This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Concurrent Apraxia and Dysarthria
By Pam Marshalla
Q: Can a child have both dysarthria and apraxia?
From my perspective, yes.
- I see apraxia as a problem in the perception of speech movements. This is an input problem.
- I see dysarthria as a problem in the control (execution) of movement. This is an output problem.
I believe that children can have one, or the other, or both.
Also see: Differentiating Between Apraxia and Dysarthria (summary) and Apraxia and Dysarthria and Real Oral Motor Therapy (detail)
2 thoughts on “Concurrent Apraxia and Dysarthria”
Please explain more about apraxia being an input problem.
Movements are perceived through tactile and proprioceptive input.
A muscle contracts or relaxes, and the tactile and proprioceptive systems detect these changes.
A. Jean Ayres (see reference below) said that apraxia was a problem in the organization of input from tactile, proprioceptive, and vestibular signals, principally those of tactile. The child has poor tactile awareness and discrimination.
Therefore, I see apraxic children as having difficulty perceiving his own movements as they should be sensed through the skin.
Therapy, therefore, becomes one of helping him perceive his tactile sensations as he moves. What it feels like to move.
Cueing systems like PROMPT and others help children cue into these movements, as well as do other approaches like simply gently stretching or patting the skin involved.
Hope that helps!
*Ayres, A. J. (1979) Sensory Integration and the Child. Los Angeles: Western Psychological.