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Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.22,0:00:06.52,Default,,0000,0000,0000,,[intro piano music]
Dialogue: 0,0:00:06.52,0:00:09.30,Default,,0000,0000,0000,,Hi everyone, good morning.
Dialogue: 0,0:00:09.30,0:00:11.82,Default,,0000,0000,0000,,Welcome back to the OTmiri channel.
Dialogue: 0,0:00:11.82,0:00:15.57,Default,,0000,0000,0000,,If you're new here \Nand we haven't met, my name is Miri.
Dialogue: 0,0:00:15.57,0:00:18.05,Default,,0000,0000,0000,,I'm a licensed occupational therapist
Dialogue: 0,0:00:18.05,0:00:21.64,Default,,0000,0000,0000,,and in today's video, I'll be talking \Nto you guys about apraxia,
Dialogue: 0,0:00:21.64,0:00:23.67,Default,,0000,0000,0000,,specifically the difference between
Dialogue: 0,0:00:23.67,0:00:26.64,Default,,0000,0000,0000,,ideational and ideomotor apraxia.
Dialogue: 0,0:00:26.64,0:00:30.53,Default,,0000,0000,0000,,But before I get started, \NI just want to say congratulations
Dialogue: 0,0:00:30.53,0:00:32.40,Default,,0000,0000,0000,,to all of you who've found out
Dialogue: 0,0:00:32.40,0:00:35.53,Default,,0000,0000,0000,,that you passed \Nthe NBCOT exam this morning.
Dialogue: 0,0:00:35.53,0:00:39.22,Default,,0000,0000,0000,,I woke up so happy to all of your messages
Dialogue: 0,0:00:39.22,0:00:41.62,Default,,0000,0000,0000,,and thoughtful, sweet notes,
Dialogue: 0,0:00:41.62,0:00:46.28,Default,,0000,0000,0000,,whether on Instagram or on Facebook \Nor here on this channel.
Dialogue: 0,0:00:46.28,0:00:50.02,Default,,0000,0000,0000,,I want you guys to know that \Nit makes such a big difference uh,
Dialogue: 0,0:00:50.02,0:00:51.88,Default,,0000,0000,0000,,when you guys share the news with me
Dialogue: 0,0:00:51.88,0:00:56.13,Default,,0000,0000,0000,,and to know that um, I was able \Nto share this journey with you
Dialogue: 0,0:00:56.13,0:00:57.67,Default,,0000,0000,0000,,leading to your success.
Dialogue: 0,0:00:57.67,0:01:03.42,Default,,0000,0000,0000,,It uh, gives me such a great sense \Nof satisfaction and pride for you
Dialogue: 0,0:01:03.42,0:01:06.25,Default,,0000,0000,0000,,and it motivates me to keep going.
Dialogue: 0,0:01:06.25,0:01:09.50,Default,,0000,0000,0000,,So much so that this is the first thing\Nthat I'm doing in the morning.
Dialogue: 0,0:01:09.50,0:01:12.32,Default,,0000,0000,0000,,I haven't even showered. \NI'm still in my pajamas,
Dialogue: 0,0:01:12.32,0:01:15.15,Default,,0000,0000,0000,,which I guess making \Na video in my pajamas
Dialogue: 0,0:01:15.15,0:01:17.81,Default,,0000,0000,0000,,is not my first time so you guys\Nare probably used to it,
Dialogue: 0,0:01:17.81,0:01:19.81,Default,,0000,0000,0000,,but thank you, guys.
Dialogue: 0,0:01:19.81,0:01:24.92,Default,,0000,0000,0000,,Um, I, I will be celebrating \Nin spirit with you today.
Dialogue: 0,0:01:24.92,0:01:28.27,Default,,0000,0000,0000,,Um, but let's get started. Apraxia.
Dialogue: 0,0:01:28.27,0:01:30.89,Default,,0000,0000,0000,,Now if you're preparing uh, for the exam
Dialogue: 0,0:01:30.89,0:01:33.01,Default,,0000,0000,0000,,and you're studying this content area,
Dialogue: 0,0:01:33.01,0:01:35.89,Default,,0000,0000,0000,,you might find yourself feeling confused
Dialogue: 0,0:01:35.89,0:01:38.42,Default,,0000,0000,0000,,or frustrated at times. I know I was.
