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Apraxia

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Apraxia. Considered as dyspraxia (separate from dysphasia ... play, plant, praise, prank, prawn, pray, price, practice, predict, printer, precise, prattle... – PowerPoint PPT presentation

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Title: Apraxia


1
Apraxia
  • Considered as dyspraxia (separate from dysphasia
    / aphasia)
  • Considered as one of the problems in case of
    afferent motor aphasia (A. Luria)

2
Case 1
  • 27 y.o female.
  • Stroke in the left hemispere following a heart
    surgery
  • Was admitted to the rehabilitation ward at the
    Gold Coast Hospital a week later
  • Started having speech pathology intervention 5
    days a week two times a day

3
Case 1
  • She only used gestures and pointing to
    communicate
  • Was not able to consistently answer yes and no
    questions
  • She also had trouble with comprehension and
    written language

4
Case 1 word lists
  • Apraxia drills proved to be very useful!
  • 1. Word lists. E.g. pie, pay, pea, pat, poke,
    pick, pack, peek, prime, pace, paid, pair, pam,
    pass, peg, peel, poor, pyre, pet, past, play,
    place, play, plant, praise, prank, prawn, pray,
    price, practice, predict, printer, precise,
    prattle...
  • We mostly used repetition. Visual help only
    if necessary.

5
Case 1 rhyming series
  • 2. Rhyming series. E.g. he me pea bee we
    tea d knee lee re key ghee fee
    v thee see she tree free flea ski
    glee three...
  • We mostly used repetition, later on reading
    as well. Again, visual help the last option.

6
Case 1 Word pairs
  • 3. Word pairs. E.g. Pair contrasts voice vs.
    unvoiced bee pea, bay pay, beach peach,
    ben pen, dogs togs, door tore, guilt
    kilt, gave cave, zoo sue, zinc sink, vocal
    focal, vigor figure.
  • We started with immediate repetition. Moving
    on to work on the work memory, using repetition
    with a delay. Building the delay up to 10 sec.

7
Case 1 - results
  • Within two weeks of speech pathology intervention
    and these apraxia drills the patients speech was
    a lot more fluent and the problems with her
    speech were almost unnoticeable. Her language
    skills were slowly improving as well.

8
Case 2
  • 82 y.o female
  • Stroke in the left hemisphere of the brain
  • She was admitted to rehab. in East-Tallinn
    Central Hospital a month after the stroke.
  • Started having speech therapy 5 times a week

9
Case 2
  • She was only able to use one word utterances,
    which were distorted too
  • She was not able to consistently answer yes and
    no questions, mostly due to apraxia
  • Her language comprehension was good
  • She had some problems with written language as
    well.

10
Case 2 word lists
  • Apraxia drills proved to be very useful again!
  • 1. Word lists. E.g. Kana, kiri, koer, karu, kass,
    kari, kare, kiisu, kord, kisa, kaart, kübar,
    kärme, kuld, koi, küla, kükk, kõik, käik, külm,
    kõva, kera, kivi, kurb, kell, kink, kild, kiisk,
    kurss, korv, käsi, küsi, kuut, köha, kohv, kukk,
    kapp, koot, kulm...
  • We mostly used repetition. Reading and visual
    help only if necessary.

11
Case 2 Rhyming series
  • 2. Rhyming series. E.g. vool tool kool mool
    pool sool nool hool rool lool...
  • We mostly used repetition and reading.
    Visual help if needed.

12
Case 2 Word pairs
  • 3. Word pairs. E.g. voiced vs. unvoiced initial
    labial sounds põlv-võlv, pere-veri, parm-varb,
    pesa-visa, pihk-viht, pala-vala, pilu-vilu,
    pärg-märg, pilk-mürk, puus-muus, panna-manna,
    pass-mass, püri-muri...
  • We used mostly repetition (immediate rep. To
    start with). Reading and visual help if needed.
    Moving on to work on the work memory, using
    repetition with a delay. Building the delay up to
    10 sec. The patient achieved this pretty easily.

13
Case 2 - Results
  • The patient spent only 2 weeks in rehabilitation
    and was then sent home.
  • Her language improved to a level where she could
    express most of her thoughts, but she was still
    struggling a bit due to apraxia and mild
    expressive aphasia.
  • She spend another 10 days in rehab. 3 months
    later, but the speech pathology intervention did
    not have as much effect then.

14
Some thoughts and points noted!
  • If a word does not have a meaning, it is a lot
    harder to say in case of apraxia.
  • Visual help (seeing another person saying the
    same word) is like a way of escaping the apraxia.
    Patients like to take advantage of it, but it
    does not help them to get over apraxia in longer
    terms.
  • The drills can be very frustrating and might seem
    pointless to a patient, but on my experience they
    really have proven to be useful and help patients
    get over apraxia.
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