What is Apraxia?
Apraxia is a neurologically base breakdown of the organization or sequencing of movement that can involve language, perception and thought. Apraxia often occurs with problems in other areas such as sensory integration, attention, memory and fine/gross motor skills. A child may have oral apraxia or verbal apraxia or both. Oral apraxia involves problems with volitional control of non-speech movement. This would involve such things as tongue movement and sequencing movements for different parts of the mouth such as puckering lips, blowing, smiling, etc. Verbal apraxia involves problems with volitional movement for speech production. This usually involves sound sequencing but can also involve syllables, words or even phrases. Often, but not always, a child will have both oral and verbal apraxia
Early signs & symptoms:
- Limited or little babbling as an infant (void of many consonants). First words may not appear at all, pointing and “grunting” may be all that is heard.
- The child is able to open and close mouth, lick lips, protrude, retract and lateralize tongue (move from side to side) while eating, but not when directed to do so.
- First word approximations occurring beyond the age of 18 months, without developing into understandable simple vocabulary words by age 2.
- Continuous grunting and pointing beyond age 2.
- Lack of a significant consonant repertoire: child may only use
“ b”, “m”, “p”, “t”, “d”, and “h” sounds.
- All phonemes (consonant and vowel sounds) may be imitated well in
isolation, but any attempts to combine phonemes are unsuccessful.
- Words may be simplified by deleting consonants or vowels, and/or
replacing difficult phonemes with easier ones.
- Single words may be articulated well, but attempts at further
sentence length become unintelligible.
- Receptive language (comprehension) appears to be better than
attempts at expressive language (verbal output).
- One syllable or word is favored and used to convey all or many
words beyond age 2.
- A word (may be a real word or a nonsensical utterance) is used
to convey other words beyond age 2.
- The child speaks mostly in vowels.
- Verbal perseveration: getting “stuck” on a previously
uttered word, or bringing oral motor elements from a previous word
into the next word uttered.
- The child has difficulty moving the tongue where they want it to
go.
- “Pop-outs” or automatic words and phrases are spoken
clearly, but they cannot be imitated when directed or may not be
heard again.
- Other fine or gross motor delays are typical
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