What is Apraxia?
Apraxia is a motor speech disorder that affects a person's ability to plan and coordinate the movements necessary for speech production. People with apraxia have difficulty coordinating the movements of the tongue, lips, jaw, and other speech muscles, which can result in slow, effortful, or distorted speech.
Apraxia is characterized by difficulty in planning and programming speech production, and unlike other disorders, the errors are often inconsistent. They may struggle to produce sounds or words correctly, or they may substitute one sound or word for another. There are two forms of apraxia:
Acquired Apraxia of Speech, which often follows a primary event, such as a cerebrovascular accident (stroke) or a traumatic brain injury (TBI), as well as other accidents or illnesses that can damage the brain.
Childhood Apraxia of Speech, which is usually diagnosed during childhood and often has no known cause, or may occur in conjunction with developmental disorders such as autism or cerebral palsy.
How a speech-language pathologist can help with apraxia?
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A speech-language pathologist can help with both acquired apraxia of speech as well as childhood apraxia of speech in many different ways, i.e:
Evaluate individuals and diagnose both acquired apraxia of speech and childhood apraxia of speech utilizing norm-based assessments and observations.
Create a treatment plan utilizing the background information on the individual as well as the assessment data.
Introduce and implement effective treatment strategies for the individual to incorporate into their everyday life.
Childhood apraxia of speech and acquired apraxia of speech are treated in similar ways, though treatment for childhood apraxia of speech may be tailored for younger individuals in a way that is more enjoyable for them and easier to keep them engaged. Treatment might include:
Oral exercises.
Focus on developing consistent production of consonant sounds as well as training or retraining the articulators in said productions.
Discussing the emotional impact of apraxia on the individual’s daily life/centering goals around that individual.
Discussing alternative forms of communication.
What methods are used to treat apraxia?
Drilling of speech sounds
In many cases, both consonant and vowel sounds are affected by apraxia of speech. It often benefits individuals to drill these sounds in order to learn or relearn the correct production and assist in training/retraining the muscle memory needed to produce them.
Motor exercises
Motor exercises are used to treat many motor speech disorders, including dysarthria as well. These exercises work to retrain and train muscles and to assist in building their coordination, even when weakness may not be present.
Learning other forms of communication
For severe cases of apraxia, alternative forms of communication may need to be learned. This may be done through communication boards or electronic devices that a speech-language pathologist can assist an individual in learning to navigate.
There are several methods of treating both acquired apraxia of speech and childhood apraxia of speech, and both forms of treatment are very similar. Though, treatment for childhood apraxia of speech is often tailored in order for a child to better understand and enjoy the treatment. Some of these treatments include:
How is apraxia of speech diagnosed?
Background check
A speech-language pathologist may begin an assessment by obtaining background information about the individual, such as their medical history and in the cases of children, their developmental history. They or their parent/guardian may be asked when symptoms appeared (whether it was after some sort of event, such as a stroke, or if the symptoms appeared in early childhood).
Evaluation of speech production
If concerns are raised to the speech-language pathologist, they might observe the adult or child’s speech production, along with the aforementioned normative-based assessment of their speech. These assessments typically look at the individual’s production of certain speech sounds as well as their physical appearance when producing said speech sounds (i.e. is groping present? Incoordination?)
Analysis of speech errors
The SLP will analyze the individual's speech errors to determine the type of apraxia present and the specific areas that need to be targeted in therapy.
Apraxia of speech is typically diagnosed utilizing a norm-based assessment as well as observations made by the speech-language pathologist. Some evaluation methods include:
Overall, the diagnosis of apraxia of speech involves a comprehensive evaluation of the individual's speech production and may involve collaboration with other professionals to rule out any underlying conditions.
How is apraxia of speech treated?
There are several treatment options for acquired apraxia of speech and childhood apraxia of speech. Childhood apraxia of speech treatment might be more tailored towards children, but overall is very similar to treatment that is done with acquired apraxia of speech. Treatment options include:
Sound Drills
Focus of treatment might be on producing speech sounds correctly. This can be done through repetitive production of speech sounds in order to learn/relearn the correct production.
Rate of Speech
Many individuals with apraxia, whether it is childhood or acquired, might struggle with speaking either too fast or too slowly. Treatment can work towards practicing an acceptable rate of speech.
Tactile Cues
Tractile cues, similar to drilling, works towards producing the sound correctly in a repetitive manner. However, utilizing tactile treatment involves touching the articulators to cue the individual to where their articulators need to move and touch.
Visual Cues
Visual cues involve the use of an object like a mirror, so that the individual being treated can see the physical production of the sound they are making and whether or not the production is correct.