Apraxia is a Disorder of the Brain and Nervous System of Toddlers

Do Parents know what apraxia is? Apraxia is a neurological condition in which the person experiencing it will find it difficult, or even unable to perform certain motor movements.  

This disorder may be very foreign to the ear, even rare. However, as a precaution, Parents should know what apraxia is, its symptoms, causes, and how to prevent it.

Apraxia Is a Disorder of the Toddler’s Brain

Quoting fromWebMD, apraxia is a neurological condition that is not fully understood. Adults or children who experience it find it difficult or impossible to perform certain motor movements, even though their muscle condition is normal.

Apraxia can occur in various forms, one of which is orofacial apraxia. People with orofacial apraxia cannot perform certain movements involving the facial muscles. For example, they cannot lick their lips or blink their eyes.

While apraxia of speech is when someone finds it difficult or unable to move their mouth and tongue to speak. Even though they have the desire to speak and the muscles of the mouth and tongue are physically able to form words.

Types of Apraxia of Speech

There are two forms of apraxia of speech, namely acquired apraxia and childhood apraxia of speech.

Acquired apraxia can occur in people of all ages. However, it is usually found in adults. This condition causes them to lose the ability to speak that they once had.

Childhood apraxia of speech is a motor speech disorder. It is present from birth and affects a child’s ability to form sounds and words. 

Children with apraxia of speech often have a much greater ability to understand speech than to express themselves with spoken words.

The majority of children with apraxia of speech will experience significant improvement, with proper treatment.

What is the Difference Between Apraxia of Speech and Aphasia?

Apraxia is sometimes confused with aphasia, or another communication disorder . The confusion can be compounded by the fact that the two conditions can occur together.

People with apraxia and aphasia may have difficulty expressing themselves with words. However, there are distinct differences between the two. 

Aphasia describes problems in a person’s ability to understand or use words in and of themselves. This may make it difficult for someone with the condition to speak, read, or write. 

However, apraxia does not describe a problem with understanding language. Apraxia refers to a person’s difficulty initiating and carrying out the movements necessary for speaking. This difficulty occurs despite the fact that there is no weakness in the muscles.

Apraxia Type

Apraxia appears in several different forms, namely:

1. Extremity-Kinetic Apraxia

Inability to make precise movements with the fingers, arms, or legs. An example is the inability to use a screwdriver even though the affected person understands what to do and has done so in the past.

2. Ideomotor Apraxia

Inability to carry out commands from the brain to imitate movements of the limbs or head performed or suggested by another person.

3. Conceptual Apraxia 

Very similar to ideomotor ataxia, but implies a more profound malfunction where the function of the apparatus is no longer understood.

4. Ideational Apraxia

Ideational apraxia is the inability to make plans for specific movements.

5. Buccofacial Apraxia (Facial-Oral Apraxia) 

Inability to coordinate and perform facial and lip movements such as whistling, blinking, coughing, etc., on command. This form includes developmental verbal or speech apraxia, perhaps the most common form of the disorder.

6. Constructional Apraxia 

This condition affects a person’s ability to draw or copy simple diagrams or to construct simple pictures.

7. Oculomotor Apraxia

Oculomotor apraxia is a condition in which the patient finds it difficult to move his eyes.

Apraxia disorders are believed to be caused by lesions in the brain’s neural pathways that contain learned movement patterns. They are often symptoms of neurological, metabolic, or other disorders that may involve the brain.

Symptoms of Apraxia

The main symptom of apraxia is the inability to perform movements without physical paralysis. Commands to move are understood, but cannot be carried out. 

When the movements begin, they are usually very awkward, uncontrolled, and appear abnormal. In some cases, the movements may occur involuntarily. Apraxia is sometimes accompanied by a loss of a person’s ability to understand or use words (aphasia).

Certain types of apraxia are characterized by the inability to perform certain movements on command. For example, in buccofacial apraxia, a child with it cannot cough, whistle, lick his lips, or blink his eyes when asked. 

In construction apraxia, an individual cannot reproduce simple patterns or copy simple drawings.