Dialogue: 0,0:01:38.42,0:01:40.71,Default,,0000,0000,0000,,Because, depending on the literature,
Dialogue: 0,0:01:40.71,0:01:43.56,Default,,0000,0000,0000,,the authors, or even the country
Dialogue: 0,0:01:43.56,0:01:46.61,Default,,0000,0000,0000,,where these articles \Nare written, or textbooks,
Dialogue: 0,0:01:46.61,0:01:50.17,Default,,0000,0000,0000,,you'll come across \Na wide range of terminologies,
Dialogue: 0,0:01:50.17,0:01:53.22,Default,,0000,0000,0000,,ranging from oculomotor apraxia,
Dialogue: 0,0:01:53.22,0:01:55.21,Default,,0000,0000,0000,,dressing, constructional,
Dialogue: 0,0:01:55.21,0:01:58.61,Default,,0000,0000,0000,,limb apraxia, \Nthere's also limb kinetic apraxia,
Dialogue: 0,0:01:58.61,0:02:00.02,Default,,0000,0000,0000,,and the list goes on and on.
Dialogue: 0,0:02:00.02,0:02:01.78,Default,,0000,0000,0000,,And the way these are classified
Dialogue: 0,0:02:01.78,0:02:04.29,Default,,0000,0000,0000,,are not always universally accepted,
Dialogue: 0,0:02:04.29,0:02:06.51,Default,,0000,0000,0000,,which makes it \Nthat much more challenging.
Dialogue: 0,0:02:06.51,0:02:08.82,Default,,0000,0000,0000,,So in this video today, \Nand for the purposes
Dialogue: 0,0:02:08.82,0:02:10.88,Default,,0000,0000,0000,,of making it less overwhelming\Nfor you guys,
Dialogue: 0,0:02:10.88,0:02:13.71,Default,,0000,0000,0000,,I am going to talk about \Ntwo general categories
Dialogue: 0,0:02:13.71,0:02:17.01,Default,,0000,0000,0000,,that you'll see most often \Nin the rehabilitation literature
Dialogue: 0,0:02:17.01,0:02:19.11,Default,,0000,0000,0000,,as well as in your clinical setting,
Dialogue: 0,0:02:19.11,0:02:23.56,Default,,0000,0000,0000,,which are the ideational apraxia \Nand ideomotor apraxia.
Dialogue: 0,0:02:23.56,0:02:28.33,Default,,0000,0000,0000,,So let's first get started \Nby defining what apraxia is.
Dialogue: 0,0:02:28.33,0:02:32.35,Default,,0000,0000,0000,,It's basically a dysfunction or difficulty
Dialogue: 0,0:02:32.35,0:02:37.30,Default,,0000,0000,0000,,in execution of a skilled\Nor purposeful activity
Dialogue: 0,0:02:37.30,0:02:40.38,Default,,0000,0000,0000,,that cannot be attributed to or explained
Dialogue: 0,0:02:40.38,0:02:44.48,Default,,0000,0000,0000,,by sensorimotor \Nor cognitive comprehension deficits.
Dialogue: 0,0:02:44.48,0:02:47.03,Default,,0000,0000,0000,,So in other words, put another way,
Dialogue: 0,0:02:47.03,0:02:51.98,Default,,0000,0000,0000,,apraxia can occur\Neven in the absence of weakness,
Dialogue: 0,0:02:51.98,0:02:54.88,Default,,0000,0000,0000,,spasticity, motor or sensory loss,
Dialogue: 0,0:02:54.88,0:02:57.73,Default,,0000,0000,0000,,memory or comprehension \Nor cognitive deficits.
Dialogue: 0,0:02:57.73,0:02:59.28,Default,,0000,0000,0000,,Interesting, right?
