Apraxia Across the Lifespan
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Questions and Answers

Which of the following is a defining characteristic of apraxia?

  • Involuntary movements
  • Reduced muscle tone
  • Excessive muscle tone
  • Inconsistent word productions over repetitive trials (correct)

    • What percentage of motor speech disorders (MSDs) does apraxia make up?

  • 10%
  • 5%
  • 8% (correct)
  • 15%

    • Which term refers to a group of neurologic speech disorders resulting from abnormalities in movements required for control of speech production?

  • Dysarthria (correct)
  • Articulation disorder
  • Apraxia
  • Phonological disorder

    • What type of movements are characteristic of dysarthria?

    <p>Slow and uncoordinated</p> Signup and view all the answers

    What is a common pathophysiologic disturbance associated with dysarthria?

    <p>Spasticity</p> Signup and view all the answers

    Which term refers to an atypical production of speech sounds that may interfere with intelligibility?

    <p>Articulation disorder</p> Signup and view all the answers

    What is the main characteristic of Apraxia of Speech (AOS) as described in the text?

    <p>Trouble saying words correctly and consistently</p> Signup and view all the answers

    What distinguishes Apraxia of Speech (AOS) from a developmental delay of speech?

    <p>It requires highly structured intervention</p> Signup and view all the answers

    Which types of neurological conditions can contribute to Apraxia of Speech?

    <p>Multiple sclerosis and traumatic brain injury</p> Signup and view all the answers

    How does the text describe the prognosis for functional recovery in patients with Apraxia of Speech?

    <p>Poor without treatment, fair for severe patients with treatment, good for mild to moderate patients with treatment</p> Signup and view all the answers

    What is one distinguishing factor between Acquired Apraxia of Speech (AOS) and Childhood Apraxia of Speech (CAS)?

    <p>CAS appears in children from birth, while AOS can affect individuals at any age</p> Signup and view all the answers

    What does the text recommend regarding the timing of therapy initiation for patients with Apraxia of Speech?

    <p>Starting therapy early within one month provides a better chance for therapeutic gains</p> Signup and view all the answers

    What is the most challenging for apraxics to produce?

    <p>Consonant clusters</p> Signup and view all the answers

    What is a technique that involves teaching patients to sing words or phrases set to simple melodies?

    <p>Melodic Intonation Therapy</p> Signup and view all the answers

    Which therapy tool was initially developed for severe non-fluent aphasia but is now also used for apraxics?

    <p>Melodic Intonation Therapy</p> Signup and view all the answers

    What type of blends are known to be challenging for speech production?

    <p>/r/ blends</p> Signup and view all the answers

    What does the Kaufman Speech Praxis Kit involve starting at?

    <p>V simple vowels in isolation</p> Signup and view all the answers

    What distinguishes oral apraxia from other speech disorders?

    <p>Difficulty in using speech musculature for non-speech acts</p> Signup and view all the answers

    Which of the following tasks is NOT mentioned as part of the Motor Speech Evaluation?

    <p>Forced Vital Lung Capacity</p> Signup and view all the answers

    What is a common feature observed in speakers with apraxia according to the text?

    <p>Awareness and frustration with articulatory errors</p> Signup and view all the answers

    Which disorder may require provisional diagnostic classification if signs are consistent but CAS cannot be ruled out?

    <p>Childhood Apraxia of Speech (CAS)</p> Signup and view all the answers

    What type of errors are typically demonstrated by individuals with apraxia?

    <p>Articulatory errors such as substitutions and omissions</p> Signup and view all the answers

    What should be addressed first if it significantly impacts communication, before starting apraxia-based therapy?

    <p>Oral motor weakness</p> Signup and view all the answers

    Which of the following is NOT included in the Apraxia Battery for Adults (ABA-2) test?

    <p>Speech intelligibility test</p> Signup and view all the answers

    What characteristic is used to differentiate between Apraxia of Speech (AOS) and Oral Apraxia?

    <p>Oral apraxia is characterized by difficulty in purposefully using the speech musculature for non-speech acts.</p> Signup and view all the answers

    What type of assessment tasks are particularly challenging for individuals with Childhood Apraxia of Speech (CAS) or AOS?

    <p>Automatic speech tasks and words of increasing complexity.</p> Signup and view all the answers

    What is a common early indicator of Childhood Apraxia of Speech (CAS)?

