Apraxia

• ·Is a disorder of motor planning/programming.
• ·Motor programming refers to the ability to plan and sequence movements of the articulators, arms, and legs to perform voluntary acts such as speaking, dressing, gesturing, using objects, walking, etc.
• ·Not to be attributable to neuromusclar problems, such as, weakness, discoordination, or sensory loss.
• ·5 bx types of apraxia: 
•      1) Apraxia of Speech
•      2) Oral Apraxia
•      3) Phonatory Apraxia
•      4) Limb Apraxia
•      5) Swallowing Apraxia

• Refers to difficulty performing or sequencing non-speech oral movements, such as, opening mouth, sticking out/lateralizing tongue, rounding lips, blowing, etc. 
• Not attributable to weakness
• Usually co-occurs with an apraxia of speech
• The production of these oral postures is characterized by:
•  inability to perform (initiation problems), awkwardness in performance (groping), and sequencing problems
• often normal oral movement during automatic acts, e.g., licking lips, blowing out candles, etc.

• Is a motor speech disorder of articulation and prosody resulting from brain damage. It impairs the capacity to program and sequence articulatory movements in the absence of significant muscle weakness, sensory loss or incoordination.
• Ofter associated with Broca's (nonfluent) aphasia, but may occur independently.  
• Characterized by groping articulatory postures, initiation difficulties, distorted speech sounds, substitutions, and dysprosody.

• Is the inability to initiate voluntary phonation.
• The patient is essentially mute (does not mouth words) except that you will hear involuntary phonation during coughing, sneezing, crying, groaning, and throat clearing.
• These acts of involuntary phonation indicate that vocal folds are capable of producing phonation.
• Patients with phonatory apraxia always have severe apraxia of speech and oral apraxia.

• Is a disorder of learned, skilled, purposeful limb movements that occurs in the absence of significant weakness, incoordination, and sensory loss.
• e.g., asking the patient to pretend to write, they're unable to perform the task.
• 2 subtypes of limb apraxia:
• ⇾ ideomotor
• ⇾ ideational or conceptual

Person with limb apraxia may have difficulty sequencing the steps to get dressed and this is referred to as a dressing apraxia

• Characterized by awkwardness in performance and difficulty sequencing movements/steps in complex gestures. ex. pretending to drink from a cup.
•     Performance of ideomotor apraxics usually improves if you give them the actual object to perform the gesture with

Characterized by a person performing the wrong gesture or not performing the gesture even when given the actual object.

It is like they have lost the "idea" of what to do with the object.

Characterized by searching movements with the tongue...(with) inability to organize front to back lingual and bolus movement normally characteristic of a swallow.

Problems with initiation and sequencing the motor acts necessary to perform the initial (voluntary) part of the swallow.