Joan Horky
Rachel Kleinsteiber
Apraxia
Disorder and prevalence:
Childhood
apraxia of speech (CAS) is a motor speech disorder (i.e., the brain has
difficulty planning the motor movements of speech). It is not due to
weakness or paralysis of the muscles. A child with apraxia will have
difficulty saying sounds, syllables, and words even though the child
knows the word they want to produce (ASHA website).
There
are multiple signs or symptoms that a child with apraxia may exhibit.
These symptoms may include a lack of babbling, late first words, a
limited sound inventory, difficulty combining sounds, and simplified
words in a very young child. An older child may grope for words, make
inconsistent sound errors, have difficulty imitating speech, have more
difficulty speaking when anxious, and has abnormal stress patterns.
Other symptoms could include delayed language development, difficulties
with fine motor movement, hypersensitive or hyposensitive mouth, or
difficulties with readings, spelling, and writing (ASHA website).
A
child should be assessed to rule out the possibility of other disorders
(e.g., dysarthria). An oral motor, melody of speech, and a speech
sound assessment should be conducted. If a child is diagnosed with
apraxia, there are treatments available and intervention should focus on
improving the planning, sequencing, and coordination of muscle
movements for speech production (ASHA website).
According
to ASHA, there is very little data about the prevalence of childhood
apraxia, but the number of diagnoses appears to be on the rise (ASHA
website). Lewis et al. (2004) stated it was difficult to determine the
prevalence of childhood apraxia due to age-related variation in
symptoms. Some cases may be called mild articulation disorders, and then
called childhood apraxia once remediation has been tried (Lewis et.
al., 2004).
Development of Reading and Writing:
For
many children with childhood apraxia there are more issues than
speech-sound problems, but language deficits as well. Lewis et al.,
2004, cited Thoonen et al. (1997) in their paper, by stating 9 out of 11
children with childhood apraxia had language impairments. The
difficulties in language tended to be worse for expressive language
skills in contrast to receptive language skills. The expressive delays
that are typically seen in children with apraxia affect the areas of
reading, writing, and spelling (Lewis et. al., 2004).
Children
who have spoken language problems are at risk for developing literacy
problems (Gretz, 2005). Children with spoken language problems may have
issues with phonological awareness. Phonological awareness is the
foundation for literacy. For instance, in order to properly spell a
word a child has to be able to segment a word into sounds before
selecting a grapheme. For reading, a child has to be able to decode
print letters, graphemes, into sounds. Phonological awareness is
pertinent to literacy development. Children with difficulties with
spoken language, have problems with phonological awareness, which
affects literacy development. According to Gertz (2005), there are two
different routes for reading. The direct route, is when a child
develops a sight vocabulary. When children learn the phoneme-grapheme
correspondence, and sound out the words, this is the indirect route. It
is believed children with apraxia lack these phonological awareness
skills, and never progress to the indirect route of reading (Gertz,
2005). According to McNeil et al. (2009), children with apraxia
demonstrate poor phonological awareness and phonological representation
skills. These children are challenged by the lack of phonological
representations and therefore the execution of motor movements cannot be
implemented due to incomplete phonological template. The deficits in
phonological representation may disrupt vocabulary development (McNeil
et al., 2009). Because they have difficulty pronouncing words they will
have problems with phoneme segmentation. Phoneme segmentation will make
it possible for the child to decode the word. Deficits in the area of
reading comprehension are common in children with apraxia due to poor
decoding skills. Spelling relies on many phonological processing skills.
Many children with apraxia struggle with spelling due to their
phonological and sound sequencing impairments (Lewis et al., 2004).
Resources
American Speech-Language-Hearing Association. Childhood Apraxia of Speech. http://www.asha.org/public/speech/disorders/childhoodapraxia.htm
American Speech-Language-Hearing Association. Childhood Apraxia of Speech: Causes and Number. http://www.asha.org/public/speech/disorders/ChildhoodApraxiaCauses.htm
Gretz, S. (2005, 02 05). Literacy and children with apraxia of speech. Retrieved from http://www.apraxia-kids.org/site/apps/nl/content3.asp?c=chKMI0PIIsE&b=788449&ct=464197
Lewis, B.A., Freebairn, L.A., Hansen, A.J., Iyengar, S.K., & Taylor, H.G. (2004).School-age follow-up of children with childhood apraxia of speech. Language, Speech, and Hearing Services in Schools, (35), 122-140.
McNeil, B.C., Gillon, G.T., & Dodd, B. (2009). Phonological awareness and early reading development in childhood apraxia of speech. International Journal of Language and Communication Disorders, (44) 2, 175-192.
Youtube Videos:
Child with Apraxia: http://www.youtube.com/watch?v=szjfC9K190U
Speech Therapy for a Child with Apraxia: http://www.youtube.com/watch?v=VvZAgWZR-Ek&feature=related
http://www.youtube.com/watch?v=VvZAgWZR-Ek
Additional Resources
www.apraxia-kids.org
No comments:
Post a Comment