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Childhood apraxia of speech

Apraxia of speech is also known as

  1. Acquired apraxia of speech,

  2. Childhood apraxia of speech, or

  3. Verbal apraxia.

It is a motor speech sound disorder. A person with apraxia of speech faces difficulty in saying what they want to say consistently and correctly.



When we speak something, a signal is generated in our brain and it is transmitted to various muscles of our mouth. The message tells the muscles how to move in order to produce speech. Apraxia being a neurological disorder, has an impact on this transmission system (the brain pathways) involved in planning and programming of movements involved in speech. The child faces difficulty in moving his or her lips and tongue, even though their muscles are not weak.


The child is well aware of what they want to say, they just have difficulty in producing the speech sounds due to defects in the neural pathways. The severity of apraxia of speech can vary from person to person. Sometimes it can be so mild that the child faces difficulty only in the pronunciation of certain words that have many syllables. However, in most of the cases a child with apraxia of speech ends up facing difficulties in communicating effectively.


One important point to be noted is that, apraxia being a neurological disorder does not get better on its own, a child almost always requires speech therapy to overcome the condition.


Signs and symptoms of apraxia


A child with apraxia may exhibit underlying symptoms-

  • Difficulty in saying long and complex words with many syllables.

  • Difficulty or inability to use syllables properly to form words.

  • Speech inconsistencies- difficulty in saying certain sounds correctly every time.

  • Stressing on incorrect words.

  • Distorting the vowel sounds.

  • Difficulty in pronouncing certain words, hence repeatedly pronouncing them.

  • Consonant omission- omitting consonants at the beginning and end of words.

  • Minimal babbling as a baby.

  • Excessive use of nonverbal forms of communication.

  • Taking long pauses or difficulty in moving between two syllables or words.

  • Can understand others better than they can express themselves.





Causes of childhood apraxia of speech


The specific underlying cause of childhood AOS hasn't been confirmed yet. However, several researchers have linked the condition to genetic causes. It can also occur as a part of various complex disorders like, -

  • Autism

  • Epilepsy

  • Cerebral palsy

  • Traumatic brain injury

  • Galactosemia


There is often positive family history, as this condition is linked to genetics. It appears to affect boys more than girls.


Diagnosis of childhood apraxia of speech


Childhood apraxia of speech is diagnosed by a Speech language pathologist. An SLP specializes in diagnosing and treating various speech and language associated disorders.


As such there is no specific guideline for diagnosis of childhood apraxia of speech. Therefore the SLP will look for a group of common apraxia symptoms (few of them are mentioned above). They can assess a few things like-

  • The child's ability to repeat the same word correctly and in the same manner every time.

  • The child's ability to repeat a list of words that get difficult.

  • Ability of the child to produce certain sounds, syllables, and words.

  • Check how well others can understand what the child is trying to say.

  • Examine the child's tongue, facial muscles, and check for any other structural abnormalities.

  • They may refer to a radiological examination like MRI- it can help rule out the neurological causes of apraxia.



Treatment of apraxia


A child with apraxia of speech will not recover on his own without any intervention. They will neither learn speech by being around other children. Speech therapy is very important for a child to overcome the condition.


There is no specific approach that is followed while treating childhood apraxia of speech. A speech therapist often designs a tailor made plan based on the severity of speech and language problems the child faces.


Frequent one-on- one therapy can be quite helpful, as the therapy often comprises repeated exercises and personal attention on the child. The therapy often aims to help the child-

  • Plan the movements of muscles required to produce certain sounds.

  • And in making these movements in a proper manner.

Here the aim is not to strengthen the muscles involved in speech, as the muscles are not weak. The focus is on proper use of muscles.


Along with exercises the child is also assisted to use various cues to help understand the sounds. For instance-

  • Putting their finger on their lips while producing the 'p' sound.

  • Looking in the mirror while talking.

  • Recording themselves while producing a sound, and learning how to improve it if produced incorrectly.


Apart from speech the child can also use various other aids to communicate better. Augmentative and alternative communication(ACC) is using various aids like sign language, picture books, computers, phone apps, etc, to communicate better.



Childhood apraxia of speech talks time to be resolved. Be patient with your child and practice what the child learns at speech therapy. Sometimes the exercises can be exhaustive, take it easy on the kid and make learning fun. You should communicate with your child's SLP regarding their progress at home. It helps in better and quicker recovery of the child.





References








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