Apraxia is a poorly understood neurological condition. People who have it find it difficult or impossible to make certain motor movements, even though their muscles are normal. Milder forms of apraxia are known as dyspraxia.
Apraxia can occur in a number of different forms. One form is orofacial apraxia. People with orofacial apraxia are unable to voluntarily perform certain movements involving facial muscles. For instance, they may not be able to lick their lips or wink. Another form of apraxia affects a person's ability to intentionally move arms and legs.
With apraxia of speech a person finds it difficult or impossible to move their mouth and tongue to speak. This happens, even though the person has the desire to speak and the mouth and tongue muscles are physically able to form words.
What Are the Symptoms of Apraxia of Speech?
There are a variety of speech-related symptoms that can be associated with apraxia, including:
Difficulty stringing syllables together in the appropriate order to make words, or inability to do so
Minimal babbling during infancy
Difficulty saying long or complex words
Repeated attempts at pronunciation of words
Speech inconsistencies, such as being able to say a sound or word properly at certain times but not others
Incorrect inflections or stresses on certain sounds or words
Excessive use of nonverbal forms of communication
Distorting of vowel sounds
Omitting consonants at the beginnings and ends of words
Seeming to grope or struggle to make words
Childhood apraxia of speech rarely occurs alone. It is often accompanied by other language or cognitive deficits, which may cause:
Limited vocabulary
Grammatical problems
Problems with coordination and fine motor skills
Difficulties chewing and swallowing
Clumsiness
Are There Treatments for Apraxia of Speech?
In some cases of acquired apraxia, the condition resolves spontaneously. This is not the case with childhood apraxia of speech, which does not go away without treatment.
There are various treatment approaches used for apraxia. How effective they are can vary from person to person. For the best results, apraxia treatment must be developed to meet a given individual's needs. Most children with apraxia of speech benefit from meeting one on one with a speech-language pathologist three to five times a week. They may also need to work with their parents or guardians to practice the skills they are developing.
Therapy for childhood apraxia of speech aims to improve speech coordination. Exercises may include:
Repeatedly practicing the formation and pronunciation of sounds and words
Practicing stringing together sounds to make speech
Working with rhythms or melodies
Using multisensory approaches, such as watching in a mirror while trying to form words or touching the face while talking
Many therapists believe that sign language is beneficial for children who have difficulty being understood. They often recommend that children attempt to say the words they are signing to practice making the necessary movements with their mouths.
People with more extreme cases of acquired apraxia may also benefit from sign language. Or they may use assistive electronic devices, including computers that can be used to produce words and sentences.
Very few studies have been done to determine the relative effectiveness of various treatment approaches for childhood apraxia of speech. This may be due, in part, to ongoing debate among experts as to which symptoms and characteristics merit a diagnosis of apraxia.
Are There Tests to Diagnose Apraxia of Speech?
There is not a single test or procedure that is used to diagnose childhood apraxia of speech. Diagnosis is complicated by the fact that speech-language pathologists have different opinions about which symptoms indicate the condition.
Most experts, though, look for the presence of multiple, common apraxia symptoms. They may assess a patient's ability to repeat a word multiple times. Or they may assess whether a person can recite a list of words that are increasingly more difficult, such as "play, playful, playfully."
A speech-language pathologist may interact with a child to assess which sounds, syllables, and words the child is able to make and understand. The pathologist will also examine the child's mouth, tongue, and face for any structural problems that might be causing apraxia symptoms.
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