Developmental apraxia is an uncommon speech problem in children. A child with the disorder is unable to form certain words and produce certain sounds because of a neurological defect. In most cases, the nerves, muscles, and other structures in and around the vocal cords are completely normal, leading researchers to believe that the problem lies within the brain. Developmental apraxia can be very frustrating to the sufferer, but dedicated speech therapy and support from family, teachers, and doctors can help many children learn how to overcome many of their problems and communicate effectively with others.
Despite decades of neurology research, the exact causes of developmental apraxia are not known. The condition is not associated with lesions or damage on particular areas of the brain. Some neurologists believe that developmental apraxia may have a genetic component, since many patients have family histories of speaking, hearing, or learning disorders. Regardless of the cause, most children who have the condition are otherwise physically and mentally healthy.
A child with developmental apraxia usually understands written and spoken language at a level appropriate for his age. He cannot, however, articulate his thoughts into understandable speech. For many children, the problem is mild and only affects their ability to make certain sounds and syllables. A child might, for example, simply be unable to string several syllables together to make a long word. A particular phonetic noise, such as a rolling "r" or a long "a," may cause problems. Speech inconsistencies can also fluctuate: a word that was easily pronounced the day before might be impossible today, while previously difficult sounds can suddenly become easy.
Patients with severe apraxia can be very limited in their communication. In the most extreme cases, nothing said is fluent and tone, inflection, and volume are very inconsistent. Major communication barriers can become exasperating to a patient, and frustrations can lead to depression, behavioral outbursts, and overwhelming stress.
Diagnosing developmental apraxia is a cooperative effort among pediatricians, neurologists, and speech-language pathologists. Imaging tests and physical exams are performed to check for other problems, such as brain damage and vocal cord impairment. If no obvious defect is uncovered, the pathologist can perform tests over several weeks to gauge the severity and unique characteristics of the patient's apraxia.
It is difficult to predict the success of treatment, but many children with developmental apraxia are able to start communicating better with ongoing speech therapy. Personalized exercises developed by pathologists train patients to mimic noises and work their way through difficult words. If problems persist despite regular therapy, a child can still learn to communicate through sign language and other forms of nonverbal interaction.
