Apraxia is a neurological disorder that refers to difficulty in performing skilled movements. In this case, the person experiences impairments in the coordination of muscles or in the planning process, even though they are normally capable of doing so. Apraxia is usually the result of brain damage and can be of various types.
What are the Types of Apraxia?
- Motor Apraxia It is characterized by impairment of the kinetic formula acquired through experience.
- Limb-Kinetic Apraxia: The speed, fluency and fineness of movement are lost. Left frontal-anterior parietal/supplementary motor area lesions or premotor area lesions are responsible. It is unilateral and manifests in the extremity across the lesion.
- Ideomotor Apraxia: The ability to activate the motor system in response to an idea, a sequence of actions is impaired. It is caused by inferior parietal lobe lesions. Patients perform the movement sequence incorrectly, especially when commanded. When the real object is handed to them, they perform it better than when shown by imitation. They have difficulties in performing movements independently of the object. It is seen in left side lesions. In this type of apraxia, the patient's perception of impaired motor performance by himself or others is also impaired.
- Ideatory Apraxia: The mental schema of how to perform the action and the associated plan is impaired. For this reason, the sequence of a complex series of movements is disrupted, they are performed one by one, but cannot be performed when asked to be performed one after the other.
- Apraxia of Gait: It occurs in medial frontal cortex lesions. It may occur as a result of bilateral subcortical infarction and stretching of the fibers projecting from the medial part of the frontal lobe due to hydrocephalus while passing in front of the ventricle.
- Apraxia of speech (Verbal Apraxia): The dominant inferior frontal region is responsible.
What is Apraxia of Speech (Verbal Apraxia)?
It is a motor disorder related to the programming of speech in adulthood and childhood. The adult form occurs after normal speech and language development. Childhood apraxic speech occurs as a result of structural brain damage. It is also defined as sensory motor speech disorder. It is a motor planning disorder in the center necessary to produce words and voluntary muscle movements.
What are the Characteristics of Apraxic Speech?
Pronunciation problems are frequently observed. In addition, phonation coordination, frequency and/or emphasis are effective. The patient is aware of his/her inadequacy, and the problem increases as word length increases. Pronunciation disorders are not consistent; repetitions, prolongations or word
variations are seen in their changes. Consonants are more difficult to articulate than vowels, initial consonants are more difficult than final consonants. Perfectly voiced parts of speech are common, especially in automatic and frequently used words.
What is the overall goal of apraxia therapy?
The main goal of apraxia therapy is to increase the patient's voluntary control of the articulatory movements necessary for speech production. If apraxia is very severe, intelligible speech may not be a realistic goal. For these people, developing an alternative and supportive communication system may be a more meaningful goal.
