Apraxia

Apraxia

Apraxia of speech is a motor speech disorder in which a child or adult has difficulty speaking syllables, words, and sentences with motor-planning instead of muscle movement.  Essentially, the brain (which is healthy) has difficulty telling the muscles (which are healthy) what to do. Some doctors also refer to apraxia as verbal dyspraxia. CAS (Childhood apraxia of speech) is prevalent in about 1 out of 1000 children (or somewhere between 3 and 4% of children diagnosed with speech disorders.  It is typically found more often in boys than girls and is associated with a few diseases including Fragile X syndrome.  As a speech disorder, it is fairly rare. 

Symptoms

Some symptoms as explained by the American Speech Language Hearing Association (ASHA) are:

• inconsistent errors on consonants and vowels in repeated productions of syllables or words
• lengthened and disrupted coarticulatory transitions between sounds and syllables
• inappropriate prosody, especially in the realization of lexical or phrasal stress. (Reference)

While these are not the only symptoms, these are the most indicitive of apraxia. Severe phonological disorders which use consistent patterns are not apraxia of speech, however apraxia can occasionally have patterns of difficulty with specific sounds or patterns.  Additionally, apraxia of speech also is seen in apraxia of limb movement (inconsistent movements of arms and legs) as well.

Apraxia can also affect a child's language development.  Children with apraxia frequently have difficulty with grammar, expressive language, reading, and writing. 

Causes

ASHA has identified several causes of CAS (Reference).  Neurological difficulties such as stroke, infection, brain surgery, etc., neurobehavioral disoders including autism, epilipsy, and other syndromes, and idiopathic speech sound disorders.  Essentially, should a child have some sort of trauma to the brain or a syndrome or disease which affects the brain they are at higher risk.  Additionally, like all speech and language disorders, occasionally there are some children who are just born with these difficulties and will require therapy in order to resolve their problems.

Treatment

Treatment is focused on increasing intelligibility using both articulation and language therapy together.  Traditional articulation approaches may be used in conjunction with therapy focusing on increasing general intelligibility and language abilities. Treatment can also utilize tactile and visual cues to help increase motor planning skills. Children with CAS also benefit from using melodic tones when speaking to improve speaking functions. 

Treatment is also more beneficial when given intense treatment more frequently (3-5 times a week) alone rather than in groups. 

References:

Childhood Apraxia of Speech

ASHA Technical Report