Moving Together: Apraxia Awareness and the Power of Co-Regulation
By Jessica Jordan, MS. OTR/L
Apraxia and Dyspraxia: What's the Difference?
Apraxia is a motor (or movement) disorder, often referred to in the context of speech production, although that is not the only type of apraxia. Apraxia affects an individual’s ability to execute purposeful movements and is a common sub-diagnosis within an autism diagnosis. Apraxia can impact the entire body, affecting gestures, fine motor skills, and overall coordination for many individuals. A study conducted at the Penn State Milton S Hershey Medical Center found that nearly two-thirds (approximately 64%) of children initially diagnosed with autism also had apraxia. That is a significant amount!
Individuals might also use the term dyspraxia to identify what is happening in their body. The prefix “dys” comes from Greek methodology and means “difficult” or “impaired.” It is often used in the medical world to indicate a dysfunction or challenge in a particular process. Regarding what we are about to discuss in those posts, we would consider both terms to be interchangeable (I.e., apraxia and dyspraxia).
What is Apraxia?
An individual with apraxia has trouble getting the messages from their brain to their muscles in order to make them move. It’s important to understand that the individual’s brain knows what it wants to say or do, but the messages get disconnected. Due to outdated perceptions of autism, apraxia is often overlooked or misinterpreted as a cognitive delay or a lack of understanding. Apraxia is prevalent among nonspeaking, minimally speaking, and unreliably speaking autistic individuals, and this disconnect between intention and execution often leaves many autistic individuals feeling frustrated with their bodies and their ability to communicate.
Common Challenges Associated with Apraxia in Autism
Speech and Communication Difficulties – Many autistic individuals with apraxia may not be able to rely on verbal speech as their primary communication method. They may benefit from AAC (Augmentative and Alternative Communication), spelling to communicate, or other forms of multimodal communication.
Motor Coordination Struggles – Difficulty with fine and gross motor planning can impact daily tasks such as eating, dressing, or writing.
Sensory-Motor Overload – Apraxia can contribute to sensory regulation challenges, leading to increased stress and difficulty navigating environments.
Behavior Misinterpretation – Motor planning challenges may be mistaken for “noncompliance” or “behavioral issues,” when, in reality, the individual may be trying but unable to complete the requested action.
The Connection Between Apraxia and Regulation
Motor execution requires a regulated nervous system. When an autistic individual experiences apraxia, their brain and body are working extra hard to coordinate movement, often leading to heightened stress levels. This is where co-regulation becomes essential.
What is Co-Regulation?
Co-regulation is the process of a regulated, attuned partner (such as a parent, therapist, or caregiver) supporting an individual’s nervous system to help them achieve regulation. Instead of expecting a dysregulated person to self-soothe, co-regulation provides the external support needed to return to a calm, connected state.
For autistic individuals with apraxia, co-regulation can:
Reduce motor planning demands by creating predictable, supportive interactions.
Help establish trust and safety, essential for motor execution.
Provide external cues that support motor initiation and completion.
How to Support Co-Regulation in Autistic Individuals with Apraxia
1. Prioritize Emotional and Sensory Regulation
Minimize demands during moments of stress or dysregulation.
Create a safe, low-pressure environment for communication and movement/motor demands.
Offer sensory supports that support the individual’s sensory profile. Talk to a licensed occupational therapist to better understand your loved one’s sensory motor profile.
2. Align Energy and Offer Affirmations
Match the individual’s energy level and provide a calming presence.
Use gestures, affirmations (I.e. “you got this”), and body positioning to signal support.
Allow time for motor initiation before assuming a lack of understanding.
3. Reduce Motor and Anxious Load
Offer predictability when at all possible and make expectations and changes in schedules clear with supports in place if necessary. **This doesn’t mean speak to the individual with truncated, childish language. It means reducing the amount of “unknown” by providing answers to anxious thoughts.
Simplify unnecessary movement sequences and provide scaffolding to foster inter-independence and allow the apraxic individual to feel successful with the completion of a motor task
Break down motor tasks into smaller, achievable next steps to promote success. Using motor coaching is essential to this step!
4. Respect Multimodal Communication
Acknowledge that speech is not the only valid form of communication.
Support the use of all types of multi-modal communication: spelling, AAC, sign language, or gestures.
Encourage communication attempts without correcting or demanding perfection.
5. Maintain Your Own Regulation as a Caregiver or Therapist
Your nervous system directly impacts the individual you’re supporting.
Practice self-regulation techniques to remain calm, present, and responsive.
Model co-regulation strategies, demonstrating how to manage emotions and stress.
Final Thoughts: Apraxia and Co-Regulation
Apraxia in autism is more than just a speech or movement challenge—it’s deeply tied to regulation. Understanding the role of co-regulation allows caregivers, therapists, and loved ones to provide the necessary support for motor learning, communication, and emotional well-being.
By shifting away from outdated models that emphasize "fixing" autism and instead focusing on safety, trust, and attunement, we can empower autistic individuals with apraxia to navigate their world with greater confidence and autonomy.
Would you like to learn more about neurodiversity-affirming approaches to motor coaching and regulation? Explore our resources or reach out for mentorship and training opportunities.
Helpful Links
If you found this post helpful, you’ll love our therapy resources! Whether you’re a parent or therapist, our apraxia and autism courses are here to offer practical tools, compassionate guidance, and real-world strategies you can use every day.
👨👩👧👦 For Parents & Caregivers: Autism Training | Online Course for Parents and Caregivers
🧑🏫 For Therapists: Therapist Course for Apraxia and Autism | Mentorship for OTs and Therapists
🏥 Work With Us: In-Person Occupational Therapy (San Diego & Long Beach Areas) | Virtual Coaching
