Apraxia

WHAT IS APRAXIA?

Apraxia is a motor disorder in which a child's ability to select and sequence movements is impaired. There are different types of Apraxia, such as Oral Apraxia, Verbal Apraxia and Ocular Motor Apraxia.

Apraxia affects the child's ability to use their muscles voluntarily. For example, a child with Verbal Apraxia may absent mindedly utter certain speech sounds (e.g. ‘baba’) but may find it difficult to produce them on demand.

WHAT ARE THE CAUSES OF APRAXIA?

Apraxia is caused when the area of the brain that tells the muscles how to move and what to do in order to perform a particular action, such as making a certain sound or series of sounds, is damaged or not fully developed. This makes it difficult to retrieve the ‘motor plan’ for that activity (e.g. how to co-ordinate the different parts of the mouth for saying something).

No one yet knows the precise nature of the brain impairment that leads to Apraxia. However, it is clear that muscle impairments are not the cause of Apraxia. The evidence for this is that children with Apraxia can use the same muscles for other activities. For example, whilst a child may be impaired in their ability to use their muscles for speech, they can use the same muscles for eating.

ORAL APRAXIA

In Oral Apraxia, the child has difficulty in using his mouth for non-speech purposes such as chewing, swallowing and coughing. Other symptoms that a child with Oral Apraxia may display include difficulty with sticking their tongue out and with blowing kisses.

VERBAL APRAXIA

In Verbal Apraxia the child has difficulty using their speech articulators (i.e. tongue, teeth and lips) and also has difficulty producing words and sentences. Their speech is characterised by them searching for the right word and by having several attempts before getting it right.

Some of the main characteristics of Verbal Apraxia are as follows:

• A young child may have limited speech sounds that they can use automatically, such that they may use a simple syllable (e.g. ‘da’) to mean almost everything.
• A child who can use several different consonants will show inconsistency in the way they use them. For example, they may be able to say a ‘p’ at the start of a word if it is followed by an ‘o’ but not if followed by an ‘e’.
• A child may be able to say short words in isolation but will have difficulty using two or three words in a row.
• The longer the utterance, the worse the accuracy of the speech.

There are other problems which can be caused by Verbal Apraxia. For example, as well as having difficulties with forming words, children with Verbal Apraxia may also find it hard to find the words they want to say.

As a result of their frustration at not being able to communicate, young children with Apraxia may act aggressively towards their peers. Older children with Apraxia may become shy as a response to their inability to communicate with others.

Some children with Apraxia may actually speak quite fluently when talking about a given topic. However, when the topic is changed, they may become quiet and unsure of their ability to communicate. Others may have difficulty sequencing their ideas and this may also be reflected in their written language. Many children with Apraxia also have difficulties in learning to read and spell.

HOW IS VERBAL APRAXIA TREATED?

In order to gain fluency, a child with Verbal Apraxia must be referred to a speech and language therapist. Therapy is usually quite intensive and is started as soon as the child is ready for it (18-30 months). Therapy is likely to last at least two years and often lasts for even longer. In most cases children with Verbal Apraxia can become competent communicators as a result of therapy.

OCULAR MOTOR APRAXIA

Children with Ocular Motor Apraxia have difficulties controlling their horizontal eye movements. When they rotate their head to the side to look at an object, their eyes lag behind and then move in the opposite direction. To compensate, a child may jerk their head sharply past the object in order to bring their eyes into a position where they can view the object.

Ocular Motor Apraxia is a rare condition and little is known about what causes it. It usually begins to improve and may subsequently disappear after a child has reached the age of five.

Some of the symptoms of Ocular Motor Apraxia are as follows:

• A child may seem visually unresponsive from birth, behaving as if blind;
• A child may have difficulty with horizontal eye movements;
• A child may develop head jerks and blinking which helps them to break their focus and then realign it;
• A child may have low muscle tone;
• The child may also have a Developmental Delay, (i.e. they develop certain skills more slowly than their peers). This is because a lot of development is linked to vision;
• A child may fail hearing tests despite nothing being actually wrong with their hearing. This is because the hearing test may not account for the impact of visual impairment on the child's responses.

There are no known cures for Ocular Motor Apraxia. However, there are certain ways of relieving the effects of the condition. For example, a child can undergo physiotherapy if they have low muscle tone and there are toys and equipment designed specially for children with Ocular Motor Apraxia.

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Although the information we have provided here is meant to be helpful to you, Douglas Silas Solicitors cannot be held responsible for any damage or loss caused by any inaccuracy or reliance placed upon it. If you have any concerns about your child, you should seek professional educational or healthcare advice as soon as possible.