Tuesday, May 14, 2013

First Ever National Apraxia Awareness Day!!

On May 14, 2013, the Childhood Apraxia of Speech Association of North America (CASANA) invites communities worldwide to learn about the needs, challenges, and abilities of children affected by apraxia. Apraxia is among the most severe speech and communication problems in children.

So in honor of this day, I thought I would share some information about Apraxia. 

What is Apraxia:

Childhood Apraxia of Speech (CAS) is a neurological motor planning speech disorder that affects a child’s ability to clearly and correctly produce syllables and words. The most obvious thing that others notice is that the child has significantly limited and/or unclear speech.

What causes Apraxia:

Currently, all of the causes of CAS are not known. Most often no specific cause is found. These instances are called “idiopathic” in that we just don’t know why the child has this difficulty. (This is the case with Karen) However, some children may have CAS as a part of a larger neurological diagnosis or as part of a genetic or mitochondrial disorder.

Why does Apraxia make it hard for kids to speak:

The act of speaking is a highly sophisticated one! It involves processes of our  brain and it also involves muscles of the mouth, face, tongue, and soft palate as well as all of the pathways in between the brain and the muscles.

We start with an idea of what we want to say. Then, subconsciously, we have to correctly assemble the string of sounds and words. Next, we must create a movement plan or “program” that is associated with those sounds and words. Along with planning for which speech muscles should move and in what order, we must assign the correct timing and force for activating the muscles needed to produce the speech. Finally we transmit those speech movement plans to the actual muscles that help us speak.

This all happens in a time shorter than the blink of an eye. It is thought that children with apraxia of speech have difficulty in creating, transmitting or storing the speech movement plans (i.e. - this is what describes a motor planning disorder).

In addition to the physical disorder of Apraxia making it challenging to speak, most children with CAS are often keenly aware of how difficult speech is for them.  Without appropriate intervention, therapy, and positive reinforcement this awareness can compound the problem by leading them to be purposefully nonverbal.

What helps kids with Apraxia:

Primarily, children with CAS require frequent and intensive individual speech therapy from an experienced SLP. How much and how often that a child receives speech therapy will depend on each individual child, but the more severely the child is affected, the greater the need for frequent and intensive speech therapy. As children improve (which most will with appropriate therapy), less frequent individual speech therapy is needed.

My experience is: Therapy. Practice. Therapy. Practice - repeat, repeat, repeat!!

But more than anything is remembering that your child is still a child.  Apraxia is a condition that they struggle with - but it is not the only thing about them.  We have been working on focusing on those things about Karen that do define her and trying to make sure that her therapy and speech practice are framed within that context.

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