praxia

Apraxia is a neurological condition that predominantly affects movement but may also impact speech. Dyspraxia is a milder form of apraxia.

There are various different forms of apraxia, including orofacial apraxia and apraxia of speech. With orofacial apraxia, people find it difficult to move the facial muscles to perform specific actions, such as winking. With apraxia of speech, it is difficult to move the mouth to form specific sounds and this makes it difficult to speak, even if you know exactly what you want to say.

Apraxia of speech

There are two forms of apraxia of speech: acquired and developmental apraxia. Acquired apraxia usually affects adults, while developmental apraxia is most common in children. Acquired apraxia results from the loss of ability to form words and engage in verbal communication, while developmental apraxia is usually present at birth and makes it difficult for children to learn how to speak and communicate. With the right support and therapy, most children are able to learn to speak very effectively.

Apraxia is not the same as aphasia, as aphasia affects the ability to understand language, while apraxia relates to issues with the formation of sounds, rather than the comprehension. It is possible to have both apraxia and aphasia.

Symptoms of apraxia of speech include:

• finding it hard to say long words
• difficulty stringing sentences together
• not babbling or making much noise as a baby
• increased reliance on other forms of communication
• struggling to pronounce complex words
• taking a lot of tries to say words
• inconsistency with sounds; sometimes getting it first time and others taking several goes
• changing the sound of vowels and getting inflection and emphasis wrong
• missing out consonant sounds, usually at the beginning of words

It is common for apraxia to be accompanied by other developmental issues in children, which may also cause symptoms such as:

• clumsiness and falling over and tripping more frequently than usual
• lack of coordination
• struggling with fine motor skills
• a small vocabulary

How is apraxia diagnosed?

A diagnosis is usually confirmed by the presence of multiple symptoms and there is no single test used to confirm a diagnosis. Speech and language therapists usually conduct a number of verbal assessments and test to ascertain whether a child may have apraxia. They may also look out for additional signs, which may flag up problems with understanding language. It is usually not possible to make a diagnosis before a child reaches their 2nd birthday.

Causes of apraxia

Acquired apraxia usually results from damage to parts of the brain, which are responsible for speech. Possible causes include strokes, brain tumours and traumatic head injuries.

It is not understood what causes developmental apraxia, also known as childhood apraxia, and research in this area is ongoing. Some researchers believe that there is some kind of disruption in the transmission of nerve signals, while others believe there may be a genetic cause.

Is it possible to treat apraxia of speech?

In many cases of acquired apraxia of speech, speech is restored without the need for treatment. However, developmental apraxia requires treatment, usually in the form of speech and language therapy. Therapy involves a series of exercises, which are designed to enable children to learn how to form sounds and improve coordination. Examples of exercises include repeating phrases, practising rhymes and phrases, talking out loud and using songs and melodies and using mirrors to show children how their mouth changes shape when they talk.

Many children also benefit from learning sign language when they are still very young, as this gives them a channel of communication that helps to prevent them from becoming stressed and frustrated.