    <p>Avoidance of first words (grunts/points)</p> Signup and view all the answers

    Why do individuals with Apraxia of Speech (AOS) often perform better on tasks in isolation?

    <p>Simplicity of isolated tasks</p> Signup and view all the answers

    Which symptom is a red flag for Apraxia of Speech (AOS) when comparing different types of oral movements?

    <p>Automatic movement is more accurate than intentional movement</p> Signup and view all the answers

    Which characteristic is likely to be seen in children with Childhood Apraxia of Speech (CAS) regarding babbling?

    <p>Decreased babbling and cooing in infancy</p> Signup and view all the answers

    What is a distinct feature of Apraxia of Speech (AOS) related to errors in vowel production?

    <p>Vowel errors are only seen in Apraxia and Ataxia</p> Signup and view all the answers

    Which characteristic distinguishes Atypical Voice Quality in individuals with Apraxia or AOS?

    <p>Fluctuations between hyper/hypo-nasal</p> Signup and view all the answers

    Why do individuals with Apraxia often have difficulty with Diadochokinetic activities?

    <p>Detailed, precise, and volitional nature of these activities</p> Signup and view all the answers

    What causes individuals with Apraxia to have poor labial pressure when speaking?

    <p>Insufficient lip rounding</p> Signup and view all the answers

    What symptom is a key diagnostic factor for Apraxia?

    <p>Inconsistent errors in speech production</p> Signup and view all the answers

    Why might children with Apraxia have limited expressive language despite higher receptive language skills?

    <p>Motor speech disorder affecting expressive language</p> Signup and view all the answers

    What is the recommended frequency for therapy sessions for children with apraxia of speech?

    <p>3-5 times per week</p> Signup and view all the answers

    Which resource is specifically recommended for apraxia treatment in preschoolers?

    <p>Kaufman Speech Praxis Kit</p> Signup and view all the answers

    What is the ideal duration for each therapy session for children with apraxia as per the 'Perfect World Clinical Model'?

    <p>45 minutes</p> Signup and view all the answers

    Why does the text suggest that individual therapy is preferable over group therapy for clients with apraxia of speech?

    <p>Frequent one-on-one therapy is more effective</p> Signup and view all the answers

    Which statement aligns with the ASHA Position Statement regarding habilitation of children with developmental apraxia of speech?

    <p>'Frequent professional speech assistance is critical'</p> Signup and view all the answers

    Why does the text recommend five short therapy sessions per week rather than two longer sessions?

    <p>'To provide more consistent progress'</p> Signup and view all the answers

    What characteristic makes children with apraxia have difficulty 'locking in' motor sequencing movements needed for speech?

    <p>Inconsistent practice</p> Signup and view all the answers

    How many times per week are children recommended to attend therapy sessions for consistent progress based on the text?

    <p>At least three sessions per week</p> Signup and view all the answers

    What distinguishes traditional methods from the reason behind apraxia resistance according to the text?

    <p>Infrequent therapy sessions</p> Signup and view all the answers

    Dysarthria is a neurological motor speech disorder characterized by fast movements of the speech musculature.

    <p>False</p> Signup and view all the answers

    Apraxia accounts for 8% of Motor Speech Disorders (MSDs).

    <p>True</p> Signup and view all the answers

    Articulation disorder refers to the typical production of speech sounds that enhances intelligibility.

    <p>False</p> Signup and view all the answers

    Phonological disorder involves a mental operation that substitutes sounds or sound sequences causing difficulty in speech production.

    <p>True</p> Signup and view all the answers

    Individuals with Apraxia often struggle with locking in motor sequencing needed for speech.

    <p>True</p> Signup and view all the answers

    Apraxia is mainly caused by abnormalities in respiratory control during speech production.

    <p>False</p> Signup and view all the answers

    Apraxia of Speech (AOS) is a speech disorder caused by weakness or paralysis of the speech muscles.

    <p>False</p> Signup and view all the answers

    Acquired Apraxia of Speech (AOS) typically occurs in children from birth.

    <p>False</p> Signup and view all the answers

    Childhood Apraxia of Speech (CAS) is a congenital speech disorder neurological in nature.

    <p>True</p> Signup and view all the answers

    Apraxia of Speech can coexist with muscle weakness affecting speech production (dysphagia).