Dialogue: 0,0:02:59.28,0:03:01.98,Default,,0000,0000,0000,,And it's typically lateralized \Nto the left hemisphere,
Dialogue: 0,0:03:01.98,0:03:05.93,Default,,0000,0000,0000,,meaning it's due to a damage \Nto the left hemisphere of the brain.
Dialogue: 0,0:03:05.93,0:03:10.28,Default,,0000,0000,0000,,And patients are oftentimes \Nunaware of these deficits,
Dialogue: 0,0:03:10.28,0:03:13.36,Default,,0000,0000,0000,,which makes treatment \Nthat much more challenging.
Dialogue: 0,0:03:13.36,0:03:16.63,Default,,0000,0000,0000,,Now to really understand apraxia,
Dialogue: 0,0:03:16.63,0:03:19.60,Default,,0000,0000,0000,,it's helpful to know \Nwhat the praxis system is.
Dialogue: 0,0:03:19.60,0:03:22.36,Default,,0000,0000,0000,,And I'm going to just \Ntalk about it very briefly.
Dialogue: 0,0:03:22.36,0:03:26.54,Default,,0000,0000,0000,,And a lot of the information \Nthat I'm talking about today
Dialogue: 0,0:03:26.54,0:03:28.83,Default,,0000,0000,0000,,is cited from Dr. Glen Dillon's work,
Dialogue: 0,0:03:28.83,0:03:30.41,Default,,0000,0000,0000,,and he's a fantastic resource
Dialogue: 0,0:03:30.41,0:03:32.91,Default,,0000,0000,0000,,so I'll list his books \Nin the video description.
Dialogue: 0,0:03:32.91,0:03:35.61,Default,,0000,0000,0000,,But basically \Nhe talks about the praxis system
Dialogue: 0,0:03:35.61,0:03:38.06,Default,,0000,0000,0000,,as a two step process
Dialogue: 0,0:03:38.06,0:03:41.61,Default,,0000,0000,0000,,that results in the execution \Nof a purposeful activity.
Dialogue: 0,0:03:41.61,0:03:45.68,Default,,0000,0000,0000,,The first step being ideation, \Nor conceptualization,
Dialogue: 0,0:03:45.68,0:03:47.96,Default,,0000,0000,0000,,so it's having the idea or the right idea
Dialogue: 0,0:03:47.96,0:03:50.43,Default,,0000,0000,0000,,about the task and what needs to be done.
Dialogue: 0,0:03:50.43,0:03:52.93,Default,,0000,0000,0000,,And then the second step is production,
Dialogue: 0,0:03:52.93,0:03:55.70,Default,,0000,0000,0000,,so this is the actual execution\Nof that task.
Dialogue: 0,0:03:55.70,0:04:00.81,Default,,0000,0000,0000,,And together, that results \Nin execution of a purposeful activity.
Dialogue: 0,0:04:00.81,0:04:03.01,Default,,0000,0000,0000,,And when there is a breakdown
Dialogue: 0,0:04:03.01,0:04:06.56,Default,,0000,0000,0000,,in either one of those steps\Nin the praxis system,
Dialogue: 0,0:04:06.56,0:04:08.24,Default,,0000,0000,0000,,you have apraxia,
Dialogue: 0,0:04:08.24,0:04:13.59,Default,,0000,0000,0000,,inability to perform these purposeful \Nmovements and tasks, okay.
Dialogue: 0,0:04:13.59,0:04:15.80,Default,,0000,0000,0000,,So now that you know what apraxia is,
Dialogue: 0,0:04:15.80,0:04:17.46,Default,,0000,0000,0000,,let's get into a little more detail
Dialogue: 0,0:04:17.46,0:04:20.16,Default,,0000,0000,0000,,and talk about ideational apraxia,
Dialogue: 0,0:04:20.16,0:04:24.16,Default,,0000,0000,0000,,which is referring to the breakdown \Nin the ideation component.