While there are a variety of speech-related symptoms that can be associated with apraxia, including:

• Difficulty putting syllables together in the right order to make words, or an inability to do so.
• Little babbling during infancy
• Difficulty pronouncing long or complicated words
• Repeated attempts at pronunciation of words
• Speech inconsistencies, such as being able to pronounce sounds or words correctly at certain times, but not at other times
• Incorrect inflection or stress on certain sounds or words
• Excessive use of nonverbal forms of communication
• Vocal sound distortion
• Removing consonants at the beginning and end of words
• Appears to fumble or struggle to form words

Childhood apraxia of speech rarely occurs alone. It is often accompanied by other language or cognitive deficits, which can cause:

• Limited vocabulary
• Grammar issues
• Problems with coordination and fine motor skills
• Difficulty chewing and swallowing
• Awkwardness

Causes of Apraxia

Apraxia is caused by damage to the brain. When apraxia develops in someone who was previously able to perform a task or skill, it is called acquired apraxia .

The most common causes of acquired apraxia are:

• Brain tumor
• Conditions that cause gradual deterioration of the brain and nervous system (neurodegenerative diseases)
• Dementia
• Blow
• Traumatic brain injury
• Hydrocephalus

Apraxia can also be seen at birth. Symptoms appear as the child grows and develops. The cause is unknown.

As mentioned above, apraxia of speech often occurs in conjunction with another speech disorder called aphasia. Depending on the cause of the apraxia, a number of other brain or nervous system problems may be present.

Frequency of Occurrence

There is currently little data available on the incidence of apraxia. Because apraxia can accompany dementia or stroke, it is more often diagnosed in older people.

Risk Factors

Abnormalities in the FOXP2 gene appear to increase the risk of childhood apraxia of speech and other speech and language disorders . The FOXP2 gene may be involved in neural development and certain pathways in the brain. 

Researchers continue to study how abnormalities in the FOXP2 gene may affect motor coordination and speech and language processing in the brain.

Dominant genetic disorders occur when only one copy of the abnormal gene is needed for the disease to occur. This abnormal gene can be inherited from one parent, or it can be the result of a new mutation (change in the gene) in the affected child. 

The risk of passing the abnormal gene from an affected parent to their offspring is 50% for each pregnancy, regardless of the sex of the resulting child.

In adults, tissue or cell damage (lesions) in certain other parts of the brain, whether due to stroke or injury, tumor, or dementia, can also cause apraxia. These other locations include the so-called supplementary motor area (premotor cortex) orcorpus callosum.

If apraxia is the result of a stroke , it usually resolves within a few weeks. However, some cases of apraxia are congenital. When a child is born with apraxia it is usually due to a malformation of the central nervous system. 

On the other hand, individuals with deteriorating intellectual function (degenerative dementia) may also develop apraxia. 

Diagnosis

The following tests may be performed if the cause of the disorder is unknown:

• A CT or MRI scan of the brain can help show a tumor, stroke, or other brain injury.
• An electroencephalogram (EEG) can be used to rule out epilepsy as a cause of apraxia.
• A spinal tap may be performed to check for inflammation or infection affecting the brain.

Standard language and intellectual testing should be performed if apraxia of speech is suspected. Testing for other learning disabilities may also be necessary.

Treatment or Therapy for Apraxia

A toddler or child with apraxia can benefit from care from a health care team. This team also includes family members.

Occupational and speech therapists play an important role in helping children with apraxia and their caregivers learn ways to cope with the disorder.

During treatment, the therapist will focus on:

• Repeating sounds over and over again to teach mouth movements
• Slowing down the person’s speech
• Teaches various techniques to aid communication
• Recognition and treatment of depression is important for people with apraxia.

To help communication, family or caregivers should:

• Avoid giving complicated directions
• Use simple phrases to avoid misunderstandings
• Speak in a normal tone of voice, apraxia is not a hearing problem.
• Don’t assume that the person understands.
• Provide communication aids, if possible, depending on the person and their condition.

Other tips when accompanying your little one:

• It’s best to maintain a relaxed and calm environment. Take the time to show your little one how to do a task, and give them plenty of time to do it. 
• Don’t ask them to repeat a task if they are clearly having trouble doing it and it will be frustrating.
• Suggest other ways to do the same thing. For example, using shoes with hook and loop closures instead of laces.
• If depression or frustration is severe, mental health counseling may help.

Prevention

Diagnosing and treating childhood apraxia of speech early can reduce the risk of long-term persistence of the problem. If your child is having speech problems, it is a good idea to have a speech-language pathologist evaluate your child as soon as you notice any speech problems.

In adults, reducing the risk of stroke and brain injury can help prevent conditions that cause apraxia.

***

Thus the explanation related to apraxia which is one of the neurological conditions. Hopefully this information is useful for Parents !

Republished with permission from theAsianParent Indonesia