    <p>False</p> Signup and view all the answers

    Patients who begin treatment for Apraxia of Speech within one week of onset tend to have better therapeutic gains.

    <p>False</p> Signup and view all the answers

    Apraxia of Speech (AOS) is often caused by a developmental delay in speech production.

    <p>False</p> Signup and view all the answers

    Oral apraxia is characterized by difficulty in using speech musculature for non-speech acts only.

    <p>False</p> Signup and view all the answers

    Apraxia isolated in the oral cavity can never co-occur with AOS.

    <p>False</p> Signup and view all the answers

    Apraxia Battery for Adults (ABA-2) test includes tasks to measure the severity of dysarthria.

    <p>False</p> Signup and view all the answers

    Individuals with apraxia may show awareness of articulatory errors and feel frustrated with speech.

    <p>True</p> Signup and view all the answers

    Apraxia speakers demonstrate errors like repetitions and prolongations but never substitutions.

    <p>False</p> Signup and view all the answers

    Children with Childhood Apraxia of Speech (CAS) typically have higher expressive language skills than receptive language skills.

    <p>False</p> Signup and view all the answers

    Apraxia Battery for Adults (ABA-2) test does not include a subtest for limb and oral apraxia.

    <p>False</p> Signup and view all the answers

    In Apraxia of Speech, disturbances in prosody reflect precise articulation.

    <p>False</p> Signup and view all the answers

    'Automatic and well-rehearsed utterances can be produced without error' aligns with a key characteristic of Apraxia.

    <p>True</p> Signup and view all the answers

    Apraxia Treatment always starts with addressing apraxia-based therapy before any other factors.

    <p>False</p> Signup and view all the answers

    It is recommended to start apraxia treatment with the mastery of individual consonant phonemes.

    <p>True</p> Signup and view all the answers

    Consonant clusters are easier for apraxic patients to produce than single consonants.

    <p>False</p> Signup and view all the answers

    Apraxics may find it easier to produce vowels in isolation compared to blends.

    <p>True</p> Signup and view all the answers

    In the Kaufman Speech Praxis Kit, the syllable hierarchy begins with complex bisyllabics.

    <p>False</p> Signup and view all the answers

    Melodic Intonation Therapy developed by Sparks and Holland is primarily used for the treatment of dysarthria.

    <p>False</p> Signup and view all the answers

    Elongating a vowel can assist in enhancing auditory awareness and providing a prolonged visual cue.

    <p>True</p> Signup and view all the answers

    Complex Consonant Production includes sounds like /p, t, k, b/.

    <p>False</p> Signup and view all the answers

    The technique of Blend Synthesis involves vowel to consonant to vowel sequencing.

    <p>False</p> Signup and view all the answers

    In the context of treatment goals, Long Term Goals focus on non-phoneme specific syllable shapes.

    <p>False</p> Signup and view all the answers

    'Simple Phonemic/Syllabic Level' in the syllable hierarchy includes vowels in isolation and simple consonants.

    <p>True</p> Signup and view all the answers

    Poor labial pressure is a common characteristic seen in Apraxia of Speech (AOS).

    <p>True</p> Signup and view all the answers

    Vowel errors are commonly observed in individuals with apraxia and dysarthria.

    <p>False</p> Signup and view all the answers

    Atypical voice quality is not a distinguishing characteristic of Apraxia of Speech (AOS).

    <p>False</p> Signup and view all the answers

    'Flat affect' in speech is commonly observed in individuals with Apraxia of Speech (AOS).

    <p>True</p> Signup and view all the answers

    Children with Apraxia typically have expressive language skills that are markedly higher than their receptive language skills.

    <p>False</p> Signup and view all the answers

    Neuropathway memory approach is associated with habilitation rather than rehabilitation for Apraxia of Speech (AOS).

    <p>True</p> Signup and view all the answers

    Groping and posturing motions are typically avoided by individuals with Apraxia of Speech (AOS) when executing speech sounds.

    <p>False</p> Signup and view all the answers

    Children with Apraxia tend to perform better on tasks in isolation due to the simplicity of the tasks.

    <p>True</p> Signup and view all the answers

    Inconsistent errors are not a key diagnostic factor for Apraxia.

    <p>False</p> Signup and view all the answers

    'Limited consonant/vowel repertoire' is not a common characteristic observed in children with Childhood Apraxia of Speech (CAS).

