Motor planning doesn’t live in just one part of the body. And it certainly doesn’t belong to just one discipline. When a child struggles to speak, move, imitate, initiate, or coordinate their body during play, we are not looking at isolated systems. We are looking at praxis – the brain’s ability to form an idea, plan the action, execute it, and adjust based on feedback. Motor planning lives in the connection between brain and body – and when that connection is disrupted, it shows up everywhere.
At the 2026 Play Conference, pediatric SLP Alonna Bondar, M.S., CCC-SLP and occupational therapist Erin Clarelli, MS, OTR/L came together for a powerful interdisciplinary conversation which highlighted how speech apraxia and whole-body dyspraxia intersect – and how real, clinically guided play can build both.
What Is Praxis?
It is how we interact with the world. Praxis is the brain-body process that allows us to:
- Generate an idea
- Plan the movement
- Execute the action
- Integrate feedback to refine it
Praxis is not just speech and it is not just gross motor movement. It includes:
- Eye movements
- Breathing coordination
- Oral-motor control
- Postural stability
- Fine motor precision
- Executive functioning and emotional regulation
When praxis breaks down, we see apraxia or dyspraxia – difficulties in motor planning and execution despite having the physical capacity to perform the action.
Childhood Apraxia of Speech (CAS): A Motor Planning Breakdown
CAS is a speech diagnosis made by a trained SLP. It is not a medical diagnosis, although pediatricians or neurologists may suspect it and refer. Alonna states that proper diagnosis matters because CAS requires motor-based treatment – not traditional language-based therapy.
Apraxia is a difficult speech problem and when a child is diagnosed parents will often go to Google to try to understand what this means, but the results can be scary and overwhelming leading to parents becoming anxious as to what this means for their child. Alonna emphasizes that it is important for the SLP making the diagnosis to help explain to the parents that while CAS is a difficult problem, a trained SLP will know what they are doing and will be able to help remediate the child, and to reassure the parent that they are in this journey together. It is also important to help explain what CAS means in functional terms:
- Motor planning = deciding which articulators move and in what sequence.
- Motor programming = determining how those movements occur (speed, force, direction, tension).
Children with CAS may have many sounds in their repertoire – sometimes even later-developing sounds. What they struggle with is sequencing those sounds together. The breakdown often occurs in the transition from one sound to the next.
They might produce /m/ and /ee/ individually but struggle to blend them into “me.”
Early Red Flags for CAS
In early intervention, clinicians may notice:
- Limited vocalizations
- Decreased or absent babbling before 12 months
- Fewer than five consonants between 17–24 months
- Simple syllable shapes (V or CV)
- “Ghost words” (words that appear and disappear)
- Difficulty imitating words
One important myth that Alonna wants to dispel is that age is not the deciding factor when it comes to diagnosing a child with CAS. If a child can participate in a dynamic motor speech assessment and shows signs consistent with CAS, referral is appropriate – even under age three.
There is no downside to treating a child using motor speech principles when apraxia is suspected. Motor learning strategies benefit all children.
The Discriminative Characteristics of CAS
CAS is often described as “consistently inconsistent.”
When challenged to produce words, children may demonstrate:
- Awkward transitions between sounds
- Groping or trial-and-error movements
- Vowel distortions
- Inconsistent voicing errors (mixing /p/ and /b/)
- Intrusive schwa sounds
- Inconsistent production across repeated attempts
Importantly, these characteristics often emerge during supported or cued production – not necessarily on words the child already says easily.
Expanding the Lens: Whole-Body Dyspraxia
From Erin Clarelli’s occupational therapy perspective, praxis extends beyond speech.
She describes what many families experience as a brain-body disconnect: the brain understands what is being asked, but the body cannot initiate or coordinate the action.
This might look like:
- Not transitioning when prompted
- Seeming to ignore instructions
- Throwing blocks instead of stacking
- Appearing clumsy
- Struggling with fine motor tasks despite adequate strength
- Completing a task once but being unable to replicate it
This is not defiance or a lack of understanding. It is motor planning difficulty.
Emerging research from scholars such as Anne Donnellan and Elizabeth Torres has increasingly highlighted autism as involving significant motor differences – not solely cognitive differences.