Dialogue: 0,0:04:24.16,0:04:27.38,Default,,0000,0000,0000,,And so the patient with ideational apraxia
Dialogue: 0,0:04:27.38,0:04:29.41,Default,,0000,0000,0000,,will have no idea
Dialogue: 0,0:04:29.41,0:04:32.43,Default,,0000,0000,0000,,or have, don't have the right idea
Dialogue: 0,0:04:32.43,0:04:35.81,Default,,0000,0000,0000,,about what needs\Nto be done with the task.
Dialogue: 0,0:04:35.81,0:04:40.58,Default,,0000,0000,0000,,And this includes not understanding \Nthe purpose of a tool or an object.
Dialogue: 0,0:04:40.58,0:04:44.11,Default,,0000,0000,0000,,So a classic example,\Nand you may have seen this many times
Dialogue: 0,0:04:44.11,0:04:46.15,Default,,0000,0000,0000,,if you're in my Facebook study group
Dialogue: 0,0:04:46.15,0:04:48.60,Default,,0000,0000,0000,,or on my Instagram page, I also have this,
Dialogue: 0,0:04:48.60,0:04:51.65,Default,,0000,0000,0000,,um, is a photo of Ariel. \N[Chuckles]
Dialogue: 0,0:04:51.65,0:04:52.93,Default,,0000,0000,0000,,Not a surprise, right?
Dialogue: 0,0:04:52.93,0:04:54.16,Default,,0000,0000,0000,,My favorite character.
Dialogue: 0,0:04:54.16,0:04:55.100,Default,,0000,0000,0000,,I know I talk about her all the time.
Dialogue: 0,0:04:55.100,0:04:59.16,Default,,0000,0000,0000,,But you have to remember \Nthat scene in {\i1}The Little Mermaid{\i0}
Dialogue: 0,0:04:59.16,0:05:02.99,Default,,0000,0000,0000,,where she's sitting across \Nthe dining table hall with Prince Eric
Dialogue: 0,0:05:02.99,0:05:05.12,Default,,0000,0000,0000,,and she sees a fork and enthusiastically
Dialogue: 0,0:05:05.12,0:05:07.73,Default,,0000,0000,0000,,and unabashedly, \Nshe takes it up to her hair
Dialogue: 0,0:05:07.73,0:05:10.04,Default,,0000,0000,0000,,and she starts brushing her hair \Nwith the fork.
Dialogue: 0,0:05:10.04,0:05:13.68,Default,,0000,0000,0000,,This is a really good example \Nof ideational apraxia,
Dialogue: 0,0:05:13.68,0:05:16.74,Default,,0000,0000,0000,,inability to use the tool appropriately,
Dialogue: 0,0:05:16.74,0:05:18.59,Default,,0000,0000,0000,,because she has lost the sense,
Dialogue: 0,0:05:18.59,0:05:22.46,Default,,0000,0000,0000,,has no idea what the purpose \Nof the object is,
Dialogue: 0,0:05:22.46,0:05:24.72,Default,,0000,0000,0000,,and so she brushes her hair with a fork.
Dialogue: 0,0:05:24.72,0:05:27.29,Default,,0000,0000,0000,,In the clinical setting, \Nyou might see this
Dialogue: 0,0:05:27.29,0:05:31.66,Default,,0000,0000,0000,,being played out with a patient \Ntrying to write with a spoon
Dialogue: 0,0:05:31.66,0:05:37.66,Default,,0000,0000,0000,,or trying to brush their teeth \Nwith a comb, okay.
Dialogue: 0,0:05:37.66,0:05:40.48,Default,,0000,0000,0000,,Another component of ideational apraxia
Dialogue: 0,0:05:40.48,0:05:44.41,Default,,0000,0000,0000,,can be seen when the patient \Ntries to engage in tasks
Dialogue: 0,0:05:44.41,0:05:46.06,Default,,0000,0000,0000,,that require multi steps.
Dialogue: 0,0:05:46.06,0:05:48.42,Default,,0000,0000,0000,,So sequencing is really difficult
Dialogue: 0,0:05:48.42,0:05:50.69,Default,,0000,0000,0000,,because patients don't have an idea
Dialogue: 0,0:05:50.69,0:05:53.82,Default,,0000,0000,0000,,of the demands of the task, okay.
