Apraxia: Is a disorder affecting both adults and children:

Apraxia in children:

is a disorder of the nervous system that affects a child's ability to sequence and produce phonemes(sound element of speech), syllables, words, and sentences. The problem occurs in the brain's planning of the movement of the articulators (lips, jaw, and tongue). Apraxia is not a result of muscular weakness or paralysis. The child is quite aware of what they want to say however, the brain is not sending the correct message to the articulators.

• Child does not babble as an infant
• Produces only a few different consonant sounds as an infant
• Delayed onset of first words with sounds missing
• Older children make inconsistent sound errors that are not the result of maturity
• Receptive language is stronger than expressive language
• Difficulty imitating speech
• Groping behaviors
• Difficulty with longer phrases than with shorter ones

• Focus is on improving the planning, sequencing, and coordination of the articulators.
• Feedback from a multitude of senses (e.g. physical/tactile placement cues, visual representation of sounds, and auditory feedback) facilitates the process and are helpful cueing strategies.
• If the apraxia significantly hinders communication, augmentative or alternative communication systems (e.g. voice output communication devices or picture symbols) may be utilized to enhance communication skills

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Apraxia in adults:

Is a motor speech disorder caused by damage to parts of the nervous system associated with communication. It is characterized by difficulties sequencing the phonemes in syllables, words, and phrases and varies depending on the nature of the nervous system damage. Often the adult will recognize the error and try to correct it with or without success. This can be very frustrating for an individual who was once a great communicator.

Characteristics :

• Difficulty imitating speech sounds
• May have oral apraxia also (difficulty with non-speech movements such as sticking out tongue)
• Groping for sounds
• Inconsistent errors
• Relatively preserved automatic speech (e.g. Hi, How are you?)
• May occur along with dysarthria (muscle weakness)

Treatment:

• "Retraining" of the articulators (lips, tongue, jaw) to produce sounds correctly and sequence words and sentences.
• Pacing of speech to coordinate breath support with articulators
• A multi-sensory approach involving tactile, visual, and auditory feedback to improve and retrain the coordination of movements for speech production

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