Infant Apraxia

Infant Aprxia, also known as childhood apraxia of speech (CAS), is a motor speech disorder in which common communication development is missing. CAS isn’t a muscle disorder in which the mouth muscles fail to communicate, but instead a disorder in the brain, that can be caused by brain injuries during birth.

What Are the Signs of Infant Apraxia?

It’s important to understand that not all babies and toddlers are the same, and therefore may exhibit a few of the signs of apraxia or several. In general, however the most common signs include:

Infants:

  • Failure to coo or babble
  • Says first word late or doesn’t say any words at all
  • Understands only a few vowel and consonant sounds
  • May have issues with feeding

Toddlers and Children:

  • Difficulties in imitating speech
  • Difficulties in saying long words (prefers short words)
  • Words sound choppy or monotonous when speaking
  • Says words incorrectly
  • Excessive grunting and pointing
  • Speaking mostly in vowels

How is Infant Apraxia Diagnosed?

To begin with, it’s important to rule out hearing problems. An audiologist will typically perform a hearing test first to see if hearing issues are the culprit of the speech problems.

If hearing problems are ruled out, a certified speech language pathologist (SLP) that works with infants and toddler with speech problems will perform an evaluation. The evaluation generally entails assessing speech and speech sound development, oral motor skills, and determining if the child has dysarthria. 

Oral Motor Evaluation

An oral motor evaluation consists of several different assessments, which include:

  • Looking for signs of dysarthia, which typically rules out apraxia
  • Assessing the coordination and movement of the mouth and tongue
  • Evaluation of the muscle movements during speech
  • Evaluating lack of babbling and/or cooing in infants

Sound Evaluation

When evaluated sounds, SLPs normally:

  • Listen to how the toddler/child stresses syllables
  • Listening for pitch and pause marks
  • Evaluating consonant and vowel sounds
  • Evaluating how well people can understand what the toddler/child says

It’s extremely important that infants/toddlers under an evaluation for apraxia. In many instance, parents get a diagnosis from their physician, but according to speech therapist and Tatyana Elleseff, of the American Speech Language Association (ASHA), physicians normally do not do a complete and comprehensive evaluation. In many cases, a physician’s diagnosis turns out not to be apraxia after the child goes through a complete evaluation.

 What Are the Treatment Options for Infant Apraxia?

The goal when treating apraxia is to help infants learn to simple communication and help toddlers/children learn effective speech and communication. To accomplish this, a number of treatment methods can be utilized.

Kaufman Speech Praxis Treatment Approach

The Kaufman Speech Praxis Treatment Approach is a popular choice among many physicians and SLPs across the United States and Canade. Invented by Nancy R. Kaufman, MA, CCC/SLP, the Kaufman Speech Praxis Treatment Approach entails targeting vocabulary, functional expressive language, and intelligible speech with a series of different kits, learning cards, one on one sessions, and other tools.

PROMPT

Prompts for Restructuring Oral Muscular Phonetic Targets, more commonly known as PROMPT, is a  tactile-kinesthetic treatment in which touch cues are used to guide the patient through words, phrases, and sentences. The language-based technique aims to help patients feel the correct placement  by placing the mouth in a certain position when each word, phrase, or sentence is used.

Augmentative and Alternative Communication

Augmentative and alternative communication (AAC) is communications that are non-oral, but still express thoughts and ideas. For example, drawing pictures, pointing, making facial expressions, and writing are all types of AAC. When infants, toddlers, and children have severe cases of apraxia and other treatments methods fail, AAC may be recommended.

AAC treatment may include communication boards, electronic communication aids, and picture boards to help patients express themselves better. In addition, therapy sessions are encouraged, which include learning how to use body language and symbols more effectively.

Is Infant Apraxia a Common Disorder?

Unfortunately, there is not much information on how common infant apraxia is, except that the diagnosis of it seems to be increasing. However, it’s hard to tel how much of an increase there is without more information on past cases. Experts hope to gain a better insight of apraxia through increasing awareness to both families and medical professionals, increase the research on it, and expanding information to help get more research on evaluating infants.

Long-Term Outlook

With the appropriate treatment and a consistent efforts on the part of parents to help their child continue to practice the treatment at home, infants may go on to speak normally and toddlers/children may learn to speak more effectively. However, it can be extremely taxing on parents to constantly remember to help their child practice the therapy learned during treatment, which ultimately may hurt the chances of success. Therefore, it’s extremely important for parents to consistently help their child, as treatment is not only via sessions with an SLP.

On the other hand, there are times in which the numerous treatment methods will not work. This generally happens to patients who have severe cases of apraxia. As mentioned earlier, there are still options for these patients via augmentative and alternative communication.