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Apraxia (also referred to as dyspraxia, meaning a less severe form of the disorder) is a speech disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words. It is not due to muscular weakness or paralysis. The problem is in the brain's planning to move the body parts needed for speech (e.g., lips, jaw, tongue.)
Apraxia is often present in childhhood, but may develop later in life as a result of damage to the nervous system. People with apraxia know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say those words. For example, a person may try to say "kitchen", but it may come out "bipem". The person may recognize the error and try again, sometimes getting it right, but sometimes saying something else entirely.
Early Signs & Symptoms of Childhood Apraxia of Speech:
- 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.
- First word approximations occurring beyond the age of 18 months, without developing into understandable simple vocabulary words by age 2.
- Lack of a significant consonant repertoire: child may only use / b , m , p , t , d , h /.
- All phonemes (consonants and vowels) may be imitated well in isolation, but any attempts to combine phonemes are unsuccessful.
- Single words may be articulated well, but attempts at further sentence length becomes unintelligible.
- One syllable or word is favored and used to convey all or many 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 motor problems may be present.
Other Characteristics of Apraxia
- Difficulty imitating speech sounds
- Possible difficulty imitating non-speech movements, such as sticking out their tongue (oral apraxia)
- Groping for sounds
- In severe cases, an inability to produce sound at all
- Inconsistent errors
- Slow rate of speech
- Somewhat preserved ability to produce "automatic speech", such as greetings like "How are you?"
- Can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage)
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