Dialogue: 0,0:05:53.82,0:05:56.12,Default,,0000,0000,0000,,So again, idea comes into play here.
Dialogue: 0,0:05:56.12,0:05:59.79,Default,,0000,0000,0000,,And so um, think about a patient
Dialogue: 0,0:05:59.79,0:06:03.25,Default,,0000,0000,0000,,trying to uh, put on a shirt,
Dialogue: 0,0:06:03.25,0:06:07.25,Default,,0000,0000,0000,,but instead of putting their arms \Nthrough the sleeve,
Dialogue: 0,0:06:07.25,0:06:10.45,Default,,0000,0000,0000,,they'll try to put \Ntheir legs in instead, okay.
Dialogue: 0,0:06:10.45,0:06:14.34,Default,,0000,0000,0000,,Or um, they might try \Nto wear socks over their shoes,
Dialogue: 0,0:06:14.34,0:06:16.80,Default,,0000,0000,0000,,so they've forgotten the steps\Nand the sequence
Dialogue: 0,0:06:16.80,0:06:19.02,Default,,0000,0000,0000,,in which these activities occur.
Dialogue: 0,0:06:19.02,0:06:22.10,Default,,0000,0000,0000,,So uh, ideational apraxia \Nis pretty straightforward.
Dialogue: 0,0:06:22.10,0:06:25.45,Default,,0000,0000,0000,,You just have to remember \Nthe word "idea" in ideational
Dialogue: 0,0:06:25.45,0:06:28.88,Default,,0000,0000,0000,,and understand that the patient \Nwith ideational apraxia
Dialogue: 0,0:06:28.88,0:06:34.04,Default,,0000,0000,0000,,has no idea what the task uh, requires,
Dialogue: 0,0:06:34.04,0:06:35.80,Default,,0000,0000,0000,,so they don't know how to use the object,
Dialogue: 0,0:06:35.80,0:06:37.29,Default,,0000,0000,0000,,they don't know how to,
Dialogue: 0,0:06:37.29,0:06:39.98,Default,,0000,0000,0000,,how the objects work \Nin relation to each other,
Dialogue: 0,0:06:39.98,0:06:42.43,Default,,0000,0000,0000,,and they don't understand, \Nthey don't have an idea
Dialogue: 0,0:06:42.43,0:06:45.16,Default,,0000,0000,0000,,of the demands of the task, okay.
Dialogue: 0,0:06:45.16,0:06:48.14,Default,,0000,0000,0000,,Now contrast that with um,
Dialogue: 0,0:06:48.14,0:06:50.49,Default,,0000,0000,0000,,ideomotor apraxia.
Dialogue: 0,0:06:50.49,0:06:53.43,Default,,0000,0000,0000,,This is also known as, \Nand used synonymously,
Dialogue: 0,0:06:53.43,0:06:55.88,Default,,0000,0000,0000,,with motor apraxia.
Dialogue: 0,0:06:55.88,0:06:58.54,Default,,0000,0000,0000,,And unlike ideational apraxia
Dialogue: 0,0:06:58.54,0:07:02.24,Default,,0000,0000,0000,,where patients have no idea \Nwhat the demand of the task is
Dialogue: 0,0:07:02.24,0:07:03.99,Default,,0000,0000,0000,,and how to use an object,
Dialogue: 0,0:07:03.99,0:07:05.79,Default,,0000,0000,0000,,in ideomotor apraxia,
Dialogue: 0,0:07:05.79,0:07:08.14,Default,,0000,0000,0000,,patients actually do have an idea.
Dialogue: 0,0:07:08.14,0:07:11.92,Default,,0000,0000,0000,,They have an understanding \Nof what the task requires.
Dialogue: 0,0:07:11.92,0:07:16.28,Default,,0000,0000,0000,,Um, and given, \Nand if their language is intact,
Dialogue: 0,0:07:16.28,0:07:18.87,Default,,0000,0000,0000,,they might even be able \Nto verbalize to you
Dialogue: 0,0:07:18.87,0:07:21.52,Default,,0000,0000,0000,,what the task is that \Nthey have to perform.
