Apraxia is a motor disorder that can prevent you from using your muscles as you want them. Balancing a mind that knows what it wants against a body that seems to have a mind of its own can be frustrating. Even though you retain normal muscular function otherwise, certain voluntary movements may not come easy. And that’s because the brain-to-muscle messaging system in the body is essentially malfunctioning. Apraxia can impact children as well as adults. Not too much is known about the number of people living with the condition, but spotting the signs early can alleviate a lot of the attendant stress and distress that people who have apraxia live with.
The Many Facets Of Apraxia
Apraxia is a generic term for a range of conditions that result from the problem described earlier. Orofacial apraxia causes problems with whistling, winking, and other facial movements; ideational apraxia results in an inability to carry out multiple movements in sequence, like eating or dressing up; limb-kinetic apraxia makes precise movements of the legs and arms difficult; oculomotor apraxia results in difficulty making voluntary eye movements; ideomotor apraxia involves an inability to respond to verbal commands with the appropriate muscular movement; constructional apraxia interferes with the ability to create or copy simple figures or drawings; and verbal apraxia hampers with speech and mouth coordination.1
Speech Apraxia And Symptoms
Of these various types of apraxia, one that is a concern for parents of young children is apraxia of speech or verbal apraxia. That’s because it can impact children and interfere with their language and speech development. Being a rare neurological speech and sound disorder, it takes specialized diagnosis and treatment.2 Knowing how to spot the symptoms can help with getting them the right attention and treatment.
Childhood speech apraxia can be hard to spot because it is easily confused with delayed development or as a child simply being a “late talker.” Spotting the symptoms thus becomes even more important for parents of a child with apraxia of speech. Apraxia of this nature that occurs during the developmental or growing years before adulthood is developmental apraxia.3
Early Signs In Infants And Toddlers
- As infants, the child may not babble as much as other infants.
- The young child may only make a few vowel or consonant sound (not as many as others their age).
- The child will typically speak his/her first word quite late and may even fail to make certain sounds in these words.
- Combination sounds are especially difficult and the result will be pauses between each paired sound.
- The child may have trouble eating.
As the child grows up, other symptoms present.
Symptoms In Older Children
If your child can understand what is being said or written but can’t talk as well, it could be a sign of apraxia. For some kids, there may also be issues with reading, writing, and spelling.
Spontaneous speech is difficult. And while imitated speech is easier than spontaneous speech it is still quite challenging for the child. The child might continue to make errors in the sound of words, not typical of their age. Long words and sentences are a bigger challenge. Anxiety might make the condition worse. The speech itself is difficult for a new person to understand due to choppiness or monotony in the flow, with wrongly enunciated sounds.
A visual sign to watch out for is that the child may seem to struggle to make their lips and tongue form the word they want; or the jaw may not move as needed to create the sound. Fine motor skills may not be as well-honed as in peers their age.
Children with apraxia may also be over or under sensitive to touch in the mouth. This will make them dislike eating textured crunchy food or even brushing their teeth. To check for this symptom, you could also try giving the child a specific food. Put it in their mouth and have them identify it by feel. Apraxia might make it hard for them to do so.4
Acquired Apraxia Of Speech In Adults
Acquired apraxia of speech can strike an adult after a stroke, head injury, tumor, or brain damage from illness. It renders them incapable of accessing their previous ability to speak, manifesting as language difficulties and trouble with speech due to nervous system damage. In some cases, there may be an accompanying muscular weakness. Symptoms, as in the case of developmental apraxia seen in children, results in trouble with sounds, combinations of sounds, speaking, and language. Mistakes in speech tend to be inconsistent so that a word or phrase may present a challenge one day but is spoken properly the next time. Speech-language pathologists can help with diagnosis.5
Tests To Diagnose Verbal Apraxia
To determine if someone has apraxia, there are some well-established tests which will be conducted, many of which focus on speech aspects.6
Oral-Motor Assessment
During this test, physical signs of weak muscle tone in the jaw, lips, and tongue are checked for. Movements involving the use of these muscles is tested to see whether coordination is the issue. This may include actions like pouting, smiling, frowning, or rolling the tongue around. In addition, the ability to reproduce certain sounds and strings of sounds will be checked.
Intonation Assessment
This melody of speech test checks whether the person can correctly use stresses, pauses in speech, and variations in pitch to communicate the difference between sentences, questions, phrases, and so on. The specialist will also observe for any mid-sentence or mid-phrase pauses.
Speech Sound Assessment
During this assessment, the specialist checks to see how the person is able to pronounce sounds and syllables as well as words. Consonant and vowel sounds will both be checked. A listener (not familiar with the person being tested) may also be brought in to gauge how well they are able to understand words, phrases, sentences, and bits of conversation used by the person.
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