    <p>False</p> Signup and view all the answers

    In the Phoneme specific goal, the client may have more accuracy in the initial position of an utterance.

    <p>False</p> Signup and view all the answers

    Research shows that patients achieve higher success when they receive infrequent (3-5 times per week) and intensive treatment.

    <p>False</p> Signup and view all the answers

    According to the ASHA Position Statement, the frequency of professional speech assistance is not critical in the habilitation of children with developmental apraxia of speech.

    <p>False</p> Signup and view all the answers

    In a perfect world clinical model, the recommended therapy session duration is 30 minutes.

    <p>False</p> Signup and view all the answers

    The Kaufman Speech Praxis Workout Book is specifically recommended for vocabulary building in children with apraxia.

    <p>False</p> Signup and view all the answers

    Children with apraxia do not require daily practice for consistent progress, according to Shelley Velleman.

    <p>False</p> Signup and view all the answers

    Individual therapy for clients with apraxia is not supported by an overwhelming body of evidence for achieving the best results.

    <p>False</p> Signup and view all the answers

    Group therapy is more effective than individual therapy for clients with apraxia of speech, according to Rosenbek.

    <p>False</p> Signup and view all the answers

    Edythe Strand's Childhood Motor Speech Disorder Treatment advocates for infrequent and inconsistent therapy sessions for apraxia patients.

    <p>False</p> Signup and view all the answers

    Traditional methods of treatment are more effective for individuals with apraxia when compared to frequent motor practice.

    <p>False</p> Signup and view all the answers

    Individuals with verbal apraxia often have difficulty pronouncing multi-syllable words or words with complex phonemic combinations

    <p>True</p> Signup and view all the answers

    Individuals with apraxia have reduced oral motor strength.

    <p>False</p> Signup and view all the answers

    Individuals with apaxia may speak with impaired prosody, monotone quality, and/or with equal emphasis across syllables and words

    <p>True</p> Signup and view all the answers

    WHy is it important to correctly classify dysarthria? Chose all that apply.

    <p>All of the above</p> Signup and view all the answers

    An adult patient comes to you in a wheelchair for an evaluation. She has no use of her left leg or arm. Oral motor exam reveals left-sided facial asymmetry, slow and imprecise SMR and AMR, as well as breathy weak voice. In speech tasks, she presents with slow rate of speech, consistently slurred production of bilateral, alveolar, fricative, and affricate consonants. These errors are consistent across single syllable production, single word reading, automatic speech tasks, and in running speech. Intelligibility is approximately 70% in single word level, and 60% in conversation, the diagnosis is:

    <p>Apraxia</p> Signup and view all the answers

    An adult patient comes to you for an evaluation. Oral motor exam was limited, as the patient was unable to follow directions like “stick out your tongue” or “smile”. Spontaneous symmetrical smile noted when patient first walked in but was unable to reproduce on command. Automatic speech tasks were 100% intelligible, however, when completing confrontation naming taks and sentence repepition, sound distortions were noted throughout with slow, effortful speech and intermittent groping movment of the lips. Patient was visibly frustrated by his errors. The likely diagnosis is:

    <p>Apraxia</p> Signup and view all the answers

    Match the words to their definition: intelligibility, comprehensibility

    <p>no = no no = no Intelligibility = The degree to which the listener understands the acoustic signal produced by the speaker Comprehensibility = The degree to which the listener understands the communication message based on the acoustic signal plus all other information</p> Signup and view all the answers

    Indicate which area of the brain is likely to be damaged in an individual with acquired apraxia of speech.

    <p>Left frontal and parietal lobes, specifically the pre motor, primary motor, and association vortices</p> Signup and view all the answers

    Apraxia of speech results from a breakdown in which 2 steps of speech control?

    <p>Motor planning and motor programming</p> Signup and view all the answers

    Which are standardized assessment tools that can be used for the evaluation of motor speech disorders?

    <p>Assessment of Intelligibility of Dysarthric Speech (AIDS) Dysarthria Examination BAttery (DEB) Frenchman Dysarthria Assessment - 2nd Edition (FDA-2) NEw Castle Dysarthria Assessment tool Apraxia Battery for Adults 1</p> Signup and view all the answers

    The administration of AMR/SMR would be a more important assessment task than mean phonation time for individuals with suspected apraxia of speech.

