What is Apraxia?
Although Apraxia is fairly uncommon, it is incredibly disruptive to the life of the sufferer. This is because the person’s speech may be very difficult to be understood by others. This occurs as a result of improper motor planning within the brain and is not a problem with the muscles of speech in the mouth and face. Apraxia is a neurological speech sound disorder in the true sense within the areas of the brain that plan motor movements for speech production.
Are There Different Types?
Yes, there are two main types of Apraxia; Acquired and Childhood Apraxia of Speech.
This is a neurological disorder that happens due to an insult or injury to the brain that is not related to delay or disorder of development. It is a motor speech disorder that results in the motor commands for moving the mouth, tongue, and facial muscles are not properly sent within and from the brain to the articulators of the mouth. Thus, the person cannot make the proper movements for the speech sounds they are trying to say. The source of the problem occurs within the brain, not the muscles of the face.
Stroke is the most common cause for Acquired Apraxia of speech.
Childhood Apraxia of Speech
Childhood Apraxia of Speech (CAS) is a neurological speech sound disorder that occurs in childhood, between the ages of 3 – 21, and can persist into adulthood. Children who struggle with Apraxia have difficulty making the motor movements necessary to properly make speech sounds. The muscles in the child’s face, tongue and articulators are fine, it is the programming from the brain that is not wired properly.
According to the American Speech Language Hearing Association, Childhood Apraxia may occur as a result of a known neurological impairment. This can be associated with another, a more complex neurobehavioral disorder such as ADHD, Autism, or Obsessive Compulsive Disorder may be of unknown origin, or as a stand-alone neurogenic speech sound disorder. The core impairment exists in the planning and programming within the brain of the motor movements necessary for speech. This involves the precise timing and placement of the mouth, tongue, and facial muscles necessary for proper sound production.
Acquired Apraxia Symptoms
- Difficulty moving the tongue, lips, jaw, and facial muscles.
- Groping movements when trying to speak.
- Difficulty being understood when speaking.
- Slow halting speech that doesn’t have the typical rhythm and flow of comfortable speech.
- Inconsistent speech errors. May be able to say something once and then not again.
- Long and complex sentences are harder to produce and are more difficult for the listener to understand.
- Stress and trying harder can make the groping behaviors worse and make the person’s speech more difficult to understand.
Childhood Apraxia of Speech Symptoms
Apraxia can be elusive in that the onset and progression of symptoms can be very different for each child. The below characteristics have been associated with Apraxia in children.
Delayed Speech and Language Production: Children who suffer from Apraxia may be “late-talkers” with few words or sounds occurring by 18 months of age. There may be few words produced at this time and visible struggle with making few vowels or consonants. Many children with Apraxia also have delayed vocabulary skills or other language difficulties that might involve comprehension of what is said to them, producing ideas themselves, or word form and order.
- Minimal Babbling
- Excessive use of nonverbal communication
- Difficulty saying long or complex words
Speech Sound Distortions: As more sounds begin to be produced, the child experiences audible distortions in how vowels and consonants sound and the timing of sound combinations. For example, the child may have disruptions between and within syllables and may have sound differences such as “pie” for “bye”. Children may leave out sounds or continue to use a limited number of consonants and vowels as they continue to grow.
- Inability or difficulty stringing sounds together correctly to make words
- Speech inconsistencies such as being able to say a sound or word correctly at one point and then not at another
- Distorting vowel sounds
- Incorrect inflection or stress on certain sounds or words
- Omitting consonants at the beginning and end of words
Placement Difficulties: Many children who struggle with Apraxia have difficulty getting their lips, tongue, and jaw to the proper position for the production of one or more speech sounds. Many times they struggle with the placement of their mouth for sounds production and visually can be seen groping in an effort to get there. Smooth transitions between sounds can be challenging or impossible.
- Oral groping behaviors
- Struggle in making sounds and words
Childhood Apraxia of Speech rarely occurs in isolation. Many times is accompanied by other developmental difficulties which may cause:
- Limited vocabulary
- Grammatical Problems
- Physical movement and coordination challenges
- Problems with fine motor movements and control
- Difficulties chewing and swallowing
How Can Apraxia Be Diagnosed?
In addition to Apraxia of Speech being diagnosed by highly trained Speech-Language Pathologists who are familiar with and have experience treating motor speech disorders, qEEG Brain Mapping can provide insight into the brain patterns that are at the root of the neurological deficit. This neurological functioning assessment can be pivotal to improving Apraxia symptoms with greater ease and efficiency.
How to Diagnose Childhood Apraxia?
Diagnosing Apraxia can be somewhat of a challenge for Speech Language Pathologists when children are very young, however, this does not mean treatment cannot be started. Brain neuroplasticity, the ability of the brain to improve, is strongest when children are younger and thus early therapy can be very beneficial for overall outcomes of Apraxia. Using qEEG Brain Mapping makes it easier to visualize which areas of the brain are in need of optimization and thus can be predictive and guide therapy to improve treatment outcomes.
How Early Can Apraxia Be Diagnosed?
Most times Speech Language Pathologists will wait until a child turns three years of age to officially make a diagnosis, however, Apraxia may be suspected before that. The brain patterns associated with Childhood Apraxia can be assessed and visualized using qEEG Brain Mapping starting at 2 years of age and Acquired Apraxia can be assessed soon after injury in order to address the specific neurological needs of each person.
Who to Call about Apraxia?
Speech-Language Pathologists who are trained in motor speech disorders can help significantly increase the ability to produce sounds and the ability to be understood. If you or your child has been diagnosed with Apraxia and you are looking for brain-based assessment and therapy, you can call the highly trained professionals at Leigh Brain & Spine at (919) 401-9933. Using advanced technologies they can help guide early and effective treatment for your child.
How Can Brain-based Therapies Help Apraxia of Speech
Apraxia begins in the brain and thus is most efficiently treated within the brain. There is a brain pattern that is associated with developmental speech and language challenges, as indicated by the red and yellow colors in the accompanying qEEG Brain Map.
This map indicates that the areas for speech and language production are not working optimally. This pattern creates the symptoms that are associated with Apraxia. Through scientific advances and improvements in technology, skilled professionals are able to assess, analyze, and visualize the brain patterns that are associated with Apraxia. Then that information is able to be used to guide brain-based treatments, such as Neurofeedback, to optimize the impacted brain pattern so it is working efficiently.
Leigh Brain and Spine is proud to have earned the distinction as a Certified Brain Health Coach Center and is a proud member of the Amen Clinics referral network.