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Apraxia
is a motor speech disorder which affects voluntary or learned
motor acts.
| Apraxia can be oral, verbal, or developmental. |
Caused by any damage or accident to the area of
the brain responsible for performing these acts, apraxia may
or may not exist with a language
disorder and can effect any part of the body. Because our focus
is communication, we will address the types of apraxia that
impair it.
Apraxia
can be oral, verbal, or developmental. In oral apraxia the
patient has difficulty performing nonspeech tasks with muscles
in the larynx, pharynx, tongue, or cheeks.
Reflexive
or automatic tasks are intact, but the patient is usually
unable to carry out specific directions when asked. For example
the patient may open his mouth when asked to close his eyes
or say the  word
"blow" when asked to blow out a match. It is not
uncommon for a patient to insist he has elicited the correct
movement when no movement has been made at all. Many of the
responses can be considered bizarre, while the patient may
be completely unaware of any abnormality.
Verbal
apraxia is defined as difficulty executing the appropriate
movements for speech when paralysis, weakness, or incoordination
exist. As a result, apraxic patients may have extreme difficulty
making speech movements. Such impairments may lead to the
omission, distortion, or replacement of certain sounds. Errors
seem to increase as the length of the word or utterance increases,
and initiating speech can be almost impossible. Repetition
of phrases may be inconsistent and overall quality of sound
may be poor. Debate regarding the cause of apraxia continues.
It is generally accepted however, that the lesion causing
apraxia is most likely deep within the left frontal lobe.
Apraxia
can also occur developmentally in children, as noted by awkward
speech movements that cannot be connected to dysarthria.
Symptoms may include difficulty initiating speech, difficulty
sequencing speech sounds, and oral struggle behaviors. Children
with developmental apraxia 2 may not show evidence of a brain
lesion, while adults always do.
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