Friday, July 27, 2007


What is apraxia? I will keep adding to this untill I get it right.

Neurological Causes
The theory outlined by Gerald Edelman in 1992 suggests that the condition is caused by the failure of the neurones in the brain to develop correctly. This failure of the neurones to form adequate connections means that the brain takes longer to process information and there is a greater likelihood of the brain losing the suggestion and the child therefore failing to respond to requests given to him.

Apraxia can be severe, and it's not limited to speech. Apraxia is a neurologically based motor planning and sequencing disability. Anything that requires a plan and a sequence for muscle response, like jumping ,hopping, riding a bike, writing with a pencil etc., is affected. It most profoundly affects speech because so many muscles are utilized at one time. There are 17 muscles in the tongue alone!
There are various kinds of apraxia that affect different types of movement, including:

Ideomotor apraxia. Inability to mimic or perform a movement (e.g. hammer a nail, brush hair, blow out a match, cough) in response to a verbal command.

Ideational apraxia. Inability to correctly perform a series of movements to accomplish certain tasks (e.g., writing, bathing, dressing, eating or brushing teeth). Patients also may not know how to appropriately use certain tools or objects. For instance, a pen may be used in the manner of a comb.

Verbal apraxia. Inability to coordinate lip, mouth and tongue movements in order to speak. People with verbal apraxia may be unable to say a word correctly and consistently (they can say a word correctly one moment but not the next).

Buccofacial apraxia. Inability to perform movements of the face and mouth (without typically affecting a patient’s ability to speak). Patients with verbal apraxia may not be able to lick their lips, blow, cough or wink upon verbal command.
Additional types of apraxia that some experts believe should not be considered true forms of apraxia include constructional apraxia, limb-kinetic apraxia and oculomotor apraxia.

Childhood apraxia of speech (CAS, also known as DVD -- developmental verbal dyspraxia, and DAS -- developmental apraxia of speech) is a disorder that is more easily defined by what it is not. It is not a muscle disorder. It is not a cognitive disorder (although it may have some impact on language as well as speech). The problem occurs when the brain tries to tell the muscles what to do -- somehow that message gets scrambled. It's like trying to watch cable t.v. stations without the right descrambler. There is nothing wrong with the t.v. station, and nothing wrong with your set. It's just that your set can't read the signal that the station is sending out. The child's language-learning task is to figure out how to somehow unscramble the mixed message her/his brain is sending to her/his muscles. The

CAS has much more effect on volitional (voluntary, creative) speech than on automatic speech. This means that the more your child wants to communicate a particular message, the harder it will be! So, if you happen to hear her/him say something once when there is no pressure, and you say, "Say it again!", you are guaranteeing that she/he won't be able to. It is vital to put a minimum of communication pressure on the child. (NOTE: Your child's speech- language pathologist will need to put communication pressure on the child.) Low-pressure verbal activities are the most important thing a parent can do to help. These include: songs (especially repetitive songs, like Old MacDonald and finger-plays), poems, verbal routines (pat-a-cake, Willoughby Walloby Woo, etc.), repetitive books (such as some of the Mercer-Mayer books, Little Bear, etc.) and daily routines (prayers, social greetings, salute to the flag, etc.). You can make other activities into verbal routines: make up little sayings or poems that you say every time you do the same thing, label instead of counting objects in counting books ("Three dogs: dog, dog, dog"), verbalize repetitive activities (e.g., setting the table: "Plate, plate, plate, plate; fork, fork, fork, fork.."), and so on. Don't make a big fuss about whether or not your child is talking or singing along; just provide a supportive environment for her/him to do so. Don't ever say "You can't have it unless you say it first" -- that's sheer torture for a child with CAS. If your child is unable to communicate effectively right now, the use of sign language or a communication board to supplement speech temporarily not only decreases the frustration but also even seems to help with speech development. Don't be afraid to try it! Dyspraxia may affect other motor functions (e.g., fine motor control, gross motor planning) and other language functions (e.g., learning grammatical function words like "the, "is", "or", etc.; learning more complex grammatical forms like passive; spelling; putting words together into a sentence or sentences together into a paragraph, etc.). Occupational therapy, physical therapy, and learning disabilities assistance are often helpful for children who have these difficulties. CAS can be a very frustrating disorder at times. It is common for children to make progress in "fits and starts" -- good progress for a little while, then none, then more, etc. Don't get discouraged! The therapy is helping, even if you don't see the effects immediately.

The cause or causes of DAS are not yet known. There are scientists who believe that DAS is a disorder related to a child's overall language development. Others believe it is a neurological disorder that affects the brain's ability to send the proper signals to move the muscles involved in speech. Some findings suggest that heavy metals may play a role in the disorder.

