B. L., Sherman, E. M., & Strauss, E. (2009). NEPSY–II: A developmental neuropsychological assessment. Child Neuropsychology, 16, 80–101. https://doi.org/10.1080/09297040903146966

Garbarini, F., & Adenzato, M. (2004). At the root of embodied cognition: Cognitive science meets neurophysiology. Brain and Cognition, 56, 100–106. https://doi.org/10.1016/j.bandc.2004.06.003

May-Benson, T. (2005). Examining ideational abilities in children with dyspraxia. Doctoral dissertation, Boston University.

Miller, J., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts (SALT), Research Version 2012 [Computer software]. Middleton, WI: SALT Software.