    <p>True</p> Signup and view all the answers

    Mean phonation time is one of the essential components of MSD testing

    <p>True</p> Signup and view all the answers

    During an MSD assessment, individuals with apraxia are unaware of the errors and do not attempt to self-correct.

    <p>False</p> Signup and view all the answers

    Apraxia of speech can be acquired or developmental.

    <p>True</p> Signup and view all the answers

    Study Notes

    Characteristics of Oral Apraxia

    • Difficulty in purposefully using speech musculature for non-speech acts (coughing, tongue protrusion, tongue wiggling, smiling, whistling, frowning)
    • Actual speech is not impaired
    • Apraxia isolated in the oral cavity
    • Can co-occur with AOS (Apraxia of Speech), but may occur alone

    Assessing Apraxia

    • Motor Speech Evaluation
    • Dr. B's Essential 8
    • Case History/Chart Review
    • Cranial nerve exam paired with oral motor exam (non-speech tasks)
    • Diadochokinetic Task
    • Mean Phonation Time (generally WNL)
    • Collect the intensity (dB) and the duration (sec)
    • Forced Vital Lung Capacity (generally WNL)
    • Automatic Speech Tasks
    • Intelligibility Test
    • Counting (1-100) - performed better initially, but challenges arise as it gets more complex
    • Words of increasing complexity - as complexity increases, intelligibility decreases
    • Conversation: Short Conversation/Monologue (60 seconds) - shows overall communication pattern

    Apraxia Battery for Adults (ABA-2)

    • Systematic set of tasks to measure the presence and severity of apraxia in clients
    • Objective scoring system
    • Includes six subtests:
      • Diadochokinetic rate
      • Increasing word length
      • Limb and oral apraxia
      • Latency and utterance time for polysyllabic words
      • Repeated trials test
      • Inventory of articulation characteristics
    • Takes about 20-40 minutes to administer

    Differential Diagnosis

    • Demonstrates errors in:
      • Substitutions, omissions, transpositions, repetitions, and prolongations
    • Speaker may show an awareness of articulatory errors and attempt self-correction
    • Articulatory breakdown increases with increasing length and complexity of utterance
    • Disturbance of prosody reflects general articulatory imprecision
    • Receptive language skills are higher than expressive language skills
    • Automatic and well-rehearsed utterances can be produced without error

    Treatment Considerations

    • Address oral motor weakness or dysarthria first, if present
    • Start at the bottom and work up
    • Make sure the individual can verbally imitate
    • Ideally, start treatment as early as possible with moderate intensity (3x/week) and 45+ minutes per session
    • Frequent therapy is needed to make changes
    • Neuropathway memory approach:
      • CAS (Childhood Apraxia of Speech) = habilitation
      • AOS (Apraxia of Speech) = rehabilitation

    Characteristics of Apraxia

    • Early possible indicators of CAS:
      • Decreased babbling/cooing in infancy
      • Late acquisition of first words
      • Avoidance of first words (grunts/points)
      • Hyper-independent monosyllabic words favored beyond 2 years
      • Larger, more complex words more difficult
      • Limited consonant/vowel repertoire (compared to developmental expectations)
      • Vowel errors only seen in apraxia and ataxia
      • Open mouth posturing prominent
      • Disordered movement and coordination of oral structures
      • Automatic movement (chewing, blowing kisses) more accurate than intentional (volitional) or imitated movements
      • Co-existence of limb apraxia: look for OT or PT involvement or clumsiness
      • Presence of preferential sound patterns used as a default
      • Difficulty coordinating and sequencing oral movements
      • Will do poorly in oral mech
      • Diadochokinetic activities can be difficult to produce

    Treatment Approaches

    • Dabul and Bollier (1976):
      • Mastery of individual consonant phonemes
      • Rapid repetition of each consonant plus the vowel /a/
      • Buildup of sounds into syllables using CV CV combinations
      • Mastering words by breaking them down into individual phonemes, then blending them into syllables and words
    • Vowel influence:
      • Shape, origin, meaning, and emotion of words
      • Assessing vowel stimulability and knowing the vowel repertoire present in a child's speech
      • Elongating the vowel can enhance auditory awareness and provide a prolonged visual cue
      • Diphthongs can be broken down into their stressed/unstressed components
    • Syllable Hierarchy (Kaufman Speech Praxis Kit)

