Written by Dr Malini Singh, Psychologist, Change for Life
Dr Angraj Khillan, Consultant Paediatrician Western Specialist Care Centre
Childhood apraxia of speech is a condition where children find it difficult to control the movement of the muscles that make speech. This makes it difficult for the person to make speech sounds voluntarily and hence string sounds together to make words. It is important to note that there is nothing wrong with the muscles that are used in making speech. The impairment seems to be in the messages that are sent from the brain to the muscles. There are no know causes of childhood apraxia.
A person diagnosed with childhood apraxia of speech may pronounce the same word differently each time they say it; have general difficulties moving the muscles of their mouth and throat – for example, they may have trouble chewing, sucking, blowing or making certain speech sounds; look like they are searching or groping for the right sound; have difficulty imitating sounds and words; use a limited number of consonant sounds when speaking; mix up the order of sounds in words; and have more difficulty saying longer rather than shorter words and sentences.
Some very young children show signs of having difficulty planning movements of their tongue, lips and jaw. What signs should you look for that may indicate your child is at risk of future speech difficulties? Some signs are babies who don’t play with sounds – for example, coo or babble; babies and young children who have difficulties sucking, swallowing and chewing; young children who are not starting to speak like other children their age (remembering that there is enormous variation between children); and young children who only use noises, gestures and vowel sounds to communicate.
Children diagnosed with apraxia may also experience other problems including feelings of frustration because they can’t get their message across; oral language difficulties, such as the ability to turn sounds into meaning; difficulties with reading and spelling; difficulties with other motor skills, such as using scissors, writing or riding a bike; sucking, chewing and swallowing problems; difficulty performing movements with their tongue and lips when asked to do so; and clumsiness. It is very important for a speech pathologist to make a diagnosis of apraxia. They will then work with your child to develop a program where they will ask your child to to imitate sounds, syllables and words; teach the person about sounds and explain the rules about when to use certain sounds in words; use gestures or pictures or touch specific points on the face or neck to help the person make the right sound or sequence of sounds; and introduce other ways to communicate, such as communication boards, key word signing or voice output devices. This will also help to reduce some of the frustration that naturally occurs if a person has difficulty getting their message across.