A qualitative impairment in communication (APA, 1994), and such impairment is a primary feature of mercury poisoning.
Mercury-exposed children especially show a marked difficulty with speech (Pierce et al, 1972; Snyder, 1972; Kark et al, 1971). Even children exposed prenatally to “safe” levels of methylmercury performed less well on standardized language tests than did unexposed controls (Grandjean et al, 1998). Iraqi babies exposed prenatally either failed to develop language or presented with severe language deficits in childhood. They exhibited “exaggerated reaction” to sudden noise and some had reduced hearing (Amin-Zaki, 1974 and 1979). Iraqi children who were postnatally poisoned from bread containing either methyl or ethylmercury developed articulation problems, from slow, slurred word production to the inability to generate meaningful speech. Most had impaired hearing and a few became deaf (Amin-Zaki, 1978). In acrodynia, symptoms of sufferers (vs. controls) include noise sensitivity and hearing problems (Farnsworth, 1997).

Could there be a link with the pharmaceutical companies who made vaccines with mercury? The doctors who gave the vaccines, insisted they were safe; and likewise we have the scientists who said they could not find a link between autism and mercury. If there's no ``evidence of harm, then why did government officials begin removing thimerosal from the vaccines in 1999? With families struggling to find the answers and help for their children's neurological symptoms. Like U.S. Representative Dan Burton, who believes his two grandchildren suffered from thimerosal exposure in vaccines. I was not so sure there isn't a link. But then Jaded said... "I also wanted to mention that all of the newest research indicates that mercury plays no part in autism rates either in the US or internationally. Any of the studies done that indicate it does were either anecdotal or flawed". The MMR-Autism theory came to the forefront in 1998 when British Gastroenterologist Andrew Wakefield and his colleagues reviewed reports of 12 children with bowel disease and regressive developmental disorders, mostly autism, and that seemed to arise shortly after having a vaccine. The parents of nine of these children - or their pediatricians - suggested that MMR vaccinations led to the intestinal abnormalities. The study has several limitations: there were too few cases to make generalizations about the causes of autism, the cases were referred to the researchers, rather than chosen at random, and thus may not be a representative sample of cases of autism, and finally, there were no healthy control group children for comparison. In at least four of the cases, behavioral problems had begun before the symptoms of bowel disease, meaning it is unlikely that bowel disease or the MMR vaccine caused the autism. In 2004, 10 of the 13 authors of the study retracted the paper’s interpretation, saying that the data was insufficient to establish a causal link between the MMR vaccine and autism.
And a study by scientists at the University of Rochester Medical Center is the latest in a series of updates on children who have been studied since their birth in 1989 and 1990 in the Republic of the Seychelles, an island nation in the Indian Ocean. The children have been evaluated five times since their birth, and no harmful effects from the low levels of mercury obtained by eating seafood have been detected.
CAMBRIDGE, Massachusetts, August 26, 2003 (ENS) -
Autism may be a form of mercury poisoning brought on by exposure to the mercury based preservative thimerosal in vaccines, according to new research published in the current issue of "International Journal of Toxicology," the official journal of the American College of Toxicology.

The study provides the strongest clinical evidence to date supporting the theory that mercury exposure is tied to autism, a finding that is not a surprise to coauthor by Mark Blaxill, a director of Safe Minds, (Sensible Action For Ending Mercury-Induced Neurological Disorders). This nonprofit parents' organization was founded to investigate the continuing risks to infants and children of exposure to mercury from medical products, including thimerosal in vaccines.

Methylmercury has always been found naturally in fish and in our bodies, but the trace levels of human exposure haven't increased in centuries; in fact, they're dropping. And research that has followed thousands of pregnant women and their children for nearly 15 years has found no evidence that the amounts of methylmercury in our fish put children or newborn babies at risk. Even among populations eating ten or more times the amounts of fish consumed by Americans, scientists have found no credible evidence of neurotoxicity, let alone brain damage, developmental delays, retardation, or learning disabilities.

The sky-is-falling crowd of activists and government officials remains unconvinced. They persist in warning women that there is real risk in exceeding EPA-established thresholds of methylmercury exposure that were set arbitrarily and with overly conservative safety margins. To determine acceptable levels of methylmercury, the EPA began with an amount at which there was no observed effect at all in the most sensitive of the population with a lifetime of exposure — a level nearly ten times that found in American women — and then added another tenfold safety cushion to that.
In the end, it seems that no one knows who or what to blame.

The Childhood Apraxia of Speech Association of North America (CASANA)