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What is Apraxia?

What is Apraxia of speech and how does it differ from a developmental delay of speech?

Apraxia of Speech is considered a motor speech disorder. A child with apraxia of speech has difficulty sequencing the motor movements necessary for volitional speech. Apraxia of speech may also be called verbal apraxia, developmental apraxia of speech, and verbal dyspraxia. No matter what it is called the most important factor is the root word "praxis." Praxis is the ability to execute skilled movement. So to some degree or another, a child with the diagnosis of apraxia of speech has difficulty in sequencing and executing speech movements. Apraxia of speech is a specific speech disorder.

A true developmental delay of speech is when the child is following the "typical" path of childhood speech development, albeit at a rate slower than normal. Sometimes this rate is commensurate with cognitive skills. In typical speech/language development, the child's receptive and expressive skills are pretty much moving together. What is generally seen in a child with apraxia of speech is a wide gap between their receptive language abilities and expressive abilities. In other words, the child's ability to understand language (receptive ability) is broadly within normal limits, but his or her expressive speech is seriously deficient, absent, or severely unclear. This is an important factor and one indicator that the child may be experiencing more than "delayed" speech and should be evaluated for the presence of a specific speech disorder such as apraxia. However, certain language disorders may also cause a similar pattern in a child.

What causes Apraxia?

Apraxia of speech is felt to be a neurogenic (neurologically based) speech motor disorder. Many (or perhaps most) children with apraxia of speech have no abnormalities as detected by MRI scans. Others may have specific damage to a part of the brain that can account for the problem. In the latter case, some children are born with such damage and other children acquire damage to the brain by accident or illness. Through the Apraxia-Kids Internet Network we have learned that quite often children who later are diagnosed with apraxia of speech experienced some sort of incident prior to, during, or after birth. Medical doctors are either hesitant to acknowledge such a link or may even deny that such incidents are related to the speech problem; however, many parents on the List-serv find the possibility of such a connection interesting. Some of the birth problems reported in kids later diagnosed with apraxia of speech include: premature birth, placenta problems, umbilical cord around neck at delivery, meconium problems, or failure of a new-born to suck properly. This is not to say that all children born having any of these conditions will grow up to have apraxia of speech, nor that all children with apraxia experienced such problems. All that can be said is that some children diagnosed with this speech disorder have such histories. We know of no research that has been done on this link, only that through our discussion network we have seen this pattern mentioned repeatedly.

A CAPD is a receptive language disorder. It refers to difficulties in the decoding and storing of auditory information (typically incoming verbal messages). This type of receptive language disorder is a result of genetic factors and/or early otitis media though causal factors may not be able to be found. There are many signs and symptoms of CAPD, however a skilled audiologist would best be able to provide technological testing at age 7 and beyond.

Early Signs & Symptoms:

Difficulty following verbal directions.
Echolalia (repeating back words and phrases without comprehension).
Re-auditorization (repeating back what was heard, and then showing comprehension).
A child who says "huh" or "what" and requires more repetitions of verbal input messages.
Speech sound discrimination difficulties, especially in noise.
Highly distractible/active.
Unintelligible speech, but with adequate vocal inflection and gestures.
Difficulty with memorising names and places.
Difficulty repeating words or numbers in sequence.
May have speech or language "delays." 2004

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