Apraxia? | Health Eagle


by Tom Seman MD FAAP August 16th, 2012 | Pediatrician on Call
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My 5 year-old still has trouble talking.  She can speak many words one day, but some days those same words don’t come easily for her.  My friend said she might have Apraxia.  How do I find out?

There are several possible reasons for the issues that your five year old is having. Hearing loss, poor tone of the mouth, tongue and face as well as a variety of developmental delays such as autism can account for such difficulties.

Furthermore, there are several sounds and sound combinations that are not fully mastered by a child until approximately 6 years old. Most of these can be diagnosed by the child’s primary care physician with some minor tests such as a hearing (audiology) evaluations, a physical exam to check for other developmental delays such as fine motor delays, hyper and hypo sensitivity of the mouth and face and breathing and respiratory issues.

Communication is very complex although most of us take it for granted. The whole process requires a person to come up with a thought. Determine how to express that thought. The person must then figure out how to make the muscles in his/her mouth. Increasing the pressure of air across the vocal cords and in the mouth then create sounds that go on to form words. The person speaking as well as the audience to whom they are speaking hear these sounds/words and make sense of their meaning. The person speaking as well as the listener will make some adjustments when the words do not come out well and if their is a misunderstanding then the speaker makes adjustments when he/she repeats the sounds/words to make sure the meaning is understood. Hence what appears to be a simple action is very complex.

Children with apraxia, also known as verbal dyspraxia, have difficulty with forming the sounds and thus there ability to speak (expressive language) is significantly behind in their ablility to understand what is being said (receptive language). Those with apraxia have a  difficult time forming words and self correcting when they mispronounce a word. Structurally, their mouths are normal and the muscles have normal tone and strength to them. Hearing as well as other aspects of development are normal too. Evaluation for apraxia is best done by a fully trained Speech Language Pathologist – often referred to as a Speech Therapist.

Proper assessment includes an evaluation of the structures of mouth, imitation of unique sounds as well as those sounds/words that have been learned in the past. Once all of the information is obtained the Speech Therapist will make a diagnosis and create a treatment plan.

Contact your child’s primary care physician for a referral. For more information go to the following link: http://www.asha.org/public/speech/disorders/childhoodapraxia.htm

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