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Apraxia can be debilitating,
especially for children. Children with verbal apraxia – a motor disorder – can
have trouble talking. Verbal apraxia in children or adults, including with an
autism diagnosis means there is speech difficulty that is not due to any
paralysis or weakness of muscle. Instead, the difficulty in apraxia is an
inability to plan motor movements that are required to produce speech.
An individual with apraxia will produce the following
Difficulty imitating speech.
Difficulty saying longer words or phrase.
Groping behaviors when trying to coordinate the mouth,
lips and tongue for voluntary movement.
Inconsistent sound errors.
Definition Of Apraxia Apraxia of speech is considered a motor-speech programming
disorder that results in difficulty expressing and/or coordinating the
oral-motor movements necessary to produce and combine speech sound (phonemes).
This makes it difficult to form syllables, words, phrases and sentences on
voluntary - rather than reflexive - control.
The fact is, many children with
verbal apraxia are able to hear words, but they
are able to understand what they mean, but they can’t change what they hear into
the words. Children
will have problems saying sounds, syllables, and words. This is not because of
muscle weakness or paralysis. The brain has problems planning to move the body
parts (e.g., lips, jaw, tongue) needed for speech.
When the messages
from the brain to the mouth are disrupted, and the person cannot move his or her
lips or tongue to the right place to say sounds correctly, even though the
muscles are not weak. The severity of apraxia
depends on the nature of the brain damage.
Types of Childhood Apraxia of Speech (CAS)
Childhood Apraxia of Speech (CAS)
occurs in the following three conditions:
- caused by infection, illness, or injury, before or after birth or a random
abnormality or challenge in fetal development. This category includes
children with positive findings on MRI’s of the brain.
Disorders – apraxia can occur as a secondary
characteristic of other conditions such as genetic, metabolic, and/or
mitochondrial disorders. In this category would be Childhood Apraxia of
Speech that occurs with Autism, Fragile X, Galactosemia, some forms of
Epilepsy, and Chromosome translocations involving duplications and
Idiopathic Speech Disorder
(a disorder of “unknown” origin) – with this condition, it is unknown “why”
the child may have apraxia of sSpeech. Children do not have observable
neurological abnormalities or easily observed neurodevelopmental conditions.
Improving Apraxia With AIT - Auditory Integration Training
There is an auditory component
in apraxia that AIT can address. But it is not only that a person
with apraxia can't say it, they also have challenged auditory
target to aim for. A good analogy would be like when someone is aiming at a
target and shooting an arrow, and the body is positioned in archery, but the
person needs glasses in order to correctly see the target and fine tune
The first change after AIT is
usually an improved muscle tone and in some cases improved balance.
Some Speech and Language
practitioners treating apraxia will follow a neurodevelopment program
in conjunction with AIT.
These type of programs which works from the brainstem up through midbrain
and then cortex. Such a program is hierarchical and consists of
reflexes embedded in the first developmental movements that all humans do.
Practitioners treating apraxia
will also combine AIT
with work on with additional reflexes according to the person's needs. These
include fundamental movement skills such a basic gross
motor coordination, balance (vestibular system), core strength, fine motor
and proprioceptive exercises are also helpful.
Levels of Severity in Childhood Apraxia of Speech (CAS) (9:40 minutes)