Apraxia - Symptoms, Causes & Support

What is Apraxia?

Apraxia is a rare congenital or acquired neurological movement disorder where people cannot perform already learned movements. With apraxia, the ability to plan a movement and the capacity to do the movement is there, however, the movement still can’t be executed. 

As you can imagine, if you’re unable to undertake certain movements, apraxia can impact every aspect of daily life, from tying shoelaces and buttoning shirts through to using cutlery and brushing hair. Depending on the level and type of apraxia, it can be difficult for someone to live independently, especially when it comes to activities of daily living (ADLs). 

Common forms of Apraxia

There are many forms of apraxia, however, these are the 4 most common:

  • Ideomotor apraxia
  • Ideational apraxia
  • Speech apraxia 
  • Oculomotor apraxia 

Ideomotor Apraxia

Ideomotor apraxia is diagnosed when someone is unable to carry out a command from the brain to copy movements performed or suggested by others. In other words, the person knows what they want to do, but they do not know how to do it, which can impact:

  • Picking up a phone and move it to the ear
  • Imitating facial expressions
  • Midline crossing movements, e.g. hair brushing
  • Hand movement, with stiff and inflexible hand posture making it impossible to undertake simple tasks such as taking money out of a hand
  • Poor gesture production
  • Monotone and automatic movements, e.g. cutting with scissors

Ideational Apraxia

A common form of the condition, people living with ideational apraxia lose their ability to plan and perform motor actions with objects. Ideational apraxia is the inability to create a plan for a specific movement, which could result in:

  • Focusing on a specific part of an action, again and again (e.g. while writing and sending a letter, they fold the letter again and again but forget to place it in the envelope)
  • Lacking knowledge on how to use familiar objects (e.g. put a bottle on top of their head or use a smartphone as a brush)
  • Using the wrong order while performing an action (e.g. trying to open a door without pushing or pulling first).

Speech Apraxia

People living with speech apraxia have problems with the planning of speech movements, which can affect articulation, speech melody, rhythm or speech behaviour, resulting in:

  • Incomprehensible pronunciation
  • Substitutions or exchanges of sounds
  • Reduced speech tempo
  • Mistakes in word stress and some more

Oculomotor Apraxia 

People living with oculomotor apraxia struggle with their horizontal eye movements and find it difficult to move their eye on command when directed, leading to:

  • Jerky spinning movements of the head toward the direction they want to look at
  • Inability to follow rapid movements with the eyes
  • Rigid gaze (especially in young children) 

Like any condition, apraxia varies in each person and diagnosis of apraxia doesn’t mean that all actions or activities of daily living are impossible. Some actions may be performed correctly, while others may not be able to be performed at all. It always depends on each person’s apraxia and their individual level of severity. 

Causes of Apraxia 

Apraxia is believed to be caused by a lesion in the neural pathways of the brain that contain the learned patterns of movement. It’s often a symptom of neurological, metabolic or other disorders involving the brain, with apraxia occurring more often in later life, due to brain tumour, dementia, stroke or serious accident. 

Children can also be born with apraxia or develop the condition in childhood due to a neurological disorder or following an accident. The most frequent form of apraxia in children is speech apraxia, which often occurs with aphasia, which is the inability to comprehend or use words.

How to Support Someone With Apraxia

There’s no single therapy or approach for apraxia as each person's experience varies. Since everyone responds to therapy differently, some people will make significant improvement, while others may make less progress. Often one-on-one sessions work the best, especially with the support of family and friends. 

Here are ways to support someone with apraxia.

Speak to a specialist doctor. Specialists are available to provide information, support and guidance on the best way to manage the impact of apraxia on everyday life.

Learn about apraxia. The more you understand the condition, the more support you will be able to provide to loved ones living with apraxia. Take the time to educate yourself.

Engage therapists. Occupational, physical and/or speech therapists can help identify the right coping strategies to make daily life easier and assist with activities of daily living. 

Seek developmental guidance. Specialist speech therapy and special education options may be helpful in supporting children with developmental apraxia of speech.

Research new studies. Be on the lookout for new studies to identify potential treatment options. Also, research what other countries are doing to identify new methods and approaches. 

Try calming clothing. Wearing Calmcare clothing can help people with apraxia by improving their body awareness, producing a positive effect on posture and perception. Sensory clothing can also calm down your body, reduce stress and increase overall wellbeing.