    Best Practices

    • Frequency: 3-4 times a week (direct/indirect)
    • Research shows patients achieve higher success with frequent and intensive treatment
    • ASHA Position Statement, CAS (2007): "The frequency of professional speech assistance is critical in the habilitation of children with developmental apraxia of speech."
    • Perfect World-Clinical Model: 45 minutes, 2-3 times a week
    • Daily practice is critical for consistent progress
    • Frequent, short practice sessions are very important
    • Consistent and frequent therapy sessions are recommended

    Resources and Support

    • Useful clinical materials: Kaufman Speech Praxis Kit 1 & 2, Kaufman Speech Praxis Workout Book, ArticulatiBon Cards, Vocabulary Books
    • Articles for parents and caregivers: "How Parents Can Help Their Child with Apraxia at Home", "Parent Share How to Help Your Child with Speech Practice at Home"
    • Phone and iPad apps: Smart Oral Motor, MouthWorks, SpeechStickers, Target Sound ID, Hand Cue Sound Match, HCSM Apraxia Picture Sound Cards, APSC Apraxia Across the Lifespan### Motor Speech Disorders
    • Defined as speech disorders resulting from neurologic impairment affecting the motor planning, programming, neuromuscular control, and execution of speech.
    • Include dysarthria and apraxia, with apraxia making up 8% of motor speech disorders.

    Dysarthria

    • A neurological motor speech impairment characterized by slow, weak, uncoordinated movements of the speech musculature.
    • Caused by pathophysiologic disturbances due to CNS and PNS abnormalities, resulting in weakness, spasticity, incoordination, involuntary movements, or excessive or reduced muscle tone.

    Articulation Disorder

    • Defined as an atypical production of speech sounds that may interfere with intelligibility.

    Phonological Disorder

    • A mental operation that applies to speech to substitute for a class of sounds or sound sequences presenting a common difficulty to the speech capacity.

    Apraxia

    • A motor speech disorder characterized by the impaired capacity to program the speech musculature and the sequencing of muscle movements for the volitional production of phonemes.
    • Not due to weakness or paralysis of the speech muscles, but rather a disruption along motor association areas and association pathways within the brain.
    • Severity can range from mild to severe, and the smaller the disruption, the more favorable the diagnosis.

    Types of Apraxia

    • Acquired Apraxia of Speech (AOS): occurs in adults, often as a result of stroke, head injury, tumor, or other illness affecting the brain.
    • Childhood Apraxia of Speech (CAS): occurs in children, often present from birth, and is neurological in nature.

    Characteristics of Oral Apraxia

    • Difficulty with purposeful use of speech musculature for non-speech acts (e.g., coughing, tongue protrusion, tongue wiggling, smiling, whistling, frowning).
    • Apraxia isolated in the oral cavity, can co-occur with AOS, but may occur alone.

    Assessing Apraxia

    • Motor Speech Evaluation:
      • Case History/Chart Review
      • Cranial nerve exam paired with oral motor exam (non-speech tasks)
      • Diadochokinetic Task
      • Mean Phonation Time
      • Forced Vital Lung Capacity
      • Automatic Speech Tasks
      • Intelligibility Test
      • Conversation/Monologue
    • Apraxia Battery for Adults (ABA-2): a systematic set of tasks to measure the presence and severity of apraxia.

    Treatment of Apraxia

    • Start with simple sequences and move to more difficult ones
    • Focus on speech movements and practice with a variety of sounds
    • Model the sounds for the patient
    • Use of tactile or visual cues can be useful
    • Self-monitoring skills are important
    • Educate the patient and family members
    • Goals:
      • Increase intelligibility
      • Increase phonemic repertoire
      • Increase raw/standard score

    Characteristics of Childhood Apraxia of Speech (CAS)

    • Decreased babbling/cooing in infancy
    • Late acquisition of first words
    • Avoidance of first words
    • Hyper-independent mouth posturing
    • Monosyllabic words favored beyond 2 years
    • Limited consonant/vowel repertoire
    • Vowel errors only seen in apraxia and ataxia
    • Open mouth posturing prominent
    • Disordered movement and coordination of oral structures
    • Automatic movement (chewing, blowing kisses) more accurate than intentional (volitional) movements

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    Test your knowledge on motor speech disorders such as apraxia and dysarthria, which are speech impairments caused by neurologic conditions affecting motor planning and execution. Learn about the characteristics and differences between apraxia and dysarthria.

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