Apraxia is a motor speech disorder. Children who endure Apraxia or Dyspraxia (a milder form), have difficulties finding the immediate place of articulation and in moving smoothly from one place of articulation to another.
The child’s speech can often be unintelligible. The pattern of articulatory error is reported in the literature to be separate to their language development which continues to evolve. Although it is separate, as Speech Pathologists we often see an association with a mild language delay and associated learning difficulties. The overall coordination of the oromotor movements can be severely impaired. The child is thought to be just making sounds when in fact they are attempting connected structured speech.
Apraxia is commonly referred to as a disorder of voluntary muscle movement. This means that when a child is attempting to move and control the oromotor muscles of the lips, tongue, jaw and face, placement and coordination is reduced or lost.
However when they partake in more involuntary and automatic muscle movement patterns and speech, there is considerable more control and articulated sound. Often the children will produce a spontaneous utterance only to experience a failed attempt when asked by their parents to repeat it.
The terminology can be confusing.
Childhood Apraxia of Speech includes Oral Apraxia and Verbal Apraxia.
The difference between these disorders are: Children with Oral Apraxia will have difficulties using the mouth and tongue to imitate nonverbal movements such as blowing air, blowing kisses, sticking their tongue out or imitating gross motor movement patterns. The child with Verbal Apraxia will have difficulties formulating sounds at a word, phrase and sentence level. On examination, there may also be disturbance of rhythm, rate of speech and airflow for speech.
The secondary impact of a child with Apraxia can be the reduced overall language development that comes from reduced verbal communication and practise in play and general language learning situations. These reduced language skills effect how the child uses language for learning and thus manifest a learning disorder. Its impact being most obvious when the child is learning to read, spell and write. Significant behavioural problems may then follow.
There is no cure for Apraxia, however, early intervention with a Speech Pathologist will improve the child’s chances of developing meaningful communication channels. These may be nonverbal via augmentative, alternative communication systems or verbal through oromotor training or a combination of both. Each child will progress at different rates with progress often slow.
The Speech Pathologist can also offer educational resources, counselling and support to both the child and family unit. As always, if you are concerned about your child and require a professional opinion, please don’t hesitate to contact an experienced Speech Pathologist.
Mr Craig Gorman.
Speech Pathologist.