Children diagnosed with Childhood Apraxia of Speech may also display symptoms of one or several associated conditions. These conditions are separate from apraxia and need to be addressed. Watch out for these issues in the classroom to better meet the needs of your students.
Oral apraxia is seen in most children with verbal apraxia. A child who has oral apraxia may have trouble moving their mouth and imitating facial gestures. She may also have issues making raspberries or blowing on a whistle. The child may also not be able to imitate movements with their tongue. Because oral apraxia can be diagnosed before a child begins to talk and verbal apraxia can only be diagnosed after a child attempts to talk, Speech Therapists often use the oral apraxia diagnosis as an early sign of verbal apraxia.
Sensory Integration Dysfunction
Many children with apraxia also have sensory integration dysfunction. A child who has sensory issues may be sensory seeking or sensory avoiding. A sensory seeking child looks for additional stimulation while a sensory avoiding child becomes overwhelmed with sensory input, such as noise or certain fabrics. Watch children with apraxia diagnosis for signs of sensory integration dysfunction and refer them to an occupational therapist if you suspect issues.
If you notice a child in your classroom with apraxia having difficulty with reading or spelling, begin intervention with them quickly. A child who has apraxia often has difficulty blending words because they do not say all sounds when they speak a word. Additionally, he might have difficulty learning to spell because he may substitute certain sounds in words when he says them out loud. Translating of speech to correctly spelled words is often difficult for a child with apraxia.
The American Speech-Language-Hearing Associations describes dysarthria as a motor speech disorder where the muscles of the mouth face and respiratory system become weak or do not move at all. A person with dysarthia may slur their speech, use a very soft speaking voice and have limited facial movements. Some people also speak with an uneven rhythm and drool more than normal.
Because there are some similarities between dysarthia and apraxia, it can be difficult to tell if a person has both or just one of the conditions. Fortunately, several of the treatments, such as strengthening the muscles and improving breathing while talking are used with people who have dysarthria or apraxia.
Fine Motor Delays
Because apraxia is a motor planning disorder, many children with apraxia have issues planning movements using other parts of their body. A child with apraxia may also have fine motor delays that impact their ability to use scissors and write letters.
If you notice the beginning of fine motor delays or handwriting issues in a child with apraxia, have them evaluated by an occupational therapist. Because the child is prone to these types of delays, taking the wait and see approach is not advantageous in this case.
After my son was given a tentative diagnosis of verbal apraxia, we had him evaluated by an occupational therapist. The OT explained to us that my son also had mild hypotonia in his trunk area. He told us that the hypotonia was associated with apraxia, but since it was causing my son to fall while walking that we should treat it with therapy.
Another sign of the hypotonia was my son’s tendency to sit with his knees turned inward. If a child has oral apraxia and/or verbal apraxia, be sure that they are evaluated for hypotonia. Physical therapy is often used to treat hypotonia.