What Is Childhood Apraxia?
Imagine text messaging with an autocorrect function that has gone haywire. A text is entered and sent but autocorrected in the process, coming out completely warped and making communication chock-full of confusion. Apraxia is similar to this kind of malfunction. In all types of apraxias there is absence ("a") of planned movement ("praxia"). A child may understand a request to perform a task and is willing to perform the task, but cannot execute it because something goes awry. In ideamotor apraxia, for example, a child understands the function of a pen but is confused by but the action of writing with it. Conceptual (can't identify an object), orofacial (can't blow a kiss), and limb-kinetic (can't tie a shoe) apraxias are far less common.
Verbal apraxia, also known as speech apraxia or childhood apraxia of speech, is the most common kind among children. "Verbal apraxia is a language delay. Children aren't saying words, but they understand what's said to them," says William Levinson, M.D., an alumnus of the Albert Einstein College of Medicine Fellowship in Developmental Pediatrics and board-certified developmental pediatrician at Children's and Women's Physicians of Westchester in Valhalla, New York. An example is an 18-month-old or a 2-year-old who can put a toy away when told to do so, but is not speaking. "The child might point to what she wants and understand directions," Dr. Levinson explains. "Unlike with autism, she might have good eye contact and engage, but isn't saying words." Parents are often not as concerned about this initially because although the child may speak later than other children, she may use some single words sporadically.
What to look for
Kids with apraxia usually understand more language than they are able to use, but don't know how to communicate this, so they become easily frustrated. They may grope for words, having trouble finding the right word, or may have monotone or choppy speech. Although you may understand single words, longer sentences may be unintelligible. Words can be distorted, repeated, or left out and the order of words may be mangled. Kids may say words on their own, but can't when requested to do so.
How to help
"Speech and language delays should always be addressed by a speech therapist," Dr. Levinson says. Therapists suggest using picture books and pairing these with verbal cues and gestures. In speech therapy, speech pathologists teach kids how to make individual sounds and then make those sounds longer to form words and eventually sentences. One way to do this is by modeling speech -- speaking slowly and encouraging the child to frequently repeat sound sequences. With therapy, Dr. Levinson says, most children can effectively learn to communicate.
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