Dialogue: 0,0:07:21.52,0:07:24.27,Default,,0000,0000,0000,,But in ideomotor apraxia,
Dialogue: 0,0:07:24.27,0:07:26.20,Default,,0000,0000,0000,,they have lost access
Dialogue: 0,0:07:26.20,0:07:29.40,Default,,0000,0000,0000,,to kinesthetic or kinetic memory
Dialogue: 0,0:07:29.40,0:07:31.03,Default,,0000,0000,0000,,related to that task,
Dialogue: 0,0:07:31.03,0:07:34.93,Default,,0000,0000,0000,,so they're no longer able\Nto perform that task, okay.
Dialogue: 0,0:07:34.93,0:07:37.41,Default,,0000,0000,0000,,And so uh, this is really fascinating.
Dialogue: 0,0:07:37.41,0:07:39.86,Default,,0000,0000,0000,,Let me give you an example in a scenario.
Dialogue: 0,0:07:39.86,0:07:42.78,Default,,0000,0000,0000,,Uh, you see a patient,
Dialogue: 0,0:07:42.78,0:07:46.03,Default,,0000,0000,0000,,when you pass by a patient's hall,
Dialogue: 0,0:07:46.03,0:07:50.72,Default,,0000,0000,0000,,and you notice that he is brushing\Nhis hair with a comb, okay.
Dialogue: 0,0:07:50.72,0:07:53.11,Default,,0000,0000,0000,,20 minutes later, into the session,
Dialogue: 0,0:07:53.11,0:07:55.100,Default,,0000,0000,0000,,you ask him to brush his hair.
Dialogue: 0,0:07:55.100,0:07:58.34,Default,,0000,0000,0000,,You give him the verbal command \Nand you say,
Dialogue: 0,0:07:58.34,0:08:01.84,Default,,0000,0000,0000,,"Can you show me how you \Nbrush your hair in the morning?"
Dialogue: 0,0:08:01.84,0:08:04.79,Default,,0000,0000,0000,,And although he was able\Nto do it earlier in the morning,
Dialogue: 0,0:08:04.79,0:08:08.19,Default,,0000,0000,0000,,automatically, in context,
Dialogue: 0,0:08:08.19,0:08:12.01,Default,,0000,0000,0000,,he will no longer be able \Nto do that upon verbal command,
Dialogue: 0,0:08:12.01,0:08:14.06,Default,,0000,0000,0000,,where if you try to ask him
Dialogue: 0,0:08:14.06,0:08:18.13,Default,,0000,0000,0000,,or have him mimic \Nor imitate your movement
Dialogue: 0,0:08:18.13,0:08:20.75,Default,,0000,0000,0000,,and say, "Can you try to do this, \Nbrush your hair?",
Dialogue: 0,0:08:20.75,0:08:23.40,Default,,0000,0000,0000,,he won't, the patient \Nwon't be able to copy it.
Dialogue: 0,0:08:23.40,0:08:27.73,Default,,0000,0000,0000,,So, inability to perform \Na movement upon verbal command
Dialogue: 0,0:08:27.73,0:08:29.94,Default,,0000,0000,0000,,or mimic or imitate gestures.
Dialogue: 0,0:08:29.94,0:08:34.34,Default,,0000,0000,0000,,This is a classic indeomotor apraxia.
Dialogue: 0,0:08:34.34,0:08:37.39,Default,,0000,0000,0000,,Isn't the brain really fascinating? \N[Laughs]
Dialogue: 0,0:08:37.39,0:08:40.79,Default,,0000,0000,0000,,Um, so uh, that's how it's differentiated
Dialogue: 0,0:08:40.79,0:08:42.77,Default,,0000,0000,0000,,from ideational apraxia,
Dialogue: 0,0:08:42.77,0:08:45.17,Default,,0000,0000,0000,,and in ideomotor, \Nthey have an understanding
Dialogue: 0,0:08:45.17,0:08:47.57,Default,,0000,0000,0000,,of what the task is \Nand what needs to be done,
Dialogue: 0,0:08:47.57,0:08:50.89,Default,,0000,0000,0000,,but because they have lost access \Nto that kinetic memory,
Dialogue: 0,0:08:50.89,0:08:52.82,Default,,0000,0000,0000,,they're no longer able to do that
Dialogue: 0,0:08:52.82,0:08:55.89,Default,,0000,0000,0000,,um, or execute those movements.