When we shift from a behavioral lens to a motor lens, intervention changes.
The Multidisciplinary Bridge
Speech apraxia and whole-body dyspraxia frequently co-occur.
A child who struggles with postural stability, iImitation of motor actions, sensory integration and initiation of movement, may also struggle with motor speech planning.
This is where collaboration becomes essential.
When SLPs, OTPs, PTs, and other providers align their understanding of praxis:
- OT supports imitation and regulation – which prepares for speech imitation
- PT supports proximal stability – which supports jaw stability
- SLP supports motor speech planning – which increases participation and communication
The body supports the mouth.
The mouth supports communication.
Communication supports regulation and engagement.
Motor-Based Treatment for CAS
In her practice, Alonna uses gold-standard motor-based approaches such as Dynamic Temporal and Tactile Cueing (DTTC) and PROMPT.
DTTC uses a structured hierarchy:
- Simultaneous production
- Slowed rate
- High repetition
- Gradual fading of cues
- Transition from constant to variable practice
These approaches are grounded in principles of motor learning, which originated in gross motor research and emphasize repetition, intensity, and multisensory feedback.
One thing that Alonna suggests therapists look out for is not to use non-speech exercises to work on motor planning of speech. In order to get better at speech, we need to practice speech through principles of motor learning.Blowing whistles or holding objects between lips does not directly build motor speech plans. Therapy time should prioritize meaningful speech production.
The benefits of Play
Both Alonna and Erin emphasize that play is not “just play.”
When guided by a clinical lens, play becomes the perfect environment for motor learning:
- Toys with pieces (puzzles, blocks, games) create repetition
- Open-ended toys (animals, figurines, magnetic tiles) allow flexible language
- Quick reinforcers (bubbles, pop-up toys) create natural practice opportunities
- Repetitive books provide built-in motor practice
Play builds motor planning without sacrificing joy.
Regulation, Posture, and the Motor Lens
Motor planning does not happen in isolation from the body. Speech, posture, and regulation are deeply interconnected.
The jaw depends on postural stability to support refined lip and tongue movements. When a child is well positioned – often in a supported 90-90-90 seated posture – oral motor control improves because stability creates the foundation for precision. But flexibility matters. If structured seating increases dysregulation, alternatives like supported floor sitting, leaning into a therapist, lap sitting with mirror feedback, or incorporating movement breaks can help restore nervous system safety. Regulation and motor learning are inseparable; a dysregulated nervous system cannot build consistent motor plans.
Presuming competence strengthens this foundation even further. Speaking to children at their age level, involving them in therapy conversations, and using respectful, strengths-based language increases trust and engagement. Motor coaching – breaking tasks into manageable steps and narrating them clearly – supports initiation and execution. When we view behaviors such as dropping to the floor, throwing materials, or inconsistent performance through a motor lens rather than a compliance lens, we often uncover motor planning breakdown instead of defiance. Praxis underlies communication, regulation, and executive functioning.
The Big Takeaway
Apraxia – whether speech or whole-body – can feel overwhelming to families. Online searches often amplify fear.
But as both clinicians emphasized:
- It can be treated.
- Children can make progress.
- Play works.
- Motor learning principles are powerful.
When multidisciplinary teams collaborate and view children through a motor planning lens, therapy becomes cohesive, hopeful, and effective.
Praxis is behind everything we do as humans. When we support praxis, we support the whole child.
This is just a glimpse: watch the full interview plus 15 other expert-led talks from the 2026 Play Conference – The Experience Gap: Are Our Kids Experiencing the World or Just Watching It?
About Alonna Bondar
Alonna is a PROMPT certified and DTTC trained, and listed on the Apraxia Kids directory. Alonna is pediatric speech language pathologist with 25 years of experience. She specializes in apraxia and other speech sound disorders. She enjoys working with children with various diagnoses, especially those with down syndrome and autism.
Website: https://www.bondarspeech.com/
About Erin Clarelli
Erin is an occupational therapist who helps caregivers and professionals understand apraxic autism through a motor-based, competence-presuming lens. Her work blends authentic play, intentional motor coaching, and collaborative practice to support regulation, confidence, communication, and deeper connection across environments.
Website: https://www.sunrisetherapiesinc.com/