APRAXIA
WHAT IS IT?
Apraxia of Speech is defined in cognitive
terms, “as an impairment in the translation
of phonological representations into
specifications for articulation”
It is defined as a disorder of
purposeful skilled movement that
cannot be attributed to
sensorimotor dysfunction or
comprehensive deficits
PREVALENCE
Apraxia has been documented in a variety of
populations, examples include:
Brain injury
Corticobasal degeneration
Alzheimer's disease
Parkinson's disease
Huntington's disease
TYPES OF
APRAXIA
Ideomotor Apraxia: “...disorder of production
praxis system… loss of kinesthetic memory
patterns...purposeful movement”
Ideational Apraxia: “...breakdown of knowledge of
what is to be done to perform…” resulting from
loss of mental representation/neurons
EFFECTS OF APRAXIA
Meals/eating
Organization skills
ADLs (bathing, toileting)
Ability to work
Community participation Learning or relearning of old/new
Behavior
skills
RECOVERY OF APRAXIA
Improvement from Ideomotor apraxia may be related to the
lesion site
The more severe the initial impairment is in long-term limb
apraxia, the less complete the long term outcome
Limb apraxia and oral apraxia appear to follow the same
trajectory of recovery
RECENT TREATMENT
Use tactile (touch) and kinesthetic stimulation (this means how your body is
positioned in space) in addition to visual and verbal mediation input (deep
pressure, sharp touch input. soft touch, self-touch, proprioceptive input)
Practice daily gestures such as reaching and leaning forward
Practice of object use via conductive education. Object use could include
anything from hairbrush to cell phone and anything else relevant to the clients
values as taught to a person without deficit
Cognitive strategy training
Teach clients strategies to compensate/ adapt for the presence of apraxia, while
carrying out activities and noting any errors
Focus on error (initiation, execution, control)
Give : Instruction, assistance, and feedback
Behavioral training
Gesture-production exercises for those living with limb apraxia
Transitive gesture training
Intransitive gesture training
Intransitive-nonsymbolic gesture training
Other strategies
Use functional tasks as the basis for interventions
Encourage verbalization of what is to be done
Focus interventions based on the errors that are made during the task
Practice functional activities with vanishing cues
Encourage tactile exploration of functional objects and tools to
enhance performance
Compensatory strategies
Relevance to ot
Occupational therapists are used to aid and support clients, groups of clients,
or communities in functional activities and gaining independence in functional
activities of value to them
Treatment of Apraxia is best supported by Occupational therapists (OT)
through performing activities in their familiar context
Other techniques by OT's
Physical facilitation (therapist supports and aids the client through a
physical task and activity such as working together to practice the movement
of putting on a shirt)
Errorless learning (the process of training clients without allowing them to
guess or make errors)
Chaining and copying gestures (have them learn movement strategies or
routines by breaking it down into one motion at a time and having them mimic
the therapist)