Apraxia Of Speech: Types, Symptoms, Causes And Treatment
Apraxia of speech is an acquired disorder of neurological origin in which the person’s ability to produce sounds and language in a coherent and intelligible way is altered, due to the rhythm, intonation or speed of speech being altered.
In this article we will see what this disorder consists of, what are the main types of apraxia of speech and their symptoms, as well as the different treatments available.
The term “apraxia” is today used to refer to deficient motor speech programming. It was the doctor and anatomist Paul Broca who was the first to refer to this concept in the mid-19th century This disorder is a consequence of damage to the left cerebral hemisphere.
Apraxia of speech is a neurological disorder related to language that causes alterations in articulation and prosody (elements of oral expression such as accent or intonation). Evidence suggests that this condition is the result of a lesion in the third frontal gyrus of the dominant hemisphere (in Broca’s area) or Brodmann area 44 and 45. It has also been suggested that the basal ganglia could have programming functions. of similar speech.
These types of injuries They can be caused by trauma, tumors, degenerative diseases, and other neurological disorders, although the most common etiology is usually cerebrovascular accident. Brain injury normally occurs in the parietal lobes or adjacent areas, with preservation of learned movement patterns.
Less commonly, apraxia of speech results from damage to other brain areas, such as the premotor cortex (located just in front of the motor cortex), other areas of the frontal lobe, or the corpus callosum; It may also occur that there is diffuse involvement linked to degenerative dementias.
Types of apraxia of speech
There are two main types of apraxia of speech: acquired apraxia of speech and childhood apraxia of speech. Let’s see what each of them consists of.
Acquired apraxia of speech
This type of apraxia of speech can occur at any age, although it usually affects adults. This specific type of apraxia occurs as a result of injuries to areas of the brain that are involved in speech and causes loss or impairment of speaking skills. It can be the result of a stroke, head injury, tumor, or any other disease that affects the brain.
Furthermore, this type of apraxia of speech It can occur along with other disorders that affect the nervous system, such as: dysarthria, a disorder characterized by difficulty articulating sounds and words, caused by paralysis or ataxia of the nervous centers that control the phonatory organs; or aphasia, a language condition that consists of the difficulty or inability to communicate through speech, writing or mimicry, due to brain lesions.
Childhood apraxia of speech
This type of apraxia is present from birth. Childhood apraxia of speech is not the same disorder as a delay in speech development, in which the child develops normal speech but more slowly. In apraxia, children have difficulty planning the movements necessary to produce speech.
Although the muscles involved in the speech process are not weak, they do not function as they should because there is an obvious difficulty in directing or coordinating movements. However, the causes of this disorder are still not well understood, since studies and neuroimaging tests have not been able to find evidence of brain damage or differences in the brain structure of these children.
It is common for children with apraxia of speech to have a family member with a history of a communication disorder or some type of learning problem. For this reason, some researchers have suggested that genetic factors may play a significant role in the development of the disorder. It should also be noted that sex would be an equally significant variable, since this type of apraxia usually affects boys more than girls.
Characteristic symptoms
There are a series of characteristic symptoms in people who suffer from apraxia of speech. Although They can vary depending on age and the severity of the disorder And of the speech problems, the most common are the following:
The person makes trials and errors and then tries to self-correct.
Treatment
The goal of treatment for apraxia of speech is to ensure that the patient is able to communicate effectively ; Therefore, what the professional seeks is to restore, as far as possible, the patient’s speech, that is, to make it functional even if it is not possible to return the person to the levels of communication that existed before the onset of the disorder. disorder.
Currently, there is a consensus by which it is considered that there are five categories of treatment for apraxia of speech: articulatory kinematic; treatment based on rate and/or rhythm; alternative and/or augmentative communication; facilitation and intersystemic reorganization; and other treatments.
Kinematic articulatory treatment focuses on treating articulation problems, focusing on the spatiotemporal aspects of speech production. Regarding methods based on rate and/or rhythm, their method is based on treating the alteration that patients present in the times of speech production, helping them to control the rhythm to, in this way, recover the temporal patterns of speech.
As to alternative and augmentative communication, are two forms of intervention that seek to improve communication through the use of modalities other than the traditional use of speech. Some activities in this method involve the use of symbols, drawings and communication boards, computer programs, etc.
Finally, in relation to intersystemic facilitation and reorganization techniques, it should be noted that these methods include the use of systems and modalities that are intact in the patient to facilitate the implementation of other modalities and systems that are altered; For example, through the use of gestures or graphic stimuli that facilitate speech, singing familiar melodies etc.