Dialogue: 0,0:08:55.89,0:08:58.32,Default,,0000,0000,0000,,Now clinically and in daily life,
Dialogue: 0,0:08:58.32,0:09:01.99,Default,,0000,0000,0000,,ideomotor apraxia will present as uh,
Dialogue: 0,0:09:01.99,0:09:07.14,Default,,0000,0000,0000,,just general uh, \Nmotor planning difficulty or in movement,
Dialogue: 0,0:09:07.14,0:09:09.00,Default,,0000,0000,0000,,and so what you might observe
Dialogue: 0,0:09:09.00,0:09:11.72,Default,,0000,0000,0000,,is movements that are um,
Dialogue: 0,0:09:11.72,0:09:16.22,Default,,0000,0000,0000,,awkward or imprecise or um,
Dialogue: 0,0:09:16.22,0:09:18.05,Default,,0000,0000,0000,,is not coordinated
Dialogue: 0,0:09:18.05,0:09:21.57,Default,,0000,0000,0000,,or the timing of the movement \Nmay not be right,
Dialogue: 0,0:09:21.57,0:09:23.82,Default,,0000,0000,0000,,so it might be too fast or too slow.
Dialogue: 0,0:09:23.82,0:09:26.10,Default,,0000,0000,0000,,Or you might see uh,
Dialogue: 0,0:09:26.10,0:09:29.67,Default,,0000,0000,0000,,a patient that has difficulty \Nwith the manipulation of objects.
Dialogue: 0,0:09:29.67,0:09:32.40,Default,,0000,0000,0000,,A lot of tasks that require\Nfine motor movements,
Dialogue: 0,0:09:32.40,0:09:34.52,Default,,0000,0000,0000,,so think about what you might need to do
Dialogue: 0,0:09:34.52,0:09:36.65,Default,,0000,0000,0000,,when you want to get food\Nout of the vending machine.
Dialogue: 0,0:09:36.65,0:09:38.90,Default,,0000,0000,0000,,You have to be able to manipulate coins \Nout of your hand,
Dialogue: 0,0:09:38.90,0:09:41.42,Default,,0000,0000,0000,,into your palm, like those translation.
Dialogue: 0,0:09:41.42,0:09:44.00,Default,,0000,0000,0000,,Um, you won't be able\Nto do that very well.
Dialogue: 0,0:09:44.00,0:09:48.70,Default,,0000,0000,0000,,Opening the jar, \Nor adjusting the grip on your hand,
Dialogue: 0,0:09:48.70,0:09:51.34,Default,,0000,0000,0000,,fingers to use the key to open the door.
Dialogue: 0,0:09:51.34,0:09:54.94,Default,,0000,0000,0000,,All of these things \Nthat require precise movements
Dialogue: 0,0:09:54.94,0:09:59.35,Default,,0000,0000,0000,,will be challenging for patients \Nwith ideomotor apraxia.
Dialogue: 0,0:10:00.02,0:10:02.32,Default,,0000,0000,0000,,Am I talking really fast? \N[Laughs]
Dialogue: 0,0:10:02.32,0:10:04.85,Default,,0000,0000,0000,,My god, I'm like sweating right now. \N[Laughs]
Dialogue: 0,0:10:04.85,0:10:06.70,Default,,0000,0000,0000,,It's because I'm trying \Nto finish this video
Dialogue: 0,0:10:06.70,0:10:08.05,Default,,0000,0000,0000,,before my baby wakes up
Dialogue: 0,0:10:08.05,0:10:11.28,Default,,0000,0000,0000,,and still have a little bit\Nof free time to myself.
