Apraxia; It is the inability to plan the movements that require skill, except for any weakness, abnormal tone or posture, deterioration in cognitive functions, decreased understanding, and inability to cooperate. It is thought to be caused by damage to the left hemisphere due to diseases such as stroke, dementia, and tumor. It is the least understood type of speech disorder of the neurological syndromes. Apraxia; It creates serious life problems in the daily life of individuals.
What are the Findings of Acquired Apraxia of Speech?
Individuals with apraxia:
-
There is difficulty in producing sounds and words correctly.
-
Adding sounds, dropping sounds, changing the place of sounds are seen.
-
What is meant to be said the word is produced differently than desired. (like a structure-papi instead of a door)
-
As word length or sentence length increases, the number of errors increases.
-
Pausing and slow speech is seen.
-
Individuals with apraxia are aware of their faulty production. Individuals make an effort to correct their mistakes.
-
Errors in speech are inconsistent.
-
They try to put their tongue and lips in the right position for correct sound production, but there is difficulty in planning. They can speak easily.
-
Automatic speech is more fluent.
-
Individuals with severe apraxia of speech may not speak.
What are the Types of Apraxia?
Different types of apraxia occur depending on the affected body area and/or specific skill as a result of brain damage.
Ideomotor Apraxia: Motor movements manifest themselves as a disorder in programming and completion. Individuals can explain how an action will take place, but they have difficulty in showing how the action will be done. The order of the purposive motor movement sequence is disrupted. Ideomotor apraxia does not prevent automatic or spontaneous movements, only voluntary motor movements. Distortions are seen in the order. For example; They cannot comb their hair when they are told to "comb their hair," but they automatically comb their hair every morning at the sink.
Ideational Apraxia: Conceptualizing an action, formulating the motor programs needed to perform the action, or It is a type of apraxia associated with the loss of the ability to retain the thought of the action in memory long enough to successfully conclude the action and to use gestures or objects. In this type of apraxia, while individuals can easily perform simple and isolated movements, they cannot perform complex, sequential actions in a complete and orderly manner. the individual may try to put on his shoes first and then his socks, write with a screwdriver, and comb his hair with a toothbrush.
Limb-Kinetic Apraxia: During voluntary movement, the hands, arms, legs and feet are aligned The disorder in the programming of movements is the type of apraxia experienced. The speed, fluency, and subtlety of the movement are lost. Generally, the movements made are evaluated with pantomime; “Giving a military salute, unlocking with a key, combing your hair, etc.” The patient is expected to do the movements. It is a type of apraxia especially observed in stroke, brain trauma or Alzheimer's diseases.
Oral Apraxia-Buccofacial Apraxia: It is also called non-verbal apraxia. It has been observed that when people are asked to lick their lips, blow their lips, move the tongue from side to side, whistle, and bite their lower lips, they do not perform these movements properly. In order to make the desired movements; For example, they can get help from their hands to bring their mouths to the right position and/or complete the movement late. Individuals can only do a part of the desired movement and/or they can do other movements that are not necessary. They can perform spontaneous movements without difficulty. For example; When the individual is told to "kiss", he cannot perform the task, but when he wants to kiss his child, he can bring his lips to the kissing position appropriately.
Ed How Is Acquired Speech Apraxia Evaluated?
The diagnosis of acquired apraxia of speech is made by a Speech and Language Therapist. Acquired apraxia of speech occurs as a result of neurological damage. Language and speech therapists first evaluate language, cognition, communication and swallowing disorders that may occur due to brain damage. The presence or absence of dysarthria, aphasia or cognitive impairment is diagnosed by evaluating muscle strength, tone, spasticity, language and cognitive abilities. Evaluation of praxis skills should be done to identify other types of apraxia accompanying apraxia of speech.
In acquired apraxia of speech, articulation, speech rate, prosody and speech fluency are evaluated. Maximum repetition rate of monosyllabic words and maximum repetition rate of three syllables and speech rate, evaluation of prosody and speech fluency in automatic, spontaneous speech and reading are among the basic methods in the evaluation of acquired apraxia of speech.
In Speech Therapy in Acquired Speech Apraxia. What Is Being Done?
There are many different treatment approaches used for the therapy of acquired speech apraxia. Therapy approaches are selected in accordance with the severity of apraxia of speech and the characteristics of the individual. The main purpose of all therapy methods is to re-teach the motor programming necessary for the correct production of sounds (letters). Acquired apraxia of speech therapies consist of intensive, repetitive and structured treatment programs. In therapy sessions, goals are ordered from simple to complex. The most important point in therapy consists of re-teaching the movements necessary for speech and repeating the movement as much as possible until they learn it. If there are other types of apraxia accompanying acquired apraxia of speech, multidisciplinary therapy plans are made together with occupational therapists and physiotherapists.
Read: 0