Dialogue: 0,0:10:11.28,0:10:13.60,Default,,0000,0000,0000,,So that's it for today.
Dialogue: 0,0:10:13.60,0:10:16.28,Default,,0000,0000,0000,,Congratulations again \Nto everyone who found out
Dialogue: 0,0:10:16.28,0:10:17.82,Default,,0000,0000,0000,,that they passed.
Dialogue: 0,0:10:17.82,0:10:21.15,Default,,0000,0000,0000,,And if you are still um, \Npreparing for your exam
Dialogue: 0,0:10:21.15,0:10:22.70,Default,,0000,0000,0000,,and you're still striving,
Dialogue: 0,0:10:22.70,0:10:24.70,Default,,0000,0000,0000,,I just want to leave you with a quote
Dialogue: 0,0:10:24.70,0:10:26.63,Default,,0000,0000,0000,,that was always a comfort to me,
Dialogue: 0,0:10:26.63,0:10:28.61,Default,,0000,0000,0000,,um, by Winston Churchill,
Dialogue: 0,0:10:28.61,0:10:31.38,Default,,0000,0000,0000,,which, and he once said,
Dialogue: 0,0:10:31.38,0:10:36.14,Default,,0000,0000,0000,,"Success is not final \Nand failure is not fatal."
Dialogue: 0,0:10:36.14,0:10:38.74,Default,,0000,0000,0000,,And so to those of you who passed, um,
Dialogue: 0,0:10:38.74,0:10:40.80,Default,,0000,0000,0000,,know that this is just the beginning.
Dialogue: 0,0:10:40.80,0:10:42.60,Default,,0000,0000,0000,,This is not your final destination.
Dialogue: 0,0:10:42.60,0:10:44.81,Default,,0000,0000,0000,,You're going to go on \Nto achieve so much more
Dialogue: 0,0:10:44.81,0:10:47.28,Default,,0000,0000,0000,,than just merely passing this exam.
Dialogue: 0,0:10:47.28,0:10:50.34,Default,,0000,0000,0000,,And to those of you \Nwho did not pass today, uh,
Dialogue: 0,0:10:50.34,0:10:52.31,Default,,0000,0000,0000,,be slow to be discouraged
Dialogue: 0,0:10:52.31,0:10:54.03,Default,,0000,0000,0000,,but quick to be encouraged
Dialogue: 0,0:10:54.03,0:10:56.80,Default,,0000,0000,0000,,knowing that this is not a fatal moment,
Dialogue: 0,0:10:56.80,0:10:59.33,Default,,0000,0000,0000,,no matter how much you might think it is.
Dialogue: 0,0:10:59.33,0:11:02.51,Default,,0000,0000,0000,,Your efforts and everything \Nthat you're learning
Dialogue: 0,0:11:02.51,0:11:07.01,Default,,0000,0000,0000,,and all the uh, ways that you're \Ndisciplining yourself to keep going,
Dialogue: 0,0:11:07.01,0:11:09.76,Default,,0000,0000,0000,,this, this is not going to be in vane.
Dialogue: 0,0:11:09.76,0:11:12.18,Default,,0000,0000,0000,,It will all come back to serve you well
Dialogue: 0,0:11:12.18,0:11:14.19,Default,,0000,0000,0000,,and serve your patients in the future.
Dialogue: 0,0:11:14.19,0:11:18.92,Default,,0000,0000,0000,,So, keep your spirit up and um,
Dialogue: 0,0:11:18.92,0:11:20.64,Default,,0000,0000,0000,,keep going. Alright?
Dialogue: 0,0:11:21.94,0:11:24.52,Default,,0000,0000,0000,,Okay, guys. Until next time.
Dialogue: 0,0:11:24.52,0:11:27.72,Default,,0000,0000,0000,,Take good care. \NI love you guys so much.
Dialogue: 0,0:11:27.72,0:11:29.97,Default,,0000,0000,0000,,[Blows kiss] \NBye.
Dialogue: 0,0:11:30.77,0:11:34.12,Default,,0000,0000,0000,,[Outro piano music]